HIV Prevention

More ways than ever...

Today there are more tools than ever to prevent HIV. This can include:

    • using condoms,
    • not sharing injection equipment, and
    • taking a pill or injectable to prevent HIV (PrEP).

Getting tested and treated for STIs can lower your chances of getting HIV. Not having sex and not injecting drugs ensure that you won’t get HIV.

Treatment is Prevention! People living with HIV who take their medicine as prescribed can become undetectable. This means they have so little virus in their body that a blood test cannot measure it. This means they cannot give HIV to a partner through sex. The Centers for Disease Control and Prevention (CDC) state there is strong evidence about treatment as prevention for other ways HIV can be transmitted. But more research is needed for these other ways. This includes breastfeeding and injection drug use.

Getting tested is the first step in getting on PrEP if you are HIV negative. Getting tested is also the first step in getting medical care. Getting into medical care is how to become virally suppressed if you are HIV positive.

Abstinence

There have been many strides in HIV prevention. However, abstinence is still the only 100% method to prevent HIV and other STIs. The longer you wait to have oral, vaginal, or anal sex, the fewer sexual partners you are likely to have in your lifetime. Having fewer partners lowers your risk of encountering a partner who has HIV or an STI.

Condoms

If used correctly, condoms are highly effective in preventing HIV and some STIs. Condoms do not provide good protection against STIs that transmit through skin-to-skin contact. Gonorrhea and chlamydia are two examples.

There are two types of condoms: male and internal (also known as female). It is important that you know how to use both correctly for your protection.

For both male and internal condoms, only one condom should be used at a time. Using more than one condom at one time increases friction. This increases the likelihood that both condoms would tear.

A new condom should be used each time a sexual encounter occurs. After using a condom, it should be properly disposed of.

Even when you use condoms the right way every time you have sex, there is still a chance of getting HIV or STIs. If you are at high risk for HIV/STIs, you may consider adding other prevention methods.

Male (External) Condoms

A male condom, also called an external condom, is a thin layer of protection that is worn over the penis during sex. It is available in different materials.

  • Condoms made of latex provide the best protection against HIV and STIs.
  • Polyurethane (plastic) condoms are a good option for those with latex allergies. However, they break more often than latex condoms.
  • Natural membrane condoms (such as lambskin) have small holes in them. They DO NOT protect against STIs or HIV.
  • Male (external) condoms do’s and don’ts

Internal Condoms

Internal (or female condoms) are thin pouches made of a thin latex product called nitrile. It can be inserted into the vagina or anus for intercourse.

  • The internal condom can be inserted up to eight hours before intercourse.
  • For vaginal sex, the inner ring should be squeezed. With the inner ring squeezed, put the inner ring and pouch inside of the vagina. After sex, twist the outer ring and carefully pull gently to remove the condom.
  • For anal sex, the inner ring should be removed before insertion.

Lubrication

Lubrication, or lube, assists with HIV and STI prevention. It can help prevent condoms from breaking and slipping. Water-based and silicone-based lube is safe to use with all condoms.

  • Oil-based lubes and products containing oils should not be used with latex condoms. This includes hand lotions, Vaseline, and Crisco. They can break down the latex and cause the condom to break.
  • It is safe to use any type of lubricant with internal/female condoms. This is because they are made of nitrile.
  • Lubricants containing nonoxynol-9 should not be used. They can irritate the lining of the vagina and anus. The irritation can increase the risk of HIV or sexually transmitted infections.
Graphic of the correct way to use a male (external) condom from the CDC

Medication

One way to prevent HIV is to take a pill or get an injection before any "high risk" activities. This includes having sex or sharing needles or other drug equipment. This preventative pill/injection is called HIV pre-exposure prophylaxis (PrEP).

Taking a medication after possibly being exposed to HIV is called PEP. PEP stands for post-exposure prophylaxis. Possible exposure could be through:

    • sex,
    • a needle stick, or
    • contact with infected blood or another body fluid.

PEP must be administered within 72 hours of a potential exposure. For more information on PrEP or PEP, visit our PrEP and PEP page.

Additionally, people who are HIV undetectable cannot give you HIV. To be undetectable, a person has to have a viral load that is so low a standard lab test cannot measure it. To prevent transmission of HIV, a person's viral load should be undetectable for six or more months in a row. This is also called treatment as prevention, or TasP.

Comprehensive Harm Reduction

People who share needles and injection equipment are at high risk for HIV and viral hepatitis. Reusing needles can also lead to harmful infections on the skin or even a heart infection.

The Virginia Harm Reduction Program (CHR) helps reduce the negative impact of drug use. Some people call CHR services needle exchange or syringe services. CHR programs provide the following services in the Commonwealth:

    • New syringes and needles
    • Disposal of used syringes
    • Referrals to drug treatment and medical care
    • Free naloxone to reverse overdoses
    • Education and counseling
    • Testing for HIV, hepatitis, and other diseases
    • Referrals to social services and insurance

If you or a loved one could benefit from CHR services, find a location near you on our website.

Expecting Mothers

If you are pregnant, it is important to talk to your healthcare provider.

If you do not know your HIV status, getting tested is important for the health of you and your baby. Ask for an HIV test and follow the recommendations of your provider. These recommendations could include PrEP if your partner is HIV-positive.

Mothers with HIV should follow guidance from their provider, including taking medications as prescribed. While breast milk contains HIV, for mothers on medication with a sustained undetectable viral load (during and after pregnancy), the risk of transmission is less than 1%, but not zero. Talk to your provider about your options.