HIV Transmission

Sex

The most common routes of transmission of HIV is through unsafe sexual intercourse, sharing injecting equipment, receiving blood or blood products from an infected person and transmission from mother to baby, specifically through breastfeeding. In the UK the most common route of transmission is from unsafe sexual intercourse. Transmission from blood and blood products is uncommon since screening of blood and blood products started in 1985. Transmission from mother to baby in the UK is also becoming increasingly rare since the introduction of ante-natal HIV testing and the increased use of drug treatments for pregnant women.

Unsafe sex

When we talk about unsafe sex in terms of HIV transmission we usually mean unprotected vaginal or anal intercourse. In most cases of HIV transmission in the UK, sexual intercourse is the most common route of transmission.

If you choose to have unprotected sex then you need to understand the risks involved. Please check out our HIV Transmission principles page for more information. There is increased risk of HIV transmission if you are the receptive partner in sexual intercourse (i.e. you are having a penis put inside you).

If you are the receptive partner make sure that you use lots of water based lubrication, (lube), during intercourse as the lining of the vagina and anus are easily damaged and this damage can make it easier for HIV transmission to occur. Also make sure that you take part in lots of foreplay before penetration. Increased damage to the lining of the anus or vagina occurs when these areas are unprepared for intercourse and less relaxed.

Although the HIV virus is found in pre-cum it is better to ejaculate outside of the body, as ejaculating inside of the body increases the amount of HIV in the anus or vagina. Increasing the amount of HIV increases the risk of transmission.

If you douche make sure that you wait at least 2 hours before intercourse. Douching washes away the mucous membrane, which protects the lining of the anus/vagina.

As the insertive partner (i.e. the person who is putting their penis inside someone), you are still at risk of HIV transmission. The head of the penis is a mucous membrane and therefore acts like a sponge. HIV can be transmitted from your receptive partner to you through this method especially if the receptive partner has any internal trauma such as bleeding or small rips, cuts or sores in the anus/vagina.

Also remember that the presence of any other sexually transmitted infections (STI’s) can increase your risk of HIV transmission because the genital area is likely to be infected, inflamed or damaged. Using a condom significantly decreases your risk of HIV and STI transmission. Condoms come in all shapes and sizes now and we can help you find the one which is best for you. If you have any problems using condoms, including latex allergy or psychological barriers please contact the project for more help and advice. Remember you can order free condoms from our online ordering page.

Oral Sex

Transmission of HIV through oral sex including rimming and sucking is possible but it is not common. It is estimated that between 1% and 3% of all cases of HIV transmission are through oral sex. All of the reported cases of HIV transmission through oral sex are dependent on damaged tissue in the mouth or throat, the presence of an untreated STI in the mouth or throat, or ulceration in the genital area.

We recommend that if you are going to have oral sex and are worried about HIV transmission then you follow some straightforward tips:

  • Don’t have unprotected oral sex (without a condom) if you have mouth ulcers or bleeding gums.
  • Don’t brush your teeth or use mouthwash for 2 hours before you have oral sex.
  • Don’t have oral sex if you have just had dental work.
  • If you are worried about HIV transmission don’t let someone come in your mouth – if they do; spit don’t swallow.
  • Don’t have oral sex if the genital area you are sucking /licking is bleeding or ulcerated or has open sores.
  • Use a flavoured condom if you are worried or concerned.
  • Us Dental Dams / Oral Shields