如何预防肛交及阴道插入感染HIV

如何预防肛交及阴道插入感染HIV

预防HIV感染的关键是采取正确的安全措施，如正确使用避孕套、考虑使用预防药物、选择低风险的性行为、定期检测并治疗其他性传播疾病（STD），以及减少性伴侣数量。采取越多的预防措施，您就能越安全。

以下是具体的预防措施：

1. 每次发生性行为时正确使用避孕套。学习如何正确使用男性避孕套，确保每次使用时都能完全覆盖。

2. 减少性伴侣数量。性伴侣越多，你接触到的感染HIV的风险就越大。尽量减少性伴侣的数量，降低遇到病毒载量不受抑制的HIV感染者或其他性传播疾病患者的机会。

3. 咨询医生是否需要使用暴露前预防药物（PrEP）。如果你处于非常高的感染风险中，可以考虑每天服用PrEP来预防HIV感染。如果你是HIV阴性且有持续的与HIV阳性伴侣的性关系，或者你不是与刚检测HIV阴性的伴侣保持单一配偶关系，以下人群应考虑使用PrEP：

   • 曾经没有使用避孕套发生肛交的男同性恋者或双性恋者，或在过去6个月内被诊断过性传播疾病的人；

   • 与男性和女性发生性关系的男性；

   • 在没有规律使用避孕套的情况下，与你不知道HIV状态的伴侣发生性行为的人，尤其是高风险人群（如吸毒者或与双性恋者有性关系的女性）。

4. 暴露后预防（PEP）。如果你是HIV阴性，且在性行为中可能暴露于HIV（例如，避孕套破裂），应尽早与医生或急诊室医生沟通，尽快使用PEP。PEP应该在暴露后72小时内开始，每日服药28天，越早开始，效果越好。请注意，如果你的HIV阳性伴侣按时服药且其病毒载量得到有效抑制，感染HIV的风险会大大降低。

5. 定期进行HIV检测并治疗其他性传播疾病。如果你有性行为，建议每年至少进行一次HIV检测。性传播疾病可能增加感染HIV的风险，并且可能带来长期健康问题。

6. 鼓励HIV阳性伴侣接受治疗并坚持服药。若伴侣为HIV阳性，且正确按时服用抗病毒药物（ART），这将有效减少体内病毒载量至极低水平，称为“病毒抑制”，这有助于提高其自身健康状况，并极大减少传播HIV的风险。

7. 选择低风险的性行为。HIV主要通过无保护的肛交或阴道插入传播。接收方（底方）进行肛交的感染风险更高，因为直肠的黏膜较薄，容易在肛交时感染HIV。

   • 肛交：接收方进行肛交的感染风险最高。虽然插入方（顶方）也有感染的可能，但对HIV阴性伴侣来说，作为接收方的感染风险更高。

   • 阴道交：阴道交的HIV感染风险较肛交低，但仍然存在风险。大多数女性感染HIV是通过阴道性交，而男性也可能通过阴道性交感染HIV。

8. 口交的HIV感染风险较低。理论上，HIV阳性男性如果在口交时射精到伴侣的口腔，可能会传播HIV，但这种风险很低，比肛交或阴道交的风险要低。口腔溃疡、牙龈出血、外生殖器溃疡和其他性传播疾病等因素可能增加口交时传播HIV的风险。

9. 不涉及体液接触的性行为不传播HIV，但可能会传播其他性传播疾病。避免发生任何可能与体液接触的行为，比如直接接触精液、阴道分泌物或血液。

通过采取这些措施，你可以大大减少感染HIV的风险并保护自己与伴侣的健康。

How to Prevent HIV Transmission through Anal and Vaginal Sex

The key to preventing HIV infection is taking the right safety measures, such as correctly using condoms, considering preventive medications, choosing lower-risk sexual behaviors, getting tested for and treating other sexually transmitted diseases (STDs), and reducing the number of sexual partners. The more of these preventive actions you take, the safer you will be.

Here are specific preventive measures:

1. Use condoms the right way every time you have sex. Learn the correct way to use a male condom and make sure it covers completely during each use.

2. Reduce the number of sexual partners. The more sexual partners you have, the higher the risk of being exposed to HIV, especially if your partners have a high viral load or are infected with other STDs. Try to limit the number of sexual partners to reduce your exposure.

3. Talk to your doctor about pre-exposure prophylaxis (PrEP). If you're at very high risk for HIV, consider taking PrEP, a daily HIV medicine that helps prevent HIV infection. If you're HIV-negative and in a continuous sexual relationship with an HIV-positive partner, or if you're not in a monogamous relationship with a partner who recently tested HIV-negative, you should consider PrEP. PrEP should also be considered if you:

   • Are a gay or bisexual man who has had anal sex without a condom or have been diagnosed with an STD in the past 6 months.

   • Are a man who has sex with both men and women.

   • Are a heterosexual man or woman who doesn't regularly use condoms during sex with partners of unknown HIV status who are at very high risk of infection, such as people who inject drugs or women with bisexual male partners.

4. Post-exposure prophylaxis (PEP). If you're HIV-negative and have recently been exposed to HIV (for example, if a condom breaks), you should talk to your healthcare provider or an emergency room doctor about PEP immediately (within 3 days). PEP is most effective when started as soon as possible and should be taken daily for 28 days. Keep in mind that if your HIV-positive partner is on HIV treatment (ART) and their viral load is suppressed, the risk of transmission is much lower.

5. Get tested and treated for other STDs and encourage your partners to do the same. If you're sexually active, get tested at least once a year. Having other STDs increases the likelihood of getting or transmitting HIV. STDs can also have long-term health consequences.

6. Encourage your HIV-positive partner to stay on treatment. If you're HIV-negative and your partner is HIV-positive, encourage them to take their HIV medication regularly. ART reduces the viral load in the body to very low levels, which helps improve the overall health of the HIV-positive person and drastically reduces the risk of transmitting HIV to you.

7. Choose lower-risk sexual behaviors. HIV is primarily spread through unprotected anal or vaginal sex. The receptive partner (bottom) during anal sex is at the highest risk because the lining of the rectum is thin and can allow HIV to enter the body.

   • Anal sex: The receptive partner (bottom) is at the highest risk. Although the insertive partner (top) can also get HIV, the risk is higher for the receptive partner. Anal sex should always be protected with condoms to minimize the risk.

   • Vaginal sex: Vaginal sex also carries a risk of HIV transmission, but it is less risky than receptive anal sex. Most women who contract HIV get it from vaginal sex, but men can also get HIV from vaginal sex.

8. Oral sex carries a much lower risk of HIV transmission. While HIV transmission through oral sex is theoretically possible if an HIV-positive male ejaculates into a partner's mouth, the risk is very low. Factors that could increase the risk of transmission during oral sex include oral sores, bleeding gums, genital sores, or the presence of other STDs, even if they are not visible.

9. Sexual activities that don't involve contact with bodily fluids (semen, vaginal fluids, or blood) carry no risk of HIV transmission, but they could still pose a risk for other STDs. Avoid any sexual activity that might lead to the exchange of body fluids.

By following these measures, you can significantly reduce your risk of contracting HIV and protect yourself and your partners from the virus.