Attending the Brownlee Centre for HIV care there will be many opportunities to talk about your health and HIV treatment. However, you may wish to discuss other issues such as sex, relationships, condoms, or telling a partner about your diagnosis, but may not find there is the time or the opportunity to do so with your doctor.
Here are some of the areas that we can help with:
Using condoms when having penetrative sex (anal or vaginal) is the best way to significantly reduce the risks of HIV transmission. We now have lots of information available that condoms, used correctly and consistently, can prevent passing on HIV and just as importantly other sexually transmitted infections.
Using a water-based or silicon-based lube makes anal sex safe for both the insertive (top) and the receptive (bottom) partner. Using lubricant is not recommended for vaginal sex.
You can pick up a wide variety of condoms and lube completely free from a range of services and pharmacies. For more information see the Free Condoms Glasgow website.
Lower risk sex:
There are some sexual activities that carry little or no risks of passing on HIV. For example oral sex (mouth to genital contact) is very low risk in terms of HIV transmission, as long as the mouth is healthy and no other infections are present. Activities such as kissing, hugging, touching or stroking, mutual masturbation, and rimming (tongue to anus contact) carry no risk of HIV transmission.
The risk of other sexually transmitted infections needs to be considered, particularly through oral sex.
Undetectable viral load:
The information you get from your test results and discussions with your doctor about your viral load can help inform your choices around having sex. If your viral load has been undetectable for several months and you continue to take your anti-HIV drugs correctly without problems, the risks of HIV transmission during unprotected penetrative sex (anal or vaginal) is much reduced.
However not everyone is in agreement about how much the risk is reduced. Risks of other sexually transmitted infections and pregnancy issues also need to be considered when having unprotected sex.
You should discuss your Viral Load with your doctor or Sexual Health Adviser before making any decisions. More information on this is available from the National AIDS Manual (NAM) website.
What if my partner is HIV positive too?
It may seem obvious to think that if your sexual partner is HIV positive then there is no need to consider how you have sex together. This is not quite true. Apart from the risks of other sexually transmitted infections, the concern is the possibility of infection with more than one strain of HIV - or superinfection.
This could mean for example it is less likely to achieve undetectable viral load with anti-HIV drugs but the implications of this for your future health are not clear and not everyone is in agreement about the effects of this. Another concern is resistance to anti-HIV drugs being passed from person to person.
Re-infection or superinfection is less likely if you both have an undetectable viral load.
If this issue affects you it may be helpful to talk this through with your doctor at the Brownlee.
Some information about this is available on the Terrence Higgins Trust website.