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Sexual transmission

Intercourse

Anal sex

Passive (Receptive male or female partner)

Being anally penetrated by a man who is not using a condom is the most likely way of transmitting HIV. HIV in cum or pre-cum can enter the bloodstream through the lining of the anus.

Active (Insertive male partner)

Anally penetrating someone else without using a condom is another likely way of transmitting HIV. Many men think that because they are the one doing the penetrating, HIV cannot enter their bloodstream, but it can. HIV can enter the penis through the opening at the tip via blood from small cuts or scratches in the lining of the anus.

Vaginal sex

Passive (Receptive female partner)

If a woman is being penetrated, HIV in cum or pre-cum can easily enter the bloodstream through the lining of the vagina. Having your sex partner use a condom with a water-based lubricant is the best way to reduce the risk of contracting or transmitting HIV.

Active (Insertive male partner)

Penetrating a woman without using a condom is another likely way of transmitting HIV. Many men believe that because they are the one doing the inserting, HIV cannot enter their bloodstream, but it can. HIV in vaginal fluids can enter the penis through the opening.

Tips for safer intercourse

  • Always use a condom.
  • Use water-based lubricant with condoms (petroleum-based lubricants can make condoms break). Dabbing a small amount on the head of the penis or into the tip of the condom can increase pleasure for the condom-wearing partner.
  • Put the condom on before penetrative sex.

For more information, see www.whereversexhappens.com

Oral sex

Oral sex is not a significant mode of transmission.

HIV may, however, be transmitted through oral sex under the following circumstances:

  • Transmission only occurs from the insertive to the receptive partner.
  • Transmission is most likely when the insertive partner has a high viral load.
  • Transmission will only occur when ejaculation into the mouth occurs.
  • It is most likely that transmission will only occur when the receptive partner’s mouth or throat has been breached in some way, allowing HIV to enter the bloodstream. Such breaches include the presence of dental disease or mouth ulcers.

There are many reasons for the low transmission of HIV via oral sex. Air is usually involved in the process and the fragility of the virus outside the human body becomes a factor. The defensive capabilities of the mouth, in keeping out foreign pathogens, also play a vital role. In order for infection to occur, HIV must enter the bloodstream, most obviously through a breached mucosal surface in the mouth.

Saliva has inhibitory properties against some viruses and is potentially neutralising the activity of HIV. These factors give HIV a poor success rate in the mouth. Similarly if HIV enters the digestive tract through swallowing semen, the acids, bile and proteases of the digestive tract will destroy it.

Tips for safer oral sex

  • Avoid brushing or flossing your teeth before oral sex to reduce the chance of causing mouth cuts and abrasions.
  • Rinse or gargle with salty water, mouthwash or alcohol to see if you have cuts in your mouth.
  • Avoid cum in the mouth. If your partner cums in the front of your mouth, spit it out. If they come in the back of your mouth, swallow it.
  • Suck with a (flavoured) condom on your partner's penis.
  • Use a square of latex from a condom for anilingus or anal rimming
  • Use dental dams or sheets of clear plastic food wrap for oral vaginal sex (not the type used in microwave ovens is because it contains tiny holes through which the virus can pass).

Masturbation (wanking)

The risk of transmitting HIV via masturbating with another person is extremely low. As long as the semen doesn't come into contact with broken skin or a mucous membrane (like the eye, mouth, or rectum), there is almost no risk of transmission. This is why mutual masturbation has consistently been promoted as safer sex. The only caveat would be to avoid using cum as a lubricant when wanking each other, since this could get it into the urethra (the tube that connects the genitals to the urinary bladder).

Tips for safer masturbation

  • Never use cum or pre-cum as a lubricant.
  • Avoid ejaculating on any part of the body that has sores, cuts or abrasions

Anal play (fingering, toys and fisting)

Anal play has a low risk of HIV and STI infections. If bleeding occurs, the risk of HIV infection increases.

Tips for safer anal play

  • Use water-based lubricants with latex gloves or condoms, or oil-based lubricants with PVC gloves or condoms.
  • Do not share sex toys.
  • Keep sex toys clean (they are easier to clean if you have used them with a condom on them).
  • Change gloves and condoms with every different partner.
  • Avoid contaminating lubricants.

Watersports

Urinating on intact skin carries no risk of HIV infection. There is a very low risk of infection if the urine contains blood or the skin has sores, cuts or abrasions.

Scat

There is no risk of HIV infection from scat unless there is blood in the faeces (shit). There is a risk of STI infection, such as hepatitis A from the ingestion of faeces.

Take extra care to keep any faeces away from the eyes, open sores and the mouth.

Massage, body stroking, licking

HIV cannot be passed on through these practices.