I Have Sex without Condoms
Some men prefer to have anal sex without condoms. If you and your partner are both HIV negative and want to stop using condoms, it is possible to do this 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 condomless sex, as long as you are able to maintain open communication and trust in the relationship.
If you are both HIV positive, you should consider the risk of superinfection: 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, talk to Frank. 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
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 [link to 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
For poz guys, proper treatment adherence (taking medication regularly) impacts viral load, which also lowers the risk of passing on HIV.
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-different couples (one is positive, the other is negative) is very low if the HIV-positive partner is on treatment, has an undetectable viral load and is free of STIs.