Sexual Health

The landscape of HIV prevention is shifting. Condoms used with plenty of lube still top the charts as 'Most Effective Method in Reducing Risk' but they’re not your only option now either. Welcome to the bold new frontier of risk reduced fucking. Yass!

An increased understanding of the prevention methods we already have, combined with innovative biomedical technologies makes the goal of zero new HIV transmissions a real possibility. So what are some of the other ways that you can stay covered? We're glad you asked.


Let's Talk About Sex

You couldn't get more on the money than this. It might have been 1991 but these babes totally nailed what remains a simple and cost effective method of reducing the risks associated with HIV and STI transmission. Also, talking about sex means that your likely to have more fun when it gets down to it. Winning on all fronts.

The Top 5

The HIV preventions landscape has changed. Condoms and lubricant remain the most effective prevention tools against HIV, but they are no longer the only option. ‘Safe sex’ for gay men is no longer restricted to condoms only, but now refers to sex with a very low risk of HIV transmission.

There are now at least five strategies that are reasonably considered ‘safe sex’, provided that certain parameters are met. They are:

  1. The use of condoms for casual encounters
  2. HIV negative men taking pre-exposure prophylaxis (PrEP), currently not approved by the Therapeutic Goods Administration (TGA). Click here to find out more about PrEP.
  3. Men living with HIV who have a sustained undetectable viral load (UVL) and no sexually transmissible infections (STIs).
  4. Use of serosorting between HIV positive men.
  5. Negotiated safety agreements.

If you would like to know more about what is considered to be safe sex, then download ACON's What is Safe Sex? position statement below.

Condoms

1. The use of Condoms during casual encounters between serodiscordant couples or those whose HIV status is unknown.

Condoms can prevent infected fluids passing from one partner to the other when fucking. This makes penetrative sex using a condom and water based or silicon based lube safe for both the top and the bottom. If used properly condoms are very reliable. However, they can occasionally break or slip off. When fucking it’s a good idea to check from time to time that the condom is on, there’s enough lube and that it is still intact.

PrEP

2. Pre-exposure prophylaxis (PrEP).

PrEP stands for Pre-Exposure Prophylaxis, with “prophylaxis” meaning “to prevent or control the spread of an infection or disease.” PrEP is a HIV prevention method in which people who do not have HIV infection take a pill daily to reduce their risk of becoming HIV infected. The pill is called Truvada and it contains two antiviral medicines that are also used to treat people who already have HIV infection. These are the same drugs used to suppress the virus in people living with HIV. Find out more at the VAC site here.

Also, download the ENDING HIV PrEP Access Options Guide below.

Undetectable Viral Load

3. Condomless sex for those living with HIV is an option only after sustaining an undetectable viral load (UVL) and in the absence of any other sexually transmissible infection (STI).

Evidence suggests that someone with an undetectable viral load, is NOT infectious. This means that having condomless sex with someone who is certain that their viral load is undetectable reduces the risk of contracting HIV. However, if you are HIV negative, the best measures are to get onto PrEP and/or to use a condom.

What does undetectable mean? When a HIV positive man is taking treatment (or ART) the amount of HIV in his body (known as his ‘viral load’) can effectively be reduced to a level that is ‘undetectable’. It is important to note that undetectable does not mean cured or free of HIV. It simply means that the treatment has stopped the virus from replicating therefore making it far less likely to be passed on – or transmitted – during unprotected sex or higher risk play. It also means HIV is not multiplying so reducing harm to your body. Also, just like you can’t tell if someone is HIV positive by looking at them, you can’t tell if they have an undetectable viral load. For more information visit ENDING HIV and this article here.

Serosorting

4. Effective use of serosorting between HIV positive men.

Many men try to make fucking without a condom safe by trying to find a sex partner – casual or regular – of the same HIV status.

This is often done by:

  • Asking potential sex partners their HIV status,
  • Guessing from whether or not they ask to use a condom.
  • Guessing by judging someone's physical health and appearance.

NONE of these methods are reliable for reducing the risk of getting or passing on HIV during unprotected sex with a casual or regular sex partner. Also, by trying to assess someones HIV status based on their physical health and appearance plays into the stigmatisation HIV. People living with HIV, with access to the right treatment can actually live very healthy lives, they even compete at the Olympics (Ji Wallace – ENUF Ambassador).

Using condoms and water based lube is the best way to prevent HIV. This site explains why.

Negotiated Safety Agreements

5. Effective negotiated safety agreements.

Negotiated safety describes the situation where two HIV-negative men in an ongoing relationship agree to limit sex without condoms to their relationship, having first established that they have the same serostatus. Negotiated safety requires that both parties have an explicit agreement about only practising safe sex outside the relationship. The agreements also require a commitment to dialogue and to revising the agreement should it be broken, until such time as HIV negative status can be re-ascertained. 

Clearly, this strategy relies on men’s communication skills and requires ongoing health promotion interventions to support its continued effectiveness. 
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