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HIV Risk Reduction

Sexual Transmission Risk Reduction

Sexual activity is the most common way for HIV to be transmitted. People have varying ideas of what they think of as sexual activity. When determining your risk for HIV and ways to reduce that risk, consider the range of sexual activities you engage in.

It is important to understand that the risk of HIV transmission from various sexual activities falls along a continuum. Once you understand where your sexual activities are on this continuum, you can decide what steps to take to lower your risk.

The goal of safer sex practices is to avoid getting the blood, semen or vaginal fluid of sexual partners who are HIV–positive or whose HIV status you don't know in your body. It also means to avoid having your blood, semen or vaginal fluid enter your partner if you are HIV–positive or do not know your HIV status.

Anal Sex

To reduce your risk, use a latex or polyurethane condom when engaging in anal sex. Some people prefer to use "bottom condoms" which can be inserted into the rectum before engaging in anal sex. No matter what type of condom you prefer, be sure to use plenty of water–based lubricant when you have anal sex. Don't use oil–based lubricants, such as petroleum jelly or hand lotion, because oil destroys the condom and causes it to break.

Learn how HIV is transmitted during anal sex.

Vaginal Sex

To reduce your risk, use a latex or polyurethane condom when engaging in vaginal sex. Some people prefer to use female condoms which can be inserted into the vagina before engaging in sexual activity. Use plenty of water–based lubricant when you have vaginal sex. Don't use oil–based lubricants, such as petroleum jelly or hand lotion, because oil destroys the condom and causes it to break.

Learn how HIV is transmitted during vaginal sex.

Oral Sex with a Man

To reduce your risk of HIV transmission, use a latex or polyurethane condom when performing oral sex on a man. If you do not use a condom you can also reduce your risk by not having your partner ejaculate in your mouth. Talk to your partner about their sexual health and do not perform oral sex on someone who has an active sexually transmitted disease. Do not perform oral sex if you have other oral health conditions which have significantly compromised the tissue in your mouth.

Learn how HIV is transmitted during oral sex with a man.

Oral Sex with a Woman

When performing oral sex on a woman you can completely eliminate HIV risk by using a barrier such as a dental dam or plastic wrap. If you do not use a barrier you can reduce your risk by not performing oral sex on a woman who is menstruating. Talk to your partner about their sexual health and do not perform oral sex on someone who has an active sexually transmitted disease. Do not perform oral sex if you have other oral health conditions which have significantly compromised the tissue in your mouth.

Learn how HIV is transmitted during oral sex with a woman.

Oral to Anal Sex

When engaging in oral to anal sex you can completely eliminate the HIV risk by using a barrier such as a dental dam or plastic wrap.

Learn how HIV is transmitted during oral–anal sex.

Non–Sexual Transmission Risk Reduction

Injection Drug Use

One way to reduce your risk of HIV infection is to abstain from injecting drugs. Current users or those who may be at risk for substance abuse may choose to find support from treatment programs or other sources. Another way to reduce your risk is to use a new syringe each time you inject and use it only once. If you have to reuse, only use your own and don't share. In Minnesota, it is legal to possess ten or fewer clean syringes. Some Minnesota pharmacies sell syringes in "ten packs" to any individual.

If you have no other options but to share a syringe, clean it and all of your equipment with water, then sterilize it with full strength bleach making sure the bleach stays in contact with the barrel for a full 30 seconds. Rinse the bleach out thoroughly with water. If you are using a cooker to cook or mix your drugs, or cotton to filter, never share those either. Blood gets caught in both and HIV or other blood borne viruses can be transmitted to another user. Also, never share rinse–water. If you are sharing drugs, divide them before injecting.

You can exchange your used syringes through the Minnesota AIDS Project's syringe exchange program.

Learn how HIV is transmitted during injection drug use.

Tattoos and Piercings

There have been no documented cases of transmission of HIV by piercing or tattooing. However, there is a theoretical risk for transmission of HIV and other blood borne viruses. To eliminate your risk only use licensed tattoo and piercing services that comply with universal precautions.

Learn how HIV is transmitted during tattooing and piercing.

Reducing Risk from Mother to Infant During Pregnancy, Childbirth and Breastfeeding

In the United States, reducing the risk of transmitting HIV from mother to child during pregnancy or childbirth has been a success story. With the use of antiviral therapy during pregnancy, the rate of transmission for HIV–positive women to their infants, has decreased overall from 25 percent to less than two percent.

It is recommended that all pregnant women who do not know their HIV status have an HIV test as early as possible in the pregnancy. If this test does not show the woman is HIV–positive, but she is engaged in high–risk activities, the test should be repeated during the pregnancy, preferably three months after the last known high–risk activity. Knowing your status allows you to make the best decisions to protect your health and the health of your baby.

If a woman is HIV–positive, receiving antiviral treatment for HIV will reduce the risk of transmission to two percent or less. Treatment will include anti–retroviral medication during the pregnancy and labor and delivery. In some cases a physician may decide that a cesarean section will further reduce the transmission risk, but this is not always necessary.

After birth, additional steps are taken to reduce the risk of HIV infection for the infant. antiviral therapy is given to the infant for four to six weeks. Breast milk contains HIV and it is possible for an HIV–positive woman to transmit HIV to her baby through breast feeding. Talk to your physician to determine the best alternative to breast feeding to eliminate this risk.

Determining the HIV status of an infant takes time and requires repeat testing. Standard HIV tests look for the presence of HIV antibodies. Because infants of HIV–positive mothers have the mother's HIV antibodies, they will automatically test "positive" after birth. It can take up to 18 months for an infant to clear these antibodies and receive an accurate HIV antibody test. Because of this issue, physicians recommend using a testing method that looks for the presence of the actual HIV virus and can give a definitive result in within a few months of birth.

If you are HIV–positive and suspect you are pregnant, see your healthcare provider as soon as possible. It is important for the health of you and your baby that you thoroughly discuss HIV treatment options with your provider.

Learn how HIV is transmitted from mother to infant.

Reducing Risk in Occupational and Controlled Exposure Settings

The best way to reduce risk in occupational settings is to use universal precautions. However, accidents can occur which involve a potential exposure putting a person at risk of infection. Post–exposure prophylaxis (PEP) treatment used immediately following a serious exposure that poses a demonstrated risk for HIV infection can significantly reduce the likelihood of the exposure resulting in an infection.

The idea behind PEP treatment is to attack the virus with HIV antiviral drugs; this prevents the virus from starting its replication process in the body. PEP treatment is routinely used in occupational settings, particularly in healthcare settings to prevent infection from work–related exposures. In some circumstances, physicians will prescribe PEP treatment for individuals who have experienced a recent non–occupational exposure such as a sexual or injecting drug use exposure.

PEP treatments typically include a combination of HIV antiretroviral drugs and will last for one month. The combination may vary depending upon the seriousness of the exposure. PEP treatments needs to start as soon as possible after an exposure and no more than 72 hours after the exposure.

CONTACT AIDSLINE

Questions about HIV? Contact the AIDSLine.

HIV RISK ASSESSMENT

Understand your risk with our HIV Risk Assessment.

HIV SERVICES LOCATOR

Living with HIV? Our HIV Services Locator can help.