Should you read this?

This information is about preventing human immunodeficiency virus (HIV) infection. Some frank language is used to get the message across. This brochure also assumes you know some basic information about HIV and acquired immunodeficiency syndrome (AIDS).

You can avoid risk of HIV infection by following a few steps. These steps may be straight forward, but talking about them and putting them into practice is often harder.

Help is available, read on.

The Basics:

• HIV is a virus that attacks the body’s immune system.

• The virus can enter your bloodstream if:

  • you have unprotected sexual intercourse (oral, anal, or vaginal) with someone who has HIV.

  • you share needles or other injection equipment with someone who has HIV.

• HIV can enter your body through the infected person’s blood, semen or vaginal fluids. A mother with HIV can pass it on to her baby.

• Anyone who has unprotected sex or shares needles or other injection equipment is at risk for HIV — no matter where you live, your sex, age, sexual orientation or ethnic origin. 

• HIV is NOT spread by insect bites, sitting on toilet seats; food handling or sharing hugs and kisses. 

• Individuals can have HIV for years and not show symptoms of the virus. This means a person can look and feel well yet still infect others with HIV.

• Over time, HIV weakens the body’s immune system so much that it has difficulty fighting off even a simple infection.

• There are drugs that may slow down the disease so people with HIV can stay healthier for a longer time.

• Having HIV does not mean you have AIDS. If HIV is left untreated, your immune system will no longer be able to defend your body from infections, diseases or cancers that can kill you. This is called AIDS.

• To know whether you’re infected with HIV or not, you need to get an HIV antibody blood test.

• The only way to prevent infection is to avoid risk.

There is no cure for HIV. There is no vaccine to prevent HIV.

Assess Risk...Know Yourself

• Do you take more risks when drinking or using drugs?

• Do you know your partner’s views about abstinence, safer sex and condoms?

• Do good intentions get left behind in the heat of sexual passion?

• Ask yourself, “What am I doing to put myself at risk of HIV?”

okay, let’s talk about sex!

Sex is never completely safe but you can make it safer. Take control, and you can be confident your choices do not put you, or others, at risk.

Your risk of getting HIV increases every time you come into contact with semen, vaginal fluid or blood of someone who may be infected.

You are at high risk for HIV if:

• you do not know your partner’s HIV status;

• your partner is having sexual relations with other partners;

• you have anal, vaginal or oral intercourse without using a condom; 

• you share sex toys with someone who has HIV.

Having sex with only one person, or being monogamous, doesn’t necessarily protect you from HIV infection or other sexually transmitted infections (STI) - also known as sexually transmitted diseases or STD.

Ask yourself:

• Have I had unprotected sex? Have I shared needles or other injection equipment?

• Do I know if my partner has or is having other sexual relationships?

• Do I know if my partner shares needles or other injection equipment?

Remember, participating in unsafe sex exposes you to every sexual partner your partner ever had, every partner your partner’s partner ever had and so on and so on...

You greatly reduce your chances of getting HIV infection if you practice safer sex. For example, instead of intercourse without a condom, you correctly use a condom each and ever time you have intercourse (anal, vaginal or oral sex). Today there are condoms for both males and females. See the section on “condoms”.

Safer sex means making sure semen, vaginal fluids or blood does not get into your (or your partner’s) body.

To practice safer sex, use a condom or dental dam correctly, each time you have vaginal, anal or oral sex. Other examples of safer sex practices include kissing, hugging, massaging, petting and masturbating. If the vagina or anus is entered using fingers, make sure you don’t have tiny cuts on them, as this can become an entry point for infected fluids.

Be warned. You are at risk if these activities turn into unprotected sex.

Remember, you and your partner are less likely to think about safer sex if you are drunk or stoned. In a recent survey, Albertans reported drinking as a major cause of unsafe sex.

Sex is safe from HIV only when partners are not HIV infected. The only way to be sure you are free of infection is to be tested. See the section on “testing” in this brochure.

How risky is oral sex?

Oral sex is not risk free. Using a condom or dental dam during oral sex - every time - reduces the risk of HIV infection. A dental dam is a piece of latex used to cover the anus or vagina.

