HIV/Aids

Infection

HIV can be transmitted during sex between men if infectious blood or semen comes into contact with the relevant mucous membranes (intestines or penis) or enters open wounds. Other bodily fluids such as saliva, sweat or urine are not infectious. As the penis, with its sensitive glans, rubs intensely against the anal mucous membrane during sex, both the active and passive partners can become infected with HIV from each other. Condoms offer protection in this situation. You should wear gloves when fisting. This also protects against hepatitis C.

The risk of infection during oral sex is very low, provided no semen enters the mouth or throat. Pre-ejaculate poses no risk due to its low viral concentration.

Speaking of risk: it is impossible to predict exactly how likely you are to contract HIV, as many different factors play a role, including how long the sex lasts, how vigorous it is, whether you have other sexually transmitted infections (STIs), or how high the concentration of the virus (viral load) is in the blood and semen of the HIV-positive person. One thing is certain, though: the more often you have unprotected sex, the greater your risk. So – even if it didn’t work out last time – make sure you use a condom next time.

In many people who are HIV-positive and take their HIV medication regularly, the virus is no longer detectable – or is barely detectable – in their blood, semen and anal mucosa. According to current scientific knowledge, transmission of the virus is therefore practically impossible. Under these circumstances, sex between an HIV-positive and an HIV-negative man is just as safe without a condom as it is with one. The so-called viral load method should only be used if the HIV-positive partner takes his medication daily, his viral load has been undetectable for at least six months and he has this checked regularly.

Disease Progression

If the infection remains untreated, HIV damages the immune system until it eventually collapses, allowing a wide variety of illnesses (AIDS) to develop.

In the first few weeks after infection, the immune system tries to fight off the virus. During this time, flu-like symptoms may occur. However, this phase can also be asymptomatic. Nevertheless, the concentration of the virus in the blood and semen is particularly high during this period, which is why someone who has recently been infected is highly infectious without even realising they are infected.

Even if those affected remain symptom-free for years, their immune system is usually progressively damaged. However, if an HIV infection is detected and treated in time, there is a good chance of preventing the onset of AIDS and leading a normal life.

Treatment

There is currently no cure for HIV. A combination of highly effective medicines can largely suppress the virus’s replication in the body, thereby preventing damage to the immune system. The medicines must be taken daily for the rest of the patient’s life. It is important to have a good, trusting relationship with an HIV specialist.

Tips:

• During oral sex, try to avoid getting semen in your mouth. If it does happen, spit the semen out and then rinse your mouth thoroughly with plenty of liquid.
• Condoms protect you during sex – whether you’re the top or the bottom. At sex parties, in saunas or darkrooms, make sure you put on a fresh condom whenever you change partners.
• An HIV-positive man is not infectious whilst on effective treatment. In this case, HIV cannot be transmitted even without a condom. Other sexually transmitted infections (STIs), however, can be transmitted more easily without a condom.
• Following a high-risk encounter, PEP (post-exposure prophylaxis) is an option. This involves taking HIV medication for one month, which is highly likely to prevent infection. You should start this as soon as possible after the exposure. Every hour counts! Mann-O-Meter or Aids-Hilfe (Tel. 0180 33 19411, www.aidshilfe.de/en) can help you find a suitable doctor – even at the weekend.
• Get tested regularly for HIV and other sexually transmitted infections such as gonorrhoea, chlamydia and syphilis. Syphilis often goes unnoticed, but it can increase the risk of HIV transmission. Mann-O-Meter offers tests for HIV, syphilis, gonorrhoea, chlamydia and hepatitis C.
• If you have any questions about safer sex and gay health, Mann-O-Meter is here to help. We can also provide you with information about reputable doctors in Berlin.