Protecting yourself against HIV

Reviewed by our clinical team

HIV (short for Human Immunodeficiency Virus) is a virus carried in bodily fluids that can be transmitted from one person to another during sex, or when sharing drug injecting equipment. If you get HIV and it goes undiagnosed and untreated, the virus will progressively damage your immune system until you’re unable to fight off infections. This late or advanced stage of HIV infection is also referred to as AIDS (Acquired ImmunoDeficiency Syndrome).

Thanks to advanced medical treatment, deaths related to late-stage HIV (AIDS) have become rare in the UK. In 2009 there were 19,300 deaths recorded compared to 622 deaths in 2019. If you get diagnosed with HIV in the early stages and you take your treatment, it's possible to live a long and healthy life. However, the best way to protect yourself is to avoid getting infected in the first place.

How does safe sex prevent HIV?

The human immunodeficiency virus is carried in blood, semen, vaginal fluid, breast milk and anal fluid. It’s most often spread during unprotected vaginal or anal sex ("unprotected" meaning sex without a condom or where the condom has split or come off) but it can also be spread during unprotected oral sex.

This is why it’s important to always practise safe sex. In general, if you’re having sex with a new or casual partner, and you don’t know their STI status (i.e. they haven’t recently been tested), you should use condoms and dental dams. Using lubricants can also help because they reduce friction, thereby preventing tiny cuts or tears. Sore or injured skin makes it easier for the virus to enter.

How to use condoms, dental dams and lubricant

Condoms are available for men and for women, and are the best way to protect against STIs and unwanted pregnancy. Condoms are most often used for vaginal and anal sex, but they can also be used for oral sex. 

When using condoms make sure they’re not out of date, and that don’t have any tears or breaks in them. After sex, remove the condom from the penis while it’s still erect, check that it's not leaking, tie it and throw it in the bin. If you have sex again, use a new condom. If you’re using a condom on a sex toy, put on a new one every time a new person uses that toy. Learn more here.

Dental dams are thin flexible pieces of plastic that you can put over the anus or genitals when you’re giving someone oral sex. 

Before using one, inspect it to make sure there aren’t any breaks or tears. Use a new dam each time you have sex, and for any different areas of the body. Wrap used dams in tissue and throw them in the bin. Learn more here.

Lubricant not only helps to enhance pleasure by reducing friction and dryness, it can also reduce the risk of condom breakage. Just make sure you’re using a lube that’s water-based, because oil-based products can weaken latex, the material most condoms are made from.

PrEP and PEP

How does PrEP prevent HIV?

Pre-exposure prophylaxis is a preventative treatment that can stop you from getting HIV if you have sex with someone who is HIV positive.  The tablets are taken before sex, and they block the virus if it gets into your system.

If you’re someone considered to be at high risk of HIV (e.g. your partner is HIV positive and the condom broke) you will be offered PrEP. This is available on the NHS. At the time of writing, PrEP is available from sexual health clinics in England, Scotland and Wales. In Northern Ireland, a pilot trial is running at GUM clinics.

How to take PrEP

There are two ways of taking PrEP: every day or “on demand” i.e. when you’re preparing to have sex.

When you visit a sexual health or GUM clinic to get PrEP, the doctor or nurse will talk you through your options and tell you how to take it. They will usually recommend that you do an HIV test, a full sexual health screen and a blood test to check your kidneys are working okay. It’s important to take PrEP exactly as directed, otherwise you might not be protected.

How does PEP prevent HIV?

Post-exposure prophylaxis (PEP) is different to PrEP as it’s designed to be taken after unprotected sex with an HIV-positive person who is not on treatment or whose viral load is not yet undetectable. When taken as directed, it’s almost 100% effective in preventing HIV.

PEP is a last resort. It's an emergency treatment. It must be taken as soon as possible after the unprotected sex; the latest you can take it is 3 days (72 hours) afterwards. Ideally it should be started within 24 hours. It needs to be taken for 28 days.

PEP is typically available from sexual health clinics and HIV clinics. On the weekends and out of hours you can visit your nearest A&E for help.

If you’re not sure whether you need PEP, take this online assessment on the Terrence Higgins Trust website to find out.

How to take PEP

If your doctor prescribes PEP you’ll need to start taking it within 72 hours of unprotected sex. You’ll need to take the medication as prescribed for 28 days, making sure you don’t miss a dose for more than 24 hours (4). 

How important is an early HIV diagnosis? 

Getting an early diagnosis of HIV can make a huge difference to your life expectancy  and quality of life. Once you are diagnosed with HIV, starting antiretroviral therapy (ART or HAART) straight away will usually be recommended. You'll need to take the tablets for the rest of your life, but they will stop the virus from multiplying  and damaging your immune system.

After about six months of treatment, many people will have an undetectable viral load – this means the virus won’t be damaging your immune system, and you won’t be able to pass HIV on to anyone else (5). 

Get tested for HIV with Online Doctor 

It’s really important to get tested for HIV if you think you’ve been exposed to the virus, or if you’re regularly having unprotected sex with new or casual partners.  

HIV tests are available from NHS centres like sexual health clinics, GUM clinics and GP surgeries. You can also order a quick, accurate home test kit from Online Doctor. Visit our secure online STI clinic to learn more. 

References

https://www.gov.uk/government/statistics/hiv-annual-data-tables
https://www.nhs.uk/conditions/hiv-and-aids/causes/
https://www.nhs.uk/conditions/hiv-and-aids/prevention/
https://www.tht.org.uk/hiv-and-sexual-health/prep-pre-exposure-prophylaxis
https://www.tht.org.uk/hiv-and-sexual-health/pep-post-exposure-prophylaxis-hiv
https://www.tht.org.uk/hiv-and-sexual-health/living-well-hiv/hiv-treatment/how-hiv-treatment-works