HIV can be found in blood, semen and vaginal fluids.

Remember:

• do NOT brush or floss teeth and gums before having oral sex;

• do NOT have oral sex if either partner has cuts or sores around or in the mouth, penis, vagina or anus;

• do NOT have oral sex (mouth to vagina) during a woman’s menstruation cycle (period).

One other caution...other sexually transmitted infections (STI) are spread easily through oral sex. For protection from STI, use a condom or dental dam each and every time you have oral, vaginal or anal sex.

Are men and women at equal risk?

Both males and females are at risk of infection during any kind of unprotected sexual intercourse. The penetrated (entered) partner is at more risk during anal or vaginal sex. Anal sex without a condom is particularly risky since HIV can enter the bloodstream through tiny tears in the rectum (anus).

Of course, everyone is at high risk if they share any injection equipment such as needles, syringes (rigs) or spoons (cookers). See the section on “sharing needles”.

how risky is sharing needles?

Injecting drugs with used or unclean needles or using any form of used or unclean injection equipment is one of the riskiest things you can do.

Sharing injection equipment is very dangerous since HIV (and other illnesses such as hepatitis B and C) is spreading rapidly among injection drug users.

If you inject, reduce your risk by not sharing needles or other injection equipment. Use only new or sterilized equipment. Remember, when you share needles you may be transferring infected blood directly into your body or into someone else’s body if you are infected.

You may also get HIV if unclean needles or unsterilized equipment are used to:

• tattoo

• skin pierce

• inject steroids

If you have to re-use injection equipment, be sure to clean it first by flushing full strength bleach through the works at least two times.

• Fill the syringe with bleach, then tap it a few times to loosen any dried blood that might still be in the needle.

• Rinse the syringe a few times with clean tap water.

Cleaning needles or other injection equipment REDUCES BUT DOES NOT REMOVE the risk of HIV infection. This method of cleaning does NOT kill the hepatitis C virus.

the “C” word: condoms 

Do condoms work?

Condoms offer protection. If you choose to have intercourse, you greatly reduce your risk of STI and HIV infection by correctly using a condom. Thousands of condoms are sold daily so there is no need to be shy about buying them. It’s life. It’s your life.

Using condoms only some of the time is a dangerous strategy when dealing with a life-threatening illness. Not wearing a condom could change your life forever.

Beware - birth control pills will NOT protect you or your partner from HIV and STI.

Use a condom every time you have vaginal, anal or oral sex - no matter what other method of birth control you or your partner may use.

Both male and female condoms help protect partners from HIV and STI.

What about female condoms?

Female condoms, similar to male condoms, help provide protection against HIV and other STI as well as unwanted pregnancy. They are made of polyurethane - a thin, transparent, soft plastic.

A female condom is inserted into the vagina before intercourse. During intercourse, the penis goes inside the female condom. The female condom acts as a barrier and prevents pregnancy by stopping sperm from entering the vagina.

Information in the condom package provides instructions on how to correctly use the female condom.

A female condom should NOT be reused.

What about male condoms?

Male condoms made from latex or polyurethane also help provide protection against HIV and other STI as well as unwanted pregnancy.

Tips:

• Lubrication on the inside and outside of the condom improves the feel and ease of having sex as well as putting the condom on.

• Use only water-based lubricants such as KY Jelly™.

• Never use oil-based products such as Vaseline™ or baby oil because THESE DESTROY LATEX.

• Squeeze the top of the condom before putting it on. A man who is not circumcised should slide his foreskin back first. As the condom is rolled to the base of the erect penis, smooth out any condom wrinkles or air bubbles.

• After ejaculating (coming), pull out the penis while it is still erect (hard). Hold the base of the penis and remove the condom - being careful not to spill semen. Throw the condom in the garbage. Wash your hands afterwards.

• Never re-use a condom.

• Latex becomes brittle over time or under extreme temperature conditions. Do NOT keep condoms in your wallet or car glove compartments for a long time. Store them away from direct sunlight, heat or cold.

• Check the expiry date of condoms. Throw out old condoms and buy fresh ones.

