8 Simple Steps to Prevent HIV

Know the Risks

HIV prevention starts by getting the facts straight—understanding the various modes of transmission and identifying which activities place you, as an individual, at risk.

Start with knowing the basics:

• HIV is spread by intimate contact with semen, preseminal fluid ("pre-cum"), blood, vaginal fluid, rectal fluid, and breast milk.
• HIV is mainly spread through anal sex, vaginal sex, and shared needles.
• HIV can also be spread from mother to child during pregnancy or breastfeeding, or through occupational exposure (such as a needlestick injury).
• HIV cannot be spread by touching, kissing, mosquitos, shared utensils, toilets, sinks, drinking fountains, spitting, or touching body fluids.

Take PrEP

HIV pre-exposure prophylaxis (PrEP) is a prevention strategy in which a daily dose of HIV medications, known as antiretrovirals, can reduce your risk of getting HIV by as much as 99%.

Apretude is a newer PrEP option that does not involve taking a daily pill. It is given as an injection administered every two months to the uninfected partner and has been shown to greatly reduce infection risk.

According to the Centers for Disease Control and Prevention (CDC), all individuals who are sexually active adults and adolescents should be educated about PrEP. PrEP is recommended for anyone more likely to be diagnosed with HIV, including people in serodiscordant relationships when their partner's viral load is detectable or unknown; people with one of more sexual partners of unknown HIV status; and people who have had a bacterial STI in the past six months.

PrEP can be used by anyone at risk of HIV who wants to reduce their odds of infection.

Get and Stay Undetectable

Undetectable = untransmissible (U=U) is an evidence-based strategy in which people with an undetectable viral load cannot pass the virus to others.

A viral load is a measurement of the amount of virus in a sample of blood. Undetectable means that no virus was detected in the blood sample, which is defined as having under 200 copies of HIV per milliliter of blood.

Based on evidence from the PARTNER1 and PARTNER2 studies which ran from 2010 to 2018, you cannot pass the virus to others if you achieve and sustain an undetectable viral load.

Use Condoms

There is no reason to be lax when it comes to condoms. Short of abstinence, internal and external condoms are still the most reliable means of preventing pregnancy, HIV, and other sexually transmitted diseases (STDs). No other preventive strategy can do all three.

Preventing STDs is important because they can increase the risk of HIV by compromising delicate vaginal or anal tissues. This is not only true of STDs like syphilis that cause open sores but also any STD that causes genital inflammation.

Conceive Safely

In nearly half of all couples living with HIV, one partner is HIV-positive and the other is HIV-negative.

With advances in HIV therapy, serodiscordant couples today have a greater opportunity than ever to conceive—enabling pregnancy while minimizing the risk of transmission to a partner without HIV.

In fact, the combination of PrEP and an undetectable viral load should all but ensure protection against transmission in serodiscordant relationships.

Avoid Mother-to-Child Transmission

The prevention of mother-to-child transmission of HIV involves all stages of pregnancy. Due to the routine screening of HIV during pregnancy, mother-to-child transmission is uncommon in the United States. Even so, it still occurs.

By placing the mother on antiretroviral therapy early in the pregnancy, the risk of transmission is extremely low. Even if treatment is started later in the pregnancy, the overall risk is still less than 2%.

Since HIV can be found in breastmilk, nursing should also be avoided.

Avoid Sharing Needles

The rate of HIV among people who inject drugs (PWIDs) is high. Studies suggest that anywhere from 20% to 40% of PWIDs are infected due to the shared use of needles or syringes.

And, it's not only PWIDSs who are at risk. Their sexual partners may also be at risk, particularly if they are unaware of their partner's drug use.

Free, government-sponsored needle exchange programs are available in many states to prevent the spread of HIV and other bloodborne infections (like hepatitis C). Clean needle programs have been shown to dramatically reduce the risk of HIV among PWIDs by reducing the risk of needle sharing.

Prevent HIV After an Exposure

If you believe you have been exposed to HIV, either through condomless sex or other high-risk activities, you can take a 28-day course of HIV drugs to potentially avert the infection.

Called post-exposure prophylaxis (PEP), the strategy works best if started soon after exposure to the virus. Research has shown that PEP can reduce the risk of HIV by up to 81% if started within 72 hours. The earlier you start treatment, the better.