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My Sex Life: Info for Young Poz People

March 2013

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Sexually Transmitted Infections (STIs)

Using protection such as condoms, gloves and dental dams decreases the chances of getting or passing an STI.

Like HIV, other STIs -- including chlamydia, gonorrhea and syphilis -- can be passed from person to person through vaginal, frontal or anal sex. Some STIs can be easily passed on during oral sex.

If we do get an STI (which happens to a lot of people), most of the time it's not a big deal. STIs are easily treated. When living with HIV, staying on top of our sexual health, protecting our bits and knowing about STIs can be important because:

  • People can have STIs without having any symptoms.
  • It can be easier for us to get other STIs and be sicker if we do. Not fun.
  • If we are not using barriers like condoms or dental dams, it's easier for HIV to be passed to our sexual partners if we have an STI, because our viral load (a measure of the amount of HIV in our blood) might be increased. For example, a rectal STI can increase the amount of virus in our rectal fluid, even if the viral load in the blood is undetectable. This can increase the risk of HIV passing to others through anal sex.
  • If we're not using barriers to cover our bits and our HIV-negative partner has an STI, our partner might be more likely to get HIV because the immune system is weakened by fighting the STI. Some STIs cause sores or openings in the skin that can be a route for HIV to get into the body more easily.


Hepatitis C (Hep C)

"The good news is that unlike HIV, treatments for hep C can clear (cure) the virus."

Hep C is a virus that is passed by blood-to-blood contact and can be passed when you share substance-use equipment, when you have rough, unprotected sex, or when you share other things that could have blood on them like toothbrushes, razors and tattooing and piercing equipment.

If you think you're at risk for hep C, you may want to consider asking your healthcare provider to test you because hep C and HIV can be tricky to deal with at the same time.


Getting Tested

"Testing is a good idea for everyone!"

When we're living with HIV and sexually active, getting tested for STIs regularly (once a year or more frequently if we think we're at risk) is a great way to detect STIs early and get them treated. Between regular checkups, we should get tested immediately for STIs if we have symptoms or think we've been exposed. It's important to be in charge of our own sexual health regardless of what our partners tell us. It's also a good idea to encourage our sexual partners to get their regular checkups too.

It's our right to receive respectful and supportive healthcare, and our healthcare provider should provide testing to us when we ask for it. Sadly, this isn't always the case. If your healthcare provider is judgmental, asks too many questions, or will not provide you the tests you want, it may be time to find a healthcare provider who is more supportive. Get recommendations from people you trust. You can also check out the resource section of this booklet for agencies that can help connect you to testing.


Keepin' It Safe and Coverin' Your Bits

"My boyfriend talks dirty to me about how he is going to do me without a condom, just before we have sex. He tells me he is going to cum inside me, and I find it really hot. The whole time he is putting on a thin rubber and lubing his penis. Talking about it is hot, but we still need to protect each other."

Sometimes focusing on using protection can be a turnoff, so it's a good idea to incorporate barriers into foreplay. Make it fun by thinking about having sex with your partner and how hot they are as you slip the barrier into place.


Condoms

Condoms are an effective way to prevent HIV. They come with the added bonus of preventing STIs and pregnancy. All that safety in one little piece of latex! If you and your partner have decided to use condoms and are struggling, don't give up! It can be hard to have protected sex all the time, so remember, having protected sex as often as possible is better than not at all!

Some people don't like to use condoms. They may use different strategies instead, like monogamy or sero-sorting (see below). Those kinds of decisions should be made with full knowledge of the risks involved and responsibility for those risks.

If you are using safer sex materials like condoms, lubes, gloves and dental dams (more on these coming up), keep them close for those hot and heavy moments. If they are accessible, we're more likely to use them, especially if we have sex under the influence of drugs or alcohol.

Condoms:

  • The more we use condoms for sex, the more comfortable we will be using them. Everyone can practice putting them on their hands or on a sex toy. People with penises should practice using a condom while jerking off so that they can get comfortable being turned on while wearing one.
  • Find a condom that's comfortable for you. Explore. This can be fun. Try different brands and types. Condoms come in different sizes, colors, flavors, thicknesses, shapes, sensitivities and materials. Find yours! You might even decide to use different kinds during the same encounter or different kinds with different partners.
  • Some people have allergies to latex. Most manufacturers offer polyethylene or nitrile brands that are latex-free. Polyethylene and nitrile condoms have other benefits too. They are stronger and some people like the feel better. Polyethylene and nitrile condoms also make better covers for sex toys because the material is less likely to tear. Unlike latex condoms, which shouldn't be used with oil-based lubes (slide down to the lube section below for more info), polyethylene and nitrile condoms can also be used with all lube types, including oil-based lubes.
  • Sometimes, the condom breaks or we switch partners during sex. In these instances, always make sure to use a new condom before getting back at it.

