I Have Sex without Condoms
Some men prefer to have anal sex without condoms.
We now have more HIV prevention tools than ever before. If condoms aren’t right for you, PrEP—which refers to taking an anti-HIV medication once-a-day—is shown to be incredibly effective at preventing HIV transmission. British Columbians can access PrEP without cost as of January 2018.
If you and your partner are both HIV negative and want to stop using condoms and don’t think PrEP is right for you, it is possible to do so safely. You both need to get tested for HIV. Even if your test results are negative, you should keep using condoms until you have a second test to verify the results after your window period. For more information on window periods of different HIV tests, visit Types of HIV Tests. If the second test comes back negative, and you’ve used condoms consistently in the meantime, you can be certain that you are both negative. If this is the case, then you can consider anal sex without HIV/STI preventative tools, as long as you are able to maintain open communication and trust in the relationship.
Although rare, if you are both HIV positive, there is the risk of reinfection with a different strain of HIV. Although this is rare, it can affect your health and future treatment options. Another consideration is other STIs. Some STIs such as syphilis and hepatitis C have a more serious impact on people with HIV. Make sure you are tested regularly. For more information on HIV and hepatitis C, check out the CATIE website. If one of you is positive and one of you is negative or just doesn’t know, you will need to keep using condoms during anal sex in order to most effectively reduce your risk for HIV.
Reduce Your Risk
In reference to HIV transmission, pre-exposure prophylaxis (PrEP) refers to a prevention strategy in which HIV-negative individuals take an anti-HIV medication once-a-day. While PrEP is a relatively new prevention tool, studies have shown that an individual who is on PrEP and adheres to treatment guidelines is risk-free from contracting HIV in the occasion that they are exposed to the virus. British Columbians can access PrEP without cost as of January 2018.
Check out HIM’s getpreped.ca for everything you need to know about PrEP.
It’s important to remember that while PrEP effectively protects from HIV, it does not protect from other STIs, so you might want to consider using PrEP along with some of the other risk-reduction tools outlined in this page.
Knowing your HIV status and that of your partner will allow you to make decisions about how to best reduce sexual risk-taking (this requires regular HIV testing).
Limit Your Partners
Another way to reduce your risk is to limit your number of partners, or establish friends-with-benefits, or regular partners who you communicate with and trust.
Sometimes guys forget that semen can be on their hands or faces. Try not to get semen in your eyes. Using someone else’s semen as lube when you masturbate can also be risky. If a finger goes in your anus, make sure it doesn’t have someone else’s semen on it.
Harm Reduction (may be less risky, but not risk-free)
Guys reduce the spread of HIV in several other ways:
- having less risky sex (hand jobs, oral sex, etc.)
- sero-sorting (looking for partners with the same HIV status)
- strategic positioning (putting the negative guy on top)
- not ejaculating inside each other (pulling out or withdrawal)
- ensuring that both partners are free of other STIs by getting tested
Undetectable Viral Load
The BC Centre for Excellence in HIV/AIDS and other HIV/AIDS research institutions have found that the risk of HIV transmission for sero-discordant couples (one is positive, the other is negative) is nonexistent if the HIV-positive partner is on treatment, has an undetectable viral load and is free of STIs.