Having HIV can affect people’s feelings about sex in many different ways.

Some people become anxious about passing HIV on, or feel less desirable. While some people go off sex altogether, others look for it more and more. It may seem more important than ever to feel wanted or to have moments of intimacy and pleasure.

It’s worth knowing that:

• Most people living with HIV do continue to have sex and form relationships.
• People living with HIV can have children who don’t have HIV.
• If your HIV treatment is fully effective, it’s unlikely that you will pass HIV on to a sexual partner.
• If you use condoms, it’s unlikely that you will pass HIV on to a sexual partner.

Condoms are important for your health too – they will protect you from sexually transmitted infections. Some infections, like syphilis and hepatitis C, can be more difficult to treat when you have HIV. If you ask, your clinic can provide a regular sexual health check-up.

When choosing a contraceptive method, HIV treatments may need to be considered. Some anti-HIV drugs can interact with the pill and other hormonal contraceptives.

Anal and vaginal sex are the most common ways that HIV is passed on.

The risk of transmitting HIV during other sexual activities is much, much lower. There's more information on these over the page.

If condoms are used during anal or vaginal sex, HIV transmission is highly unlikely. Condoms prevent body fluids containing HIV from passing from one person to another. Using a water- or silicone-based lubricant makes condoms even safer.

Similarly, if you are taking HIV treatment and have an 'undetectable' viral load, then it's highly unlikely that you'll pass HIV on during sex. When a person's viral load is 'undetectable', this means that there is only a tiny amount of HIV in the body.

The risk of HIV transmission will be extremely low if all of the following apply:

• Blood tests show that your viral load has been undetectable for several months.
• You take the right amount of your anti-HIV drugs at the right times.
• You do not have any sexually transmitted infections.
• Your partner does not have any sexually transmitted infections.

Research shows that HIV treatment reduces the risk of passing HIV on to a regular partner by 96%.

Your doctor can give you - and your partner - more detailed advice, based on your circumstances.

Compared to unprotected anal or vaginal sex, the risk of passing HIV on during other sexual activities is much, much lower.

Oral sex is considered to be low risk. If you are a man living with HIV, there's a small possibility of transmission if you have a high viral load and you ejaculate in somebody's mouth. If you are a woman living with HIV, there's virtually no risk of passing HIV on during oral sex.

There's also virtually no risk of transmission during mutual masturbation (rubbing each other's penis, vagina or anus). It's impossible for HIV to be passed on through kissing, cuddling or stroking.

Also, there is no risk during normal social contact. No-one has ever picked up HIV from:

• sharing household items like cups, plates or cutlery,
• using the same toilet, or
• breathing the same air as someone with HIV.

If you’re worried that you might have just exposed someone to HIV (for example, if you had sex without a condom, or if a condom broke), an emergency treatment called PEP may be available.

PEP is a course of anti-HIV drugs that must be started very soon after the risk has been taken – the sooner the better and definitely within 72 hours (three days). It can prevent HIV being passed on.

PEP is usually available from HIV clinics, sexual health clinics and Accident & Emergency departments.

You might have already heard about people going to prison for passing on HIV. While it’s important to be aware of this, you should know that so far this has only happened to around 25 people in the UK.

In England and Wales, you could be convicted if, at the time you had sex:

• you knew you had HIV,
• and you understood how HIV is transmitted,
• and you had sex with someone who didn’t know you had HIV,
• and you had sex without a condom,
• and you transmitted HIV to that person.

However, it’s not against the law simply to have sex without a condom or without telling your partner that you have HIV. A conviction can only happen when HIV is passed on.

In Northern Ireland, the law is similar to that in England and Wales.

But Scottish law is different – a conviction is possible even if HIV was not passed on.

Sometimes, the police have launched investigations when no-one has done anything wrong. If the police start to ask you questions, it’s essential to get expert advice. Call THT Direct on 0808 802 1221.

If you are thinking of making a police complaint about the person you think gave you HIV, it’s important to be aware of the possible consequences for you. It’s worth getting advice from an organisation that has experience of these situations. You should give yourself time to think through what’s best for you.

If you do go to the police, they will closely examine your sex life and may contact your previous partners. This may lead to other people finding out that you have HIV. The process can take a lot of time, and it can become difficult to withdraw a complaint.

For more information and advice, call THT Direct on 0808 802 1221.

• Transmission and viral load (Basic leaflet with pictures.)
• Post-exposure prophylaxis (One-page factsheet.)
• HIV & sex (88-page booklet.)
• HIV & contraception (Online, interactive tool.)