What is HIV?
The Human Immunodeficiency Virus (HIV) attacks the immune system-the body's defence against illnesses. People with HIV are said to be HIV Positive (HIV+). It is possible for people to have HIV for many years and remain well.
There are many treatments for HIV, but no cure. Once a person is diagnosed with HIV, they will have HIV for the rest of their life.
What is AIDS?
A person is said to have Acquired Immune Deficiency Syndrome (AIDS) when they have an illness or condition as a result of HIV weakening their immune system. Such illnesses are called Opportunistic Infections. They are caused by viruses and bacteria that most of us already have and that are usually controlled by a strong immune system.
HIV weakens the immune system by targeting a cell called a CD4 cell (also called T4 or 'helper' cells). The CD4 cells are a vital part of the body's immune system. The CD4 cells tell other cells of the immune system what to do when an invading organism, germ or cancer is found in the body. As HIV kills off the CD4 cells the body is less able to fight off other, opportunistic infections.
Getting HIV
How do you get HIV?
You CAN get HIV from: Having unsafe sex: this is anal or vaginal sex - fucking or being fucked - without using condoms and a water-based lubricant;
Sharing injecting equipment
You CANNOT get HIV from...
- Casual contact such as sharing drinking glasses or cutlery, or from sitting on a toilet seat
- Body contact such as hugging, cuddling, massaging or kissing;
- Having sex using a condom and water-based lube (unless it breaks)
How is HIV passed on?
Only body fluids such as cum (including pre-cum), blood and vaginal fluids can pass on the virus. Saliva does not pass on HIV. For a person to be infected three things have to happen:
1. There has to be HIV in the cum, blood or vaginal fluid
2. There has to be enough HIV in the body fluid to cause infection
3. The infected body fluid has to get into another person’s bloodstream
Without these three things happening HIV CANNOT be passed on.
How does a person know if they have HIV?
Many people experience no physical symptoms when they first become infected with HIV and consequently have absolutely no idea that they are HIV positive until they have an HIV test, or develop AIDS related illnesses months or even years later. Other people however do experience a range of symptoms soon after exposure to HIV. This is known as seroconversion illness. The symptoms can include: prolonged fever (4 – 14 days) and aching limbs, red blotchy rash over the trunk, sore throat, ulceration in the mouth or genitals, diarrhoea, severe headaches and sensitivity to light.
Of course, these symptoms may be the result of other infections - flu, glandular fever, tonsillitis and a serious herpes attack have similar symptoms to those reported in seroconversion illness – and do not in themselves indicate that you have become HIV positive. If you have any reason to think that HIV infection is possible (such as an unsafe sexual encounter ), getting tested for HIV is the only way to find out for certain.
This material adapted from information at www.aidsmap.com. For more information about seroconversion illness, visit: www.aidsmap.com and enter keyword: seroconversion.
How does cum, blood or vaginal fluids get into the bloodstream?
The two main ways that cum, blood or vaginal fluids can enter your body are:
1. having anal or vaginal sex without using a condom and water-based lubricant. You can get HIV whether you are the person fucking or the person being fucked.
2. sharing injecting equipment such as syringes.
How can I know what a sexual partner’s HIV status is?
Many people ask, assume or try to guess whether their sexual partner is HIV positive or HIV negative so they can decide whether or not to use condoms with them. However, you cannot know someone is HIV negative just by asking them, or just by looking at them, by where and how you met them, or by whether or not they are expecting to use condoms when you have sex.
It is impossible to be completely sure that a casual sex partner is HIV negative, even if they tell you they are. For example: if a casual partner is prepared to have unprotected anal sex with you because you both believe you’re HIV negative, he could be HIV positive from the last time he had unprotected anal sex, if he incorrectly believed that sexual partner was HIV negative.
Another example: a sex partner might tell you – and believe – he is HIV negative because that’s what his last HIV test result told him – but how long ago was the test, what has he done since then and how well does he understand and practice safe sex?
Many men who assume they are HIV negative expect sex partners to tell them if they’re HIV positive, before they have sex together. Some HIV positive men do tell their casual sex partners their HIV status but many don’t. Think about it, if you were HIV positive, would you trust a complete stranger to respect your confidentiality and not tell other people your HIV status? Many HIV positive men are also reluctant to reveal their HIV status because they have had bad reactions from would-be sex partners in the past.
The safe way to have casual sex is to assume that everyone is positive and to use condoms and water-based lubricant. If you have casual sex it’s likely that one or more of your partners over time will be HIV positive. Using condoms means it doesn’t matter what your partner’s HIV status is, which means you don’t need to talk about it.
