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HIV Prevention

Man opening a condom package Today, more tools than ever are available to prevent HIV. In addition to limiting your number of sexual partners, never sharing needles, and using condoms correctly and consistently, you may be able to take advantage of newer biomedical options such as pre-exposure and post-exposure prophylaxis.

How can I prevent getting HIV from anal or vaginal sex?

Not having sex is the most effective way to prevent HIV. If you are sexually active, the following steps can reduce your risk of getting HIV:

How can I prevent getting HIV from oral sex?

Oral sex involves giving or receiving oral stimulation (i.e., sucking or licking) to the penis (fellatio), the vagina (cunnilingus), or the anus (anilingus). Most types of oral sex carry little to no risk of HIV. The highest oral sex risk is to individuals performing fellatio on an HIV-infected man, with ejaculation.

Factors that may increase the risk of HIV transmission through oral sex are oral ulcers, bleeding gums, genital sores, and the presence of other sexually transmitted infections.

Although anilingus (rimming) carries little to no risk of transmitting HIV, it does come with a high risk of transmitting hepatitis A and B, parasites, and other bacteria to the partner who is doing the rimming.

To reduce your risk of HIV or other infections during oral sex or oral-anal contact, you can use barriers such as condoms, natural rubber latex sheets, dental dams, or cut-open non-lubricated condoms. See Tips for Using Condoms and Dental Dams.

How well do condoms prevent HIV?

When used correctly and consistently—every time you have sex—condoms are highly effective in preventing HIV infection. Latex condoms provide the best protection against HIV. Polyurethane (plastic) or polyisoprene (synthetic rubber) condoms are good options for people with latex allergies. Natural membrane (such as lambskin) condoms are porous, meaning that infections can pass through them, and therefore do not protect against HIV and certain other sexually transmitted infections (STIs).

Because condoms cover only the penis, they are more effective at preventing STIs transmitted through body fluids, like gonorrhea, chlamydia, and HIV. Condoms provide less protection against STIs spread through skin-to-skin contact like human papillomavirus (genital warts), genital herpes, and syphilis.

We do not yet have research on how well female condoms prevent HIV and other STIs when used for anal sex. But we do know that HIV cannot pass through a female condom. Also, unlike latex male condoms, it is safe to use any kind of lubricant with female condoms (see “Can using a lubricant help reduce my HIV risk?”).
For more information, see Tips for Using Condoms and Dental Dams.

Can using a lubricant help reduce my HIV risk?

Yes. For anal sex, using water- or silicone-based lubricant with a latex condom helps to minimize damage to the rectum during sex, reduce condom breakage, and prevent the transmission of HIV and some other STIs. For vaginal sex, if dryness is a concern, using water- or silicone-based lubricant can prevent irritation and the condom breaking.

Oil-based lubricants and products containing oil such as hand lotion, Vaseline, or Crisco should not be used with latex condoms because they can weaken the condom and cause it to break. For condoms made of polyurethane or polyisoprene, it’s safe to use lubricants that contain oil.

Lubricants containing nonoxynol-9 should not be used because they can irritate the lining of the vagina or anus and increase the risk of getting HIV.

Can male circumcision prevent HIV?

Male circumcision reduces the risk that a man will get HIV from an infected female partner, and also lowers the risk of other sexually transmitted infections (STIs), penile cancer, and infant urinary tract infection. Studies have not consistently shown that it prevents HIV among men who have sex with men. Circumcision is only partly effective and should be used with other prevention measures. Men who are considering circumcision should weigh its risks and costs against its potential benefits. For more information on male circumcision and HIV, see CDC’s male circumcision site.

Can I take medicines to prevent getting HIV?

Yes. You should consider pre-exposure prophylaxis (PrEP) if you routinely have sex without using a condom, especially if your sex partner is HIV-positive or has HIV risks (for example, they inject drugs or are having sex with other people) or if you have recently been diagnosed with a sexually transmitted infection. PrEP involves taking a pill (brand name Truvada) every day that contains two HIV medicines. These are the same medicines used to reduce the level of virus in people who are already infected.

You and your health care provider may consider the following factors in deciding whether PrEP is right for you:

Can I take medicines to prevent HIV after exposure?

Post-exposure prophylaxis, or PEP, is a 4-week course of drugs that may prevent HIV infection for people who think they may have been recently exposed. PEP is used to prevent HIV after possible exposure during a single event; it is not intended for long-term use. For example, health care workers can be exposed on the job through infected needles, sharp instruments, or body fluids. Others can be exposed through sexual assault or during episodes of unprotected sex or needle-sharing injection drug use.

