Prevention is a core component of maintaining a healthy sex life. Whether it’s STI or HIV prevention, there are affordable and accessible options available for you to choose.
Condoms, dams and gloves are the most effective forms of barrier-based prevention available for STIs. Using barriers for oral, anal, vaginal or front-hole sex, fingering, fisting and for arse play helps prevent STIs from spreading.
What do they prevent?
Condoms, dams and gloves help prevent common STIs such as syphilis, chlamydia and gonorrhoea. Some STIs spread easily through oral sex and skin-to-skin contact. Using condoms for blowjobs and fucking, dams for rimming, and gloves for fingering maximises your protection against STIs. Barriers help prevent STIs but they don’t eliminate the risk. Some STIs such as crabs, scabies and meningococcal C can still spread despite using barriers.
How do you use them?
When it comes to condoms, size matters. Condoms are available in different sizes. Finding one that fits can help avoid it slipping off or breaking, and make sex more pleasurable.
After putting the condom on, applying water or silicone-based lube will help prevent them from slipping off or breaking. Oil-based lubricants are not recommended for use with condoms.
How to use a condom
Most condoms are made from latex. If you have a latex allergy, there are polyurethane, lambskin and other options available. You should check which lube works best with the condom material as some can damage them.
Condoms and Toys
STIs can spread when sharing sex toys between people. Use a fresh condom on vibrators, dildos, butt plugs and other insertable toys with each new partner. Also, wear a condom when sharing masturbation toys. Remember to clean sex toys thoroughly, especially between partners. Check the manufacturer’s information or search online for tips on cleaning sex toys.
Where can I get them?
You can buy affordable condoms from pharmacies and supermarkets. For speciality condoms or free condoms, search online or contact your local sexual health and HIV organisation.
Remember to wash your hands after handling used condoms, dams and gloves. Some STIs spread easily from fingers to other areas. Washing your hands thoroughly between sex partners after removing a used barrier helps prevent STIs.
Vaccinations are available to protect against some STIs.
Vaccinations differ in terms of how many doses you need, when you need to have them, who they are recommended for, and how much they cost.
The hepatitis A vaccination is a two-dose injection with each injection given roughly six months apart. It ranges in cost and is recommended for all guys who fuck.
The hepatitis B vaccination is a three-dose injection with each injection given over the course of 12 months. It’s free in Australia for guys who fuck and is recommended for all people living with HIV.
The HPV vaccination is a three-dose injection with each injection given over the course of six months. It ranges in cost and is recommended for all guys who fuck.
The meningococcal vaccination is a single dose injection, or for people living with HIV, a two-dose injection. It ranges in cost and is recommended for all guys who fuck.
Ask your doctor about getting vaccinated. Alternatively find a sexual health specialist or a doctor.
STI PREVENTION AND TESTING
Regular sexual health check-ups are an important part of STI prevention. Having an STI might not always come with symptoms, which means you could have an STI and not know about it. Testing helps identify if you have any STIs. If you do have any STIs, accessing treatment ensures you stay healthy and stops onward transmission.
If you have an active sex life, test every three months. If you don’t have sex or you’re in a monogamous relationship, you should still test at least once a year. It’s OK to test more than once a year because you can get some STIs in other ways besides sex, such as kissing.
TIPS FOR TRAVELLING
Heading overseas for a short holiday or an extended trip? There are a few points to consider. The following are a guide for travellers. Do your research before you go — it’s better to know the answers before you head off instead of trying to navigate a healthcare system in a foreign country, especially if you don’t speak the language.
- Your preferred condoms might not be readily available, so be sure to take plenty with you
- Check whether you can take your bottle of lube with you — there may be restrictions for travelling with large containers of liquids
- Ensure your vaccinations are up to date. STIs such as hepatitis A, hepatitis B, meningococcal C and HPV can be vaccinated against, so discuss these with your doctor
- Be conscious of local laws and culture regarding acceptable behaviour, sexuality and sexual practices, including if you’re planning to travel with sex toys
- Get a sexual health check-up before you go and then also when you come back
- Learn words in other languages to help negotiate sexual safety
- Understand whether the countries you’re visiting impose any entry restrictions for people living with HIV
- Understand whether the countries you’re visiting have any restrictions on travelling with PrEP or HIV treatment medication
When it comes to navigating international healthcare systems, it’s worth considering the following questions before travelling overseas:
- If you experience symptoms of an STI or a sexual partner has notified you, how might you access a medical service such as paying to see a doctor or sexual health clinic? Does your travel insurance policy include coverage for this?