However, if a would-be sex-partner tells you they are HIV positive and you realise you don’t feel comfortable having sex with someone you know to be HIV positive, even with condoms, you should respect his feelings as well as your own. It is important that you tell him so considerately rather than simply walking off or saying something to make him feel bad.
Many men who assume they’re HIV negative think that if a casual sex partner doesn’t mention or use condoms they must be HIV negative - because they have nothing to pass on during sex. However, many HIV positive men assume that if their casual sex partner doesn’t mention or use condoms they must be HIV positive too – because they must have it already if they’re not taking precautions. As Clint says in his story on this site: assumptions are the mother of all fuck-ups!
The only way to know if a sexual partner is HIV positive or HIV negative is to get HIV tests together in the process known as ‘negotiated safety’ or ‘The Four T’s’ (see ‘fucking without condoms’ below). This process is only suitable for a relationship with an ongoing partner.
Having regular HIV tests – and tests for other STIs - is the best way to know and preserve your own HIV status.
Does it matter if I get HIV?
Before anti-HIV medications were developed, in 1996, getting HIV was in most cases a death sentence. Today being HIV positive is a manageable condition and many HIV positive people today live active and successful lives. So, does this mean that getting HIV these days is no big deal? No! Being HIV positive is still a chronic health condition that can impact on your day-to-day life in the following ways:
Short and long-term side effects of the HIV treatment drugs range from nausea and diarrhoea, to the moving and wasting of fat deposits around the body (lipodystrophy).
Discrimination and ignorance still affect HIV positive people in their personal and professional lives.
Sexual negotiation – how will you avoid passing the virus on to others?
Travel – some countries do not accept HIV+ visitors and travelling with HIV medications can be a real hassle.
The impact of other sexually transmitted infections such as syphilis are much greater if you’re HIV positive.
For more information about these points visit the National Association of People Living With HIV/AIDS website at: www.napwa.org.au or talk to someone who’s HIV positive about it!
Viral load
Viral load is the actual amount or measurement of HIV in a person's blood. A high viral load means that a person has a lot of the virus in their body and is highly infectious. A low or undetectable viral load means that a person has very little of the virus in their body – usually because they are taking anti-HIV drugs to suppress the virus. However, an undetectable viral load doesn’t mean that person has NO HIV in their body, only that they have less HIV than the viral load test is able to detect.
When a person is first infected with HIV, the amount of virus in their body is extremely high, as their body has not yet developed any natural defences against it. When a person first becomes HIV positive they are more likely to pass the virus on to others – not only because of their high viral load but also because they may still test HIV negative and may therefore mistakenly think they pose no risk to others.
Viral load fluctuates throughout the course of infection and varies among different people. It is highest when a person is first infected and also if their immune system is eventually overwhelmed by HIV and they develop full-blown AIDS.
Using condoms
Using condoms with a water-based lubricant is the best way to reduce your risk of getting or passing on HIV and other STIs. Condom use may not come easily at first so try experimenting with them before using them for sex. Here are some tips for using condoms correctly:
- Find a brand and size that suits you.
- Get used to how they feel: try wanking with them on.
- Put the condom on before you start to fuck, not just before you're about to cum.
- Try not to use your teeth to open the condom packet and remove the condom carefully so you don’t tear it.
- Before you unroll the condom make sure it’s the right way round and not inside out, or you will have trouble trying to unroll it.
- Squeeze the air out of the tip of the condom (by holding it between two fingers) as you roll it on your cock. This leaves room for cum, minimising the risk of breakages.
- Roll the condom right down to the base of the cock.
- Use water-based lube such as KY jelly, Wet Stuff, Glyde or Lubafax on the condom and in the arse. Oil-based lubes (like Vaseline, Baby Oil, hand creams, Intensive Care etc) weaken the latex of the condom and can cause it to break. Saliva (spit) is insufficiently lubricating and should NOT be used as a lubricant.
- Stop occasionally to relubricate and check the condom hasn’t broken.
- When you pull out, hold onto the base of the condom so it doesn't slip off.
- Never re-use a condom. Dispose of used condoms (bin, don’t flush!)
- Don’t use someone else's cum as a lubricant on your cock. It can enter the tip of the cock, or through small abrasions. This can allow HIV to be passed into the bloodstream.
- Ultra-thin condoms are made for vaginal sex. Anal sex puts more stress on condoms than vaginal sex so ultra-thin condoms are more likely to break.
- Avoid using out-of-date condoms: check the use by date on the packet.
