HIV prevention has the power to eliminate HIV. In order for prevention to work, strategies must take into account women's life circumstances.
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.
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?
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.
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.
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.
Flavoured condoms or non-lubricated condoms can be used for oral sex on a penis.**
HIV Treatment and Viral Load Suppression
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.
WHAI's resource on Post-Exposure Prophylaxis (PEP) for women.
WHAI's resource on what undetectable = untransmittable means for women.
CATIE's fact sheet on HIV treatment and an undetectable viral load to prevent HIV transmission.