Reducing the risk without using condoms
Condoms are an effective way of preventing transmission of HIV. There are ways of reducing the risk of HIV being passed on if you don't use condoms when you fuck but - be warned – even when you combine these methods, they will not be as safe as using condoms. These methods are not sufficient to prevent exposure to HIV and the more often that someone is exposed to HIV, the more likely it is that that person will become infected with HIV.
If you are HIV positive, and you do not tell your partner your HIV status, it is possible that you could be prosecuted for transmitting HIV if you do not use a condom, even if you have made other efforts to reduce the risk.
Have less sex
It's boring, but it's true. The more times you fuck without using a condom, and the more men you fuck with, the greater the chances you will infect someone with HIV or that he'll infect you. If you have less sex, or you have sex with fewer men, you reduce the chances that you'll have sex that can lead to HIV being passed on.
Have different kinds of sex
Some kinds of sex carry no risk of HIV transmission (wanking, rimming) and some are pretty low risk (blowjobs, especially if cum doesn't get in the mouth). Not every gay man enjoys fucking and if you don’t want to use condoms you might want to explore other less risky ways of getting your rocks off.
Sero -sorting
For HIV to be transmitted sexually, one of the partners must be HIV positive. Sero-sorting is the name given to the practise of selecting partners with the same HIV status (i.e. HIV positive men only sleep with other HIV positive men, HIV negative men only sleep with other HIV negative men). If everyone only had sex with people who had the same HIV status then there would be no increase in the number of people living with HIV.
Many HIV positive men use online dating sites, such as gaydar, to find other HIV positive men for condomless sex. For some HIV positive men, whether or not they use condoms, having sex with people who share their status removes the anxiety of infecting their partners, and makes the sex more relaxed and enjoyable. There is a risk that an HIV positive man can be reinfected with a different strain of the virus. We now know that this can happen, although we don't know how often it happens or what all the consequences are, although it is possible that reinfection with a drug resistant strain of the virus may reduce your treatment options. We do know that the transmission of drug resistant virus is decreasing in this country, partly due to more effective medications. Having sex without condoms will leave you vulnerable to other sexually transmitted infections (such as syphilis, NSU, gonorrhoea, herpes and hepatitis) which can be harder to treat in men with a compromised immune system.
If you're HIV negative and only have sex with other HIV negative men then you won't catch HIV from sex. The challenge is to be sure that the men you have sex with really are HIV negative. It is hard to know exactly how many gay men in London have HIV but most estimates range between one in eight and one in ten. While you may be able to tell that some of these men have HIV, in most cases you won’t know for sure. There are no visual signs or sexual behaviours which will always guarantee someone will be HIV positive or negative, even if you’ve guessed right in the past. There are also many reasons why someone may not know or want to tell you their status. Between a third and a quarter of HIV positive men in London do not know that they are infected and a recent anonymous survey confirmed that some men who are HIV positive believe themselves to be negative. If you are sexually active and have taken even small risks in the past, the only way to be sure of your status is to have an HIV test.
Get regular sexual health check-ups
Sexually transmitted infections make HIV positive men more infectious and HIV negative men more vulnerable to infection. It is possible to have an STI without knowing it. Fortunately most STIs can be treated so long as they are detected soon enough. How often you get checked out probably depends on how many men you have sex with, and the kind of sex that you have. An STI check up every six months is enough for most gay men. If you do have symptoms, you should get checked out straight away.
Withdrawal
Pulling out before cumming will reduce the chance of HIV transmission for the guy who’s getting fucked. There is more HIV in cum than there is in pre-cum, in terms of both the quantity of the body fluid and the concentration of HIV in that liquid. It's still possible to get infected from pre-cum, but it is less likely. It's extremely unlikely that HIV can be transmitted orally without cum getting in the mouth.
Withdrawing before cumming makes little difference to the chances of catching other sexually transmitted infections. It also makes little difference if the negative partner is the person doing the fucking.
Use plenty of lube
Whether or not you use condoms, using plenty of lube makes it less likely that HIV will be transmitted. Lots of lube when you fuck means that there is less chance of damage to your cock or arsehole which makes it safer for both of you. Both the cock and arse should be well lubed before you fuck.
If you like long fuck sessions you should reapply the lube about every 20 minutes. Water-based lubes especially, tend to dry out after 20 minutes of hard pounding.
Using plenty of lube makes little difference to the chances of catching other sexually transmitted infections.
Viral load
The lower the level of viral load that an HIV positive person has, the less infectious they will be. Viral load is the term used to describe the amount of HIV a person has in their blood and cum. People who have been diagnosed as having HIV will be encouraged to have regular blood tests. Looking at viral load in the blood helps doctors monitor an individual's progress, for example to see if the drugs are working for him. Modern anti-HIV drug therapies mean that many people with HIV have a very low, or even undetectable, viral load. Most doctors believe that viral load has a large impact on how infectious a person is. A person with a low viral load will be less likely to transmit HIV.
Unfortunately it is very difficult to know exactly what your viral load is. Viral load tests usually take more than a week to process, so by the time you get your result the information is already out of date. Viral load can alter dramatically in a short period of time, especially if you pick up any other infections, including the flu. Sexually transmitted infections can make your viral load shoot up, which will make you more infectious.
What's more, the viral load level in someone's blood isn’t the same as it is in his cum or anal mucus. In some men viral load is usually higher in their blood than in their cum, but in other men it is higher in their cum than in their blood. The prostate gland can harbour HIV, so the level of virus in a man's cum may be increased if he has recently been fucked. HIV treatments have been shown to be less effective at reducing the levels of virus in anal mucus than they are in the blood, so someone with undetectable viral in his blood may still have high levels of virus in his anal mucus. This means that there would still be considerable HIV risk from fucking a positive man without a condom if his blood viral load was low. Tests at an HIV clinic usually only measure the viral load in blood.
Be a top if you're HIV negative or a bottom if you're HIV positive
Gay men are more likely to catch HIV from being fucked (being bottom) than from fucking (being top). Men who do not have HIV have less chance of becoming infected if they do the fucking (are top). If you have HIV there is less chance of you passing it on to your partner if he fucks you.
Although there is less risk of catching HIV if you're a top, many men are infected this way. This is because there is HIV in the anal mucus of the person getting fucked which can enter the body of the person doing the fucking through his urethra. Fucking someone without a condom is riskier than giving someone a blowjob, even if they cum in your mouth.
Look after your arse
If the lining of your arse is damaged, and you get fucked without a condom, there is more chance of HIV being transmitted. The lining of the arse is very delicate and can be damaged easily, even if there are no signs of bleeding. If your arse is damaged, the body's defences will spring into action, and these are the cells that HIV infects. For this reason, fucking someone who has just been fisted, or had sex toys shoved up his arse, makes it more likely that HIV will be passed on. If you take the time to relax someone's arse before fucking them, by gently playing with them, then you are less likely to damage the lining of their arse.
Don’t use poppers
Poppers (amyl nitrate) has been linked with an increased risk of HIV transmission when guys use them whilst fucking without condoms. In one study, 80% of men who has recently become infected with HIV had used poppers compared with 58% of those who remained HIV negative. Some researchers think that this is because it can cause the blood vessels in your arse to dilate. This gives the virus a better chance of entering the bloodstream. It may also be linked to the fact that poppers can relax the arse muscles making it easier for some men to get fucked, and for longer.
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