When it comes to HIV/AIDS, one message is worth repeating: HIV is preventable and you can protect yourself by taking a few precautions.
In 2005, Health Canada estimated that over 17,000 Canadians are living with HIV but are unaware of their status. Since many people have HIV and don't even know it, you should be aware of how you can reduce your risk of contracting the virus.
You can protect yourself against HIV/AIDS. It's simply a matter of making healthy and informed choices.
Safer Sex
What kind of sex you want to have is a personal decision. Some sex acts carry a high risk of passing on HIV. With other sex acts, it's not so clear.
Unprotected anal or vaginal intercourse is high risk. Sharing insertive sex toys is also a high risk activity. Oral sex has a lower risk.
The basic rule for having safer sex is that you don't want your blood, semen, pre-cum, vaginal or anal fluids to get into your partner's body, and you don't want any of his or her fluids to get into you.
Safer sex involves using barrier contraceptives: male condoms, female condoms, and dental dams.
The birth control pill, IUDs, vaginal rings, patches, and injections like Depo Provera can prevent pregnancy but DO NOT prevent infection by HIV or other sexually transmitted diseases. These birth control methods are not safer sex. Safer sex means a physical barrier between partners to prevent the exchange of body fluids.
You have several choices. You can choose not to have sex at all. Or you can choose to avoid oral, vaginal and anal sex and find satisfaction in other activities. If you choose to have sex, proper use of condoms (latex or polyurethane) and dental dams will reduce the risk. This is called safer sex because it reduces the risk but does not eliminate it entirely.
Since a person living with HIV does not look any different, and may not even know they have the virus, it is very important that safer sex be followed each time you have sex.
Knowing how to prevent the transmission of HIV is the first step. Making the choices and sticking with them can be difficult – but they can save your life.
Male Condoms
If used correctly and every time you have sex, condoms significantly reduce the risk of HIV and other sexually transmitted infections (STIs). However, condoms do not give 100% protection, especially if they are not used correctly or every time you have sex.
If you are having sex, make sure you use a latex or polyurethane condom. Natural membrane or animal skin condoms are not effective barriers against HIV and other STIs. If one partner has a latex allergy, polyurethane condoms can be used. Male condoms should also be put on shared sex toys that are used inside the body.
Never use 2 condoms at once, as the friction caused by two condoms rubbing against each other can cause the condoms to break.
All condom packages should carry an expiry date. Throw them away if the date has passed. Never store condoms in direct sunlight or in very warm or cold places. For example, instead of carrying condoms in a pants pocket where they may be warmed by body heat, carry them in a shirt pocket.
To use a male condom, put it on as soon as the penis gets hard. Remember that pre-cum, the fluid on the tip of a penis even before ejaculation, can transmit HIV. Pinch the tip of the condom before putting it on to squeeze the air out of the tip. Be sure to smooth down the condom well so there are no air bubbles in it. Air inside the condom can cause it to break.
It is a good idea to use lubricated condoms and/or additional water-base lubricants like K-Y Jelly or Astroglide. More lubrication makes for safer sex because it lowers the risk of tiny breaks or lesions on or inside the genitals. These microscopic tears provide an easy way for HIV to enter the bloodstream. Vaseline, hand cream, butter or anything that contains oil can cause a condom to break down and should not be used.
Condoms with spermicide are NOT recommended. Some safer sex pamphlets suggest using condoms or lubes that contain a spermicide called nonoxynol-9. However, research has shown that while it may give some protection against pregnancy, spermicide doesn't lower the risk of passing on HIV. In fact, spermicides cause skin irritation that can actually increase the risk of HIV transmission.
When you are finished having sex, take the condom off while the penis is still hard. Hold the open end of the condom, at the base of the penis, while the penis comes out. This prevents any semen from leaking out, or the condom being left in your partner.
Throw the condom out, being careful not to spill any semen. Never use a condom more than once. Never flush a condom down the toilet. Always wash your hands with soap and water before returning to your partner.
Female Condoms
If used correctly and every time you have sex, condoms significantly reduce the risk of HIV and other sexually transmitted infections (STIs). However, condoms do not give 100% protection, especially if they are not used correctly or every time you have sex.
A female condom is a thin piece of polyurethane that acts like a loose lining inside the vagina. There are two flexible rings on either end to help keep the condom in place.
To use a female condom, squeeze the inner ring and simply push gently inside the vagina with your finger, as if inserting a tampon. Push the condom in as far as it will go; the inner ring will stop at the cervix and can not accidentally pass into the body. The outer ring remains outside the body and covers the labia. Make sure the condom is not twisted. The female condom can be inserted up to 8 hours before intercourse.
After ejaculation and before standing up, take the condom by the outer ring and gently twist as you remove it from the vagina, being careful not to spill the fluids inside. Female condoms should be used only once and thrown in the garbage after use.
Do NOT use a male and female condom at the same time. This increases the risk of slipping or breaking. Female condoms are recommended for vaginal sex only.
