Q. What are the chances of developing resistance to my treatment?
Antiretroviral Therapy uses three different types of drugs to fight HIV – targeting the virus at different stages of its life cycle. The risk of developing resistance to treatment is low as long as you are adherent and do not have a strain of HIV that is resistant to the treatment that you are on.
Resistance to treatment most often arises when the level of HIV treatment in your blood is not high enough to fully suppress the virus. This can happen if medication is not taken as prescribed resulting in a spike in viral load. When this happens, newly replicated viruses that have genes that make them resistant to treatment are selected to survive and continue to replicate.
Another way of developing resistance is if you have unprotected sex or share needles with another person who has a resistant strain of HIV and is not undetectable. The strain of HIV that they have would have to be resistant to the treatment that you are on for it to be able to replicate in your body, even if you are taking your medication as prescribed.
Q. If I have a high CD4 count can I still access treatment?
Policy around prescription of HIV drugs in New Zealand does take your CD4 count into account, as this provides information about the health of your immune system. To find out more about CD4 counts contact the NZAF.
Q. Can I still enjoy a drink while on treatment?
Yes. Unlike many medications, HIV medications do not interact negatively with alcohol.
Q. How long after the last time I have brushed and flossed my teeth would it be safe to have oral sex? I'm still a virgin thus I've never had any physical sexual activity with anyone including kissing. I'm on my early 30s and I had my first HPV (Gardasil-9) vaccine almost a month ago. I met a guy online and he's quite nice. He wants to meet a week from now and he's not pressuring me to have sex, although we might end up with kissing, cuddling, touching, or mutual masturbation in the shower. However, I am confused with how to go with it as I still have 2 more doses for the HPV vaccine to receive and also concerned if I could get other STIs. I'm not sure what intimate activities we can do.
The risk of transmitting HIV through oral sex is extremely low even with brushing/flossing, but common advice is that you should wait at least four hours after flossing. If you're worried about flossing then don't do it that day - just use mouthwash.
This only applies for HIV though, transmission of other STIs (eg syphilis and gonorrhoea) can still be passed on through oral sex. If you're concerned, you could use a condom for oral sex. There is also some evidence that gargling with Listerine can prevent gonorrhoea.
If you're anxious about having sex for the first time and potential STI risk, it could be worth talking to one of the counsellors at NZAF - book an appointment using our Book a Test form.
Q. I'm in my early 30s and planning to get the HPV vaccine. I was told it would take 6 months to complete the 3 doses. Does it mean immediately after the 3rd dose (6 months) it's safe for me to have sex and be protected from HPV or do I have to wait a few days or months after completing the 3 doses?
HPV is one of the most common STIs globally and it is transmitted by direct skin-to-skin contact. It is therefore more than likely that you have had an HPV infection already at some point in your life – this information is not something that should cause concern to you as clinical disease caused by HPV is comparatively extremely rare compared to the rate of infection with HPV and most of these infections are cleared naturally by the body without intervention.
HPV-related cancers are extremely rare and affect roughly 5 in 100,000 guys who have sex with guys. The types of HPV that cause cancer (high-risk [HR] HPV) infect the openings of the body and for males these are the penis, anus, and mouth/throat and to infect these openings, penetration generally has to occur. There is limited evidence that HPV can be transmitted through kissing and through the sharing of bodily fluids, however there is some evidence to suggest that transmission can occur through sharing of sex toys and penetration with fingers. With all this in mind, there is no need to change/delay your sexual plans due to risk of HPV infection – the use of condoms has been shown to reduce the risk of acquiring anal HPV infection.
In regards to the protection offered by vaccination with Gardasil-9, it is one of the most effective and safe vaccines that are available. Quite often when a person is infected with HPV they will not generate an immune response as the virus is very good at hiding from the immune system, and if one is generated it is usually a relatively weak response. When we vaccinate we end up generating an immune response to HPV that is over 10-times greater than the natural immune response after the full three doses are given. Even after the first shot the immune response is equivalent or greater than the naturally generated response. We have no idea what level of immune response is required to provide immunity against HPV and it is likely that this level will be different for each individual. What we can say is that from the studies of the existing vaccination programmes, those who have received all three doses are the least likely to have any infection with HPV. But even those who have received only one dose of the vaccine are significantly less likely to be infected with HPV than those who have not been vaccinated at all. However, please also bear in mind that vaccination does not mean that you can never be infected with the pathogen that you have been vaccinated against - vaccines are never 100% effective because biology doesn’t work that way, there is always an exception to every rule - but you are 95% less likely to get HPV if you are vaccinated against it than if you weren’t.
