Sexual Health

HIV and Sexual Health

Thanks to advances in HIV treatment, people living with HIV who are diagnosed early in their infection, linked to HIV medical care, and who get and stay on HIV medicine can keep the virus under control and live a long and healthy life. That can include having a safe and healthy sex life.

If you are sexually active, talk about your HIV status with your sexual partner(s) and take steps to protect your health and your partners' health.

The following actions can reduce your risk of transmitting HIV:

  • Get and stay on antiretroviral therapy (ART). ART reduces the amount of HIV in your blood and body fluids. ART can keep you healthy for many years, and greatly reduce your chance of transmitting HIV to sex partners if taken consistently and correctly. Always take your HIV medicine as directed and visit your health care provider regularly.
  • Choose less risky sexual behaviors. Oral sex is much less risky than anal or vaginal sex. Anal sex is the highest-risk sexual activity for HIV transmission. During anal sex, it is less risky for you as the HIV-positive partner to be the receptive partner (bottom) than the insertive partner (top). Sexual activities that do not involve the potential exchange of body fluids carry no risk for getting HIV (e.g., touching). Get customized information about HIV transmission risk.
  • Use condoms consistently and correctly.
  • Talk to your partner(s) about pre-exposure prophylaxis (PrEP), taking HIV medicine daily to prevent HIV infection. PrEP should be considered for HIV-negative partners who are in an ongoing sexual relationship with an HIV-positive partner. PrEP should also be considered for HIV-negative men who have had an STD or any anal sex (receptive or insertive) with a male partner without condoms in the past 6 months, and who are not in an exclusive relationship with a recently tested, HIV-negative partner.
  • Talk to your partner(s) about post-exposure prophylaxis (PEP) if you think they have had a possible exposure to HIV. An example of a possible exposure is if you have anal or vaginal sex without a condom with someone who is or may be HIV-positive, and you are HIV-negative and not taking PrEP. Your chance of exposure to HIV is lower if your HIV-positive partner is taking antiretroviral therapy (ART) consistently and correctly, especially if his/her viral load is undetectable.  Starting PEP immediately and taking it daily for 4 weeks reduces your chance of getting HIV.
  • Get tested and treated for STDs and encourage your partner(s) to do the same. If you are sexually active, get tested at least once a year. STDs can have long-term health consequences. They can also increase the chance of getting HIV or transmitting it to others. Find an STD testing site and read more below.

You should also encourage your partner(s) who are HIV-negative to get tested for HIV at least once a year so they are sure about their HIV status and can take action to keep them healthy. They may benefit from more frequent testing (e.g., every 3-6 months). Use the HIV Testing and Care Services Locator to find an HIV testing site. Also, visit our page, Mixed-Status Couples to read more about sexual relationships in which one partner is HIV-positive and the other is HIV-negative.

What Do I Need to Know About STDs?

Living healthy with HIV includes preventing other sexually transmitted diseases (STDs). An STD is an infection that’s passed from person to person through sexual contact. HIV is an example of an STD.

Other types of STDs include:

  • Chlamydia,
  • Genital herpes,
  • Gonorrhea,
  • Hepatitis B and C,
  • Human papilloma virus (HPV), and
  • Syphilis.

The only way to avoid getting other STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting other STDs:

  • Choose less risky sexual behaviors
  • Use condoms consistently and correctly
  • Reduce the number of people with whom you have sex
  • Limit or eliminate drug and alcohol use before and during sex
  • Have an honest and open talk with your health care provider and ask how frequently you should be tested for STDs.

For people living with HIV, it can be harder to treat STDs. STDs increase your viral load in your genital fluids, and some types of STDs can lower your CD4 count. Because HIV weakens the CD4 cells in the immune system, your body has a harder time fighting off STDs. This also means that if you are living with HIV and also have an STD, you may be able to transmit HIV to your partner(s) even if your viral load is undetectable. In fact, people living HIV who are also infected with another STD are 3 to 5 times as likely as others living with HIV to spread HIV through sexual contact.

It’s important for people with HIV to get tested and treated for other STDs. Being tested and treated for STDs helps you maintain good health and avoid transmitting an STD unknowingly. Encourage your partner(s) to do the same. You or your partner(s) can have an STD without having symptoms. If you have HIV and are sexually active, get tested at least once a year.

Your health care provider can offer you the best care if you discuss your sexual history openly. Locate a provider near you.

Family Planning

A person living with HIV can become a parent. But, since there is a potential to transmit HIV to an uninfected partner during conception or to the baby during pregnancy and childbirth, it is important to learn about the ways to reduce these risks and to work closely with both your partner and your healthcare provider.

Visit our Family Planning page to learn about the options for having children safely, and for preventing both pregnancy and HIV transmission if you don’t wish to become pregnant.

Talk to Your Partner

It is important to tell your intimate partner(s) about your HIV status. It’s also important to discuss your partner’s HIV status and whether either of you have any STDs.

You and your partner should determine what sexual behaviors and prevention practices are going to be used in your relationship—and outside of it if you are not exclusive. The goal of this communication is to keep you BOTH healthy and free from new infections. CDC’s Start Talking. Stop HIV. campaign has tips and resources to help you start the conversation.

Last revised: 03/30/2017