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You can absolutely have sex if you’re living with HIV, or if you’re interested in having a sexual relationship with someone who’s received an HIV diagnosis.

You just have to take certain precautions to prevent transmission.

Here’s what you need to know.

Nope.

Receiving treatment certainly plays a big role in reducing the risk, but you can still engage in sexual activity, even if you haven’t started treatment.

No, again.

Although having undetectable HIV can help ease any concerns, you don’t need to swear off sexual activity entirely while waiting for your treatment to take effect.

As long as you take precautions and both parties are comfortable with it, that is.

Most people living with HIV achieve an undetectable viral load within 1 to 6 months of starting treatment with antiretroviral therapy (ART) when taken as prescribed.

Six months can feel like a lifetime when you’re jonesing for some good lovin’. There are plenty of lower-risk and oh-so pleasurable ways you can get off with a partner or solo to hold you over in the meantime.

Touching, kissing, and oral sex carry little to no risk for HIV transmission. Here are some ideas to help you get your fix:

  • Make-out sesh. HIV is not transmitted through saliva, so why not enjoy a hot and heavy make-out sesh? It’s a great way to kick up the intimacy and love hormones.
  • Erogenous play. Explore, discover, and conquer each other’s pleasure points safely with erogenous play. BTW, there are way more of these spots than just the usual suspects — and some of them have the power to lead to orgasms when touched right.
  • Masturbation. Whether you want to enjoy some solo play or try your hand at mutual masturbation, it’s bound to be a good time. Throw a sex toy into the mix to take it to another level. Just be sure to sanitize toys before and after sharing.
  • Dry humping. As long as you keep things dry and avoid any scratchy or stabby materials, buttons, or zippers, dry humping is a safe way to get off with a partner, a pillow, or your favorite stuffed toy. Apologies in advance to teddy bears everywhere.
  • Oral sex. The risk of HIV from giving or receiving oral is negligible. This goes for blow jobs, cunnilingus, and rimming. That said, it’s possible to contract other STIs from oral sex. If you want to get licky with it, use a barrier.
  • Fingering and fisting. Use lots of lube and have at it — as long as the person doing the fingering or fisting removes any rings and keeps their nails trimmed to prevent cuts and scratches. Finger condoms and latex gloves can also be used as a barrier.
  • Watersports. Urine doesn’t carry HIV, so there’s no risk involved with watersports or “piss play.”

Talking HIV status and sex with a potential partner can be intimidating, because you can’t predict how someone will react.

Even if they have some knowledge of HIV and safer sex, they might still be worried about having sex with someone living with HIV.

Here are some things that might help make the convo easier:

  • Pick a time and place to talk where you can take your time without being interrupted.
  • Be prepared with information on HIV treatments and prevention methods, so you can answer questions and direct them to resources.
  • Talk to them about U=U (undetectable equals untransmittable) and the precautions you can take to protect their health during sex.
  • Share what you’re doing to stay healthy, such as adhering to treatment and visiting regularly with your healthcare professional.
  • Be open to hearing what they have to say, and give them time to process the information.
  • Be prepared for the possibility that they may react negatively or not want to move forward, and try not to take it personally. Their reaction is all their own.

There are several precautions you and your partner(s) can take to prevent contracting or transmitting HIV through sexual activity.

Use condoms and other barrier methods

Barrier methods, like condoms and dams, provide a, well, barrier. This can help prevent contact with bodily fluids during sex with someone living with HIV.

When used correctly, barriers can prevent transmission of HIV and other STIs.

Using enough lube can also help reduce the risk of HIV, too — not to mention, make sex a helluva lot better.

Lube makes sex safer by helping with dryness and friction, which reduces the risk of tears that can allow the virus to enter the bloodstream. It can also lower the chance of a condom breaking.

Be sure to stick with water-based lubes, since lubes containing oil weaken latex and can result in the condom ripping.

Stay on top of medications, including ART, PrEP, and PEP

There are a few medications available that can help prevent the transmission of HIV:

  • ART. A person living with HIV may take medication known as ART to help them stay healthy and prevent the transmission of HIV. Most people who take it as prescribed can lower their viral load to an undetectable level.
  • PrEP. Short for pre-exposure prophylaxis, PrEP is a drug that someone who is HIV-negative can take to lower the risk of contracting HIV by as much as 99 percent.
  • PEP. Post-exposure prophylaxis, or PEP, is a drug regimen that can help reduce the risk of HIV after a possible exposure when started within 72 hours.

Get regularly tested for STIs

It’s important for you and your partner(s) to get regular testing for STIs. Early detection and treatment of STIs can reduce the risk of complications.

Having an STI can increase the risk for contracting HIV.

Be aware of potential symptoms for HIV and other STIs

Being in the know about potential STI symptoms is important for anyone who’s sexually active.

See a healthcare professional if you notice any of these:

  • unusual discharge from the anus, penis, or vagina
  • unusual vaginal bleeding, like bleeding after sex or between periods
  • burning or pain when peeing
  • frequent or urgent need to pee
  • sores, bumps, or blisters on or around your genitals or anus
  • rash on or around your genitals or anus
  • genital itching

Yep. Penis-in-anus and penis-in-vagina sex are higher risk activities.

Penis-in-anus sex is the riskiest type of sex for contracting or transmitting HIV. The risk is higher for the receptive partner, sometimes referred to as the “bottom.”

This is because the rectum’s lining is very thin. Tiny abrasions give infected bodily fluids direct access to the bloodstream.

The risk is slightly lower for the insertive partner, or “top,” though they can still contract HIV. The virus can enter the body through the urethra, the foreskin (if they’re uncircumcised), or any open sores or tiny scratches on the penis.

Penis-in-vagina sex isn’t as risky as anal, but it’s still higher risk. Most vagina-having folks who contract HIV do so from penis-in-vagina sex.

A person with a vagina can contract HIV from unprotected sex when the virus enters the body through the mucus membranes lining the vagina and cervix.

The partner with the penis contracts it from blood or vaginal fluid that enters the body through the urethra, foreskin, or small cuts or open sores on the penis.

Yes, but the risk is low.

There are two main types of HIV:

  • HIV-1, which is the most common type, accounts for around 99 percent of all contractions in the United States.
  • HIV-2 is uncommon, less transmissable, and mostly concentrated in West Africa.

It’s possible, but treatment can lower the risk of transmitting HIV to the baby to less than 1 percent.

This involves the mother with HIV taking ART as prescribed all through pregnancy and childbirth, as well as giving the baby HIV medicine for 4 to 6 weeks after birth.

Absolutely!

Avoid sharing drug injection equipment, like needles and syringes, which can expose someone to blood infected with HIV.

Keep any alcohol intake or drug use in check. If needed, consider seeking help for substance use, which is linked to a higher risk of HIV and other STIs.

Don’t hesitate to reach out to your doctor or another healthcare professional if you or your partner has any concerns.

A healthcare professional can help you with:

  • HIV and STI testing
  • treatment and prevention medications
  • concerning symptoms
  • referrals to counseling
  • referrals to mental health professionals
  • referrals to family planning clinics or professionals with experience in HIV

Sexual activity doesn’t have to be off the table because you’re living with HIV.

There are plenty of lower risk acts that are high on pleasure you can engage in. There are also several precautions you can take to prevent contracting or transmitting HIV, even if going bareback.


Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.