- Be sure to buy condoms made to Australian standards: check the outside of the pack for the Australian Standards logo.
- Never leave condoms out in the sun, near any sharp objects that might damage them, or in the glove box of your car or wallet for prolonged periods.
- Don't store your condoms near extreme heat or cold.
Condom size
A certain number of condom breakages occur because of people wearing the wrong size condom. Condoms that are too big or too small can lead to tearing. The size that really matters is diameter, not length.
At least one condom brand (Glyde) produces condoms that come in three sizes, based on the diameter of the unrolled condoms. The smallest size (usually sold as ‘Average’) is 49mm; medium-sized condoms (usually sold as ‘Large’) are 53mm; and the next size up (‘Extra Large’) is 56mm across.
Kissing and cuddling
HIV cannot be spread by spit (saliva). HIV cannot be spread by kissing or cuddling.
Wanking
HIV is NOT passed on by:
Wanking, yourself or someone else;
Massage, body stroking and licking;
Cumming on somebody.
Oral Sex
There are a number of documented case reports that confirm that HIV transmission can occur during oral sex between men. In most cases of HIV transmission as a result of oral sex the HIV is passed from the person being sucked to the person sucking. We don’t know the exact risk of HIV transmission through oral sex but it does not occur very often – anal sex remains by far the highest risk sexual activity for transmitting HIV.
The risk of HIV transmission during oral sex increases if:
The person being sucked has a high viral load
He comes in your mouth
The person sucking has cuts or sores in their mouth that can allow HIV to enter their body There are a number of factors that make it more likely that tears will occur in your mouth during oral sex or that tears already exist. These are:
Oral lesions, particularly those caused by STIs
Ulcers (which can be more common in people with HIV
Brushing or flossing your teeth within two hours of oral sex
Eating abrasive or spicy foods
Dental disease
Recent dental treatment
Gingivitis (inflamed or bleeding gums)
Certain prescribed and non-prescribed drugs that irritate oral tissues (including amphetamines)
Allergies
Trauma
Piercings
Oral herpes
Rough or very vigorous oral sex There are things you can do to make tears occurring in your mouth during oral sex less likely.
Avoid oral sex if you have:
eaten in the last couple of hours
recently brushed your teeth
currently have any conditions in the mouth such as ulcers, herpes or gingivitis (see above)
Gargle with salty water to see if any stinging occurs. If it does, it is likely you have cuts in the mouth.
Have regular dental check-ups and maintain good oral health. (Avoid oral sex for a day after dental visits if necessary)
Have regular STI check-ups, including the mouth.
The only ways to completely remove the risk of HIV transmission during oral sex is to use a condom or have oral sex with someone whose HIV status is the same as yours
Bottom or passive partner
Being fucked up your arse by another guy's cock without a condom is the most likely way of getting HIV, unless you know for a fact that your partner is HIV negative (see ‘fucking without condoms’ below). Cum that carries HIV can easily cause infection through the lining of the arse and through small cuts or abrasions that occur during fucking. Having your sex partner use a condom with a water-based lubricant is the best way to reduce the risk of getting or passing on HIV and other STIs. Top or active partner
Many men think that they won’t get HIV when fucking without a condom if they are the person doing the fucking, but they are wrong. While the risk of HIV transmission during unprotected anal sex is not as high for the top (i.e. the person doing the fucking) as it is for the bottom (i.e. the person being fucked) there are large numbers of men who have become HIV positive as the top or active partner during unprotected anal sex.
HIV can enter the cock through the opening at the tip (the meatus) or through cuts or scratches on the cock. Reduce the risk of getting or passing on HIV and other STIs by using a condom and water-based lubricant.
Making anal sex safer
Always use a latex condom and plenty of water-based lube (like K-Y, Wet Stuff, or Glyde).
Never use oil-based lubricants (like Baby Oil, Vaseline or Crisco). These lubricants can weaken the condom, causing it to break.
If you use sex toys (e.g. dildos, butt plugs), putting a latex condom on them and replacing the condom with a new one for each partner will help reduce risk. Also, be sure to wash sex toys thoroughly with soap and hot water before sharing. Sex toys that are shared and not cleaned can transmit STIs.
Withdrawal
Withdrawal (pulling out before cumming) does not protect your partner from getting HIV. If you're an HIV positive guy who likes to fuck, you can pass on HIV through your pre-cum, even if you pull your cock out of his arse before you cum. (Pre-cum is the sticky lubricating fluid that seeps from your cock during arousal).
