In the United States, HIV is mainly spread by having sex with someone who has HIV. There are several steps you can take to reduce your risk of getting HIV through sexual contact, and the more of these actions you take, the safer you can be. These actions include:
- Choose less risky sexual behaviors. Oral sex is much less risky than anal or vaginal sex. Anal sex is the highest-risk sexual activity for HIV transmission. If you are HIV-negative, insertive anal sex (“topping”) is less risky for getting HIV than receptive anal sex (“bottoming”). Remember: HIV can be sexually transmitted via blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluid, and vaginal fluid. Sexual activities that do not involve the potential exchange of these bodily fluids (e.g. touching) carry no risk for getting HIV. For more details, see Sexual Practices and HIV Risk, below.
- Use condoms consistently and correctly. When used consistently and correctly, condoms are highly effective in preventing HIV. For more details, see Using Condoms, below.
- Reduce the number of people you have sex with. The number of sex partners you have affects your HIV risk. 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 sex partner with a sexually transmitted disease. Both of these factors can increase the risk of HIV transmission. Remember: one in six people living with HIV in the U.S. are unaware of their infection.
- Talk to your doctor about pre-exposure prophylaxis (PrEP). PrEP is taking HIV medicine daily to prevent HIV infection. PrEP should be considered if you are HIV-negative and in an ongoing sexual relationship with an HIV-positive partner. PrEP also should be considered if you are HIV-negative and have had a sexually transmitted disease (STD) or any anal sex (receptive or insertive) with a male partner without condoms in the past six months and are not in an exclusive relationship with a recently tested, HIV-negative partner. For more information, see our page on PrEP.
- Talk to your doctor right away (within 3 days) about post-exposure prophylaxis (PEP) if you have a possible exposure to HIV. An example of a possible exposure is if you have anal or vaginal sex without a condom with someone who is or may be HIV-positive, and you are HIV-negative and not taking PrEP. Your chance of exposure to HIV is lower if your HIV-positive partner is taking antiretroviral therapy (ART) consistently and correctly, especially if his/her viral load is undetectable. Starting PEP immediately and taking it daily for 4 weeks reduces your chance of getting HIV. For more information, see our page on PEP.
- Get tested and treated for other sexually transmitted diseases (STDs) and encourage your partners to do the same. If you are sexually active, get tested at least once a year. STDs can have long-term health consequences. They can also increase your chance of getting HIV or transmitting it to others. Find an STD testing site.
- If your partner is HIV-positive, encourage your partner to get and stay on treatment. ART reduces the amount of HIV virus (viral load) in blood and body fluids. If taken consistently and correctly, ART can keep people with HIV healthy for many years, and greatly reduce their chance of transmitting HIV to sex partners.
Of course, you can also reduce your risk of getting HIV by not having sex. If you aren't having sexual contact, you are 100% protected from getting HIV in that way. Alternatively, if you are having sex, you can reduce your risk if you and your partner have both been tested and know that you are both HIV-negative and you practice monogamy. Being monogamous means: 1) You are in a sexual relationship with only one person and 2) Both of you are having sex only with each other. However, monogamy won't protect you completely unless you know for sure that both you and your partner are not infected with HIV.
