HIV is a virus found in infected blood, cum, pre-cum, anal mucus, vaginal fluids and breast milk; it is passed from person to person when one of these fluids enters a person’s body and makes its way into their bloodstream. The main risks of becoming HIV positive are through unprotected fucking and sharing injecting equipment.  

Whilst being a top and bottom both carry risks for HIV, being a bottom without a condom will put you at 7 times more risk of catching HIV. 

Fucking without condoms is the main risk for sexual transmission and this risk is amplified with any sort of arse play that affects the inner lining of the anus.  This means fisting, bareback fucking, rough sex, unwashed sex toys, and prolonged fucking sessions – especially chemsex and group sex, all significantly increase the risk of contracting HIV.  All of these acts involve the possibility of broken skin, blood and cum making it an easy entry point for HIV to get inside your bloodstream.

For people living with HIV the level of the HIV virus present in cum and other bodily fluids guys can increase if there are any other STIs present. The virus can be present in genital ulcers or sores caused by STIs. Similarly for HIV negative guys having other STIs will also increase the chances of contracting HIV.

Despite current and past studies that suggest that an undetectable viral load means that a HIV positive person is 100% non infectious, we need to be cautious about what has been proved, it will probably never be possible to show with mathematical certainty that the risk of transmission from someone on successful HIV therapy is absolutely zero. In addition, this excludes situations where ART could possibly have failed in the HIV positive partner.

Seroconversion is the term used to describe the process of converting from non HIV positive to HIV positive.  Some people will develop symptoms during this period of conversion whilst others may not, so you may not even know it is happening.   During seroconversion possible symptoms may include flu like symptoms, rashes, sore throats and swollen glands.  These are common symptoms for many other illnesses and as a result are easily overlooked – that is if they are present at all.

Testing for HIV is now easier than ever.  A simple finger prick test can detect antibodies in your system which indicates that you may have acquired HIV.  With this particular type of test HIV antibodies may not be detectable for 3 months (window period).

A blood test where blood is taken directly from the vein has a shorter window period of 4 weeks.

There is no cure for HIV, however, there are treatments to help manage the virus in the body. Once detected, there are treatments that can manage and control the virus.  Being aware of the HIV diagnosis, monitoring the virus within the body and adhering to anti-viral medications will greatly reduce the chance of further damage to the immune system.  If left undetected HIV can lead to serious illness and this is why it is so important to test regularly and know your HIV status.

HIV medications can reduce the amount of the virus in a person’s body to a point where it is classed as undetectable.  It has been proven that a person who is on treatment and has an undetectable viral load is less likely to pass the virus on to a partner, however at the time of writing this could not be proven with absolute accuracy that a potential risk did not still exist.

When fucking, using condoms and water based lube is the most effective way of preventing HIV transmission.  

Recent research has proved that PEP, PrEP and TasP are also highly effective ways of stopping HIV transmission.

When sucking dick, the risks of HIV transmission are very low, as the skin inside the mouth is quite thick and saliva contains antibodies that neutralises and deactivates the virus.  It is wise to avoid swallowing or getting cum in your mouth if you have any recent dental work or any cuts or sores in your mouth as this allows direct access to your bloodstream.  Vigorous brushing or flossing can also make your gums bleed exposing you to a potential risk, so keep this in mind when getting ready for a hot hook up. If your partner cums in your mouth it does increase the risk of HIV, because HIV is in cum (it's in precum too, but in much lower amounts). The risk is still extremely low, but you should spit or swallow quickly. Stomach acid and enzymes in the esophagus kill HIV, so it’s the length of time the cum is in your mouth that’s the risky part. 

Having an STI can also increase the chances of contracting or passing on HIV, so test regularly.

You can read more about other methods of HIV prevention in the Health and Well Being section on PEP, PrEP and TasP

If you think you may have been exposed to HIV with the last 72 hours, you should access PEP immediately.

For HIV positive guys there are some extra things to be aware of about STIs.

Having your bloods done lets you know what the viral load was in your blood at the time of testing.  This is something that can change and alter with wavering health.  The blood test also does not measure the levels of viral load in your bodily fluids such as cum, pre-cum and anal mucus.

The presence of an STI can make the transmission of HIV more likely. 

Some STIs, like the hepatitis group, can be more difficult to treat for a person with HIV, whilst others such as Herpes can become more aggressive when teamed up with a weakened immune system.  Some researchers believe that syphilis can cause more neurological problems later in life – such as brain disease – in an HIV+ person compared to an HIV- one.  Co-infection with HIV and Hep C in gay men is on the rise and can be a difficult combination to treat at the same time.

Using condoms is still the best protection against most STIs but they do not protect against all the possible ways in which STIs can be transmitted.  For this reason, in addition to using condoms it is important to maintain a regular sexual health testing routine.  Even having no visible symptoms, does not necessarily mean that you are STI free.

For positive guys a good testing regime could include:

• Testing for Syphilis every 4-6 months when you get your bloods done
• A full sexual health screen at least once every year and more often if you are having a lot of sex.
• Get tested for Hep C at least once a year
• Ensure you are vaccinated for Hep A and B and that they are up to date.