Some guys don’t use condoms all the time and use other methods to reduce (but not eliminate) their risk of contracting or passing on HIV. Knowledge of your HIV status and that of your partners is critical (and disclosure of your HIV positive status, prior to sex, is actually required by law in NSW).
These strategies have varying degrees of effectiveness but are based on many conditions which must be met. For more advice on risk reduction strategies, use the risk calculator here.
Here is a quick overview of the strategies:
SAME STATUS OR SEROSORTING
This is just what it sounds like – you only fuck without condoms with guys who have the same HIV status as you. The thing is, you have to actually know your status and your partner’s to get it right. You can’t guess or assume with this one.
UNDETECTABLE VIRAL LOAD
This refers to the amount of virus present in a positive guy’s blood. If it is classified as ‘undetectable’, it means that the virus is still present; however it is below the level of where tests can pick it up. For HIV positive men, an undetectable viral load, sustained over six months or more, makes HIV transmission much less likely.
Find out more about undetectable here.
This is when the top pulls his cock out of his partner’s arse before cumming. It reduces the risk somewhat over NOT pulling out, however not by much. It’s a high risk strategy.
NEG TOP / POS BOTTOM
This is a relatively simple concept – the negative man tops and the positive man bottoms. While this strategy is certainly lower risk than when the pos guy does the topping, there is still a medium risk of HIV transmission.
NEGOTIATED SAFETY/RELATIONSHIP AGREEMENTS
This is when two HIV-negative men agree to limit sex without condoms to only between partners within a regular relationship. Any sex with other partners outside the relationship must be with condoms. Negotiated safety requires that both parties continue to talk, test, and trust
and to maintain a relationship agreement that reflects the mutual commitment made and incorporates any mutually agreed changes. Find out more about relationship agreements here.
PrEP (pre-exposure prophylaxis)
is an HIV prevention approach where HIV negative guys take HIV medications prior to risky sexual encounters to prevent HIV infection. As of May 2016, Truvada is licensed for PrEP in Australia by the Therapeutic Goods Administration (TGA). While this is a key development for PrEP access in Australia, PrEP is not yet available at a subsidised price through Australia’s Pharmaceutical Benefits Scheme (PBS). An application is underway for a PBS listing. In the meantime, accessing PrEP
through criteria based enrolment in the EPIC-NSW study
or personal importation remain the most affordable ways to get PrEP.
Condoms continue to provide one of the most effective barrier against HIV.
Find out more about Condoms here
To understand the level of risk involved in each of the strategies, use the Risk Calculator
From the risk reduction strategies outlined above, the following are considered safe sex, provided certain conditions are met: