What’s safe sex?
The easiest way to protect yourself and your sex partners from passing on HIV and most STIs during sex is to use a condom and water-based lubricant (lube).
You may hear talk of “safe sex”, “unsafe sex”, “protected sex” and “unprotected sex”.
Sex with condoms is called safe or protected sex because condoms keep people safe from HIV and most other STIs.
Sex without a condom is called unsafe or unprotected sex because it can put you or your partner at risk of getting HIV or another STI.
What about being careful choosing sex partners?
Some people think that they don’t need to use condoms as “protection” from HIV because they know their sex partner is “clean”. This can be a big mistake.
You can’t tell someone has HIV or an STI by looking at them – it could be that you picked it up a week ago and have no symptoms. It could be that your sex partner recently picked up HIV and has no symptoms.
The only way of knowing that you don’t have HIV is to get tested – and to test regularly.
Even if a new sex partner tests for HIV regularly, it’s still important to use condoms. Tests for HIV can only detect HIV after the person has been infected with HIV for six weeks or so. Before that the test won’t pick it up but the HIV is very infectious during this time. This is called the HIV test “window period”.
Catching an STI or HIV can happen to anyone
Some people think that only gay men, sistergirls and brotherboys get HIV from having sex. Not right. People who have anal sex without a condom are more likely to get HIV, but men and women who have vaginal sex without a condom can get it too. People who have other STIs are at higher risk of getting HIV.
People with HIV aren’t dirty or unclean – they just have a medical condition.
Talking about HIV in this way is hurtful. Stigma and shame are big issues for people in our community and it’s important that people with HIV are treated with respect.
We need to talk about HIV in ways that encourage people to test and not feel ashamed. Having regular sexual health checks is something to be proud of – it’s taking responsibility for your own health and doing something that will help bring down STI and HIV rates in our community.
If you inject drugs it’s very important not to share injecting equipment – don’t share needles or syringes.
A needle or syringe may look clean but there could be a tiny amount of blood you can’t see – enough for getting HIV or hepatitis C. This means it’s also important to clean up even tiny blood spills and try to wash your hands with soap before and after injecting.
You can get disposable syringes in NSP (needle and syringe program) services, some chemists, health clinics, and community centres. Find out where you can get a supply so you always have some handy. And use a new syringe every time.
Try not to be ashamed or embarrassed about getting disposable syringes. The places that hand them out know you’re doing the right thing. They won’t judge you or lecture you about using drugs.
It’s best to get tattooed in a tattoo shop because you can make sure they use clean equipment.
Looking out for cuts
HIV can be transmitted through open cuts. If you have an open cut on your body cover it up, especially when playing contact sports. It’s best to cover up open cuts anyway.
Is there a vaccine against HIV? Is there a cure?
No. There’s no vaccine against HIV yet, and no cure. Scientists are working on this.
People with HIV who take HIV treatment tablets can live very healthy lives – but only if they keep taking the treatment tablets.
People with HIV who are on treatment can have very low levels of HIV in their blood. This is called having an ‘undetectable viral load’. People need to keep taking their daily HIV treatment tablets to keep the virus at this low level.
What’s PrEP? Is there a tablet to prevent HIV?
The drug Truvada is usually taken by people with HIV to treat HIV.
It’s also possible to take Truvada pills to prevent HIV. This is called “PrEP”, which is short for pre-exposure prophylaxis – taking the pill before sex, or pre-exposure to the risk of getting HIV.
Some people take PrEP because they know their sex partner has HIV and they want extra protection. Other people take PrEP because they have lots of casual sex and they want extra protection in case one of their sex partners has HIV.
You can only buy Truvada from chemists if you have a doctor’s prescription. Truvada for HIV prevention – for PrEP – is very expensive if you buy it in Australia.
Some people buy Truvada, or generic versions of the drug, online. To buy Truvada online you will still need a prescription from your doctor.
If you are interested in PrEP, talk to your doctor about whether it would be a good option for you. PrEP only works if you take your doctor’s advice about when to take it, and how long to stay on it.
PEP is different to PrEP.
PEP stands for post-exposure prophylaxis. PEP means taking prescription tablets because you have had unsafe sex or shared a drug injecting equipment. If you’ve had unsafe sex or shared injecting or tattooing equipment with someone who has HIV, PEP tablets can kill off any HIV in your system.
It’s important to get PEP within 72 hours of having unsafe sex, or sharing injecting or tattoo equipment.
If you have unsafe sex or share a needle, go to your local sexual health clinic, hospital emergency department or GP ASAP and ask about PEP.
If you ask your health service or doctor about PEP and they aren’t able to prescribe it, ask them to call the closest sexual health service to find out where you might be able to get it.
Sometimes Hospital Emergency Department staff don’t know about PEP and say it is not available. Ask your health worker to see if PEP is available locally by looking at www.getpep.info.
PREVENTING HIV – ‘COMBINATION PREVENTION’
So HIV prevention is no longer just about using condoms. People now talk about ‘combination prevention’ as the new ‘prevention toolbox’. The toolbox includes PrEP and PEP, as well as other new ways of preventing HIV.
Treatment as prevention (TasP)
Another important tool in the prevention toolbox is called “treatment as prevention” or TasP.
TasP refers to the fact that people with HIV who are on treatment can have so little HIV in their blood that it is undetectable in tests. This is called ‘undetectable viral load’ or UVL.
Research has shown that when a person with HIV has an undetectable viral load it is highly unlikely that HIV will be transmitted during sex or sharing injecting equipment – their UVL is acting as a type of prevention. The effect of this is that if most people with HIV can access treatment and reach UVL, HIV transmission rates will go down dramatically.
Needle and syringe programs
Needle & syringe programs or NSPs are services that provide disposable syringes to injecting drug users. This actively discourages sharing of equipment and is referred to as a harm reduction policy.
Introduction of NSPs in Australia is the main reason why rates of HIV among injecting drug users have remained low compared to other countries.
Rates of HIV among Aboriginal and Torres Strait Islander people who inject drugs are higher than for non-Indigenous Australians, so it’s important to encourage people in our community to access NSPs and not be shamed – tell people that NSP staff will know they’re doing the right thing and won’t judge or lecture about using drugs.
Opioid substitution therapy
Opioid substitution therapy is where people who are dependent on an illegal drug are given a legal drug instead. These legal drugs are called pharmacotherapies. In Australia the main pharmacotherapies used for people who are dependent on heroin are Methadone, Buprenorphine, and Naltrexone.
Detox and rehabilitation programs
Detox and rehabilitation programs can assist people to stop or reduce drug or alcohol dependence. Programs can involve counselling and group support, residential rehabilitation, detox as well as pharmacotherapies such as methadone, buprenorphine, or naltrexone.