Today, people with HIV have more opportunities to live happy and successful lives. This is due to improvements in care and treatment. These changes have greatly affected the way we talk about sex and sexual health.
We now know that medications that treat HIV also prevent its transmission. This means that if you take medication that suppresses your HIV to undetectable levels, you can’t pass the virus to your sexual partners (“undetectable = untransmittable” [“U=U”]).
If you are not on treatment or are taking treatment and still have a detectable viral load, you can use condoms or your sex partners can take pre-exposure prophylaxis (“PrEP”). PrEP is when HIV drugs are taken by HIV-negative people before sex to prevent transmission. Another option is post-exposure prophylaxis (“PEP”), which is when an HIV-negative person takes a course of HIV drugs after possible exposure. If someone requires PEP regularly, then PrEP may be an option for them.
Looking after your sexual health is important when you have HIV. Having this virus can make sexually transmitted infections (STIs) and other sexual health problems more complicated to diagnose and treat. U=U means that you have more flexibility about when to use condoms, but you will need to think about your STI risk and other related conditions. If you are living with HIV and are sexually active, it is important to do what you can to maintain your sexual health. This means having regular sexual health checkups with a knowledgeable doctor or service provider who knows your HIV status and your sexual history.
Unless you are in a monogamous relationship with one partner, you should be tested regularly for STIs. This is even more important if you are not using condoms. At a routine sexual health appointment, you will be tested for a range of infections including chlamydia, gonorrhea and syphilis. Often these infections have no symptoms, but if left untreated they can cause serious complications. Once diagnosed, these infections can usually be easily treated and cured with antibiotics.
Among the communities who are affected by HIV, gay, bisexual and men who have sex with men have specific needs when it comes to their sexual health. Some HIV positive men use drugs like GHB, crystal meth and ketamine during sex to prolong and enhance the experience; this is known as “party n’ play” or “PnP”. This can sometimes lead to drug dependency, overdose, mental health problems, and difficulty giving or obtaining consent. Health care providers are starting to develop services for men who party, and there are steps you can take to reduce the risk and harms associated with it.
To learn about HIV and your sexual health, check out:
Your Sexual Health: A guide for people living with HIV – This CATIE resource explores sexual health for people with HIV. It lets you know what you can do to manage your sexual health and talks about the importance of regular sexual health check-ups.
Want more information? Visit:
HIV Prevention and Safer Sex:
The Power of Undetectable: What you need to know about HIV treatment as prevention – How taking HIV treatment and maintaining an undetectable viral load prevents HIV transmission.
HIV Treatment to Prevent HIV – This video explains the concept of U=U and what this means for people living with HIV.
PrEP to prevent HIV: Your questions answered – This answers commonly asked questions about pre-exposure prophylaxis (PrEP) and contains key messages on access, effectiveness and monitoring, including information for people who are pregnant or breastfeeding/chestfeeding and trans people.
Safer Sex Guide – This guide helps readers take charge of their sexual health by exploring how to make sex safer and giving readers tips on preventing STIs.
Sexually transmitted infections:
What you need to know about chlamydia – CATIE fact sheet on chlamydia, with information about transmission, treatment and prevention.
What you need to know about gonorrhea – CATIE fact sheet on gonorrhea, with information about transmission, treatment and prevention.
What you need to know about syphilis – CATIE fact sheet on syphilis, with information about transmission, treatment and prevention.
What you need to know about human papillomavirus (HPV) – CATIE fact sheet on human papillomavirus (HPV), with information about transmission, treatment and prevention.
What you need to know about genital herpes – CATIE fact sheet on genital herpes, with information about transmission, treatment and prevention.
What you need to know about hepatitis A – CATIE fact sheet on hepatitis A, with information about transmission, treatment and prevention.
What you need to know about hepatitis B – CATIE fact sheet on hepatitis B, with information about transmission, treatment and prevention.
The Sex You Want – This interactive website from Gay Men’s Sexual Health Alliance [GMSH]) helps gay men explore what they really want from sex and how to get it.
Party and Play in Canada: What is its impact on gay men’s health? (Prevention in Focus, Spring 2019)