High-risk Sexual Behaviorsa

High-risk Sexual Behaviors

High-risk sexual behavior is statistically correlated with HIV infection. The three statistically significant high-risk sexual behaviors known to transmit the virus from one partner to another include the following:

• Penile-anus sex (penis in contact with the anus)
• Penile-vaginal sex (penis in contact with the vagina)
• Brachio-anal sex (finger(s) or hand in contact with the anus)
• Unprotected sex (sex without a condom or other barrier)

Most HIV infections are transmitted through penile-anal and penile-vaginal contact. The risk for transmission is dramatically reduced with the use of condoms. However, in rare cases, HIV has been transmitted via penile-anal and penile-vaginal sex, even when condoms were used.

Factors that increase risk for transmission include the following:

• Enema or rectal douching before anal intercourse
• Anal or vaginal irritation or infection, including the following:
• Chlamydia
• Condyloma
• Gonorrhea
• Herpes
• Syphilis
• Trichomonas
• Sexual activity that may damage the mucosal lining of the vagina or rectum
• Tampon use (Tampons can cause vaginal dryness and cellular abnormalities. Sanitary napkins are recommended.)
• Vaginal dryness (A water-based lubricant is recommended.)

Safer Sex for Patients with HIV Who Have CD4+ Counts Less Than 200

Patients with compromised immune systems are at increased risk for contracting opportunistic infections. Intestinal infections are especially debilitating for patients who have HIV, and it is essential to practice safe sex to lower the risk for transmitting HIV and other infectious viruses and bacteria.

People with low CD4+ counts should avoid any contact with oral and rectal fluids by practicing the following safer sex behavior:

• Limit the number of partners with whom they are "deep kissing."
• Use dental dams or plastic wrap as a barrier during cunnilingus (vaginal-oral sex) and anilingus (anal-oral sex).

The NIH warns that studies have not been done to prove that dental dams, plastic wrap, or latex condoms that have been cut open can effectively prevent transmission of HIV or other STDs.