AIDS and HIV Infection • Preventing HIV transmission
Preventing sexual transmission of HIV
Know your partner
Whether you are male or female – heterosexual, homosexual or bisexual – your risk of acquiring HIV infection is directly related to the likelihood that your partner is infected.
Your risk is substantially higher if your partner has ever injected drugs, has unprotected sex with casual partners, or has a sexual history unknown to you.
Understand which sexual acts put you at most risk
All forms of penetrative sexual intercourse (anal, vaginal, oral) with an HIV-infected man or woman carry a risk of transmission. Unprotected anal intercourse is one of the riskiest practices. This is true even when a condom is used because of the increased likelihood that the condom will be damaged during this form of sex. Unprotected vaginal intercourse carries the next highest risk of infection. Oral sex also carries a small risk of transmission, particularly if there are mouth or throat injuries present such as bleeding gums, lesions, sores, abscessed teeth, throat infections, or oral STDs present.
To protect yourself, always use a condom during penetrative sexual acts.
What you need to know about condoms
- Latex condoms lubricated with silicone or a water-based lubricant are
recommended as a barrier method to reduce the risk of HIV transmission during anal,
vaginal and oral intercourse.
(If additional lubricant is desired, a water-based variety should be used rather than an oil-based lubricant such as Vaseline®, which can break down the latex.)
- Latex condoms are only effective if they are used properly and do not break.
- Natural membrane condoms, often made from sheep gut, are not recommended because they have tiny pores through which HIV could pass.
- For maximum effectiveness, the condom must be put on before the penis touches any part of the rectum, vagina or mouth. It should be put on when the penis is erect, taking care to leave a reservoir at the tip to contain the semen. Care should be taken during withdrawal of the penis (with the condom still in place) to avoid spillage.
- Female condoms, such as the REALITY® condom, are now available. The female condom is a soft, loose-fitting plastic pouch made of polyurethane (not latex) that lines the vagina. It has a semi-stiff plastic ring at each end. The inner ring is used to insert the device inside the vagina and hold it in place. The outer ring partly covers the labia area and holds the condom open.
Seek medical advice or treatment for STDs
The presence of an untreated sexually transmitted disease – such as gonorrhoea, chlamydial infection, syphilis, herpes or genital warts can enhance both your acquisition and transmission of HIV by a factor of up to 10. If you suspect you have an STD, or have been exposed to one, it is imperative that you seek medical advice and treatment immediately.
Common symptoms include an unusual discharge from the vagina or penis, burning or pain during urination, and sores or blisters near the mouth or genitals. Other symptoms in women may include unusual bleeding (other than the menstrual cycle) and vaginal pain during intercourse.
Microbicides are products intended for vaginal or rectal administration that can decrease the transmission of HIV and other micro-organisms that cause STDs. Discovery of an effective microbicide is needed to expand prevention options.
In recent years, it was suggested that spermicides might have microbicidal properties. To date, two trials have failed to show that the spermicide nonoxynol-9 is effective against HIV and STD transmission. However, more than 35 microbicides are undergoing trials, and research continues into this method of prevention.