Q. What Are The Signs/Symptoms Of Having HIV?
Not everyone who gets HIV will experience any short-term symptoms. So, symptoms or not, it's important to test twice a year - or more often if you haven't been playing safe.
In some people, symptoms may occur from two to four weeks after HIV infection and may include flu-like symptoms that are easily confused with other infections, such as fatigue, fever, night sweats, sore throat, swollen lymph nodes, headache, loss of appetite or skin rash. These symptoms usually last less than two weeks although they can last as long as 10 weeks. If you‘ve recently had unprotected anal sex and experience any of these symptoms, you should have an HIV test at your emergency room, GP or sexual health service.
Also, keep in mind that not all doctors will recognise the symptoms of HIV. If you see a doctor because you have one of the symptoms listed above, it’s important to explain that you feel at risk of HIV and ask to be tested, even if they don't suggest it. Don't assume you will be tested for HIV just because they take your blood. Ask to be sent a copy of the results.
Q. How Exactly Does PrEP Work?
PrEP is pill that is taken daily to significantly reduce the risk of becoming infected with HIV. It is a combination of two HIV medications (tenofovir and emtricitabine) and it works by maintaining a certain level of drug in the body that can prevent HIV establishing an infection. This means that you have to take the pill every day to maintain this level of drug. Studies have shown that if it is taken every day as prescribed it reduces the risk of getting HIV by at least 92%.
Q. I Was Chatting To A Guy On Grindr And He Said It's Safe To Fuck Him Without A Condom Because He's On PrEP. Is It Really Safe?
It's great that he's taking action to reduce his risk of getting HIV by using PrEP, but him being on PrEP is not a 100% guarantee that he hasn't got HIV. He may, for example, have stopped taking it for a period of time and unknowingly acquired HIV. So you're still at risk unless you're taking action to protect yourself either by using condoms or taking PrEP yourself.
Keep in mind that PrEP doesn't protect against other STIs like syphilis, gonorrhoea or Hep C, and you won't always know if someone has another STI because they can have no symptoms. Using condoms is the best option for protecting against both HIV and other STIs, but if you struggle with condoms then PrEP at least will provide protection from HIV.
Q. How Long Does It Take For PrEP To Be Effective?
If you're using PrEP to provide protection during anal sex, you need to take it daily for 7 days prior to any sex without condoms to ensure that the levels of the drug have built up to provide enough protection.
You also need to continue taking it daily for 28 days following the last episode of anal sex without condoms for maximum protection.
Q. I Had Sex Without A Condom Two Nights Ago And During Sex, The Guy Tore His Foreskin And Was Bleeding Badly. I'm Too Embarrassed To Go And Talk To A Doctor But I'm Really Concerned - Is There Anything I Need To Do?
Unfortunately with HIV there's a window period of a few weeks, which means that if you've contracted HIV it won't show up in a test result straight away. Anal sex without condom is the highest risk activity for HIV transmission, and even higher if significant bleeding is involved. We'd recommend visiting your local free sexual health clinic to talk about it.
If the guy you were with was living with HIV, depending on his viral load, there is a risk that HIV could have been transmitted. If you know the guy is HIV positive then a short treatment course called PEP is available, but you would need to start the regime within 72 hours of being exposed to HIV for it to be effective.
Q. Is It Very Easy To Get HIV If I Have Ulcers In My Mouth And Give Blow Job To A Guy I Just Meet? Assuming He Has HIV...
When it comes to oral sex, it's what we consider very low risk for HIV transmission. It's important to manage the risks as much as possible, and still enjoy sex. A couple of things to consider to keep that risk to a minimum is not letting them cum in your mouth and checking for cuts or ulcers either in the mouth or on the penis, as they become potential entry points for HIV to enter into your blood stream. So yes, if you have ulcers in your mouth and you get his cum or pre-cum on those ulcers there is some risk.
Q. What's The Deal With Cock Piercings And Condoms? Is It Still Safe To Have Sex With A Cock Piercing If You Use A Condom?
