The human immunodeficiency virus (HIV) is a virus that attacks the body’s immune system, weakening its defenses against other diseases and infections. It can be passed from person to person through contact with blood and other bodily fluids. Most often, it is spread through unprotected sex, but it can also be passed by sharing needles for drug injection or from an HIV-positive mother to her baby during pregnancy, childbirth, or breastfeeding.

Currently, there is no cure for HIV, so a person has HIV for life once they become infected with the virus. However, there are medications that one can use to manage HIV, reduce the risk of spreading it to others, and stop the virus from progressing to AIDS (acquired immunodeficiency syndrome), which is the final stage of infection in which the body’s immune system is severely damaged.

Individuals with HIV can take steps to have safe sex and protect themselves and their sexual partners. Below are the three most important and effective safe sex measures for preventing the spread of HIV when at least one of the participants is (or may be) HIV-positive.

ART: Antiretroviral therapy

Antiretroviral therapy, or ART, is a combination of medications that stops HIV from damaging the body’s immune system and/or becoming AIDS. Taken daily, these HIV medicines can reduce a person’s viral load, which is the level of HIV in the blood. The goal of ART is to reduce a person’s viral load to an undetectable level, meaning that it is so low it cannot be detected by a viral load test. A person with an undetectable viral load has “effectively no risk” of passing the virus to a sexual partner (CDC, 2021). Nevertheless, not everyone who uses ART will reach undetectable viral levels, and it is important to have regular blood tests to monitor the viral load even once an undetectable level is reached.

Condoms

Condoms reduce the risk of spreading HIV when they are used correctly for the entirety of a sexual encounter. Refer to this article for information on how to use condoms properly.

PrEP and PEP

Pre-exposure prophylaxis, or PrEP, is a medication that a person who is at risk of HIV infection (either through sex or injection drug use) can take to reduce this risk. The Centers for Disease Control and Prevention (CDC) recommend that HIV-negative individuals who have had vaginal or anal sex in the last six months, have a sexual partner with HIV, have not consistently worn condoms, and/or have had a sexually transmitted infection (STI) in the last six months consider taking PrEP.

PrEP medications should be taken every day. Consistent use of PrEP can lower the risk of contracting HIV during sex by 99% and the risk of contracting the virus during drug injection by 74%. A person should speak with their health care provider about whether they should consider taking PrEP.

Post-exposure prophylaxis (PEP) is a medication that should be used as an emergency measure after possible exposure to HIV through unprotected sex or injection drug use. PEP must be started within 72 hours (3 days) of the potential exposure to HIV. Once a person begins taking PEP, they will continue to take the medication for 28 days.

Refer to this article for more information on PrEP and PEP.

It is important to take steps to protect yourself and your sexual partner(s) from HIV and other STIS. Being informed, communicating openly, and practicing safe, consensual sex are crucial elements of a healthy sexual relationship.

Resources:

• Centers for Disease Control and Prevention (CDC). (2021, February 22). HIV Treatment as Prevention. https://www.cdc.gov/hiv/risk/art/index.html
  
  
• Heid, M. Medically reviewed by Arefa Cassoobhoy, MD, MPH. (2020, June 9). Safe Sex When You’re HIV-Positive. https://www.webmd.com/hiv-aids/single-tablet-hiv
  
  
• HIV.gov. (2020, June 5). What Are HIV and AIDS? https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids
  
  
• HIVinfo.NIH.gov. (2021, August 19). Post-Exposure Prophylaxis (PEP). https://hivinfo.nih.gov/understanding-hiv/fact-sheets/post-exposure-prophylaxis-pep
  
  
• HIVinfo.NIH.gov. (2021, August 10). Pre-Exposure Prophylaxis (PrEP). https://hivinfo.nih.gov/understanding-hiv/fact-sheets/pre-exposure-prophylaxis-prep
  
  
• NIH: National Institutes of Health. (2019, October 10). HIV/AIDS. https://medlineplus.gov/hivaids.html