Barebacking (bb, fucking without a condom, raw, au naturel)
Do you find condoms to be a turn off? Do you like your sex to be raw? If you have bareback sex, make sure you do it because it’s something you like to do, and not because you want to please someone else or prove that you love or trust them. Being clear about your limits will help you make the most of your experience.
New scientific data has shown that barebacking no longer represents an elevated risk of HIV transmission if you use one (ideally, more than one) prevention strategy.
Some guys only fuck bareback with regular partners or with HIV-positive partners whose viral load is undetectable, others do it with casual partners or people they don’t necessarily know. The choice is yours!
Extremely important if you are living with HIV
The information presented in the following section does not protect you from the risk of criminal prosecution if you do not tell your partner or partners that you are living with HIV. At this point in time, you must have a low viral load (fewer than 1,500 copies / mL of blood) and wear a condom if you do not disclose your status. For more information, visit the Criminalization of HIV Exposure section of the COCQ-SIDA website (in French).
PrEP & PEP
There are two strategies that can provide excellent protection against HIV when you have sex:
PrEP: Pre-exposure Prophylaxis
PrEP is a preventive treatment that you can take before sex to prevent HIV infection. You may find PrEP to be a good choice as an HIV prevention strategy if you don’t tend to use condoms with your partners. To get PrEP, you need a prescription from a doctor. The medication can be taken daily or on a intermittent basis (as needed, before and after you have sex). It is important to take PrEP as indicated on the prescription, making sure not to skip any doses.
People can decide to take PrEP for a variety of reasons, but the main one is always the same: To avoid getting infected with HIV. PrEP does not protect you from getting infected with other STBBIs. If you have any doubts, concerns, or questions about PrEP, contact your local HIV organization.
PEP: Post-exposure Prophylaxis
PEP is a treatment that needs to be started as soon as possible after a high-risk encounter – within a maximum of 72 hours after a possible exposure to HIV (unprotected anal sex or sharing needles with someone whose HIV status is unknown or with someone who is HIV-positive and whose viral load is unknown). Because PEP needs to be started as quickly as possible, you can obtain it by going to a hospital emergency department. It is also available at certain specialized clinics. To be effective, PEP must be taken every day for a period of one month. As with PrEP, it’s important to take the treatment as indicated and not skip any doses.
Top / bottom
Top: Active partner, the one who penetrates, who does the fucking
Bottom: Passive partner, the one who is penetrated, who gets fucked
Whether you’re a top, a bottom, or versatile is a question of preference. Choosing sexual positions is also often thought to be an HIV prevention strategy, known as seropositioning. During penetration, the bottom has a higher risk of being infected with HIV than the top. However, the top can still be at risk. It’s important to know that HIV can be found in the anal lining (mucosa) and can therefore be transmitted to the top through the inside of the foreskin and urethra, which are more susceptible to letting the virus through. The bottom can also still be exposed to HIV even if the top doesn’t ejaculate inside him because the virus is present in pre-ejaculatory fluid (precum).
In short, the best way to reduce the risk of transmission for both tops and bottoms is to combine several different prevention strategies such condoms, PrEP, testing, or negotiated safety. See the Your Hook-up Kit section to learn more.
Serosorting consists of choosing sexual partners based on their HIV status. Some guys refuse to have sex with people living with HIV, thinking that this will protect them from infection, but this is not necessarily true. Given that one HIV-positive gay man in five doesn’t know he is living with HIV, only having sex with people who think they are HIV-negative won’t protect you from the virus.
In fact, serosorting is risky and its effectiveness can vary a great deal because it’s not always possible to be sure about your partner’s HIV status – or even your own. This is why some HIV-negative men decide to take PrEP, or to only fuck with HIV-positive men who have an undetectable viral load. It’s up to you to decide what works for you. Combining more than one method helps to increase your protection!
Some HIV-positive men also decide to choose partners based on HIV status. Being HIV-positive and only having sex with other HIV-positive guys is a safe practice, except when it comes to other STBBIs!
Dipping generally refers to the partial insertion of the penis into the anus, although it can also mean complete insertion without a condom for a few seconds, which people sometimes do in order to get really hard. Practices such as these that involve pulling out before ejaculation still carry a risk of HIV transmission, because the virus can be present in the precum of the top or in the anus of the bottom. The risk can be considerably reduced, however, if you use one or more prevention methods such as PrEP or taking viral load into consideration.
You might have heard that being circumcised can protect you against HIV. Although studies have demonstrated some effectiveness in countries with high rates of HIV, in Canada, circumcision isn’t recommended as a prevention method. Circumcision is a personal choice that should be made for reasons other than HIV prevention.
Before having anal sex, many people like to clean out their ass using an enema bulb or anal douche. It’s up to you and your partner to decide if this is something that works for you.
Avoid douching with chemical products, which can irritate the lining of the anus and rectum or even remove a layer of protective cells, making it easier to become infected with HIV.
Using lukewarm water (neither too hot nor too cold) is the best option. Avoid too much pressure if you’re using an anal douche. This can be done right before sex, but you can also do it before you meet up with someone which will allow you to take your time. Either way, be sure to pace yourself and respect the limits of your body.
Douching after sex is not advised, since it can actually force fluids deeper into your rectum rather than flushing them out.
Taking viral load into consideration
Viral load is a measurement that allows us to quantify the amount of active virus in the blood. Viral load is considered to be undetectable when the level of virus is so low that it’s no longer possible to detect it using conventional tests. In order for viral load to reach undetectable levels, a person living with HIV needs to be on an effective anti-HIV treatment and receive regular follow-up by a physician.
If you fuck or get fucked by a partner with an undetectable viral load, the risk of HIV transmission is greatly reduced for both the top and the bottom, particularly if no other STBBIs are present. If you combine an undetectable viral load with another prevention method such as PrEP, the risk become close to nothing.
To learn more, see the section on Viral Load.