Prevention


SFSEX

The only way to avoid all risk of HIV infection is to abstain from activities that can result in HIV transmission, such as sexual contact and sharing injection equipment. However, even for those who do partake in higher risk behaviors, there are many things that can reduce the risk of HIV infection.

A note about language

Within the trans community, language around bodies and gender is continually evolving. In the creation of this site, we strived to use the most current and respectful language possible. In some cases, we used traditional anatomical language such as penis and vagina (without an assumption about gender identity) to make things clear. Please keep in mind that people may use different language for their body parts than you have heard or than is listed on this site. Be respectful of each trans person’s language choice. When in doubt, ask what language is preferred. Please see the following piece by Dean Spade for more information on respectful language:
http://www.deanspade.net/wp-content/uploads/2011/02/Purportedly-Gendered...

HIV and sex

The risk of HIV infection through sexual activities can be greatly reduced through safer sex practices. ''Safer sex'' refers generally to anything that lowers the risk of contracting STDs. In common usage, this term refers to using barrier methods, such as condoms, dental dams, and gloves to prevent the exchange of bodily fluids during sex. While there is risk of failure (either through misuse or breakage) inherent for all barrier methods, this risk is extremely small if the method is used properly.

Condoms

The best condoms for preventing HIV transmission are made from latex or polyurethane. While lambskin condoms are effective in preventing pregnancy, they are not appropriate for the prevention of disease transmission, due to microscopic pores in the membrane of these condoms, which many disease-causing microbes can pass through. When using a condom, it is important to avoid using oil-based lubricants (e.g. Vaseline, baby oil, hand creams), as oil will weaken and eventually destroy latex. Instead, use water-based or silicone lubricants, as these will not destroy latex.

Click here for more information on how to use a condom.

The female or receptive partner condom

The receptive partner condom (while it is more commonly known as the female condom, we prefer receptive partner condom to avoid associations with gender) is a loose-fitting polyurethane tube fitted with soft, flexible rings at both the open and the closed ends. The receptive partner condom is inserted into the vagina/front hole or rectum prior to sex. Because it can be inserted up to several hours before intercourse, the receptive partner condom provides the receptive partner with a safer sex option under their own control that does not depend on the cooperation of the penetrating partners. Sometimes pre or non-surgical male-to-female transwomen may use receptive partner condoms on their genitals if they are no longer able to achieve erections.

Dental dams

A dental dam is a square sheet of latex or polyurethane, which is placed over the labia/front hole/transcock or the anus to prevent the exchange of bodily fluids during cunnilingus (oral-vaginal stimulation) or analingus (oral-anal stimulation). Dental dams can be found in some places where condoms are sold, but they can also be made by cutting a condom or latex glove. Plastic wrap (i.e. Saran Wrap) can be used for this purpose, as well. If you plan to use plastic wrap as a safer sex barrier, make sure that you do not use "microwaveable" plastic wrap, as this kind of plastic wrap is perforated with tiny holes which makes it permeable to infectious agents. Oftentimes taking testosterone can cause growth in a female-to-male transman’s genitals making dental dams an uncomfortable barrier for oral sex. Please see the information below on ways to alter a glove to use during oral sex with an FTM.

Gloves

Latex or nitrile gloves can be used for a variety of activities, including penetrative (vaginal/front hole/anal) sex with your hands. Gloves can also be altered to use for oral sex with transmen/FTMs/transmasculine people. To alter a glove for this purpose, cut the fingers off of the glove and then cut along the pinky side of the glove. The thumb of the glove is placed over the transman’s phallus while the rest of the glove is spread out over the labia/front hole/vaginal region.

Toys

The use of sex toys is common practice for many people. Many toys are made of silicone, glass or other non-porous materials that are easy to sterilize. Be sure to sterilize between use with different partners or use condoms for additional protection. Some toys are made from rubber or other porous materials that can never be fully sterilized. Without using condoms, bacteria can grow resulting in infections for yourself or your partner/s. Be sure to use condoms over any porous toys and consider limiting the use of those toys to only one person.

HIV and Drug Use

HIV is most easily spread by contact with infected blood, which means that sharing needles for injecting drugs, either recreational drugs or hormones, is an activity which carries a high risk for the transmission of HIV and other blood-borne infections. While it is best to use clean, unused needles (as well as other supplies, such as spoons and cotton) for each new injection, in some areas, these are difficult to come by. If unused supplies are unavailable, it is possible to clean needles and syringes with bleach to cut the risk of disease transmission.
Even though HIV can be spread directly through use of infected needles for injecting drugs, non-injection drugs (including alcohol) can increase risk factors when combined with other risk factors. A person under the influence of mind-altering substances may take risks that one might not take when sober, such as not using barrier methods during sex. If you do use recreational drugs of any kind, be wary of the ways your inhibitions may be changed while you are under the influence.

Know your HIV status

Get tested! HIV testing has become readily available, and in many places, rapid tests are available which let you know your HIV status the same day you are tested. You can request a test for HIV (as well as other sexually transmitted diseases) during a visit to a doctor's office, or in many areas, there are clinics set up at which you can get tested for HIV for free or at reduced cost.

Communication

Being physically and emotionally safe involves communicating with partners and prospective partners about ways to keep each other safe. If you are dating a trans person, be sensitive about the language they may use to talk about their bodies. Pre- and post-operative trans people may use different language to talk about their bodies that feels more gender affirming than the clinical language typically associated with those parts. For example, a transman/FTM may refer to his cock and front-hole rather than a clit or a vagina. Similarly, a transwoman/MTF may use the word clit and labia instead of penis and testicles to refer to her genitals. If you are unsure, ask your partner what language is ok for you to use.

Everyone is different: while some trans people are comfortable using their genitals during sex, some may want to use toys only. This may change depending on each situation, how safe someone feels, how familiar they are with someone, etc. Communicate openly and honestly with each other. Ask permission before trying something new to make sure the interaction stays fun and safe for everyone.

Disclosure:

Finding the right time to disclose your trans status can be anxiety provoking and challenging. There’s not just one right way to disclose this information. Some people like to disclose early on to avoid getting too attached if the person happens to react negatively. Others prefer to let someone get to know them better first in hopes that a strong connection may increase the chances of a positive response. It’s often safer for everyone involved if you disclose your trans status prior to engaging in intimate sexual activity. Surprises may catch people off guard, which unfortunately, can put a trans person at risk for physical or emotional harm.

Safe dating:

Before going on a date, take precautions to make sure you are as safe as possible:
-Talk on the phone ahead of time.
-Let a friend know whom you will be with, the address of where you will be and your expected time of return.
-Meet in a public place where there are plenty of other people around.
-Try to meet in a place that is familiar for you.
-If you feel unsafe at any time for any reason, listen to your gut and get yourself out of the situation. --Never go home with someone you feel uncomfortable with.
-Have a back up. Ask a friend to call or text to check up on you during the date.
-Keep it time limited. If you’re not having a good time, you’ll be able to leave and you won’t have to go on a second date.