- Is PEP available in your destination and how might you access it if needed?
- Is PrEP available in your destination and how might you access it if you needed to replace or top-up your supply?
- If you’re living with HIV, are your treatment medications available in your destination? How might you access them if you needed to replace or top-up your supply?
- Travel information and updates can be sourced from the Smartraveller website. Additionally, researching online, in travel forums or seeking advice from friends can help ensure you’re prepared for your trip.
UNDETECTABLE VIRAL LOAD (UVL)
What is viral load?
Viral load refers to the amount of HIV in someone’s body. This is measured by a blood test. The higher someone’s viral load, the greater the risk of HIV transmission occurring during unprotected sex.
What does undetectable viral load mean?
Undetectable viral load means the amount of HIV in someone’s body is so low it can no longer be detected by a test — this doesn’t mean someone is cured of HIV but it does mean the virus in their body is considered undetectable.
Having an undetectable viral load means HIV cannot be passed on during sex because there isn’t enough of the virus to enable onward transmission.
This is what’s meant by Undetectable = Untransmittable, or U=U
How does someone manage an undetectable viral load?
Nearly all people living with HIV who use treatment maintain an undetectable viral load. This is because using HIV treatment medication reduces the amount of virus in their body. This keeps them healthy and prevents onward transmission of the virus. The sooner someone starts treatment, the quicker and more likely someone can become undetectable.
What if someone’s not undetectable?
A small number of people living with HIV who use treatment as advised do not have an undetectable viral load. However, some people with low but not undetectable viral loads also cannot transmit HIV. If someone you’re fucking does not have an undetectable viral load, consider using PrEP, condoms or a combination.
How do we know it works?
Three large-scale studies looked at couples where one partner was HIV positive and using treatment, and the other was HIV negative. The results identified zero HIV transmissions between partners in the studies. Each of the studies included same-sex male couples with one study exclusively focusing on this group. After 140,000 acts of condomless sex, there were zero HIV transmissions. Researchers concluded that people living with HIV who maintain an undetectable viral load for at least six months cannot sexually transmit the virus.
Peak health organisations such as the World Health Organization (WHO), the Centers for Disease Control in the United States (CDC) and the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) endorse the message that having a sustained undetectable viral load means someone cannot sexually transmit HIV.
PRE-EXPOSURE PROPHYLAXIS (PrEP)
What is it?
PrEP stands for Pre-Exposure Prophylaxis. PrEP refers to the use of oral medication taken by people who do not have HIV to protect them against the virus.
PrEP is suitable for anyone who is at risk of HIV.
Unlike PEP, which is taken after a possible exposure, PrEP is taken before a possible exposure to HIV.
How does it work?
When HIV enters the body it attaches itself to particular cells and begins to replicate, establishing an infection. PrEP works by preventing this replication from occurring, protecting these vulnerable cells. When HIV is unable to replicate, the virus cannot establish infection and dies off.
How do I use it?
There are different ways to use PrEP. Daily PrEP offers highly effective HIV prevention all day, every day. Using daily PrEP involves taking a single pill once a day. Speak with your doctor about how to use PrEP safely as this varies depending on your gender and who you fuck.
10 Things You Need to Know About PrEP
Another way to use PrEP is during certain times when you decide you want to be protected against HIV. This is called on-demand PrEP. On-demand PrEP is only suitable for use by cisgender guys who fuck guys.
