Sexual Activities
Kissing
- Without exchange of blood
NO RISK - With exchange of blood LOW RISK
"French Kiss, necking, smooching, wet kiss"
There is no potential for transmission in pressing dry lips together. In the absence of blood in the mouth, wet kissing can be classified as no risk.
There is a very small potential for transmission in wet kissing where blood may be exchanged.
Oral sex: Fellatio
- With condom NO RISK
- Without condom, and taking semen in the mouth or having an infection in the mouth LOW RISK
- Without condom, after using mouthwash or brushing teeth LOW RISK
"Giving or getting head, headjob, cock-sucking, blowjob"
The risk in fellatio can be reduced by avoiding ejaculation of semen in the mouth and can be eliminated by using a condom.
It is also recommended that the partner giving fellatio wait 30 minutes to two hours after brushing or flossing teeth before engaging in fellatio, since brushing and flossing teeth may cause temporary bleeding of the gums.
Oral sex: Cunnilingus
- With protection NO RISK
- Without protection LOW RISK, unless in case of a throat infection
- Without protection, after using mouthwash or brushing teeth LOW RISK
- Without protection, during menstruation LOW RISK
There is a potential for transmission of HIV by performing cunnilingus (licking the clitoris and/or in or around the vulva) because vaginal fluid and blood (increased risk) can get in the mouth.
Oral sex: Anilingus
- With protection NO RISK
- Without protection NEGLIGIBLE RISK, unless in case of a throat infection.
"Rimming, licking out, eating out, licking or eating ass"
It should be noted, however, that anilingus is an efficient route of transmission for other STIs, such as syphilis, gonorrhea, Hepatitis A and B, and various intestinal parasites.
Intercourse: Penile-Vaginal
- With condom LOW RISK *
- Without condom HIGH RISK, as well as the possibility of pregnancy and other STBBI
* Condoms are not 100% reliable. There is enough evidence of transmission due to condom breakage or improper use to classify this activity as low risk.
Penile-vaginal intercourse without a barrier is a high-risk activity. The majority of documented cases of HIV transmission throughout the world are the result of unprotected penile–vaginal intercourse.
Intercourse: Penile-Anal
- With condom and lubricant LOW RISK *
- Without condom HIGH RISK
* Condoms are not 100% reliable. There is enough evidence of transmission due to condom breakage or improper use to classify this activity as low risk.
Transmission to the male partner during unprotected penile-anal intercourse may occur in one of two ways. Minor or microscopic cuts or tears on the penis may allow the virus to enter, and sores on the penis (e.g. genital ulcers) can pose even more risk by providing a point of entry for the virus. There is also evidence that transmission can occur directly through the mucosal lining of the urethra (through the opening at the tip of the penis) or of the foreskin.
Fingering (anal and vaginal)
- With latex glove NO RISK
- Without latex glove and with no lesions NO RISK
Digital stimulation of the clitoris, labia, vagina or anus or insertion of a finger in the vagina or rectum carries NO RISK unless the inserted finger has an open cut, sore, lesion, burn or rash.
Fisting (anal and vaginal)
- With latex glove NO RISK
- Without latex glove LOW RISK, if injuries are caused by insertion of the hand
"Manual penetration/fist fucking"
For this reason, the risk is greater for the receiving partner. The performing partner may have cuts or abrasions (including hangnails).
Masturbation
- Self-masturbation NO RISK
- Performing or receiving with a partner NO RISK
The practice of masturbating a man through manual stimulation of the erect penis, or of masturbating a woman by manual stimulation of her genitals, carries no risk for the person holding the penis or fingering the clitoris or the labia unless there are cuts on the fingers or hands.
Using Insertive sex toys
- Insertion of an unshared sex toy NO RISK
- Insertion of a shared sex toy, without a condom HIGH RISK
- Insertion of a shared sex toy, with a condom NEGLIGIBLE RISK *
- Insertion of a disinfected sex toy NEGLIGIBLE RISK **
* The condom could be defective or improperly used, making it impossible to classify these activities as no risk.
** There is a possibility that the toy may not be cleaned properly.
This activity may cause trauma to the vaginal or rectal lining, making it easier for HIV transmission to occur later with unprotected penile intercourse.
Using sex toys (e.g. dildos, vibrators, Chinese balls, butt plugs, anal beads) and other objects can cause trauma to the mucosal lining of the rectum or vagina. The extent of trauma varies depending on the size of the device.
Sadomasochistic activities
- Sadomasochistic activities (using universal precautions) NO RISK
- Sadomasochistic activities with bleeding HIGH RISK
"S & M, S/M"
Some sadomasochistic activities with partner(s) may lead to the incidental or intentional drawing of blood (e.g. whips, nipple-clamps, restraints, severe spanking, tattooing, skin piercing), in which case, they may be high-risk activities.
Contact with feces
- On unbroken skin NO RISK
- On open cuts, sores, lesions, ulcers, burns or rashes NEGLIGIBLE RISK
"Scat, shit play, brown"
Urination
- Receiving urine on the body NO RISK
- Receiving urine into the body NEGLIGIBLE RISK
- Receiving urine with presence of blood HIGH RISK
"Watersports, golden showers, pissing, yellow"
Vulva-to-vulva rubbing
- Vulva-to-vulva rubbing NO RISK
- Vulva-to-vulva rubbing during menstruation or with an infection NEGLIGIBLE RISK
Vulva-to-vulva rubbing poses the potential for transmission because there is a possibility that vaginal fluid may be exchanged between partners. During menstruation, the risk is increased by the potential exchange of blood.
Docking
- Docking (sex play with two penises) NEGLIGIBLE RISK
- Docking with exchange of semen or pre-ejaculate NEGLIGIBLE RISK *
"Docking"
* The lack of documented cases would lead this activity to be categorized as Negligible Risk. In this case though, the potential for risk associated with the activity precludes making a risk assignment.
Docking is placing the foreskin of one partner over the penis of another partner followed by masturbation of both penises simultaneously. There is a small potential for transmission by the entry of semen into the partner’s urethra, especially if the foreskin is sealed tight enough to prevent the escape of semen.