We all need to know how HIV is transmitted and therefore how we can prevent this transmission. There is no excuse for ignorance. Semen, blood, vaginal fluids and breast milk are all potentially infectious and can contain enough of the virus to transmit it to another person. So if you are having unprotected sex, i.e. sex without a condom or a dam, then there are degrees of risk for transmission of HIV as well as other sexually transmitted infections (STIs). Don’t wait until you are in bed, in the heat of the moment before you bring up safe sex. Many people think discussing safe sex in advance is ‘unromantic’, but you have to take up the challenge of doing this with a partner because your health is paramount.

If you have been involved in a long term relationship with your partner and you wish to stop having safe sex, you can use a method known as ‘testing’ as a negotiating tool. This means that both partners agree to be tested for HIV (and other STIs) at the same time, then continue to have safe sex for a three months, which is the window period for the virus to develop to detectable levels, then be re-tested. The idea is to determine if both of you have the same HIV status. Included in this process is the need for pre and post-test counselling which is available from your local GP or sexual health clinic.

Many of the transmission areas cannot be classified as either absolutely safe or unsafe, there are many ‘grey’ areas and so it is hard to give definite answers. It is important to remember to be protected against any possibility of infection however slight. Oral sex, whether on a man or woman, is considered to be low risk, but the degree of risk is increased if there are co-factors, such as the partner who is performing oral sex having bleeding gums, ulcers or cuts in their mouth. Each of these extra factors can increase the likelihood of transmission. It is important to be aware of oral hygiene and if you are concerned about these areas it is better to use a latex barrier – either a dam, which is a square of latex you can use for oral sex with a woman or anal sex with a woman or man, or a condom if the oral sex is being done on a man.

Withdrawal as a safe sex strategy is not safe. HIV has been isolated in what has been called ‘pre-come’ which is fluid which might come out of a man’s penis prior to him ejaculating semen. So it is not recommended as a safe sex method – use a condom instead. You cannot presume by looking at anyone if they have any kind of STI, so safe sex must be a necessity for any unknown sexual partners. Many people groan at the mention of safe sex, thinking it is boring or unromantic, not just practising it, but even talking about it. Condoms come in all types of sizes, colours and textures and water-based lubricants come in many different flavours. Safe sex can actually make your sex life more interesting, playful and exciting. Worrying about whether you are getting an STI, or even HIV, is not very erotic, let alone romantic. Knowing that you are protected makes you able to be relaxed and comfortable about the sex you are having.

Kissing does not transmit HIV. Although HIV has been isolated in saliva, you would have to swallow a swimming pool full of saliva before you could get infected. The only concern is if someone was bleeding profusely from the mouth who was infected with HIV, this is an unlikely scenario. If you do not know the HIV status of the person you are having sex with and you have cuts or wounds on your hands you could cover them up with bandaids or alternatively for extra protection you could wear a latex gloves. To some people gloves may seem very clinical, but it can take on a different meaning if you make putting on the gloves an erotic, playful encounter.

Unprotected, penetrative anal sex is high risk for HIV and other unprotected sex with people who do not know their HIV status is also risky. How many people know the HIV status of the people they are having sex with? So we must develop a sexual language and confidence in order to talk about these issues. This may not be easy, especially for women, but it is empowering. For more information go to your GP, if you are confident of their knowledge and you are comfortable talking to them or you can go to a sexual health clinic and if you want specific information on HIV/AIDS contact your local AIDS Council.