Dental Dams
If used correctly and every time you have sex, condoms significantly reduce the risk of HIV and other sexually transmitted infections (STIs). However, condoms do not give 100% protection, especially if they are not used correctly or every time you have sex.
If used correctly and every time you have sex, dental dams can significantly reduce the risk of HIV and other sexually transmitted infections (STIs). However, dental dams do not give 100% protection, especially if they are not used correctly or every time you have sex.
A dental dam is a rectangular piece of latex that can be used as a barrier during oral sex. The dam is placed over the vulva or anus and held in place during oral stimulation. A few drops of water-based lubricant can increase sensation. Be sure not to flip the dam over; you can use a pen to mark which side is which.
Dental dams can be hard to find in stores, but it is easy to make your own out of a male condom. Simply snip off the tip and open end of a condom and cut down the length. What you will have is a square piece of latex that can be used the same as a dental dam.
Just like male and female condoms, dental dams should be stored away from direct sunlight or extreme temperatures, used only once, and thrown in the garbage after use.
Safer Injecting
It is important to be as healthy and safe as possible if you are injecting drugs or steroids.
Sharing needles and works (filters, spoons, cookers, water, ties, and pipes) is a very easy way for HIV and Hepatitis C (HCV) to spread from one person to another. If you are going to inject, there are some precautions you can take to protect yourself and others from infections such as HIV and HCV.
Use a new, clean needle or rig every time you inject. You can get new needles and other resources from needle exchange programs like Safeworks. The Safeworks mobile van service can be reached 7 evening per week at (403) 850-3755. You can also visit one of the Safeworks Outreach sites listed below:
- Calgary Drop In Centre (403) 699-8216
- Centre of Hope (403) 410-1180
- Sheldon M. Chumir Health Centre (403) 955-6014
If you can't use a new needle, make sure you re-use only your own needle and rinse it after each use:
- 1. Fill the needle with fresh cold water (hot water can clog) and shake it for 30 seconds then squirt it out.
- 2. Fill the needle with full-strength bleach and shake it for at least 30 seconds then squirt it out. Repeat this using new bleach.
- 3. Fill the needle again with fresh cold water and shake it for 30 seconds then squirt it out. Repeat this to make sure you rinse out all the bleach before using the needle again.
When injecting with others, have your own needles and works. You can mark your things to make it easier to tell which are yours. Let other people know NOT to use your needles or works.
Try not to share needles or works. If you absolutely must share, always rinse the needle with bleach and fresh cold water between each use (see steps above). Bleaching isn't 100% guaranteed to kill HIV, and it is believed that bleach
DOES NOT kill HCV, but it is better than doing nothing.
Consider a drug substitution that doesn't have to be injected (i.e. smoking or taking heroin orally instead of using needles).
Wash you hands and injection site with soap and water before you shoot. Use just water or alcohol wipes if that's all you have.
Try to use a different injection site on your body each time you inject to give veins time to heal. Avoid dangerous sites on your body like the groin, thighs, breasts, wrists or neck.
Inject in as clean a place as you can find.
After you inject, recap the needle and put it in a sealed non-glass, puncture proof container like a plastic pop bottle and bring it to a needle exchange or leave it in one of the yellow drop boxes around the city. Don't dump it where someone could find it and get hurt.
Try to also practice safer sex.
For more info, check out this online resource:
- Pre.Fix: Harm Reduction for + Users
(Source: Pre.fix: Harm Reduction for + Users. Canadian AIDS Treatment Information Exchange. 2002)
Safer Piercing & Tattoos
Tattooing and body piercing are safe when done by professionals who are careful to protect their customers from infections such as HIV and Hepatitis C (HCV). However, infections are possible through unsafe body art practices. If you are thinking of getting a piercing or a tattoo, there are some things to consider.
When choosing an artist, try to get a referral from a trusted friend. Visit several shops before you make your decision. Talk to the artists and check out their portfolios. To reduce your risk of infection, make sure:
- New needles are used every time
- New ink is used and poured into new disposable cups
- New latex gloves are used
- New jewellery made of surgical steel or niobium is used
- Stud guns are not used for piercing
- Reusable equipment is sterilized properly in an autoclave
- After-care instructions are provided
- The shop is licensed and the artist is experienced
- Safety information is posted on the wall or in the waiting area
If you are going to tattoo or body pierce yourself or someone else, it is important to follow the same precautions:
- Don't share needles (or anything else you could use as a needle such as guitar strings, staples, or threads) or tattoo guns
- If you must share a tattoo gun, it should be completely cleaned with bleach and rinsed with water. It is not 100% guaranteed to kill HIV, and it is believed that bleaching DOES NOT kill HCV, but it is safer than doing nothing.
- Don't share inks and don't put used ink back in the bottle
- Always wear latex gloves when tattooing or piercing someone else
(Source: Based on How do I Know if Tattooing or Piercing will be Safe? Canadian AIDS Society. 1999)