Sexual pleasure can be influenced by many factors and circumstances – the kind of sex you desire, where you meet (home, online, sauna, cinema, backroom, club, pub, party), who you are with (whether having casual sex or a more intimate relationship), and whether you are drinking alcohol and/or using recreational drugs.
Whatever your sexual pleasure or desire, keep one basic principle in mind when you consider any sex act:
HIV-infected semen or blood has to enter the bloodstream of a person through an opening in the skin (or mucous membrane) for HIV to be transmitted.
Anal Sex without condoms remains the most common way HIV is passed on between two male partners, in particular if the HIV positive partner is ‘top’ (inserting).
If the HIV positive partner is ‘bottom’ (receptive), a HIV negative partner is still at risk of HIV infection if blood is present which can enter the body through the eye of the penis, or through cuts and sores if another infection is present, for example genital warts or syphilis.
Using condoms for anal sex is the best way to prevent HIV transmission and many other STIs.
Oral Sex presents a very low risk of transmitting HIV. However, if you are HIV positive and you are the ‘insertive’ partner, the risk is higher if you ejaculate into the mouth of an HIV negative partner especially if your partner has ulcers, bleeding gums and/or a sore throat.
Rough oral sex or deep-throating can cause small cuts in the lining of the throat increasing the risk. Brushing teeth can tear the flesh in the mouth causing gums to bleed also increasing the risk of infection.
Use a condom for oral sex to reduce the risk, and avoid brushing teeth before performing oral sex.
Rimming is only a risk for HIV transmission if blood is present. Rimming can be a higher risk activity for transmitting other STIs such as Hepatitis A or a gut infection like Shigella. Dental dams, or a flavoured condom cut into a square, can be used to reduce the risk by placing it over the anus for rimming.
Sex toys only present a risk of transmitting HIV and other STIs if shared and not cleaned properly (with warm water and soap). Some people use condoms on their toys and change the condom between sharing. Others prefer not to share and use only their own toys.
Fisting presents little risk of HIV transmission. Using latex gloves and plenty of lube can reduce the risks. It is safer not to engage in fisting prior to penetrative sex as this can cause bleeding and therefore increase the risk of HIV transmission during anal sex, particularly if a condom is not used.
Kissing, sucking, wanking, nipple pulling, touching, rubbing, massaging, spanking, stroking, water sports are all safe. Using hands or fingers (not shared) to penetrate the anus are also safe providing there are no cuts, sores or scratches on the hands.
Some bacterial infections, such as Shigella, that affect the gut and cause serious diarrhoea, are transmitted by getting bacteria into the mouth. Washing hands and showering can greatly reduce the risk of transmission and infection.