How can you get HIV when having sex?

HIV is transmitted through seminal fluid (sperm and the fluid that appears before ejaculation, when the penis is erect – pre-ejaculatory fluid), vaginal secretions, blood, and anal secretions. During unprotected sex, an individual’s bodily fluids can enter their partner’s body. This occurs through the mucous membranes of the penis, vagina, and rectum, or through wounds in the mouth and/or throat.

You can only get HIV from someone living with HIV who has a detectable viral load.

Do certain types of sex have a higher risk of HIV infection?

Anal sex and HIV

Anal sex carries the highest risk of HIV infection because the lining of the anus is more sensitive than the lining of the vagina. This means it can be more easily damaged, providing a route for HIV to enter the body. Receptive anal sex (“being passive”) poses a higher risk than insertive anal sex (“being active”).

Oral sex and HIV

The risk of acquiring HIV through unprotected oral sex is extremely low. It poses a risk only if the person performing oral sex has oral ulcers, wounds, or bleeding gums, or if the person receiving oral sex has genital sores.

Vaginal sex and HIV

Both male and female partners can contract HIV through vaginal sex. The risk of acquiring and transmitting HIV through vaginal sex increases during menstruation.

Sex Toys, Fingering, Fisting, and HIV

Sex toys, such as dildos, come into direct contact with rectal/vaginal secretions and mucous membranes. This means that using an unwashed dildo or other sex toy can transmit HIV. Using sex toys on oneself (exclusive use by a single person) carries no risk.

There is no direct risk of HIV infection through fingering or fisting (unless you have cuts on your hands). Damaging anal/vaginal tissues, especially when there is bleeding, can increase the risk of transmitting HIV if you subsequently engage in anal, vaginal, or oral sex.

Kissing and HIV

HIV is not found in saliva, so you cannot get HIV through kissing.

Other Factors

If you have multiple sexual partners and/or an STI and do not use protection, the risk of HIV infection through sex is increased.

How can I avoid getting infected with HIV during sex?


Condoms are the most effective way to prevent the transmission of HIV and other STIs.

They can be used during anal and vaginal sex, as well as during oral sex. They should be put on before any sexual contact, as HIV can also be transmitted through pre-ejaculatory fluid, vaginal secretions, and anal secretions.

There are internal (female) and external (male) condoms, and you can experiment and use what works best for you.

Internal condoms can be used for both vaginal and anal sex – after removing the inner ring, which is mobile.

Pre-exposure Prophylaxis (PrEP)

PrEP is a pill that HIV-negative individuals can take for HIV prevention. It contains antiretroviral medications that stop the virus from replicating in your body.

PrEP is recommended for individuals at higher risk of HIV infection: people in a relationship with someone living with HIV (serodiscordant couples) or people belonging to groups at higher risk of HIV infection – such as men who have sex with men, sex workers, etc.

Consult a healthcare professional to find out if PrEP is right for you. Currently, PrEP is not available everywhere, but access is expanding. Unfortunately, in Romania, it is not yet available.

When taken properly, PrEP eliminates the risk of becoming infected with HIV. PrEP will not protect you against other sexually transmitted infections (STIs). Condoms are still the best protection against STIs.

Antiretroviral Treatment

Antiretroviral treatment reduces the amount of HIV in the body, making HIV transmission less likely.

If you are living with HIV, on treatment, and have an “undetectable” viral load, it means you have such a small amount of HIV in your body that you cannot transmit HIV through sex.

If you are HIV negative, you cannot get HIV by having sex with someone who is HIV positive and undetectable.

Not everyone on HIV treatment has an undetectable viral load, so to be sure you are “undetectable” (and to remain undetectable), you need to periodically monitor your viral load.


Lubricants make sex safer by reducing the risk of injury to the anus or vagina from dryness or friction. They can also reduce the risk of condom breakage.

Lubrication is particularly important for anal sex because the anus is sensitive and does not self-lubricate.

Use water-based or silicone-based lubricants instead of oil-based lubricants, as oil-based lubricants (such as Vaseline) degrade latex condoms and can cause them to break.

Dental Dam

A dental dam is a small sheet of rubber that can be used to protect the mouth, vagina, or anus during oral sex, reducing the risk of STI transmission.

Post-exposure Prophylaxis (PEP)

PEP is a combination of antiretroviral drugs that can prevent HIV infection after a possible exposure event, such as having unprotected sex (or a broken condom) with someone whose HIV status you do not know.

PEP can stop HIV infection, but it must be taken within 72 hours of the potential exposure.

Unlike condoms or PrEP, PEP is not and should not be a regular form of protection.

Your doctor or another professional can advise you on PEP. PEP may not be available in your city.

HIV Testing

Knowing your status is an important part of sexual health care and can help you have safer sex. If you know you are HIV positive, you can take antiretroviral treatment to stay healthy and reduce the risk of transmitting HIV, and if you are negative, knowing your status will motivate you to protect your sexual health.

It is important to test periodically for other sexually transmitted infections (STIs) as well, as an STI increases the chance of HIV infection.