PEP consists of two or three antiretroviral medicines prescribed on the basis of your likely exposure risk. These medicines keep HIV from making copies of itself and turning into infection. To be effective, PEP must begin as soon as possible, but always within 72 hours (3 days) of a possible exposure. Keep in mind that PEP should only be used in situations right after a potential exposure. It is not a substitute for other proven HIV prevention methods, such as correct and consistent condom use.

Because there still may be some risk of HIV infection, you should continue to use condoms with sex partners while taking PEP. This will help avoid spreading the virus to others if you do become infected.

For more information on preventing exposure to HIV, see the PEP Q&A , the CDC fact sheet, Occupational HIV Transmission and Prevention Among Health Care Workers, or the PEPline page.

Can I get vaccinated to prevent HIV?

No. There is currently no vaccine that will prevent HIV infection or treat those who have it.

Can I use microbicides to prevent HIV?

No. Microbicides are gels, films, or suppositories that can kill or neutralize viruses and bacteria. Researchers are studying both vaginal and rectal microbicides to see if they can prevent sexual transmission of HIV, but none are currently available for use.

If I am living with HIV, can I take HIV medicines to prevent passing it to others?

If you are living with HIV, antiretroviral therapy (ART) reduces the amount of virus (viral load) in your blood and body fluids. ART can dramatically improve your health and extend your life, but there are also prevention benefits to treatment: If you have an undetectable viral load you are much less likely to infect others through sex or sharing needles. However, the risk of spreading infection is still not zero, which means that you should still use other prevention methods, such as condoms.

If you are taking ART, follow your health care provider’s advice. Stay in care and always take your medicine when and how you are supposed to.

You should also be aware that your partners may benefit from pre-exposure prophylaxis (PrEP), daily medicine to prevent HIV for people at ongoing risk, or post-exposure prophylaxis (PEP), a 4-week course of medicine to prevent HIV after possible exposure during a single event.

If I have an undetectable viral load, does that mean I can’t pass HIV to my partner?

Viral load refers to the amount of HIV in the blood. An undetectable viral load is when the amount of HIV in the blood is so low that it can’t be measured. The goal of antiretroviral therapy (ART) is to reduce viral load, ideally to an undetectable level. If a person’s viral load goes down after starting ART, then the treatment is working.

Having an undetectable viral load is good for an HIV-positive person’s overall health. It also reduces the chance of transmitting the virus to a sexual or drug-using partner who is HIV-negative.

However, people with an undetectable viral load still have HIV in their body, which means there is a chance that they can transmit HIV through sex or sharing needles or injection equipment. An HIV-positive person can infect a partner even if they have an undetectable viral load, because

How can I prevent getting HIV from drug use?

Injecting drugs, including hormones, steroids, or silicone, can transmit HIV directly through needles or equipment (works). In addition, some drugs, such as methamphetamine, cocaine, or alcohol, may put you at risk for HIV by lowering your inhibitions and making you more likely to engage in risky behavior.

The best way to reduce your risk of HIV is to stop using drugs. If you cannot stop using drugs, talk with your doctor or health care provider, counselor, loved one, or someone else you trust about getting into a treatment program. Find a treatment facility near you or call 1-800-662-HELP (1-800-662-4357).

If you are injecting drugs and believe you cannot stop using yet, here are some other ways to reduce your risk of getting HIV or spreading it to others:

These steps, promoted in prevention programs for substance users, have helped decrease the new cases of HIV resulting from injection drug use in recent years.

One additional prevention note: If you are likely to be in a situation where alcohol and other kinds of drugs will be used, have a condom with you in case you have sex.

How can I prevent passing HIV to my baby?

Get tested for HIV when you are planning a pregnancy or as soon as possible after you find out you are pregnant. If you are HIV-positive, the right prevention steps can lower your risk of giving HIV to your baby from 20% (no prevention steps) to 2% (if you receive antiretroviral drugs during pregnancy, labor, and delivery; have your baby by cesarean, or C-section; and avoid breastfeeding). Newborn babies born to HIV-infected mothers are also given medicine to protect them.

You should be tested again in your third trimester if you engage in behaviors that put you at risk for HIV.

Of course, some women do not find out they are HIV-positive until they are already in labor. But if they receive antiretroviral drugs during labor and delivery and avoid breastfeeding, the chance of passing the infection to the baby can still be significantly decreased. For more information, see CDC’s HIV Among Pregnant Women, Infants, and Children.

 


 

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