safe sex (prevention of HIV1 & other STDs)

^[1]^[2]^[3]^[4]^[5]^[6]

Management

activities with no risk of HIV transmission
- abstinence
- dry kissing
- hugging
- massage
- clothed body rubbing
- fantasy
very low risk of HIV transmission
- external water sports
- sexual activities involving urine
- oral sex with a condom
- oral sex with a dental dam
- deep kissing
- masturbation on healthy, dry skin
low risk of HIV transmission
- insertive vaginal intercourse with a condom
- insertive anal intercourse with a condom
- receiving oral sex without a latex barrier
medium risk of HIV transmission
- receptive vaginal intercourse with a condom
- receptive anal intercourse with a condom
- giving oral sex without a latex barrier
- masturbation on open or broken skin
- inserting finger or hand into vagina or anus without latex barrier
- sharing sex toys without a condom or disinfecting toys
high risk of HIV transmission
- anal stimulation with tongue (rimming)
- insertion of entire hand into vagina or anus (fisting)
- inserting anal intercourse without a condom
- insertive vaginal intercourse without a condom
very high risk of HIV transmission
- receptive anal intercourse without a condom
- receptive vaginal intercourse without a condom

condoms are 98% effective in preventing sexual transmission of HIV1 & other STD
male circumcision protects against heterosexual transmission of HIV1 (RR 0.4)^[3]
1% tenofovir gel used intravaginally before & after sex reduces incidence of HIV1 by up to 54%
oral tenofovir/emtricitabine reduces HIV1 transmission in serodiscordant heterosexual couples by 62-73%^[5]
contraception safe for women with HIV1^[6]

↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
↑ Veterans Administration, Mather, CA
↑ ^3.0 ^3.1 AIDS Clinical Care December 28, 2005
↑ Abdool KQ et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science 2010 Jul 19 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20643915 <Internet> http://www.sciencemag.org/cgi/content/abstract/science.1193748v1
↑ ^5.0 ^5.1 University of Washington - Health Sciences/UW News, Community Relations & Marketing; Public release date: 13-Jul-2011 Pivotal study in Africa finds that HIV medications prevent HIV infection http://www.eurekalert.org/pub_releases/2011-07/uow--psi071211.php
CDC Press release: July 13, 2011 CDC Trial and Another Major Study Find PrEP Can Reduce Risk of HIV Infection among Heterosexuals http://www.cdc.gov/nchhstp/newsroom/PrEPHeterosexuals.html
↑ ^6.0 ^6.1 Centers for Disease Control and Prevention Update to CDC's U.S. Medical Eligibility Criteria for Contraceptive Use, 2010: Revised Recommendations for the Use of Hormonal Contraception Among Women at High Risk for HIV Infection or Infected with HIV MMWR June 22, 2012 / 61(24);449-452