HIV Prevention

Are You at Risk for HIV?

Any activity that exposes you to another person’s semen, vaginal fluid, breast milk, rectal fluid, or blood could put you at risk for HIV. There are also some behaviors that put you at increased risk. These include:

• Having unprotected vaginal or anal sex with someone who is living with undiagnosed or untreated HIV
• Sharing injection drug equipment
• Exchanging sex for money or goods
• Acquiring a sexually transmitted infection

In Iowa, some populations also experience higher rates of HIV, which means that members of these groups are more likely to be exposed to HIV. These populations include:

• Blacks or African American individuals
• Hispanic or LatinX individuals
• Men who have sex with other men

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How Can You Reduce Your Risk?

Anyone can get HIV, but there are more tools today to prevent HIV than ever before.

Get Tested and Know Your Partner’s HIV Status

Talking to your partner(s) about HIV testing and getting tested before sex are great first steps in understanding your risk. To best understand your risk and/or get tested, talk to your doctor or use this testing locator to find testing and counseling across Iowa.

Assess Risks Involved With Sexual Activities

Sex is the primary way that HIV passes from person to person. Condoms and/or medications can reduce this risk. If you aren’t taking PrEP regularly or don’t have a condom handy, you may want to discuss less risky types of sex with your partner(s). Receptive anal sex is the type of sex most likely to transmit HIV. It is possible for either partner-- the top or the bottom--to get HIV, though it is much riskier for an HIV-negative partner to be the bottom/receptive partner. This is because the lining of the rectum is thin and micro-tears may allow HIV to enter the body during sex. Though the risk of transmission is lower for the top partner, HIV may still enter the body through the penis via small cuts, scratches or other open sores. If a condom is not available, some people use lube to reduce tearing when having anal or vaginal sex.

While vaginal sex is less likely to transmit HIV, similar risks apply like tearing of the vaginal wall, open sores, or cuts on or in the pubic region. Oral sex (e.g. fellatio, cunnlingus, and anilingus) and touching present the least risk for HIV transmission. Partners should be aware of gum bleeding, open sores in or on the mouth, and open sores on the penis, anus, or vagina.

Practice Safer Sex with Insertive or Receptive Condoms

While abstaining from sex and/or limiting the number of your partners greatly reduces the chances of your risk for HIV, there are several tools you can use to have safer sex.

1. Insertive condoms, sometimes known as male condoms, are highly effective in preventing HIV and some STDs when used correctly. Water and silicone-based lubricant can be used during sex to prevent condom breakage and tearing of tissue.
2. Receptive condoms, sometimes known as female condoms, are also highly effective in preventing HIV and some STDs when used correctly. Receptive condoms can be used internally by people who have vaginal or anal sex. Like insertive condoms, water and silicone-based lubricants can also be used during sex to prevent condom breakage and tearing of tissue.
3. Dental dams are latex or polyurethane sheets used between the mouth, vagina, or anus during oral sex. Dentals dams are effective in prevention HIV and some STDs when used correctly.

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Taking Medicine To Prevent Or Treat HIV

In the Living with HIV section, you can learn more about how people living with HIV (PLWH) are using medications to manage their health and treat their HIV. Many PLWH who take their medications as prescribed are able to achieve viral suppression, meaning that they have no detectable HIV in their blood. When there is no detectable HIV viral load in your body you have no risk of sexually transmitting the virus. This is commonly known as Undetectable = untransmittable or U=U. For more information check out this fact sheet developed by the Centers for Disease Control. 

Pre-Exposure Prophylaxis (PrEP)

PrEP is a single, daily-dose pill that is prescribed to prevent HIV infection prior to exposure. If taken consistently and as prescribed by your provider, PrEP can reduce your risk of becoming infected by over 90%. You can find more information on accessing PrEP in Iowa at PrEP Iowa. The power of prevention is in the palm of your hand.

Post-Exposure Prophylaxis (PEP)

If you have a recent possible exposure to HIV, your provider can prescribe the same medicines used for PrEP to reduce your chances of becoming HIV-positive. Post-Exposure Prophylaxis (PEP) is used within 72 hours after a recent possible exposure to HIV. There are some side effects that can be treated and are not life threatening.

If you need PEP contact your doctor or nearest emergency room.

Safer Substance Use

Some forms of substance use can increase your risk related to HIV. Persons who use or inject drugs can reduce their risk by not sharing or re-using substance use equipment.

Read more here at the Iowa Harm Reduction Coalition website.

Find Testing or Services Near You

Substance use can present direct and indirect risks, increasing the chance that you may be exposed to HIV. In this section, we will explore how substance use may present opportunities for HIV transmission and highlight resources available for people who use or inject drugs.

Indirect Risks of Substance Use

Using some drugs can cause you to do things that increase your risk of getting or transmitting HIV. Some drugs like alcohol, methamphetamine, poppers, and ecstasy, may reduce inhibitions around safer sex. Some people use meth to last longer while having sex which may require multiple condoms in a session. This requires users to be extra aware of the quality of safer sex materials, which may be a challenge in the heat of the moment. Additionally, drugs like alcohol may also affect your judgement or reduce your inhibitions enough that you forget to use a condom. If you’re going to a party or another place where you know you will use drugs, you can prepare by bringing a condom with you to reduce your risk.

Direct Risks of Substance Use

People who inject drugs (PWID) are at risk for getting or transmitting HIV and hepatitis B and C if they share needles or equipment, or works, used to prepare drugs such as cotton, cookers, and water, because they may contain blood that is infected with HIV. As of June 2018, implementation of syringe service programs remains in conflict with Iowa Code § 124.414 which prevents distribution of hypodermic syringes or needles for an unlawful purpose. While syringe service programs are not legal in Iowa, the Iowa Harm Reduction Coalition (not endorsed by the Iowa Department of Public Health) in Iowa City, Cedar Rapids, Des Moines, and Sioux City currently provides PWID with harm reduction materials and education, overdose prevention and response kits, and referral services. PWID may have luck in accessing sterile equipment by accessing services at a local pharmacy. Pharmacies in the state of Iowa do not require a prescription to purchase new syringes or needles. However, some pharmacists may choose not to sell syringes to individuals who do not have a prescription with their pharmacy for a medication that must be administered intravenously.

While we work to address COVID-19, it is also important to know how to take care of your sexual health. Here are a few simple tips: