Treatment as Prevention (TasP)
TasP refers to an HIV positive person whose viral load is suppressed to undetectable levels from HIV treatment. When the viral load is undetectable the risk of HIV transmission can be lowered by 96%. As a result, it considered a viable HIV prevention tool. When combined with a sexual partner who is correctly taking PrEP, the is even lower.
PrEP stands for Pre-Exposure Prophylaxis and is a once daily pill that can prevent HIV. If taken as directed the drugs efficacy can be more than 92% effective.
PEP stands for Post-Exposure Prophylaxis and is for persons who have experienced possible exposure to HIV. PEP is a combination of drugs which must be prescribed within 72 hours of the possible exposure for maximum efficacy. The drugs are taken for a period of at least 28 days and can be 81% effective at preventing HIV infection.
Tools and Technology
Female (Insertive) Condoms
Female condoms are sometimes referred to as “insertive condoms” and are FDA approved for insertion into the vagina. Many have found that they can also work anally. The female condom is a larger version of traditional condoms and has two rings- one is placed inside the vagina and the other is placed just outside the vaginal opening. For anal use, the insertive ring can be removed. Then, the tip of the condom is placed inside the anus and the remaining ring is placed just outside the entrance to the anus.
Rapid HIV Testing
Knowing your HIV status is another tool in the prevention tool box. The Centers for Disease Control recommends that men who have sex with men be tested every 3 months, but new HIV rapid tests allow for accurate results after just 14 days.
Sero-sorting refers to having sexual partners with the same HIV status as themselves. This type of risk reduction is not highly effective since persons may not be aware of their current HIV status or may have engaged in high risk behaviors since their last HIV test.
Condoms-Only / No Anal Sex
Utilizing condoms or not engaging in anal sex does not have a high percentage of effectiveness. In fact, a study conducted in 2012 revealed a 74% reduction in HIV infections using this method. A second study in 2013 resulted in an even lower reduction at 70%.
Sero-positioning refers to choosing who is the insertive (top) and receptive (bottom) partner based on HIV-status. Having an insertive partner who is HIV-positive poses a higher risk than if they were the receptive partner. So, someone who is HIV-negative may choose to be the top if their partner is positive or unsure of their status. A 2012 study found this method to be 75% effective in reducing HIV transmission.
According to a 2012 study, men who have sex with men and top exclusively (they are only ever the insertive partner) experienced an 86% reduction in HIV transmission rates. This reduction is due to the inherent lower risk of topping. The CDC estimates that risk to be 0.065% per sexual experience.