Having HIV can affect our feelings about sex in many different ways.

For some, it can make us anxious about passing HIV on, or we may feel less desirable. While some people go off sex altogether, others look for it more and more. Moments of intimacy and pleasure may become more important than ever.

It’s worth knowing that:

• Most people with HIV do continue to have sex and form relationships.
• Safer sex will protect both you and your sexual partner(s) from infections.
• Many people with HIV are able to have healthy children.
• To look after your own health:
• Condoms will protect you from many sexually transmitted infections.
• Some, like syphilis and hepatitis C, can be more difficult to treat when you have HIV.
• Ask the clinic about having a regular sexual health check-up.
• When choosing a contraceptive method, HIV treatments may need to be considered. Some anti-HIV drugs can interact with the pill and other hormonal contraceptives.

In terms of sex, it’s worth being clear about when there is and when there isn’t a risk of passing HIV on to someone else.

Vaginal and anal sex without condoms are the most common ways that HIV is passed on. Condoms provide an effective barrier for preventing infected fluids passing from one partner to the other during penetrative sex. Using a water based lubricant makes condoms even safer.

There is less risk of HIV being passed on during oral sex, but it does happen. If you are a man with HIV and someone sucks your penis, HIV can be transmitted – especially if you have a high viral load, or you ejaculate in their mouth.

There’s a much lower risk if you are a woman with HIV and someone performs oral sex on you.

HIV is not normally passed on through:

• vaginal sex, with condoms
• anal sex, with condoms
• someone with HIV performing oral sex on (“going down on”) someone who doesn’t have HIV
• mutual masturbation (rubbing each other’s penis, vagina or anus)
• kissing, cuddling or stroking.

People around you may be worried about getting infected with HIV. You can reassure them that there is no risk during normal social contact. No-one has ever picked up HIV from:

• sharing household items like cups, plates and cutlery
• using the same toilet
• breathing the same air as someone with HIV.

PEP (post exposure prophylaxis)

If you’re worried that you might have just passed HIV on to someone (for example if a condom broke), an emergency treatment called PEP is available. PEP is a course of anti-HIV drugs that must be started very soon after the risk has been taken – the sooner the better and definitely within 72 hours (three days). It can prevent HIV being passed on. PEP is available from HIV and sexual health clinics, and some Accident & Emergency departments.

You might have already heard about people being prosecuted for passing on HIV. While it’s important to be aware of this, you should know that so far this has only happened to less than 20 people.

In England and Wales, you could be convicted if, at the time you had sex:

• you knew you had HIV
• and you understood how HIV is transmitted
• and you had sex with someone who didn’t know you had HIV
• and you had sex without a condom
• and you transmitted HIV to that person.

But it’s not against the law simply to have ‘unsafe sex’ or to have sex without telling your partner that you have HIV. A conviction can only happen when HIV is passed on.

Thinking about going to the police?

If you are thinking of making a complaint about the person you think gave you HIV, it’s important to be aware of the possible consequences for you. It’s worth getting advice from an organisation that has experience of these situations, and giving yourself time to think through what’s best for you.

If you do go to the police, they will closely examine your sex life and may contact your previous partners. This may lead to other people finding out that you have HIV. The process can take a lot of time, and it can become difficult to withdraw a complaint.

For more information and advice, call THT Direct on 0845 12 21 200.