Casual sex partners, one of whom has HIV

Do you have a casual sex partner and is one of you HIV positive? Using condoms properly with plenty of lube will protect the other person against HIV. Moreover, treatment with HIV medication offers additional protection on top of condom use. If the person with HIV is receiving proper treatment, there is hardly any chance that his HIV will be transmitted. Do you not (or not always) use condoms? Some HIV-negative men apply strategies to try to reduce their chances of getting infected with HIV. Unfortunately, none of those strategies is watertight. You still run a risk of getting HIV (and other STIs).Do you have a casual sex partner and is one of you HIV positive? Using condoms properly with plenty of lube will protect the other person against HIV. Moreover, treatment with HIV medication offers additional protection on top of condom use. If the person with HIV is receiving proper treatment, there is hardly any chance that his HIV will be transmitted. Do you not (or not always) use condoms? Some HIV-negative men apply strategies to try to reduce their chances of getting infected with HIV. Unfortunately, none of those strategies is watertight. You still run a risk of getting HIV (and other STIs).

Condoms

As long as you use them correctly, condoms will protect you against HIV and STIs.

  • Do you have difficulty putting on or using condoms due to problems you have getting or keeping an erection? There are various different ways to deal with erectile dysfunction.
  • Do you have difficulty using condoms due to a latex allergy? Buy non-latex condoms.
  • Having an undetectable viral load is an extra form of protection above and beyond the use of condoms. With that, there is no need to panic if a condom breaks or slides off.  
  • What if your HIV-positive partner's viral load is still measurable and thus not undetectable? In that case, you will need to be more alert in case a condom breaks or slides off.  If that happens, go to the GGD, to an STI clinic or to a nearby hospital emergency room preferably within two hours but certainly no later than 72 hours after it happened. Consult with the staff there to find out if you are eligible to receive treatment with PEP. PEP reduces your chances of becoming infected with HIV. The earlier you start with a treatment with PEP, the greater your chances of remaining HIV negative will be.

Do you need to use condoms if you being successfully treated for HIV?

Scientists currently assume that STIs temporarily increase the amount of HIV in anal secretions and sperm. If you are HIV positive and you have an STI, that could increase your chances of passing on your HIV after all, even if you are being treated with HIV medications. Nothing would be visible in your blood: the virus would still be unmeasurable. For this reason, casual sex partners are advised to always use condoms if one of them has HIV. Another reason to use condoms is of course that condoms will also prevent you from getting many other STIs. 

Talk about HIV in advance

Do you think it is unnecessary to tell your sex partner that you have HIV if your virus is undetectable? There is a good reason to tell him anyway: your partner won't need to panic in case the condom breaks. The fact that you are being treated successfully offers double protection.

Are you HIV negative and do you not (always) use condoms?

Are you HIV negative and do you not want to use condoms or do you not always manage to use them? In that case, you run a risk of getting HIV. Using condoms properly offers the best protection against HIV and other STIs.
If you don't want to use condoms, consider the following ways to potentially reduce your chances of getting HIV to some extent:

  • Make sure that you only fuck actively (as the "top") and do not get fucked (as the "bottom").
  • What if you do let yourself get fucked? In that case, don't let your partner come inside you. Tell him that in advance.
  • Fuck only with men whose viral load has been undetectable for more than six months, as a result of their treatment.
  • Ask your partner if he gets tested for STIs every three months. If he has an STI, there is a greater chance that he will pass on his HIV, even if the virus is undetectable in his blood.

Please note: With this strategy, you only potentially reduce the risk in terms of HIV. You still run a risk of becoming infected with HIV.

  • Remember also that all these strategies are based on trust.
  • You can never know for sure about your sex partner's HIV status, treatment and viral load.

The same holds with the regard to the three-monthly STI test: even if your HIV-positive partner does get tested every three months, he could still get an STI in the period between tests. His most recent test could also have missed an STI, since it can sometimes take a while before an STI can be detected. With an STI, the risk of the transmission of HIV increases, even if the HIV in your sex partner's blood is undetectable.

Do you want to be completely sure or do you prefer not talking about HIV with your sex partners? In both cases, simply using condoms is the easiest and best option in terms of protecting yourself against HIV and other STIs.

Are you HIV positive and do you not (always) use condoms?

Are you HIV positive and do you not want to use condoms or do you not always manage to use them? Keep in mind the following:

  • If your viral load is undetectable thanks to your treatment, there is hardly any chance that you will transmit your HIV to your partner. Remember that you have a right to get treatment immediately if you ask your HIV internist for that. 
  • Don't fuck as the active partner without a condom, but only let the other fuck you. That way, there is even less chance that you will pass on your HIV.
  • If you do fuck actively, don't come inside your partner.
  • Get tested for STIs every three months. That way you will track down any STIs earlier. Having an STI increases your chances of transmitting your HIV via sperm or anal secretions, even if the virus is undetectable in your blood.

Keep in mind that even if you get tested every three months, you could still get an STI in between tests. Your most recent test could also have missed an STI, since it can sometimes take a while before an STI can be detected. That could increase the viral load in your sperm or in the mucous membranes of your anus without your being aware of it.

Where can you go to get tested for STIs?

You can get tested for STIs through your family doctor, at an STI clinic, through your HIV internist or via Testlab. Some GGDs have special consulting hours for gay and bisexual men with HIV.

 

 

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