Something that can't be said enough is that being HIV-positive is nothing to be ashamed of.
Sadly, we have decades of homophobic rhetoric that has stigmatized those with HIV inside and outside of the LGBTQIA+ community. The reality is, those with HIV can live long, healthy lives with the advent of antiretroviral therapy (ART).
This isn’t about “risk.” This is about health.
There is a ton of language out there about the “risk” of getting HIV. We believe that language of “risk” further stigmatizes individuals living with HIV and the wider queer community, especially those having anal sex. You are not a risk. Your sex life is not a risk. Being gay or trans is not a risk. Preventing HIV is a matter of individual health, and you are the one who decides how.
For those who are HIV negative and who would like to remain HIV negative, there are benefits to understanding how HIV is transmitted, which activities post the highest likelihood of getting HIV, and what additional methods can help maintain HIV negative status.
HIV is transmitted through bodily fluids.
People can get HIV by coming into contact with someone else's bodily fluids. The body fluids HIV lives in are blood, semen, pre-ejaculate, vaginal fluids, rectal fluids, and human milk. To get HIV, these fluids would need to come into direct contact with the lining of internal organs/body parts (such as the vagina or rectum/anus), an open cut or wound on the skin or inside of the mouth or nose, or be injected into the bloodstream.
The chances of becoming HIV positive are the most extreme through receiving a full blood transfusion, though this is extremely rare given the testing most blood donations go through.
Below are the likelihoods of acquiring HIV from someone who is HIV-positive, without any preventative measures:
SOURCE: CDC, "Estimated Per-Act Probability of Acquiring HIV from an Infected Source; Risk Per 10,000 Exposures." 13 Nov 2019
There are many measures that can help someone remain negative for HIV.
Even if someone is participating in any of the activities listed above, there are plenty of ways to lessen the chances of acquiring HIV:
- Taking daily PrEP
- Taking PrEP 2-1-1, which is as-needed PrEP around sexual activity
- Using condoms, which also helps protect against other sexually transmitted infections
- Having sex only with partners who you know to be HIV negative
- Having sex with partners who you know to have an undetectable HIV viral load: this is often referred to as U=U, or “Undetectable = Untransmittable”
- Taking post-exposure prophylaxis or PEP, which are antiretroviral medicines very soon after being potentially exposed to HIV to prevent becoming infected
- Using a needle exchange program
When attention is paid to which activities have a higher probability of transmitting HIV AND other preventative measures, it can be quite easy to remain negative for HIV. And although we aren't huge fans of the "risk" language, the CDC "Risk" Estimator Tool can be a quite helpful tool for exploring the likelihood of getting HIV through insertive/receptive anal or vaginal sex.
For good measure: there are a handful of myths still floating around about where someone may get HIV, so let’s dispel those.
People cannot get HIV from:
- Sharing food
- Toilet seats
- Bathing together
- Sneezes and coughs
- Insect bites
FOLX is currently able to prescribe daily PrEP with TDF/FTC, and the process begins here. For existing FOLX members interested in adding a PrEP prescription to their plan, reach out to your clinician through your Athena patient portal or reach out to our member advocates at email@example.com. And for those who want to know more, read up on all things sexual health here, and feel free to reach out to us at firstname.lastname@example.org.