Preventing Sexual Transmission of HIV

Summary

• If you don’t have HIV, learn the risks of anal, oral, and vaginal sex and take steps—like using condoms and taking pre-exposure prophylaxis (PrEP)—to reduce your risk and protect your health.
• If you are living with HIV, getting into care and taking HIV medicine as prescribed are some of the important actions you can take to prevent passing HIV to others.
• No matter your HIV status, use the HIV Services Locator to find testing sites, PrEP providers, and other HIV treatment and prevention services near you.

Know the Risks of HIV Transmission Via Sex

HIV is mainly spread through anal or vaginal sex without correct use of a condom or without taking medicine to prevent transmission. It’s important to understand the risks of different sexual activities.

• Anal sex has the highest risk for getting or transmitting HIV. Either partner—the insertive partner (top) or the receptive partner (bottom)—can get HIV, but the risk is higher for an HIV-negative person to be the receptive partner.
• Vaginal sex also carries risk for getting or transmitting HIV, though the chance is lower than receptive anal sex.
• Oral sex has a much lower risk for getting or transmitting HIV, but the risk is not zero.

HIV is not transmitted through saliva, so there is very little risk of transmitting HIV through kissing.

If your partner has HIV, keep in mind that you can’t get HIV from having sex with someone with an undetectable viral load.

*Learn about other ways HIV is transmitted, like injection drug use or mother-to-child transmission.

Get Tested for HIV

Knowing your status can give you important information and help you make good decisions to prevent getting or transmitting HIV. The only way to know your HIV status is to get tested. Use the HIV Services Locator to find HIV testing that works for you.

Whether you test positive or negative for HIV, it’s important to get tested for other sexually transmitted infections (STIs), too. If you’re sexually active, you should get tested once a year and encourage your partner(s) to do the same. Having other STIs increases your chance of getting HIV, so it’s important to get treatment for any STI as soon as possible.

What to Do if You Test Negative for HIV

If your HIV test shows that you don’t have HIV, there are steps you can take to protect your health and prevent getting HIV through sex.

Use condoms:

• When used correctly, condoms are highly effective at preventing transmission of HIV.
• Condoms also protect against some other sexually transmitted infections (STIs), like gonorrhea and chlamydia.

Take pre-exposure prophylaxis (PrEP):

• If taken as prescribed, PrEP greatly reduces your chance of getting HIV from sex.
• PrEP may be right for you if you do not have HIV and have certain risk factors that put you at higher risk for HIV.

If your partner tests positive for HIV, encourage them to get and stay in HIV treatment.

• People living with HIV who get and keep an undetectable viral load can live long and healthy lives and will not transmit HIV to their HIV-negative partners through sex.

Take post-exposure prophylaxis (PEP) if you think you may have recently been exposed to HIV:

• If you don’t have HIV or don’t know your HIV status and think you may have been exposed to HIV, talk to a health care provider about PEP as soon as possible.
• You can talk to your regular provider, an emergency room doctor, an urgent care provider, or even a pharmacist in some states.
• PEP must be started within 72 hours (3 days) after a possible exposure to HIV, so the sooner you start PEP, the better.

Reduce your number of sexual partners:

• Having fewer partners can lower your chances of having a partner who could transmit HIV to you.
• The more partners you have, the more likely you are to have a partner with HIV whose viral load is not suppressed or to have a partner with an STI.

Decide not to have sex:

• Not having sex (also known as abstinence) is a 100% effective way to prevent HIV, other STIs, and pregnancy.
• You can be abstinent at different times in your life for different reasons that may change over time.

What to Do if You Test Positive for HIV

If your HIV test is positive, there are steps you can take to prevent transmitting HIV to a partner through sex.

Get into care and take HIV medicine as prescribed.

• This is the most important thing people living with HIV can do to stay healthy.
• When taken as prescribed, HIV medicine reduces the amount of HIV in your blood (your viral load) to a very low level, which is called viral suppression.
• HIV medicine can make your viral load so low that a standard lab test can’t detect it, which is called having an undetectable viral load.
• People living with HIV who get and keep an undetectable viral load can live long and healthy lives and will not transmit HIV through sex.
• Most people taking antiretroviral therapy as prescribed can get an undetectable viral load within 6 months.

Use condoms:

• When used correctly, condoms are highly effective at preventing transmission of HIV.
• Condoms also protect against some other sexually transmitted infections (STIs), like gonorrhea and chlamydia.

Talk to your HIV-negative partners about PrEP and PEP, medicine that may be right for them to prevent getting HIV.