HIV can be transmitted sexually through blood, semen, vaginal fluid, and anal mucus if no protection is used and the person with HIV doesn’t have an undetectable viral load.
Oral sex has a very low risk of HIV transmission. The virus can very rarely be passed on this way and only if the person with HIV has a detectable viral load.
PEP will not be prescribed for any type of oral sex as the risk of HIV transmission is very low in all cases.
Sharing toys carries a small risk of transmitting HIV, but generally you would not be prescribed PEP. Always use condoms when sharing sex toys, and change to a new one with each new partner.
Sharing sex toys without using condoms can also put you at risk of other STIs. Use a water-based lubricant with condoms.
What is PEP?
When people have been put at risk of HIV, PEP may prevent HIV infection after the virus has entered the body.
Who gets PEP?
The people who are likely to be prescribed PEP are those who've had receptive or insertive anal sex or receptive vaginal or frontal sex (or shared injecting equipment) with someone who has HIV and has a detectable or unknown viral load.
It's also recommended if you've had receptive anal sex with someone with an unknown HIV status who is from an area with high rates of HIV, such as sub-Saharan Africa.
If you've had insertive anal sex, insertive or receptive vaginal or frontal sex (or shared injecting equipment) with someone with an unknown HIV status from a high-risk area for HIV, PEP may be considered.
It'll also be considered if you've had insertive vaginal or frontal sex with someone who has HIV with an unknown or detectable viral load.
PrEP (pre-exposure prophylaxis)
Trans and non-binary people
Hormones are safe to take at the same time as PEP. There’s no evidence that PEP or PrEP drugs diminish the effects of hormone therapy for trans people.
There has been little research so far regarding HIV risk following genital surgeries for both trans women and trans men. Some types of lower surgeries may theoretically increase susceptibility to HIV and other STIs.
If you have any concerns about your sexual health following lower surgery, it’s best to discuss them with your doctor.
CliniQ has more information on PEP/PrEP for trans and non-binary people.