(Note to Allegro readers: this column contains some graphic descriptions of sexual practice.)
Who is at risk for contracting H.I.V.? Anyone. Men, women, young, old, heterosexual, gay, bisexual, rich, poor – and all racial and ethnic groups.
Yet not everyone faces equal risk. Your risk comes from what you do, and whom you do it with.
A common way that H.I.V. is spread is during unprotected sexual intercourse, either through vaginal sex or through anal sex. In general, it is easier for the receptive partner (the one taking the penis into the vagina or rectum) to become infected during unprotected sex.
But we also know that an uninfected man can get H.I.V. by putting his penis into the vagina or rectum of someone with H.I.V.
Many people worry about the risk that oral sex carries. While we don’t know everything about the dangers of oral sex, we do know that oral sex is less likely to transmit H.I.V. than anal or vaginal sex without a condom.
However, oral sex is not 100 percent safe. A small number of cases of H.I.V. infection through oral sex have been reported. Your risk for H.I.V. may be higher if you have sores, cuts, blisters or burns in the mouth or on the penis or vagina. Rough, prolonged, or repeated oral sex can hurt your mouth, throat, penis or vagina and raise your risk of H.I.V. infection. Oral sex with an infected woman is riskier if she is having her period, since menstrual blood can contain H.I.V. Since doctors believe that people who recently got H.I.V. may pass along the virus more easily, oral sex with someone recently infected may also be a heightened risk.
Safer sex involves the use of latex or polyurethane condoms. Lambskin condoms are available, but are not recommended, because they may allow passage of H.I.V. Latex has been proven to be effective in preventing the transmission of H.I.V. because it is very strong and resilient. Yet sometimes condoms do break.
The main reason for condom breakage is user failure. Make sure that condoms are not exposed to heat (glove compartments, under direct sunlight or in the pockets of tight jeans). Also, check expiration dates. It is not recommended to keep condoms longer then a year. Most condoms have an expiration date on the package. And never use an oil-based lubricant. Oil affects latex and can easily cause breakage. Use only water based lubricants such as KY jelly to reduce friction on the outside of the condom during sexual intercourse. When in doubt, more lube should be added.
It is also recommended when engaging in oral sex to use a barrier method such as a condom for a man and a dental dam for a woman. A dental dam is a square made out of latex that dentists use to isolate the tooth on which they are working. AIDS educators have advocated their use for oral sex, either mouth to vagina or mouth to anus. Because they were not originally designed for sex, they tend to be thicker than condoms; which is why many people use plastic wrap, a product found in most people’s kitchens. The wrap has been shown to prevent passage of H.I.V. and it has the advantage of being thinner, cheaper and easier to get.
Getting tested for H.I.V. is also part of reducing risk. It can be scary to consider, but learning your H.I.V. status can be an important step toward taking care of your health and planning for your future. If you are negative, you can learn how to stay that way.
There are many ways to test. Public clinics offer free, completely anonymous tests, which means that they do not take your name. Confidential testing means they will not and cannot release your name to anyone except another health care provider or an insurance company.
Some tips in preparing to take the H.I.V. test include getting health insurance before being tested. Also, try to identify people that you can talk to openly before you take the test. And think about how you will feel and what you will do when you find out your H.I.V. status.
When it comes down to it, safer sex practice shouldn’t take the fun out of your life. It should be included as part of it.
For information about H.I.V., AIDS and getting tested, call the MAP office at (212) 397-4802. Other testing options are the New York City Department of Health, (212) 427-5120; the David Geffen Center, (212) 367-1100; and Planned Parenthood, (800) 230-7526.