Insertive condoms:

"Having protected sex as often as possible is better than not at all!"
  • Insertive condoms are condoms that can be put in the vagina, front hole or anus rather than on the penis. They can be inserted up to eight hours before sex.
  • For many people, it feels odd the first time they use one. Practice inserting it and leaving it in long enough to get more comfortable. The material softens in about 15 minutes from the warmth of the body.
  • Insertive condoms are also made of polyethylene or nitrile and have the same properties as polyethylene or nitrile penetrative condoms, although they are even stronger because the material is thicker.

Dental dams:

Dental dams are squares of latex or other materials that can be used as barriers to cover your bits when performing oral sex. Dams can be made by cutting the head off a condom and slicing it along its length to make a barrier or by cutting medical gloves open.

Some people use non-microwaveable plastic wrap because it's cheaper, but it hasn't been proven scientifically to act as a barrier against STIs. Whatever barriers we use, we should make sure we know which side is ours and which is our partner's and keep using it that way.

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Lube:

Lube it up! Using lots of lube makes sex more enjoyable for everyone.

  • Put a drop of lube inside the condom or on the head of the penis before putting on the condom. Not too much though, we don't want that condom to slip off!
  • If you are doing it for a long time, pull out to have a look. Friction can wear down the condom and lube can dry, increasing the risk the condom will break. Don't be afraid to use or ask your partner to use more lube, whether you're giving or receiving!
  • Friction can also cause tiny surface abrasions that can damage the inside (mucosal) linings during sex enough so they become places where STIs can be transmitted. Lube reduces friction.
  • There are more types of lube on the market than ever before. Water-based lube can dry up fast. Silicone-based lube is more expensive, but you'll need less and it doesn't dry up as fast. Try a bunch and see what you and your partners like.
  • Make sure to use water-based and silicone-based lubes for latex condoms. Oil-based lubes can cause latex condoms to break.
  • Be careful not to use silicone lube with silicone sex toys. It can dissolve the surface of the toy and make it sticky and hard to clean.

Sex toys:

Sex toys can be a lot of fun. They are a great way to expand our pleasure solo or together with a partner. There are some things we need to consider when using them, though:

  • Sex toys can get bodily fluids on them, which can carry viruses or bacteria. Hep C, in particular, is difficult to kill.
  • If you are sharing sex toys with your partners, it's a good idea to clean them with soap and water and use them with condoms. You should do this every time a new person uses a toy or every time you switch from vaginal, frontal or anal sex to another kind of sex.

There is more variety available than ever before so try to do your research online and visit sex shops where you feel you can trust the service staff to answer your questions.

Oral sex:

When a person living with HIV goes down on or gives head to their partners, the risk that HIV will pass to their partners is small. Oral sex is a much lower risk than vaginal, frontal or anal sex for passing HIV.

Oral sex is not all risk-free, though, because other STIs, like herpes, gonorrhea and syphilis can still be passed when we're going down on someone else.

If your HIV-negative partner goes down on you with cuts or sores in or around their mouth, or with bleeding gums, it increases their HIV risk. Waiting 30 minutes after brushing or flossing teeth before having sex can reduce risk because there can be bleeding from gums that you might not notice. Cuts, sores or abrasions in the mouth need longer to heal.

If you want someone to put their mouth on your bits:

  • Be careful about deep throating. The back of the throat is more vulnerable to surface abrasion, especially if your penis has body jewelry in it.
  • Cumming in your partner's mouth can slightly increase the chances that HIV gets passed on. To reduce the risk, pull out before cumming.
  • The rougher your partners are when they lick your vagina or front hole, the greater the risk for HIV to be transmitted through tiny abrasions in your partner's mouth, especially if you have body jewelry or genital piercings.
  • There is greater risk of HIV transmission when one person is on their period because of the increased presence of blood.
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This article was provided by Canadian AIDS Treatment Information Exchange. Visit CATIE's Web site to find out more about their activities, publications and services.
 
See Also
More Info on Young People and HIV

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