The HIV antibody test
The test that doctors use to find out whether or not you have HIV is called the HIV antibody test. This is because the test detects HIV antibodies, which are produced in reaction to the virus by the body’s natural defence system, rather than detecting the virus itself. A small amount of blood is taken by the doctor and sent to a lab for analysis.
As it takes the body between two and eight weeks to produce the HIV antibodies that show up on a test, you need to wait that long after any possible HIV risk event (for example, an episode of unsafe sex) before having an HIV test in order for the results to be accurate. This two-to-eight week period is known as the ‘window period’. (See Glenn’s story on this site for an example of an HIV test that came back negative because he had the test immediately after the incident that made him HIV positive).
Deciding on having a test
When you go for an HIV test it is important to have counselling before AND after the test; this is called pre and post-test counselling. In Victoria this counselling is required by law and must happen in person. Pre-test counselling will help you to decide whether or not you need to have a test. The doctor, counsellor or nurse will talk to you about:
• What the test is for;
• What it would mean if the test were either positive or negative;
• Safe sex and safe injecting;
• How to get support during the waiting time.
Remember, the decision about whether or not to have a test is yours.
Getting support
Before taking a test, you might want to think about telling one or two friends so that you have some support. Think about who you might tell: it's a good idea NOT to tell everyone you know, otherwise they all might want to know the result. When you do tell people that you are taking the test, or telling them the test results, be very clear about whether or not they can tell other people.
when you get your results
By law, your test results can only be given to you in person and accompanied by post-test counselling.
If you test HIV+
If you test HIV+, the doctor, counsellor or nurse can help you consider the following issues:
• Coping with the diagnosis
• The effect on family and friends
• Who to tell?
• Possible discrimination by employers, doctors, dentists or others
• What support is available?
• What treatment options are available to you?
You may also be asked to help contact your past and present sex partners. Someone will be available to help you do this confidentially.
Staying healthy if you are HIV+
Regular monitoring of your health can help your doctor suggest treatment options that can minimise the progress of HIV in your body, preventing illness. Regular checks provide you with the option of making informed choices, planning ahead and feeling in control. Knowing you're HIV positive can help you make choices to avoid other risks to your health, including other STIs. For information and support contact People Living With HIV/AIDS, Victoria on 9865 6772
If you test HIV negative
If you test HIV negative, during post-test counselling the doctor, counsellor or nurse can help you consider the following issues:
• Were you involved in risk-taking behaviour that made you need to take the test in the first place?
• If so, what can you do to make sure you stay HIV negative from now on?
Fucking without condoms
Using condoms remains the safest way of having anal sex, but if you are in a sexual relationship and you and your partner want to fuck without condoms there is a process called ‘negotiated safety’ or ‘The Four T’s’ that you can your partner can undergo in order to minimise the risk of not using condoms with each other. The first step is to both get tested for HIV. See ‘negotiated safety’ in the relationships menu for more information.
If one of you is HIV Positive and the other is HIV Negative
If you and your sexual partner get tested for HIV and one of the test results comes back positive, it doesn't have to mean the end of the relationship, but it does mean that you should be using condoms. Fucking without condoms between an HIV positive and an HIV negative person is very risky sex. Remember, both the person being fucked (the bottom) and the person doing the fucking (the top) can pass on HIV to each other.
The VAC/GMHC Counselling Services offer helpful single-person and couples counselling for men who have a different HIV status to their partner. Counselling Services also run ‘Negative Partners’, a support group for HIV negative partners of HIV positive men. For information contact the VAC (03 9865 6700) and ask to speak to Counselling Services.
Call the VAC (03 9865 6700) and ask for a copy of the 'Opposites Attract' booklet, an excellent guide for HIV negative partners of HIV positive men.
If both of you are HIV Positive
Many HIV positive men choose not to use condoms when having sex with other HIV positive men, as there is obviously no risk of making their partner HIV positive. However, there is some risk of giving your sexual partner a different strain of HIV than the one they already have. This is called ‘superinfection’ or ‘cross-infection’.
Although it has been difficult to establish how common superinfection is, we do know that it happens and that it can be harmful, leading to increases in viral load and decreases in CD4 count. This is because the superinfecting virus may be either a more virulent (‘stronger’) type of HIV or it may be resistant to one or more anti-HIV drugs. For a fact sheet about superinfection visit the website of the National Association of People Living With HIV/AIDS (NAPWA): www.napwa.org.au
Fucking without condoms also puts HIV positive men at greater risk of contracting other STIs. HIV positive men need to be particularly careful as the impact of other STIs on their health can be much greater than for HIV negative men. For more information about superinfection risks for HIV positive men go to: http://www.napwa.org.au/index.php?q=node/108
Post-Exposure Prophylaxis (P.E.P.)
