Staying Safe
HIV is transmitted via blood, semen, breast milk, or vaginal fluid-most often through unprotected sex, or via sharing dirty syringes if you use injection drugs. For sex, always use a latex condom, gloves, or a dental dam with a water-based lubricant like K-Y jelly. Having safer sex is also very important for avoiding sexually transmitted diseases (STDs), which greatly increase the risk of HIV transmission; STDs may disrupt the mucosal lining of the genital tract, making it easier for HIV to infect cells. If both you and your sexual partner are HIV positive, safer sex can help you avoid reinfection-exposure or transmission of a second HIV strain or a drug-resistant one.

Safer-Sex Tips

• What's safe? Kissing, hugging, mutual masturbation (ejaculate only on unbroken skin), "water sports" (urine on unbroken skin).
• For anal or vaginal sex, use a latex condom with a water-based lubricant such as K-Y jelly. Oil-based lubricants like Vaseline weaken condoms.
• During sex, men should pull out and avoid ejaculating inside their partner, even when using a condom. If you do come inside your partner, hold the condom during withdrawal to keep the semen from spilling out.
• If a condom breaks during sex, immediately replace it with a new one.
• Avoid oral sex if you or your partner have open cuts or sores in your mouth, on your genitals, or an active STD infection.
• For oral sex with a man, use a latex condom. Avoid taking semen in your mouth, but if you do, make sure not to swallow any.
• For oral-vaginal sex, watch for cuts or sores in your mouth and avoid menstrual blood. Consider using a dental dam (a square of latex sold at drugstores) or a condom cut in half and stretched over the vulva.
• Rimming, or oral-anal contact, is low risk for HIV transmission but high risk for parasites and hepatitis. Use a dental dam or condom cut in half.
• Always use a fresh condom with sex toys. Clean toys with soap and water after every use.

Harm Reduction

• Don't share needles; use a fresh, disposable syringe each time. Watch for needles that have been rebagged to look new.
• Avoid heavy use of alcohol or drugs that impair your judgment in sexual situations.
• It's easy to slip: Consider counseling or a support group to help you stay safe and keep negotiating harm reduction every day.