Using on-demand PrEP involves taking two pills between 2 and 24 hours before you have sex, then one pill 24 hours after the first double-dose, and then a final pill 24 hours after that. If you keep having sex during that time just keep taking your PrEP every day. After you are done having sex, keep taking PrEP for two days. As long as you end with two sex-free days there’s enough of the drug in your system to prevent HIV.
On-Demand PrEP – Thorne Harbour Health
Using daily PrEP or on-demand PrEP involves checking in with a doctor every three months for HIV and STI testing.
Consider these helpful tips when starting PrEP.
How do you access it?
The first step is to visit a doctor for a check-up and to get a prescription for PrEP. Although any doctor or sexual health nurse practitioner can prescribe PrEP, not all might know about it just yet. You can use this map to find health professionals who prescribe PrEP.
There are different options for buying PrEP. All options require a valid prescription. If you have access to Medicare, PrEP is available to buy from any Australian pharmacy as a government subsidised medicine through the Pharmaceutical Benefits Scheme (PBS). Whether you do or don’t have access to Medicare, you can import PrEP from an online pharmacy, which may be a more affordable option.
You can discover more about ordering PrEP from an online pharmacy under the Australian government’s personal importation scheme.
POST-EXPOSURE PROPHYLAXIS (PEP)
What is it?
PEP is a 28-day course of medication that can help prevent you from getting HIV after a possible exposure.
How does it work?
When HIV enters the body it attaches itself to particular cells and begins to replicate, establishing an infection. This process can take a few days. PEP works by helping prevent this replication from occurring, protecting these vulnerable cells. When HIV is unable to replicate, the virus cannot establish infection and dies off. For PEP to stand a chance of working, you must act fast.
How do I use it?
PEP is best started within 72 hours of being exposed to HIV and the quicker after exposure the better. You then continue to take PEP once a day, every day for the next 28 days.
PEP can help protect you against HIV after a condom slips or breaks, if you have condomless sex with someone whose HIV status you don’t know, or if you’ve been unable to use on-demand PrEP as advised.
Once you have completed the full course of PEP, check in with your doctor for an HIV test. It’s recommended to check in again two months later for another HIV test.
How do I access it?
You can get PEP from emergency departments, sexual health centres and some doctors. Not all doctors or emergency departments might know about PEP. Visit the Get PEP website for more information or call your local state/territory PEP hotline (if available) to speak with someone about accessing PEP.
- New South Wales PEP Hotline: 1800 737 669 (1800 PEP NOW)
- Queensland PEP Hotline: 13 43 25 84 (13 HEALTH)
- South Australia PEP Hotline: 1800 022 226
- Tasmania PEP Hotline: 1800 675 859
- Victoria PEP Hotline: 1800 889 887
- Western Australia PEP Hotline: 1300 767 161
Is it for me?
If you’ve been exposed to HIV, either through anal, vaginal or front-hole sex, or by sharing injecting equipment, PEP could be right for you. If you have used PEP in the past 12 months discuss with your doctor if PrEP might be right for you.
What is it?
A condom is a physical barrier worn on your or someone else’s cock while fucking. Using condoms prevents HIV and helps prevent some other STIs.
How does it work?
Condoms work as barriers that prevent bodily fluids transferring from one person to another during sex. HIV and some other STIs may be present in some bodily fluids. Condoms only work when used correctly every time you have sex.
How do I use it?
Condoms are worn on your or someone else’s cock while fucking and then removed afterwards. To use a condom correctly, you need to know the right way to put one on and take one off. Check out this video for more information.
How to use a condom – New Zealand AIDS Foundation
How do I get them?
You can get condoms from pharmacies, supermarkets, sexual health centres, and some HIV/AIDS organisations.
Are they for me?
Condoms have been the backbone of HIV prevention for nearly 40 years. They’re widely available, affordable and fully compatible for use with all other HIV prevention methods. Using condoms correctly every time for all types of sex is also the best form of STI prevention currently available.
While condoms are typically reliable, they can sometimes slip or break. If this happens, or if a condom doesn’t get used, know about PEP for helping prevent HIV when it’s needed.
If you don’t use condoms every time you have sex, discuss with your doctor if PrEP could be right for you.