• Male condoms come in different shapes, sizes, textures and flavours. Avoid novelty condoms as they may not provide protection against HIV and STI.

• If you know you are going to have sex, take the condom out of the package beforehand. This way, it’s ready when you are. Some people relax and enjoy sex better when they know a condom will be used.

Other condom tips:

• Plan ahead. A trip to the store just to buy condoms doesn’t always fit with the mood. You are more likely to practice safer sex if condoms are handy.

• If you are not used to condoms, take one out of its package when you are alone and practice putting it on. There is nothing complicated about condoms and being familiar with them will make you more comfortable. The real risk comes from not using a condom correctly or not using one at all.

Does Nonoxynol-9 kill HIV?

Nonoxynol-9 is often found in contraceptive (birth control) foams, jellies and lubricated condoms. Nonoxynol-9 can kill sperm but DOES NOT provide protection against HIV or STD infection.

Nonoxynol-9 should NEVER be used during anal sex. It can cause irritation and may increase your risk of getting HIV or STD.

make it happen

How can I get a partner to practice safer sex?

Don’t apologize for protecting yourself. Safer sex is for both partners. If either of you has had other sexual or needle-sharing partners, you could be infected or you could run the risk of infecting each other. One approach doesn’t work in all situations.

Helpful hints for handling a difficult conversation or situation:

• Plan an appropriate time. Do NOT wait until you are in the heat of passion or have had a few drinks to talk to your partner.

• In a calm but firm way, tell your partner you believe in, and practice, safer sex.

• Try mixing humour in with understanding and knowledge. If you are clear about your views on condoms, abstinence, preferences or whatever, you won’t have to re-hash the “sex issue” with the same partner.

Safer sex conversation starters:

• “Because I care about us, we need to talk...”

• “I’d rather be safe than sorry.”

• “Let’s be clear now, so we can enjoy sex later.”

• “We need to think disease control as well as birth control.”

• “Either one of us could have been infected with HIV a long time ago. Let’s use condoms or abstain for 6 months, then get tested. Then we’ll know for sure we’re protecting each other.”

If discussing the issue of safer sex causes your partner(s) to physically or verbally abuse you, you should consider ending the relationship. Social service agencies, women’s shelters and other support services are available to help.

For information on local support services call the Office for the Prevention of Family Violence. See back cover for details.

Respect your partner’s wishes, too. Do NOT pressure anyone to have sexual intercourse. There are many risk-free ways to express your sexual feelings.

Starting a new relationship?

If you are starting a new monogamous relationship (i.e. you and your partner will not have any other partners) and want to be sure you and your new partner are free from HIV infection, you need to decide to do the following for at least six months:

• not have oral, vaginal and/or anal sex OR

• use a condom or dental dam every time you have oral, vaginal and/or anal sex and

• not share needles or any injection equipment.

After these six months (or longer), you and your new partner must then go for HIV testing.

testing

The only way to be certain you are not HIV infected is to have an HIV antibody blood test.

Why get tested?

If you have been at risk, testing is important. The important benefits to knowing if you are HIV infected include:

• receiving treatment as soon as possible,

• taking extra care not to infect others,

• understanding your health.

If I get tested right after unsafe sex (or right after sharing injection drug equipment), will I know I’m okay?

No. Having an HIV test right after having unsafe sex or right after sharing injection equipment will not tell you if you have contracted HIV. Here’s the reason: if you have HIV, your body will make antibodies to fight it. These antibodies will show up on a blood test. BUT, it can take up to six months after you get infected with HIV before the antibodies show up in a blood test. You could still have HIV but your body has not produced enough antibodies to have it show up on a test. Instead, if you have sex without a condom or share injection drug equipment, get tested 3 months after that unsafe incident. If your HIV antibody test results are positive at three months, you can seek help immediately and be treated for HIV. If your HIV antibody test results are negative, you are lucky, but not in the clear. Since it can take up to six months for HIV antibodies to show up on a blood test, get another test at the six month mark in order to be sure. 

It is important to remember that people can infect others during these months while showing no sign of infection themselves or on a test.

Can getting tested regularly prevent HIV?

