HIV PREVENTION

There are more available tools now for HIV prevention that ever before!

For three decades condoms have been the cornerstone of HIV prevention and today there are new approaches that can help prevent HIV infections. Biomedical prevention has widened the range of tools we now have available to prevent HIV, and now the prevention took kit includes;

  • Condoms
  • Post-Exposure Prophylaxis (PEP)
  • Pre-Exposure Prophylaxis (PrEP)
  • Viral Load

CONDOMS:

Condoms are a very useful way for preventing HIV and other STIs, the following tips will reduce the chances of condoms breaking or slipping off:

  • Check the date on the packet and never used condoms that are past their used by date
  • Be careful opening the packet especially if you are using your teeth as you don’t want to rip the condom
  • Hold the teat part of the condom whilst squeezing the air out of it and then place it on the head of the erect cock
  • Unroll the condom all the way to the base of the cock without stretching it.
  • Use lubrication to help prevent tearing, especially if engaging in anal sex
  • After ejaculation, hold onto the condom at the base of the cock when pulling out and gently slide the condom off your cock. 

Remember

  • Condoms are for single use only
  • There are different sized condoms so find the right size for you
  • If in a group sex situation then use a new condom for every new partner
  • If using sex toys, then put a new condom on the toy anytime it is going from one playmate to another

Where to buy condoms?

Condoms, and other safe sex products, are available from the Victorian AIDS Council, at substantially discounted prices. Condoms are available in a range of sizes to accommodate your needs. To find out more check out the safe sex products page on the VAC website here. 

POST EXPOSURE PROPHYLAXIS:

Post-Exposure Prophylaxis (PEP) is a four-week course of anti-HIV treatment drugs you can take if you think you may have been exposed to HIV through condomless sex or by sharing injecting drug equipment. PEP can, in most cases, stop HIV from establishing itself in the body and prevent you from becoming HIV-positive if the PEP treatment is begun within 72 hours of exposure to HIV and taken correctly over the next 28 days.

PEP can be a single dose pill or a combination of two, and sometimes three, anti-HIV treatment drugs that HIV-positive people take daily to minimise the virus’s ability to multiply in their body. PEP is NOT a morning after pill that makes it easy and safe to have condomless sex. You have to take these drugs every day for 28 days for it to work and these can cause unpleasant side effects such as nausea and headaches.

Once you are exposed to HIV it takes less than a week for the virus to establish itself within your body. Once it is established you will have HIV for the rest of your life. However, if you begin taking PEP in time, the anti-HIV treatment drugs prevent the HIV that is already in your body from reproducing and it dies out before it has a chance to multiply.

If you are in Victoria you should contact the PEP INFOLINE on 1800 889 887 and if you are interstate check out www.getpep.info for more information.

PRE-EXPOSURE PROPHYLAXIS:

10 Things to know about PrEP

Where can I get PrEP?

Access to PrEP in Australia is a bit more complicated than some other places around the world. In Australia there are several options for accessing PrEP, such as ordering online from overseas, enrolling in a clinical trial or having it prescribed by a local GP and accessing it locally. For more information check out prepaccessnow or prepdforchange

VIRAL LOAD:

There is some uncertainty amongst people when it comes to having sex without condoms with someone whose status is different to theirs and the associated risk of contracting and/or transmitting HIV, especially if the HIV-positive partner has a low or undetectable viral load level. This section explains what viral load means and what the concept of an undetectable viral load (UVL) means in relation to HIV risk.

What is Viral Load?

Viral load refers to the amount of HIV circulating in the blood. To find out a person’s viral load, a doctor takes a sample of blood and sends it to a laboratory where a viral load test is conducted.

When the result comes back, viral load is indicated as a number. The number indicates the amount of viral copies per millilitre of blood (written as copies/ml). Viral load can range from below 20 to over one million copies/ml. In layman’s terms, viral load refers to the amount of virus that is in the HIV-positive persons’ body.

What does undetectable mean?

An undetectable viral load level is when the level of the virus in the body is reduced to a point that it cannot be detected by current tests. This does not mean that their body is free or cured of HIV, only that there is less than the test can detect.

In fact, all HIV positive people with an undetectable viral load still have HIV in their blood, as well as in blood cells, tissue and other bodily fluids. HIV-positive people on sustained anti-HIV treatment regimes are commonly able to maintain their viral load at low or undetectable levels.

Viral Load and not using condoms

The current research has indicated that if the HIV-positive partner has a sustained undetectable viral load level and is on effective treatment their ability to transmit HIV to the negative partner is basically eliminated during sex without condoms.

The PARTNERS Study, looked at over 55,000 cases of condomless sex between straight and gay couples where one person was HIV-positive and had an UVL, and the other person was HIV-negative. They found that there were no cases of HIV transmission. This is just one of many studies regarding viral load and HIV prevention.

The body of evidence indicates that using an undetectable viral load level as a strategy is an effective way to prevent HIV transmission.

Viral Load Issues

There is one factor that can make undetectable viral load ineffective in preventing HIV transmission, and that is when the HIV-positive persons’ viral load changes rapidly as a result of their anti-HIV drugs not working effectively. This rarely happens with someone who is on an effective and sustained treatment regimen, but if you have HIV and you are on antiviral treatment it is important to have your viral load level checked regularly to ensure that it remains undetectable.