Pozitively Healthy: A Gay Man's Guide to Sex and Health in Canada
Many of us worry about passing on HIV or becoming re-infected with a different strain of HIV. That worry might never go away completely. But you can have great sex without passing on HIV or becoming re-infected with HIV. Great safer sex starts with an understanding of the risks involved in sex.
Figuring Out the Risk of HIV Transmission
When experts figure out the risk of passing on HIV during sex, they ask two questions:
Based on the answers to these two questions, experts have developed four different categories of HIV transmission risk for sex:
Condoms Can Prevent HIV Transmission
Great safer sex starts with an understanding of the risks involved in sex.
Some gay guys, no matter what their HIV status, are tired of hearing about condoms. But condoms work. When they are used properly, condoms are the single best way to prevent HIV transmission when guys have anal sex or oral sex. Condoms can also prevent you from becoming re-infected with a different strain of HIV. And condoms can protect you against many other sexually transmitted infections (STIs).
The HIV Risk Table for HIV Positive Guys
Use this table to figure out your risk of passing on HIV to a guy during sex. The information in this table is only about HIV. For information about other STIs, see Other STIs can increase the risk of passing on HIV. Most other STIs are spread more easily than HIV. Some of the information in the table will apply to you if you are a gay or queer transman. For more information about safer sex for gay and queer transmen read Primed: The Back Pocket Guide for Transmen & The Men Who Dig Them. For detailed information about your legal duty to disclose your HIV status, sex and the law, read HIV disclosure: a legal guide for gay men in Canada.
Your HIV Viral Load Can Make a Difference
You can still pass on HIV during sex even if your viral load is "undetectable."
If you are taking HIV medications and you have an "undetectable" viral load this means that your medications are doing a good job controlling the HIV in your body. But you can still pass on HIV during sex even if your viral load is "undetectable."
Most HIV experts and community groups believe HIV positive people who have undetectable viral loads should continue to use condoms when they fuck. Here are some medical and legal reasons why:
If you have an untreated STI you are more likely to pass HIV on to another guy during unprotected sex. And if an HIV negative guy has an untreated STI, it is easier for him to get HIV during sex.
Cut or Uncut
Not many studies have looked at whether circumcision (having a cut cock) can protect gay men from getting HIV or reduce their risk of passing on HIV. The results from these studies don't provide any clear answer.
Slip-Ups, Mistakes and Condom Breaks
Condoms sometimes break or slip off when we are fucking. And some of us might fuck without a condom, even though we didn't intend to and afterwards we wish we hadn't.
An HIV negative guy who is exposed to HIV can take HIV medications to try to stay uninfected. This medical treatment is called PEP -- short for "post-exposure prophylaxis." Scientists believe that PEP reduces the risk that someone will become HIV positive after being exposed to HIV.
A doctor must prescribe PEP. Go to a hospital emergency department. But doctors and other staff at medical clinics and emergency rooms may not know about PEP. Or they may not have a clear policy on who can get PEP. If a guy has problems getting PEP he should insist on seeing an infectious disease specialist doctor.
If you're on HIV medications, you may think it is a good idea to give the guy some of your medications. That's not recommended. Your HIV medications may not be an effective PEP treatment. And it may leave you short on medications later on.
New Publication Transcends Language Barriers to Share Untold Stories of Gay Men Living With HIV Around the World
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.
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