People with HIV and Sexually Transmitted Infections
Sexually transmitted infections (STIs) are very common among people who are sexually active. Anyone who has sex is at risk, including people with HIV. STIs are also commonly referred to as sexually transmitted diseases (STDs).
STIs are infections that are spread from person to person through sexual activity, including anal, vaginal, or oral sex. HIV is an STI. Other types of STIs include:
- Genital herpes
- Human papillomavirus (HPV)
STIs in the United States have increased in the past 5 years and are a public health crisis. Many STIs do not have symptoms, but when left undetected and untreated they can lead to serious health consequences. If you have HIV, it can be harder to treat STIs, especially if you have a low CD4 count. That’s why STI testing and treatment should be part of your regular HIV care if you’re sexually active.
Hepatitis B and hepatitis C can also be transmitted through sexual contact and pose health risks to people with HIV. Read more about these viruses.
What Activities Can Put You at Risk for STIs?
Behaviors that put people at risk for HIV also increase their risk for other STIs. These behaviors include:
- Having anal, vaginal, or oral sex without a condom.
- Having sex with multiple partners, especially anonymous partners.
- Having sex while using drugs or alcohol. Using drugs and alcohol can affect your judgment, which can lead to risky behaviors.
What Can You Do to Prevent Getting STIs?
If you have HIV, the best thing you can do to stay healthy is to take HIV medicine (called antiretroviral therapy or ART) exactly as prescribed and get and keep an undetectable viral load—a level of HIV in your blood so low that a standard lab test can’t detect it.
But even if you are on ART and your viral load is undetectable, it will not prevent you from getting other STIs, such as gonorrhea, chlamydia, or syphilis.
The only 100% effective way to avoid getting other STIs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting other STIs:
Choose less risky sexual behaviors.
- Reduce the number of people you have sex with.
- Don’t drink alcohol or use drugs before and during sex.
Use condoms correctly every time you have sex.
- Use a new condom for every act of vaginal, anal, and oral sex throughout the entire sex act (from start to finish).
Condoms are highly effective in preventing STIs, but not foolproof. Read this fact sheet from the Centers for Disease Control and Prevention (CDC) on how to use condoms correctly.
Protecting Your Sexual Partners
If you have HIV, are taking HIV medicine exactly as prescribed, and get and keep an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex. This is true even if you have an STI other than HIV. However, having an undetectable viral load will not prevent you from transmitting other STIs to your sexual partners.
If you have HIV and you do not have an undetectable viral load, untreated STIs may make it more likely that you will spread HIV to a sexual partner. But you can protect your partner from HIV by using condoms and choosing less risky sexual behaviors.
And if you have an HIV-negative partner who has another STI, they may have skin ulcers, sores, or inflammation that may increase their risk of getting HIV during sex.
An HIV-negative partner can take medicine to prevent HIV, called pre-exposure prophylaxis, or PrEP, but PrEP does not protect against other STIs. PrEP is an HIV prevention option for people who don’t have HIV but who are at high risk of becoming infected with HIV. PrEP involves taking a specific HIV medicine every day to reduce the risk of HIV infection.
Get Tested and Treated for STIs
If you are sexually active, getting tested for STIs is one of the most important things you can do to protect your health. Make sure you have an open and honest conversation about your sexual history and STI testing with your health care provider and ask whether you should be tested for STIs.
Encourage your partner(s) to do the same. You or your partner(s) might have an STI without having symptoms. You and your partner should determine what sexual behaviors and prevention practices are going to be used in your relationship—and outside of it if you are not exclusive. The goal of this communication is to keep you BOTH healthy and free from new infections. Here are some great tips on talking with your partner.
If you test positive, know that getting an STI is not the end! Many STIs are curable and all are treatable. If either you or your partner is infected with an STI that can be cured, both of you need to start treatment immediately to avoid getting re-infected.
The U.S. Department of Health and Human Services released the first-ever STI Federal Action Plan (STI Plan) in December 2020, providing a road map for STI prevention, diagnosis, care, and treatment. Read the STI Plan and find resources to help promote it.