Know your risk

Yes, but...This doesn't mean there’s no HIV risk to the insertive partner ("topper"). HIV is more easily transmitted from the insertive to the receptive partner but neither position is safe.

Remember:

• HIV risk is greater in the receptive position, but you can still get HIV if you’re the insertive partner ("topper");
• Many gay men get HIV even though they're in the insertive position.

No. When having sex without a condom, there's a greater chance of HIV being transmitted if an HIV-positive guy ejaculates ("cums") inside. However, HIV is also present in the pre-cum and can be transmitted through the wall of the anus, which is often damaged during sex.

Remember:

• Pull out before cumming is not an effective way of stopping HIV;
• Many gay men become HIV-positive even though there is no cum inside.

In most cases you don't. Some men who are HIV-positive choose to have sex without condoms with other positive guys. Likewise, some men who are HIV-negative choose to have sex without condoms with the guys they assume to be HIV-negative. Assumptions like this are common but unreliable.

Remember:

• It is very rare that gay men discuss their HIV statuses before they have sex;
• HIV-positive men may assume you're positive too;
• HIV-negative men may assume you're negative too.

No, but... But you may talk to him and negotiate on safer sex. This is kind of relationship agreement where HIV-negative partners in a regular relationship disclose their HIV statuses to each other, discuss risks and agree to repeat HIV testing before having unprotected anal sex. Any sex with other partners outside the relationship must be with condoms.

HIV transmission can theoretically occur through oral sex between men. What we don't know is the exact risk of HIV transmission through oral sex.

HIV transmission does not occur very often through oral sex. Transmission through oral sex usually occurs from the insertive to the receptive partner; and the risk of HIV transmission during oral sex increases if:

• the insertive partner has a high viral load;
• ejaculation into the mouth occurs;
• the receptive partner's mouth is breached in some way allowing HIV to enter.

Kissing (exclude French kissing):

Saliva does not transmit HIV and is therefore safe. However, beware of mouth ulcers which may cause blood contact during kissing.

Massage or frottage:

There is no risk of HIV being passed on through rubbing bodies against each other. However, note that massage oil can cause condom to break.

Masturbation

Masturbation is a very common sexual activity and completely safe for HIV and STIs. Mutual masturbation is when two people masturbate each other by touching or rubbing each other's genitals and is considered a safe activity for HIV—although using the other person's cum, pre-cum as lubricant does present a risk.

Fingering

Playing with someone's anus with your fingers is a low risk activity for passing HIV on. However, it is important to keep your fingernails trimmed and remove all rings so as not to cut the wall of the anus. Always wash your hands well after fingering to avoid gut infections.

Rimming

Rimming (mouth-to-anus contact) is quite safe if there is no wound or bleeding. However, hepatitis A and gut infections can easily pass on this way. Use dental dam or plastic wrap to reduce the risk.

Oral sex

Oral sex runs a small risk for HIV transmission, but the risk is higher when blood is involved. Note that other STIs, including syphilis, gonorrhoea, warts and herpes, can be transmitted through oral sex.

Fisting

Fisting means inserting your hand in someone's anus. It is possible to create serious cuts on the wall of the anus, and it is easy to pass HIV or HCV on. The scenario is even worse if the fistee has receptive anal sex, or if the fistee's anus is inserted with a finger or sex toy with cum or blood. In some serious cases, the receptive partner may even get gut perforation during fisting, and the fister could also get HIV if he has cuts or scratches on his hands. Be sure to remove your watch and all hand, wrist and arm jewellery before fisting. Latex gloves and silicone-based lubricants are important for protecting both of you.

Sex toys

HIV and other STIs can be transmitted from person-to-person through sharing of sex toys such as dildos, vibrators and butt-plugs. Putting a condom on every single toy and changing the condom before using it on a different person will prevent HIV from being passed on.

Piercing

Many people find body and genital piercings a turn-on. There are a few things about piercings to be aware of:

• Genital piercings such as a Prince Albert (a ring through the bottom of the head of the penis) can cause tears and abrasions in the anus during anal sex.
• Beware of condom tearing by the piercings on the penis.
• New piercings do occasionally get infected: if this happens to your genital piercing, avoid sex until it has healed as the infection can increase chances of passing on or getting HIV.
• Like tattooing, piercings involving penetrating the skin with devices like a needle could easily pass on HIV, HBV and HCV, or other STIs if the needle is not adequately sterilized among uses.