Post-Exposure Prophylaxis (PEP) is a month-long drug treatment you can take if you think you have been exposed to HIV. In most cases PEP will stop HIV from taking hold in the body IF the treatment is begin within 72 HOURS of the event that caused the HIV infection.
The most common reasons why people need PEP are:
• having unprotected anal or vaginal sex with someone they know or think might be HIV positive.
• sharing needles or other injecting equipment with someone they know or think might be HIV positive.
If you think you have just been exposed to HIV you can access PEP the following ways:
• Call the PEP hotline on 1800 889 887. You can talk to a nurse who will assess your risk and, if necessary, make arrangements for treatment.
• Visit the PEP website at www.getpep.info and click on: “DO YOU NEED PEP NOW?” This section provides addresses and contact numbers for clinics and hospitals that offer PEP and other helpful information.
Don’t wait until you need it to find out about PEP: visit the PEP website at www.getpep.info and click on: “WANT TO LEARN MORE?”
Warning: PEP is not a morning after pill; it is a last resort. The drugs used are highly toxic and, as Ethan, Frank and others who have taken it explain in their stories on this website, they can cause unpleasant side effects including headaches, nausea and diarrhoea.
Drugs and alcohol
Many men use drugs and/or alcohol to make them less inhibited during sex. However, if you are using drugs or alcohol, you need to be careful that they don’t affect your ability to take care of yourself in sexual situations, especially when it comes to protecting yourself or others from HIV.
If you regularly combine drug or alcohol use with sex it is a good idea to make decisions before using drugs or alcohol about what you will and won’t do during sex. This will make it easier for you to stick to these decisions during sex rather than having to make snap decisions on the spur of the moment.
Making sure, before you leave home, that you've always got condoms and water-based lubricant with you (and clean fits, if you’re planning to use injected drugs) will make it easier to stick to your decisions about what you want to do.
Vaginal sex
HIV is found in both cum and vaginal fluid, and can be passed on during vaginal sex. If you're having sex with a woman, use a condom with a water-based lube when fucking.
HIV is unlikely to be passed on during oral sex if you are going down on a woman, although the risk increases if there is any menstrual blood. If there are cuts or sores in your mouth, a dental dam or sheets of clear non-microwaveable food wrap can be used to protect against HIV being passed on.
Contact details
VAC/GMHC
6 Claremont Street
South Yarra, 3141
Counselling Services, Health Promotion Team, Condom & Lube sales
Phone - 9865 6700
Fax - 9826 2700
Freecall - 1800 134 840
TTY - 9827 3733
Positive Living Centre
HIV Services, David Williams Fund, Complementary Therapies, HIV+ Peer Support.
31-51 Commercial Road
Prahran 3181
Phone - 9863 0444
Fax - 9820 3166
Freecall - 1800 622 795
The Centre Clinics
General Practice medical clinic with STIs information, testing and counselling
Centre Clinic St Kilda
Rear 77 Fitzroy Street
St Kilda 3182
Phone - 9525 5866
Fax - 9525 3673
Centre Clinic Northcote
42 Separation Street
Northcote 3070
Phone - 9481 7155
Fax - 9482 3690
Our Website address is:
www.vicaids.asn.au
It contains links to more in-depth and updated information on many of the topics in this website as well as links to other comprehensive sites.
PLWHA Vic Inc (People Living with HIV/AIDS Victoria)
Assists PLWHA through information, advice, advocacy, support and representation.
Newsletters, forums, Speakers Bureau, Treatments Action Group, Emergency and Distress fund.
6 Claremont St
South Yarra 3141
Phone - 9865 6772/6771
Fax - 9804 7978
AIDS/Hep C LINE
Information and advice on HIV/ AIDS, hepatitis C, safer sex and sexual health. Referral to sexual health check-up sites across Victoria.
Phone - 9347 6099
Freecall - 1800 133 392
TTY - 1800 032 665
Melbourne Sexual Health Centre
STIs information, testing and counselling
Phone - 9347 0244
Freecall - 1800 032 017
TTY - 9347 8619
Directline
Needle and Syringe exchange information and referral, alcohol & drug information & counselling.
Phone - 9416 1818
Freecall - 1800 136 385
The Alfred Hospital
Commercial Road, Prahran
Phone - 9276 2000
The Royal Melbourne Hospital
Grattan Street, Parkville
Phone - 9342 7000
