How can I reduce HIV transmission?

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Before sexual or injecting activities:

• Communicate openly with your partner(s).
• Get tested for HIV and other sexually transmitted infections.
• If you’re HIV negative, talk with your primary care provider to see if PrEP (Pre-Exposure Prophylaxis) is right for you.
• If you’re living with HIV, access medical care and HIV antiretroviral medication to obtain a repressed viral load.

During vaginal and/or anal sex use:

• A latex external condom with water-based or silicone-based lubricant.
• A polyurethane external condom with water-based, silicone-based, or oil-based lubricant.
• An internal condom with water-based, silicone-based, or oil-based lubricant.

When using needles:

• Use new needles and equipment for each use.
• Never share needles or injecting equipment with others.
• Visit The Works Program to access needles, “works”, and resources.

During oral-vaginal, oral-penile, and/or oral-anal sex:

• Use a latex barrier (“dam”).
• Use a latex or polyurethane condom (assorted flavors available at BCAP).
• Avoid brushing or flossing right before oral sex to prevent creating small cuts in the mouth.

During and after pregnancy:

• Access prenatal care, including HIV testing.

If you’re living with HIV:

• Start taking HIV treatment during pregnancy to decrease the amount of virus in the blood. (However, HIV will not cross the placenta through the umbilical cord. This cord acts as a “filter”, not allowing the mother’s blood to mix with the child’s).
• Talk with your primary care provider(s) about the possibility of a c-section instead of a vaginal birth.
• Use formula instead of breastfeeding.

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How to use a condom

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During vaginal and/or anal sex, follow these steps to correctly use a condom:

• Make sure the condom is lubricated and made of either latex, polyurethane, or polyisoprene.
• Check the expiration date. Squeeze the package to make sure there is a pillow of air. This indicates the condom is undamaged.
• Carefully open the package; do not use teeth or scissors.
• Position the condom so it resembles a sombrero hat.
• Squeeze a few drops of water or silicone-based lubricant inside the tip of the condom. Do not use oil-based lubricants.
• Pinch the condom at its tip, leaving a 1/2 inch space for semen to collect. Make sure to squeeze out any air.
• Put the condom on the head of an erect penis. If this penis is uncircumcised, pull back the foreskin before putting on the condom. Then, unroll the condom to the base of the penis.
• Smooth out any air pockets between the condom and the penis.
• Add lubrication to the outside of the condom, and as needed throughout intercourse.
• Use a new condom between anal and vaginal sex, as well as between different sexual partners.
• Throughout intercourse, check to make sure the condom remains on the penis.
• When done with intercourse, withdraw the erect penis gently while holding the rim of the condom at the base of the penis.
• Gently roll the condom off the penis. Do this away from your partner’s body.
• Tie a knot at the end of the condom, wrap in tissue, and throw it away in the trash.

Also check out the video, How to Put on a Condom, with Ms Eda Bagel. Special thanks to Greenworks Video, Fascinations, and, of course, the lovely Ms. Eda Bagel.

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How is HIV transmitted?

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HIV (Human Immunodeficiency Virus), the virus that can lead to AIDS (Acquired Immune Deficiency Syndrome), is transmitted from a person living with HIV to another person through blood, semen, vaginal fluid, and breast milk. Fluids that contain HIV must get into the bloodstream in order for the person to acquire the virus. There is a high to moderate likelihood for acquiring HIV by:

• Having unprotected vaginal or anal sex, with greater risk to a receptive partner.
• Sharing needles with someone who is living with HIV. This could include injecting drugs, steroids, or vitamins; and sharing tattooing or piercing equipment.
• Breast-feeding by a mother living with HIV.
• Having unprotected oral sex with someone who is living with HIV.

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How to use additional barriers

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The use of a latex barrier (dam, latex square, or plastic wrap*) during oral-anal and oral-vaginal sex can reduce your chance of acquiring HIV and other sexually transmitted infections (STIs).

• Apply water-based lubricant on one side of the barrier. This side will be put against the skin of the receptive partner.
• Put the lubricated side of the barrier up to your partner’s vagina or anus.
• When finished with the oral sex, dispose of the latex barrier (not in the toilet).
• Remember to use a new barrier for each act of oral-vaginal or oral-anal sex or if you decide to switch between areas.
• Do not share barriers between partners, but instead use a new barrier for each person.

*Plastic food wrap may not provide a completely safe barrier, but is preferable to no barrier at all.

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Where can I get condoms and other barriers?

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BCAP, Boulder County Public Health, and Boulder Valley Women’s Health Center all offer condoms and other latex barriers at no cost. Condoms may be purchased at area pharmacies, grocery stores, and adult bookstores. Prices vary.

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What is PEP?

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Post-Exposure Prophylaxis (PEP) is an intensive four-week medication regimen to be taken within 72 hours after exposure to HIV. The sooner PEP is started within the 72-hour window period, the better. When taken as directed, it is a very effective strategy to reduce HIV transmission. PEP is prescribed to be taken once or twice daily for 28 days. PEP is safe, but involves a high concentration level of anti-retroviral medications. As a result, side effects like nausea, vomiting, diarrhea, headaches, and fatigue are common; however, these can all be treated. Though adherence is challenging, it’s imperative to follow the regimen as prescribed for maximum efficacy. When considering PEP after possible or known exposure to HIV, seek the nearest urgent care provider or emergency room doctor right away. There also is a 24-hour PEP Hotline that can be reached toll-free at 1-888-448-4911.

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What is PrEP?

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Pre-Exposure Prophylaxis (PrEP) is a new and exciting HIV prevention strategy in the form of a one-a-day medicine (Truvada®). When used daily as prescribed, it is more than 92% effective in preventing HIV transmission. For an individual on PrEP, HIV infection can become practically non-existent if it’s taken correctly alongside condoms and other prevention strategies. Efficacy depends on the user. For maximum protection, it is recommended to take the medication once a day. It takes 7 days for Truvada® to become effective in rectal tissue and 20 days in vaginal or urethral tissue. If a dose of Truvada® is missed, the protection level will decrease. Side effects such as nausea, diarrhea, stomach cramps, and headaches may occur in the first two weeks of starting Truvada®. Fortunately, these effects tend to go away shortly and don’t necessarily happen to everyone. More serious side effects are rare. PrEP is recommended for men who have sex with men (MSM), transgender women, and people in sero-discordant relationships. Nonetheless, anyone at increased risk of exposure to HIV may benefit from Truvada® as PrEP. To access PrEP, it is recommended to have a consultation with a medical professional. In Boulder, the Beacon Center for Infectious Diseases has a long history of providing quality HIV care to the community. This clinic also has experience in providing consultation, navigation, and medical care to people who are interested in accessing PrEP. Contact the Beacon Center for Infectious Diseases at 303-415-8850 for more information or to set up an appointment.

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More questions about PrEP or PEP?

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Watch the video: Demystifying HIV Pre-Exposure Prophylaxis

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