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Protecting Yourself During Sex

Choose Sexual Activities With Little to No Risk

You can’t get HIV from sexual activities that don’t involve contact with body fluids (semen, vaginal fluid, or blood)
Choose sex that is less risky than anal or vaginal sex. There is little to no risk of getting HIV through oral sex

Use Condoms the Right Way Every Time You Have Sex

Condoms are highly effective in preventing HIV and other sexually transmitted diseases (STDs), like gonorrhea and chlamydia
Use water-based or silicone-based lubricants to help prevent condoms from breaking or slipping during sex
Learn the right way to use an external condom (sometimes called a male condom) and an internal condom (sometimes called a female condom)

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Protecting Yourself During Sex (cont.)

Take PrEP (Pre-Exposure Prophylaxis)

PrEP (pre-exposure prophylaxis) is medicine people at risk for HIV take to prevent HIV
If taken as prescribed, PrEP is highly effective for preventing HIV from sex

Get Tested and Treated for Other STDs

If you have another STD, you are more likely to get HIV. Getting tested and treated for other STDs can lower your chances of getting HIV
Many people with an STD may not know they have one because they don’t have symptoms

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Protecting Yourself During Sex (cont.)

If Your Partner Has HIV, Encourage Your Partner to Get and Stay in Treatment

This is the most important thing your partner can do to stay healthy
If your partner takes HIV medicine and gets and keeps an undetectable viral load, there is effectively no risk of you getting HIV from sex with your partner

If I have HIV, what is the best way to protect others?

Get in care and take medicine to treat HIV
HIV medicine (called anti-retroviral therapy or ART) can reduce the amount of HIV in the blood (called viral load). HIV medicine can make the viral load very low—so low that a test can’t detect it (called an undetectable viral load)
People with HIV who keep an undetectable viral load (or stay virally suppressed) can live long, healthy lives. Viral suppression is defined as having less than 200 copies of HIV per milliliter of blood
If a person has an undetectable viral load, they have effectively no risk of transmitting HIV to an HIV-negative partner through sex
Having an undetectable viral load also helps prevent transmission to others through sharing needles, syringes, or other injection equipment, and from mother-to-child during pregnancy, birth, and breastfeeding
Most people can get the virus under control within six months
Taking ART does not prevent transmission of other sexually transmitted diseases (STDs)

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PrEP or Pre-Exposure Prophylaxis

There are three medications approved for use as PrEP:

Truvada
Descovy
Apretude (cabotegravir extended-release injectable suspension)

PrEP is highly effective for preventing HIV

PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed
Although there is less information about how effective PrEP is among people who inject drugs, we do know that PrEP reduces the risk of getting HIV by at least 74% when taken as prescribed
PrEP is much less effective when it is not taken as prescribed

How long do I have to take PrEP before it is highly effective?

PrEP reaches maximum protection from HIV for receptive anal sex (bottoming) at about 7 days of daily use
For receptive vaginal sex and injection drug use, PrEP reaches maximum protection at about 21 days of daily use
No data are available for insertive anal sex (topping) or insertive vaginal sex

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How Can I Start PrEP?

Talk to your health care provider if you think PrEP may be right for you. PrEP can be prescribed only by a health care provider

Before beginning PrEP, you must take an HIV test to make sure you don’t have HIV
While taking PrEP, you’ll have to visit your health care provider every 3 months for

Follow-up visits,
HIV tests, and
prescription refills

Ask your health care provider about self-testing and telehealth services for follow-up visits

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What if I Need to Stop Taking PrEP?

There are several reasons why people stop taking PrEP:

Your risk of getting HIV becomes low because of changes in your life
You don’t want to take a pill as prescribed or often forget to take your pills
You have side effects from the medicine that are interfering with your life
Blood tests show that your body is reacting to PrEP in unsafe ways

Can I take PrEP just once, if I think I might have recently been exposed to HIV?

PrEP is for people who are at ongoing risk for HIV
PrEP is not the right choice for people who may have been exposed to HIV in the last 72 hours
If you may have been exposed to HIV in the last 72 hours, talk to your health care provider, an emergency room doctor, or an urgent care provider about PEP (post-exposure prophylaxis)

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How Can I Pay for PrEP?

Most insurance programs and state Medicaid plans cover PrEP. You may also receive co-pay assistance to help lower the cost of PrEP
The Ready, Set, PrEP program makes PrEP available at no cost to those who qualify. Learn more at www.getyourPrEP.com
If you don’t have insurance, consider enrolling in an insurance marketplace, PrEP assistance program, or your state’s Medicaid plan, if you are eligible for it
Learn more about paying for PrEP at www.PrEPcost.org

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PEP or Post-Exposure Prophylaxis

PEP (post-exposure prophylaxis) means taking medicine to prevent HIV after a possible exposure. PEP should be used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV
Talk right away (within 72 hours) to your health care provider, an emergency room doctor, or an urgent care provider about PEP if you think you’ve recently been exposed to HIV:

during sex (for example, if the condom broke),
through sharing needles, syringes, or other equipment to inject drugs, or
if you’ve been sexually assaulted

The sooner you start PEP, the better. Every hour counts. If you’re prescribed PEP, you’ll need to take it daily for 28 days

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