Relationships & sex
Living with HIV doesn't mean giving up sex – quite the opposite. Here is information to help you and your sexual partners have fun and keep safe.
Research has shown that using condoms during sex is the most effective way of preventing the transmission of HIV. Use water-based or silicon-based lubes, as oil-based lubes can damage latex condoms during sex.
If you’re not ready to have sex, there are many other intimate sexual activities that you can enjoy that involve little or no risk, such as kissing, massaging, mutual masturbation and oral sex.
Frequently asked questions
What does ‘safer sex’ mean?
Safer sex means using condoms every time you have vaginal or anal penetrative sex.
When do I have to disclose to sexual partners?
In New Zealand, as long as you’re practicing safe sex (using condoms every time you have vaginal or anal penetrative sex), you are not legally obligated to disclose your HIV status.
If I’m not having penetrative sex do I need to worry?
HIV is not transmitted through kissing, touching, rubbing, massaging or using fingers to penetrate the anus or vagina. However, if your hand or your partner’s hands have cuts, sores or scratches, it is advisable to use latex gloves and water-based lubes. Menstrual blood contains HIV and you can use dams during oral sex to minimise the risk of transmission.
Do my partner or I have to wear a condom during oral sex?
While giving or getting a blowjob has a very low risk of transmitting HIV, some things you can do to further minimise the risk are to avoid brushing your teeth for at least one hour before oral sex, visit a dentist at least once a year to make sure your gums and teeth are healthy, check your mouth for ulcers, cuts or bleeding sores and avoid ejaculation into the mouth.
If both my partner and I are HIV positive, can we have sex without condoms?
This can be risky because if you’re already living with HIV, and are exposed to HIV repeatedly, it can lead to exposure to a different strain of the virus. This can result in you becoming resistant to the treatment you are on. You can read more about this in the super/co- infection section below.
Can I still pass on HIV if I have an undetectable viral load?
The risk is low, but it is not 100% risk-free. See below.
Undetectable viral load and HIV transmission
Evidence shows if you have HIV and are taking HIV medication resulting in an undetectable viral load, you have a substantially reduced risk of passing on HIV to sexual partners. This is great news, but it isn’t as simple as it may seem. When considering the role of undectable viral load in preventing HIV, there are other things to think about, in particular: having other STIs or the flu, which can increase viral load; whether you have been consistent in taking medication; when your last viral load test was and if it is still valid; as well as legal responsibilities. More information here.
When a person living with HIV is infected again through exposure to a different strain, it is known as super-infection. This may sometimes lead to the person becoming resistant, or not responding, to the combination of anti-HIV drugs they’re on. Risk factors for super-infection are a detectable viral load, having a concurrent sexually transmitted infection and, most of all, unprotected sex.
Sexually transmitted infections (STIs)
STIs are bacterial or viral infections that are transmitted from person to person during unprotected anal, vaginal and oral sex. Research has shown that infection with an STI may also increase the likelihood of HIV being acquired or transmitted.
Your nearest NZAF centre provides STI tests for HIV, syphilis, hepatitis C, chlamydia and gonorrhoea. There are STIs that are preventable by vaccines – hepatitis A, hepatitis B and human papillomavirus (HPV) – although the vaccines may not be funded. It is best to discuss this with your doctor.
Condoms and lube
Condoms and lube are the best way to protect you and your partner from contracting HIV or STIs during sex. When condoms are used consistently and correctly, the latex acts as a barrier that HIV can’t pass through.
Using lube will help stop the condom from ripping or coming off. It’s important to use water-based lube, as oil-based lubricants may damage the condom.
Supplies can be obtained free via LYC online.
Pre-exposure prophylaxis (PrEP)
Pre-exposure prophylaxis or PrEP refers to the use of HIV medication by people who are HIV negative in order to reduce their risk of HIV infection. You may have heard of PrEP and be wondering about this as a way of protecting your sexual partner(s) from becoming infected with HIV. When taken on a daily basis, PrEP ensures there is enough HIV medication in the body to significantly reduce the risk of becoming infected with HIV if exposed during unprotected sex.
When considering the role of PrEP in preventing HIV, there are other things to think about – especially STIs which PrEP does not protect from, whether the person is able to adhere to taking a daily pill, and possible side effects. Using condoms and lube for anal and vaginal sex is the most effective way to prevent sexual transmission of HIV as well as other STIs. More about PEP here.
Post-exposure prophylaxis (PEP)
PEP is a short course of anti-HIV medication that may be able to prevent infection of someone who has recently been exposed to HIV. If your partner is HIV negative and is exposed to HIV during sex, they should visit the emergency department of their local hospital as soon as possible.
PEP needs to be taken within 72 hours of exposure to be effective. Evidence shows that while PEP can reduce the chance of becoming infected with HIV, it is not as effective as using condoms and lube for sex.