Sexuality is as diverse as people are. And anything goes – as long as it’s fully consensual and no legal boundaries are overstepped. And however you live out your sexuality, if you’re aware of the risks and take the right action, you can stay healthy.
The risks of contracting HIV or another sexually transmitted infection depend on the situation. The three most important factors that put you at higher risk are:
You can protect your health from risks by getting vaccinated, taking other protective measures and getting tested.
If you’ve been in an HIV risk situation, you should immediately go to the accident and emergency department at a hospital. There, medical staff will check to see whether emergency HIV treatment, or PEP, is necessary. PEP must be taken within 48 hours, and ideally as soon as possible. PEP is not a ‘morning after pill’ and there’s no guarantee that it’ll work. It’s meant for emergencies as a last resort, for example if a condom breaks during sex.
The following are considered high-risk situations for HIV: • Any rape • Anal sex between men without a condom or PrEP • Anal or vaginal sex without a condom or PrEP with people from or in countries where HIV is particularly prevalent • Exception: people living with HIV who are receiving effective HIV therapy can no longer transmit the virus.
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The more sexual partners you have, the higher the likelihood of spreading sexually transmitted infections. What matters is not just your number of sexual partners, but also that of each of your sexual partners. There is a higher risk in the following situations:
Some groups of people are more affected by certain sexually transmitted infections (STIs) than others. The following are more affected by HIV, other STIs, and hepatitis B and C:
In the following cases, with anal or vaginal sex, there is an increased risk of HIV infection if you don’t use a condom, or if the condom rips, and you’re not using PrEP:
People living with HIV who are receiving effective therapy do not transmit the virus. Having sex with someone in this situation does not pose any risk. This is known as U=U (undetectable = untransmittable).
The more sexual partners you have, the higher the likelihood of spreading sexually transmitted infections. If you have a lot of different sexual partners, you also have a higher risk. If you have sex with sex workers, you come into contact with a wide sexual network, which also increases your risk of infection.
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In countries with high prevalence of HIV, the transmission risk is higher.
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Contaminated sex toys or sharing sex toys with others (particularly anal toys) can lead to smear infections. This is when germs from the vagina or anus get on to the surface of the toys and are passed on to others. If blood gets on a sex toy, see the information in the next paragraph.
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If mucous membranes come into contact with blood, there’s a high risk of hepatitis B and C infection. Bleeding is more likely during anal sex – for example during fisting (when the fist is inserted into the anus), when using large anal sex toys, or when engaging in BDSM (Bondage, Discipline, and Sadism, Masochism). This involves consensual violent sexual acts. Blood transports viruses. However, direct contact with menstrual blood involves a negligible infection risk.
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When injecting (anabolic steroids or drugs), snorting using straws (e.g. cocaine), if paraphernalia (syringes, needles, tubes, bottles, filters, thinners or spoons) is shared.
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Sex in combination with alcohol or drug use can have an adverse effect on precautions and lead to greater transmission risk because protection gets forgotten or doesn’t seem that important.
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And if you use drugs (inject, snort):
Chemsex is defined as group sexual activity while taking stimulant drugs. Chemsex sessions often last for several hours or days and involve sex with multiple partners. This increases the likelihood of transmitting all sexually transmitted infections. If substances are injected or snorted, there is also a risk of HIV and hepatitis B and C.
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HIV, hepatitis B and C, and syphilis can be passed on to the child during pregnancy and childbirth. In Switzerland, however, the risk is very low as tests are carried out during pregnancy. In the event of an infection, the health professional will talk to the mother about ways of protecting her child from infection.
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Oral sex and sexual practices involving fingering don’t entail any HIV risk. But you can still be infected with other STIs. If you only masturbate on your own, there’s no transmission risk – as long as you don’t share sex toys and accessories with others.