That's an interesting question as piercings are quite common these days. The best advice we can give on this is that you or your partner should remove the piercings before having anal sex. This is because there is a chance that the metal might break through the latex of the condom. Some might argue that the jewellery is smooth and won't tear the condom, but we reckon with metal against latex it's not worth the risk. Be aware too that piercings need time to heal after you first get them so sexual activity during the healing period should be avoided.
Q. I'm A Guy And For The Last Few Weeks I've Been Having Sex With Another Guy. I Have Started To Notice Black Dots In My Pubic Hair Area (But None That I Can See Around The Base Of My Penis) With About Two Strands Of Pubic Hair Coming Out From/around The Black Dot. Do You Know What This Is? And Should I Get It Checked Out?
If you are feeling concerned then yes you should go and get checked out. You could go to your GP, or if you prefer, your local sexual health clinic which is probably free. If you are concerned about having to mention your sexuality then you don't have to, it's up to you. Skin issues can happen to all men, and, while it can be bit embarrassing to go and drop our trousers and be checked out in such a personal way, a health professional will deal with it in a matter of fact way and treat you respectfully and confidentially. It will be worth it in that you will be able to stop worrying about it.
Q. What Should You Do If You Rip Your Foreskin During Rough Anal Sex?
Ouch! Any trauma should be checked out by a medical professional.
Q. Whenever I See Guys Pumping Themselves In Cruise Clubs Or Porn Movies They Seem To Have No Problem In Gradually Masturbating Successfully With A Load Of Jizz Cumming Out. I Tend To Find That The Only Way For Me To Cum Is To Use Lubricant. I Can Get A Hard Erection Quick Enough But It Annoys Me That I Can't Cum After Pumping, So I Use Quite A Bit Of Lubricant Which Makes It Happen Within 30 Secs. Is It Normal To Only Be Able To Cum After Lubricating?
It is really import to remember that everybody is different when it comes to sex. What is 'normal' for one person doesn't necessary relate to everyone, and the guys on the screen are the exception and not the rule. Bodies will produce different amounts of cum and can take time in 'refilling'. The use of lube can increase the sensation and sensitivity and ultimately the level of arousal, so experiment with different amounts. Try not to measure yourself on the quantity to determine your quality. As always if you want to talk further, give us a call.
Q. What Type Of Condom Is Inside The Free Condom Packs That You Provide?
The condoms in our free condom and lube packs are Durex confidence natural rubber latex condoms. Each one comes with a sachet of Durex Play water based lube. We also have Shield branded XL and narrow fit condoms that we can send out to you. If you would like to try either of the Shield ones just send us an email at [email protected] and we will send you some for free.
Q. I'm New To New Zealand And I Want A Free HIV Rapid Test. Where I Can Find A Place To Do That In Auckland City?
There are a number of places you can go in Auckland but if you are in the city it is probably easiest to book in for a free rapid test at NZAF Burnett Centre. The staff are all very lovely, welcoming and very skilled at what they do.
Q. I'm 16 And Not Really Out, But I Have Been Becoming More And More Interested In Getting A Relationship With A Guy And I Don't Know Where To Look As I Don't Really Know Any Gay Or Bi Guys. Do You Have Any Tips For Meeting Other Gay Teens?
Good places to start are youth groups which provide safe and reputable gay teen peer support groups and avenues to other support. We've linked to a few below.
Q. I Have Trouble Staying Hard When I Top With A Condom On. I'm Also Circumcised And With A Condom I Can't Feel A Lot. Can You Suggest Some Ways To Increase The Feeling / Keep Me Hard Longer?
There are lots of ways to help with this; number one, have you got the right size? We have 49mm, 56mm (standard size) and 60mm condoms we can send out, so if you would like to try some different kinds for free, flick us an email at [email protected] Secondly, thickness can play a part. Have a play around with some non-latex condoms, as they're super thin and may make a difference for you. The final thing to do is simply put a small bit of lube on the head of your penis before rolling on the condom. Better lubricating the inside can make a huge difference; just have a play around first before you fuck, as you want to make sure you don't use too much and risk your condom slipping off.
If you're still struggling after trying these options you could consider PrEP, the daily pill that prevents HIV. It's as effective as condoms for preventing HIV but it doesn't provide any protection from other STIs like gonorrhoea or syphilis.
Q. I Have Just Started To Finger Myself. I Tried It Once Without Lube And Once With Shower Gel In The Shower. Is It Normal If I Feel Irritated Afterwards? The Only Thing Is I Didn't Get Pleasure Out Of It? How Deep Am I Meant To Go?
