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HIV Prevention

HIV prevention has the power to eliminate HIV. In order for prevention to work, strategies must take into account women's life circumstances.

Prevention

Currently, the main methods of protection against HIV transmission are:

  • Condoms and other physical barriers when engaging in sexual activity
  • Using sterile and single use needles and other drug injection equipment (i.e. not sharing equipment with others)
  • HIV treatment to reduce the viral load of people living with HIV
  • Pre-exposure prophylaxis and post exposure prophylaxis (PrEP and PEP)

Power imbalances in women’s lives impact their capacity to prevent HIV transmission. Women need accessible and affordable self-controlled methods of prevention that do not require the knowledge or consent of their sexual and/or injection partners. As research advances and new prevention technologies are made more accessible, prevention for women is improving.

In most jurisdictions, the uptake of PrEP medication has predominantly been among gay, bisexual, and men who have sex with men (gbMSM).

The WHAI Network works to build the capacity of service providers and communities across Ontario to engage women with PrEP as a safe and highly effective prevention tool.

Condoms and Other Physical Barriers

How they work and different options

Condoms are physical barriers that can reduce the risk of a sexual exposure to HIV and sexually transmitted infections (STIs). They are made of materials that do not allow HIV or STIs to pass through them. Condoms are highly effective against HIV and STI transmission when used consistently and correctly.

What are the options?

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External Condoms (sometimes referred to as a "male condom"). External condoms are typically made of latex but polyurethane options are also available. These are to be worn on the penis* during sex.

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Internal Condoms (sometimes referred to as a "female condom"). Insertive condoms are always made from polyurethane, can be inserted into the vagina or anus up to 8 hours in advance, and may be a good option for people whose partners will not (or cannot) use external and/or latex condoms; however, they are more expensive and less available than external condoms.

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Dental dams are a square piece of latex that can be used as a barrier for vaginal*, or anal oral sex. It is important to note that the risk of HIV transmission through oral sex is negligible.

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Flavoured condoms or non-lubricated condoms can be used for oral sex on a penis.**

Click here for more information on preventing HIV and STI transmission through condom use.

* Trans communities may refer to their genitals using different language. For more information about language and safer sex with Trans women, see Brazen: Trans Women’s Safer Sex Guide. For more information about language and safer sex with Trans men, see Primed²: A Sex Guide for Trans Men into Men

HIV Treatment and Viral Load Suppression

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Undetectable = Untransmittable*

Research has shown that the consistent and correct use of HIV medications by people living with HIV can lower a person’s viral load to undetectable levels. When a person living with HIV maintains an undetectable viral load for at least 6 months, they cannot transmit the virus sexually to other people. In 2015, approximately 80% of people living with diagnosed HIV in Ontario were virally suppressed.

 

Undetectable = Untransmittable is changing the lives of many people living with HIV; however, there are important considerations that are relevant for women.

 

To learn more about U=U and Women, click here.

 

Viral load testing is part of routine checkups for people living with HIV who are engaged in care and on treatment. Accessing and staying engaged in care has shown improved health outcomes for people living with HIV, and is a very effective prevention tool.

To learn more about suppressing viral load as a prevention method, click here.

Pre-Exposure Prophylaxis (PrEP)

What is PrEP?

Pre-Exposure Prophylaxis (PrEP) is a prescription medication for HIV-negative people to reduce their risk of contracting HIV. PrEP is a combination of two drugs that fight against HIV known as “antiretrovirals” and is typically taken daily. PrEP is safe and has been approved by Health Canada. To learn more about PrEP, check out Ontario PrEP.

Post-Exposure Prophylaxis (PEP)

What is PEP?

PEP refers to a prescribed medication that prevents HIV acquisition for anyone who may have recently been exposed to HIV infection. As PEP is not 100% effective, starting earlier can increase its effectiveness. It can be prescribed up to 72 hours after exposure and the sooner it is accessed the more effective it can be.

CENTRING WOMEN'S EXPERIENCES

"We must avoid creating two classes of people with HIV; those who have an undetectable viral load and those who do not."


— Ontario AIDS Network

RESOURCES

Brochure, WHAI Resource

PEP & Women (2019)

WHAI's resource on Post-Exposure Prophylaxis (PEP) for women.

Report, WHAI Resource

Living in the Asterisk(*)

WHAI's resource on what undetectable = untransmittable means for women.

Brochure

Brazen

CATIE and the 519's safer sex guide for Trans women.

Report

Fact Sheet: HIV Treatment and an Undetectable Viral Load to Prevent HIV Transmission

CATIE's fact sheet on HIV treatment and an undetectable viral load to prevent HIV transmission.

Brochure, WHAI Resource

PrEP & Women (2019)

WHAI's resource on Pre-Exposure Prophylaxis (PrEP) for women.

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