HIV & Sex

Here’s what we know.

Sexually, HIV can be transmitted from cum, pre-cum, blood, anal fluid and vaginal fluid. (HIV doesn’t survive well outside the body or in open air)

The higher somebody’s viral load, the more likely the virus will be transmitted through these fluids. In some cases, having another STI can weaken the immune system and make it easier for HIV to take hold in your body.

It’s easiest for condomless anal sex to pass on HIV to the bottom (the guy getting fucked). This is because the lining inside your butt is very thin and it’s easy for the virus to cross into the body from there.

Sharing needles for drug use or with needle play also easily passes on HIV. Front hole (vaginal) sex and sharing sex toys without washing them can pass on HIV  as well.

Thankfully sucking cock has a very low likelihood of HIV transmission!

HIV No-Risk and Low-Risk Activities

No risk:

• Jerking off together
• Kissing / making out
• Stripteasing or dry humping
• Cock rubbing / frotting
• Solo toy play

Very low risk:

• Rimming
• Fingering
• Sharing toys with condoms/barriers for each person
• Oral sex

Many sexual activities are mental as well as physical — roleplay, exhibitionism, voyeurism, dressing up, bondage, leather/rubber. Most of these don’t involve body fluids, but if rougher play breaks skin, remember that blood can transmit HIV.

Not all HIV no-risk activities are STI-free. Some STIs (like herpes, scabies, or mpox) spread through skin-to-skin contact. Condoms can help, but regular testing is still important.

Transmission and viral load

Most often HIV is passed on when one partner is HIV-negative, and the other guy thinks he’s HIV-negative, but actually isn’t. 

Guys with undiagnosed HIV can have especially high viral loads, because they’re not on treatment yet. And even if someone tests HIV-negative, tests may not detect HIV within the first few weeks of infection. Some guys who say they’re HIV-negative aren’t actually getting tested regularly, or have had sex after their last test.

If you’re HIV negative and you’re choosing your sex partners based on HIV status, or having sex without condoms, consider that many mixed-status couples use combinations of:

• PrEP for the negative partner
• Undetectable viral load for the positive partner
• Condoms for added STI protection

When these strategies are used properly, there’s no realistic chance of HIV transmission.

If you’re living with HIV, staying undetectable means you can’t pass HIV on. But condoms reduce your risk of other STIs. Regular STI testing (including swabs) with your HIV bloodwork keeps you and your partners healthy. If you’re having trouble accessing care, there are local and culturally specific support options.

HIV Disclosure

Talking about HIV status can be tough. The law and personal relationships don’t always match up. In Ontario, you don’t have to disclose your HIV status if there’s no realistic chance of transmission. Since 2017, prosecutors have said that if someone’s been undetectable for at least six months or uses condoms, not disclosing won’t lead to criminal charges.

But legal rules aren’t the only factor — safety, trust, and context matter too. In casual or anonymous settings, there may be an unspoken understanding of risk. In relationships, disclosure can build intimacy, but it can also carry risks for people living with HIV.

Trust works both ways. HIV-positive guys can be open when they feel safe, and HIV-negative guys can help by:

• Learning the science of U=U
• Avoiding HIV stigma
• Being a safe, respectful listener

If you need more details, HALCO offers a thorough legal guide, and CATIE has resources on disclosure. If someone brings up legal threats, you can point them to HALCO, who can explain why legal action isn’t a good move for either person.

Sex should be fun, safe, and on your terms. With today’s tools (PrEP, U=U, condoms, PEP, regular testing) you can have the sex you want while protecting yourself and your partners. Learn your options, pick your strategies, and go enjoy yourself.