CAPS staff are available to do one-on-one and couples counseling around safer sex and risk reduction for HIV transmission. We often work individually with HIV-positive folk interested in reducing the chances of transmitting HIV to their negative partners, as well as reducing the chances of giving/getting a resistant strain of HIV (also known as superinfection). STDs such as syphilis, gonorrhea, NGU/NSU, chlamydia, herpes, genital warts and molluscum are also discussed. Referrals for testing and treatment can be made right here through Red Door Services of the Hennepin County Public Health Clinic.
Click here to set up an appointment for you and/or your partner to come in and talk about negotiating safer sex in your relationship.
How does HIV spread during sex?
We know a lot about HIV nearly 30 years into the epidemic... we know exactly how it is spread! Unprotected anal sex (both top and bottom), unprotected vaginal sex and sharing needles continue to fuel the HIV epidemic in our community.
HIV is a fluid-based virus and is found in high enough concentrations to cause an infection in the following fluids:
Blood (highest risk fluid)- Semen (high risk, includes pre-cum)
- Vaginal Fluid (lower risk fluid)
HIV-infected blood, semen or vaginal fluid needs to get into a person's body. The exchange of fluids must be direct (like when sharing needles or during unprotected sex) as the virus is very fragile and dies quickly when exposed to light and air. Using latex or polyurethane condoms correctly and every time will prevent HIV transmission.
If you are HIV-positive you can infect or re-infect your sex partners during unprotected sex. Studies are showing that higher viral loads can make it much easier to infect your partner, so keeping your or your partner's viral load low with HIV medication helps. If you or your partner are doing well with managing your HIV infection, the reality is that you can STILL spread HIV even if you have an undetectable viral load. It's even easier to transmit HIV if you or your partner has another STD, such as syphilis or herpes.
Figuring out the differences in risk between different activites (from unsafe to safer to safest) will help take the possibility and/or anxiety of HIV and STD transmission out of your sex life.
What if both people are already HIV-Positive?
Protecting yourself and your partner from HIV is still important, even if both parties are HIV-positive. Some HIV-positive individuals "serosort", meaning they only have sex with other HIV-positive people. This helps reduce the risk of spreading HIV to non-infected members of the community, but does not protect an HIV-positive individual from other STDs such as syphilis, gonorrhea, chlamydia, genital warts and herpes. If you have HIV, it can be easier to be infected by other STDs, and the infections themselves are often much more serious than when an individual is HIV-negative. This is especially true of syphilis.
Pregnancy is also a concern if you are having unprotected vaginal sex.
The other issue is re-infection - being infected with a different strain of HIV. There are many different strains of HIV, some more resistant to HIV medications than others. Even if someone knew who they got HIV from, each body is it's own incubator for HIV and can produce very different types of virus over time. It can depend on how well you and/or your partner are taking your meds, and what types you're using. And different types of virus have different types of resistance to medications.
We don't know everything about re-infection. But it is important to recognize that medication available to you now may not work in the future if you get a different strain.
For more information about serosorting (sex with same HIV-status), serodischordance (sex with different HIV-status) and negotiating safer sex in your sex life, contact us to set up an appointment!
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