for Veterans and the Public
What is 'safer sex'?
We know a lot about how HIV is transmitted from person to person. Having safer sex means you take this into account and avoid risky practices.
There are two reasons to practice safer sex: to protect yourself and to protect others.
If you have HIV, you need to protect your health. When it comes to sex, this means practicing safer sex (like using condoms) to avoid sexually transmitted diseases like herpes and hepatitis. HIV makes it harder for your body to fight off diseases. What might be a small health problem for someone without HIV could be big health problem for you.
Protecting your partner
Taking care of others means making sure that you do not pass along HIV to them. If your sex partners already have HIV, you should still avoid infecting them with another sexually transmitted disease you may be carrying.
Most people would agree that you owe it to your sexual partners to tell them that you have HIV. This is being honest with them. Even though it can be very hard to do, in the long run you will probably feel much better about yourself.
Some people with HIV have found that people who love them think that condomless sex is a sign of greater love or trust. If someone offers to have condomless sex with you, it is still up to you to protect them by being safe.
"Being safe" usually means protecting yourself and others by using condoms for the highest-risk sex activities, specifically for anal and vaginal sex. When done correctly, condom use is very effective at preventing HIV transmission. In recent years, "being safe" has come to include two other important strategies for reducing HIV infections; these are HIV treatment (ART medications) for HIV-positive people and PrEP for HIV negatives (see below). Both of these are very effective at reducing the risk of HIV infection. One or more of them is likely to be appropriate for you--be sure to ask your health care provider about them.
What about antiretroviral therapy (ART) for HIV prevention?
One of the most effective ways you can prevent HIV from passing to an HIV-negative sex partner is to take your ART (HIV medications) every day--if they are working well to suppress the HIV in your body they also will prevent transmission of HIV.
What about pre-exposure prophylaxis (PrEP)?
HIV-negative individuals may, under the supervision of their health care providers, take an anti-HIV pill every day to prevent themselves from becoming infected. We call this pre-exposure prophylaxis, or PrEP. Usually these are persons who are at relatively high risk of becoming infected with HIV (for example, because they have a partner with HIV, they have risky sexual exposures, or they share injection drug equipment). The medication used for PrEP is Truvada, a combination tablet containing tenofovir and emtricitabine. PrEP appears to be extremely effective if it is taken every day, and is not effective if it is taken irregularly. Your VA health care provider can tell you more about the potential benefits and shortcomings of PrEP for HIV-negative persons.