Firstly, go buy some lube or get us to send you some. The shower gel you're using could have harsh chemicals in it which might be why your asshole feels irritated - soaps can interfere with natural bacteria and irritate sensitive membranes.
You should get some pleasure from rubbing around the anus, and then from the prostate, which is about a thumb's length inside your ass towards your bellybutton.
Q. If Both Partners Have Tested Negative For HIV And Other STIs, Is It Safe To Have Bareback Sex?
This short answer is that it's not very safe - because you can never be 100% sure of somebody's HIV status (or even your own status), for the following reasons:
First, it can take up to three months form the date of infection for HIV to show up in a test. So, even if you both tested negative yesterday, it's possible that one of you does have HIV and it hasn't shown up on the test.
Second, HIV is most infectious in the few weeks after somebody catches it. So if a guy caught HIV a few weeks ago he won't know it yet because it often has no symptoms and it my not show up that early on a test. He'll also be highly infectious at this stage, with a very high chance of passing it on. This is actually how most HIV in New Zealand is passed on - from guys who don't know yet that they have it yet.
Relying on negative HIV status to prevent HIV is risky. It requires constant, open communication with your partner(s), and regular testing. And even then, it won't necessarily work. Condoms or PrEP, however, are very effective at preventing HIV regardless of the HIV status of you partner(s).
Q. He Spat On The Condom As Lube - Is There A Risk Of HIV Infection?
HIV is not spread through saliva, even when used as lubricant for anal sex. However, if he had oral herpes this could be transmitted to your anus.
Spit is generally not a great lubricant though, so this could lead to anal bleeding. We'd recommend getting a water-based lube from the pharmacy or supermarket (or in the free condom packs we give out!)
Q. How Can I Live A Long Life, Even I Have HIV? Is There Any Medicine That Can Stop The Reproduction Of Virus In Our Veins Or Kill The Virus? If So, Where Can I Purchase This Medicine? And Is It Expensive?
There is no vaccine or cure for HIV, but there are numerous HIV treatment options available. Treatment for HIV is currently provided by highly active anti-viral therapy (HAART). These medications attack the virus at different points and stages in its life-cycle. A list of antiretrovirals can be found by clicking on the link below (please note that not all meds listed are available or funded in NZ).
In New Zealand, HIV medications need to be prescribed by a doctor, and the most common medications are free (funded by Pharmac). The first thing you should do is get a free HIV test by clicking on the link below. If the test is positive, you will be offered free counselling and support services, as well as referred to the appropriate doctor for treatment.
Q. What Are The Signs Or Symptoms Of HIV - Is There Anything I Can Look For If I'm Worried?
Some people show no signs or symptoms of HIV infection, but others experience seroconversion illness which can include flu-like symptoms, fever, rashes, a sore throat and swollen glands.
If you think you might have been infected, we suggest you book in for a fast, free HIV test with results in 20 minutes.
Q. I Have Met A New Man And He Is HIV Positive. I'm HIV Negative. If I Wear A Condom To Have Anal Sex With Him Is It Safe For Me?
Condoms and water based lube, when used consistently and correctly, are highly effective in preventing the sexual transmission of HIV. If you have any questions about putting on a condom feel free to check out the video below.
If your new man has an undetectable viral load the risk is reduced even further.
Q. What Is The Difference Between AIDS And HIV? I Do Not Understand How So Many Men Have HIV, But No Serious Symptoms.
In very simple terms: HIV is a virus that attacks the immune system, while AIDS is a condition that develops when HIV has been left untreated and caused serious damage to the immune system. HIV can now be managed with medicines, which means it is much less likely that AIDS will develop.
People who are diagnosed with AIDS can recover and regain their health, but they will still be HIV positive. Many people living with HIV continue to look and feel well throughout their lifetime. They may not even be aware that they are living with the virus. However, many HIV positive people do eventually develop different infections and cancers that the body would otherwise normally be able to fight.
Q. Can You Catch HIV From Kissing?
Kissing on the mouth is extremely low risk for HIV transmission: the only time it would be possible if both people had open wounds in their mouths that were bleeding and kissed for a long,long time.
The NZAF is passionately committed to working hand in hand with partners and the community to end HIV in New Zealand. By staying safe, testing often and treating early we can stop HIV in its tracks. Read more...