Ongoing prevention messages regarding consistent use of condoms and water-based lube are essential but you might forget that you have other options available, depending on your unique needs. Combination prevention is a strategy of combining two or more proven HIV prevention methods that suit your unique lifestyle and that, if used properly, will either:
- reduce your risk of becoming HIV positive and of contracting other sexually transmitted infections (STIs), or
- reduce your risk of infecting your partner with HIV and of preventing you from contracting other STIs if you are already positive
Combination prevention relies on changing behaviours that might increase the risks of HIVtransmission, coupled with technology such as medication, condoms and latex-compatible lubricants to reduce infection risks. No single HIV prevention method is foolproof or provides 100% protection; a combination of methods is best, and there are several options available so that you can find the best combination that works for you.
Reducing your number of sexual partners means less potential exposure to infections. Strange as it may sound, more frequent masturbation can be seen as a valid preventative behavior for some if it helps reduce their potential risks of exposure. Likewise, some guys use sex toys to curb their regular needs so that they don’t feel compelled to cruise for sex partners as often as they might want to.
Avoid barebacking. Unprotected anal sex facilitates the spread of HIV and other sexually transmitted infections (STIs). Avoid having sex while using drugs or alcohol so that you make responsible decisions regarding your health. If you inject drugs never share needles with someone else. Consider negotiating an open relationship rather than cheating on your partner, and develop a plan that ensures you both remain healthy. Stick to the agreed plan.
Sero-sorting is a strategy of only having sex with people with the same HIV status as you. A problem is that you cannot be sure of anyone’s HIV status; many guys have not been screened and just assume they are negative. Sero-sorting often works best for HIV positive guys who are networked with other positive guys. Sero-positioning is choosing your role during anal sex according to your HIV status- An HIV positive guy will be the bottom during anal sex with an HIVnegative partner to prevent the semen of the positive partner entering the anus of the negative partner if the condom breaks.
Condoms and compatible lubrication remain your best defense against infections. Find a condom brand you like or use female condoms for anal sex. Water-based lubricant is safe with condoms but should not be used without condoms as it may irritate the lining of the anus and increase the risk of HIV and STI infection if you bareback. STIs that cause sores create an opening which allows entry of HIV . Get screened for STIs every six months.
Post-Exposure Prophylaxis (PEP) is a strategy of HIV -negative guys taking antiretroviral (ARV)medication for 28 days if they have been exposed to the virus in order to reduce their chance of becoming positive. Pre-Exposure Prophylaxis (PrEP) involves HIV -negative guys who are at risk of repeated exposure to HIV taking ARV medication long term and before the possible exposure takes place. PrEP is not available in public sector clinics.
Treatment as prevention (TasP) involves treating HIV positive men with antiretroviral drugs to lower the amount of HIV in their bodies and thus in their blood and semen, reducing their risk of infecting a partner.
Whatever works for you, remember that consistent use of condoms and appropriate lube should form the basis of any prevention strategy.