No. Being tested regularly does NOT protect you against HIV. Repeated testing does NOT prevent HIV. You CAN prevent HIV by changing your risky behaviours.

Once you’ve tested positive, there is nothing you can do to change it. There may be drugs available to slow down the disease so you stay healthier for a longer time period BUT there are no drugs to get rid of HIV or to cure AIDS.

Should I be tested for HIV if I am pregnant?

Yes. A woman with HIV can pass it on to her baby while pregnant, during birth or when breastfeeding.  Getting tested for HIV means you can get the early help you and baby will need.

In Alberta, testing for HIV is part of good prenatal care. All pregnant women are tested unless they request their doctor or midwife not to test. You have the choice to be tested or not. However, if you choose not to be tested, this would cause a delay in specific treatments you and your baby will need if you are HIV infected.

Pregnant women who have been at risk of HIV infection should be tested immediately.

Where can I get tested?

Testing is available through doctors’ offices, STI clinics in Calgary, Edmonton, Fort McMurray and at some family planning clinics. Information on places for testing is available at the back of this brochure.

Don’t assume you are being tested for HIV if you have other tests or physical examinations. If you want to be tested you need to ASK for an HIV antibody blood test. Testing can only be done if consent is given to test.

How much does it cost to be HIV tested?

If you are tested because of health concerns, you are not charged.

If you are tested in order to apply for life insurance, a foreign work Visa or another non-medical reason you may be charged a fee. Costs vary so ask before you are tested.

Who will see my test results?

HIV test results are confidential. Your HIV status is not given to people like your employer, landlord or family. Your results cannot be shared with people outside of the health profession.

In Alberta, positive HIV tests are notifiable. This means the medical officer of health in your health authority and Alberta Health and Wellness are notified of positive test results.

A public health professional working with the medical officer of health will talk with you so they can trace and talk to people you may have infected. These people need to be tested. Your name is not given to these contacts.

is the blood supply safe?

In Canada, donated blood has been screened for HIV since November 1985. However, you should ask your doctor to test you if you received blood or blood products between 1978 and 1985.

Some countries do not screen all blood products for HIV. If you plan to travel outside of Canada, refer to the Travel Medicine Program at Health Canada by visiting: http://www.travelhealth.gc.ca/.

What about donating blood?

Do NOT donate blood as a way to get an HIV antibody blood test.

If you are unsure about the safety of donating your blood, contact Canadian Blood Services in your local phone directory.

final thoughts

Okay, I’ll practice safer sex and stop sharing injection equipment. Does that cover everything?

It goes a long way, but there is more.

HIV gets inside one body from another through direct routes, such as unprotected sexual intercourse and through sharing injection equipment.

For further protection, stop all other ways HIV can enter your body:

• Don’t share anything that might have small amounts of blood, semen or vaginal fluids on it. We’ve talked about sex toys. Razors and equipment for tattooing or ear piercing should never be shared.

• You are not at high risk helping someone who is bleeding, as long as that person’s blood does not get into cuts or sores you may have on you. 

• When possible, wear gloves if handling blood or dealing with an injury.

• If handling trash or used needles, syringes or injection equipment, use thick gloves to avoid needle stick injuries.

With what you now know, you are your own best HIV prevention resource.

It’s not that easy, is it?

Yes and no. It’s up to you!

Prevention is straightforward. Try putting small steps into practice everyday so they become routine. Plan ahead. Talk with friends, partners and family members about what does or doesn’t work.

Leave unsafe ways behind. Just because you have been unsafe in the past doesn’t mean you can’t start being safer today ... or tomorrow. Each day is a new day.

Help is available. Contact the following agencies for ideas and support.

where can I go for more information?

Community HIV and AIDS Organizations

Harm Reduction / Needle Exchange Programs

HIV Residential Services

STD Clinics:

Condom Information:

Referrals to Government Programs:

AADAC offices are listed in local phone books.

Regional health authority offices are listed in phone books or visit: http://www.health.gov.ab.ca/

STD/HIV Information Line
1-800-772-2437
(toll free)

Phone numbers correct as of December 2003

AID10

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