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Prevention

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• Know Your ABCs to Prevent HIV
• Take Time to Talk Before Having Sex
• How to Use Condoms
• IV Drug Use
• Keep Your Baby From Getting HIV
• Keep Your Kids from Getting HIV
• Additional Resources on Prevention
• Additional Resources on Prevention & Pregnancy
• Additional Resources on Keeping Your Kids From Getting HIV

Know Your ABCs to Prevent HIV

Taking simple steps to prevent getting or spreading HIV will pay off both for you and for those you love. An easy way to remember how to prevent getting or spreading HIV through sex is to know your "ABCs."

• A stands for "abstinence" (not having sex of any kind). Abstaining from sexual activities, including vaginal, anal, or oral sex, is the surest way to avoid HIV.
• B is for "be faithful." Being in a sexual relationship with only one partner who is also faithful to you can help protect you. This limits your number of sexual partners and the possibility of infection.
• C is for condoms. Using a male latex condom for all types of sexual contact can greatly lower your risk of getting HIV during sex. If you or your partner is allergic to latex, use polyurethane condoms. If your partner can’t or won’t use a condom, you can use a female condom. It may protect against HIV, but it’s not as good as a male latex condom. “Natural” or “lambskin” condoms don’t protect against HIV. Be aware that condoms don't provide complete protection against HIV. The only sure protection is abstinence (not having sex of any kind).

The following steps also can help lower your risk of getting HIV:

• Don't share needles. Don't share needles or drug injection equipment for illegal drugs like heroin and cocaine and legal drugs like steroids and vitamins. If you get a tattoo or body piercing, make sure the needles are sterile (clean).
• Limit your number of sexual partners. Your risk of getting HIV goes up with the number of partners you have. Condoms should be used for any sexual activity with a partner who has HIV or with any partner outside of a long-term, faithful sexual relationship. Dental dams also can be used to help lower your risk of getting HIV during oral-vaginal or oral-anal sex.
• Know that not all types of birth control will protect you from HIV. Other methods of birth control, like birth control pills, shots, implants, or diaphragms, will not protect you from HIV. If you use one of these methods, be sure to also use a latex condom or dental dam correctly every time you have sexual contact.
• Don't use nonoxynol-9. Some contraceptives, like condoms, contain the spermicide nonoxynol-9 (N-9). N-9 can irritate the vagina, which might make it easier for HIV to get into your body.
• Get screened for STIs. Having an STI, particularly genital herpes, increases your chances of becoming infected with HIV during sex. If your partner has an STI in addition to HIV, that also increases your risk of HIV infection. If you have an STI, you should also get tested for HIV.
• Talk with your partner. Learn how to talk with your sexual partner about HIV and using condoms. It's up to you to make sure you are protected. Remember, it's your body!
• Don't douche. Douching removes some of the normal bacteria in the vagina that protects you from infection. This can increase your risk of getting HIV.
• Don’t abuse alcohol or drugs, which is linked to sexual risk-taking. Drinking too much alcohol or using drugs also puts you at risk of sexual assault and possible exposure to HIV.

Remember, if you choose not to follow A, B, or C, you could get HIV or other STIs. You can feel proud knowing you are doing your best to keep both you and your partner safe and healthy for life.

Take Time to Talk Before Having Sex

Talking about sex is awkward for some people. So, they don’t bring up safe sex or STIs with their partners. But keep in mind that it’s your body, and it’s up to you to protect yourself. Talking with your sex partner about using condoms before having sex will help you to avoid misunderstandings during a moment of passion. Let your partner know that you will not have any type of sex at any time without using a condom. If your partner gives an excuse for not using condoms, be ready with a response. Here are some ideas:

If he says: “Trust me … I don’t have any diseases.”
You say: “It’s not about trust. Some people have STIs and don’t even know it because they have no symptoms. Using a condom will protect both of us.”

If he says: "Sex doesn’t feel as good with a condom."
You say: "Let’s try another brand or style."

If he says: “Stopping to put on a condom spoils the mood.”
You say: “I can’t enjoy sex if it’s not safe.”

If he says: “Let’s just do it this one time without a condom.”
You say: “It only takes one time to get pregnant or get an STI.”

If he says: "I don’t have a condom with me."
You say: "That’s okay. I do!"

How to Use Condoms

Male and female condoms can be used to protect yourself against HIV. But don't use them both at the same time! They do not stay in place when used together. Read the instructions and practice a few times before using condoms for the first time. Also, follow these guidelines: 

Male Condom

Use male condoms made of latex, or polyurethane if you or your partner is allergic to latex. Use male condoms for vaginal, anal, or oral sex.

• Keep male condoms in a cool, dry place. Storing condoms where it can get hot, like in the car or your wallet, can cause them to break or tear.
• Check the wrapper for tears and to make sure the condom is not too old to use. Carefully open the wrapper. Don’t use your teeth or fingernails. Make sure the condom looks okay to use. Don’t use a condom that’s gummy, brittle, discolored, or has even a tiny hole.
• Put on the condom as soon as the penis is erect, but before it touches the vagina, mouth, or anus.
• Use lubricants only made with water, such as K-Y jelly. Oil-based lubricants, such as Vaseline, can weaken the condom. The lubricant is put on the outside of the condom. It helps to keep the condom from tearing. Don’t regularly use lubricants with spermicide called nonoxynol-9 (N-9), which might make it easier for HIV to get into your body.
• After sex, pull out the penis while it is still erect, holding the condom firmly at the base of the penis so it does not slip off.
• Use a new condom if you want to have sex again or in a different way.

Female Condom

The Reality female condom is made of polyurethane. It has a ring on each end. The inside ring holds the condom in place inside the vagina. The outer ring stays outside the vagina so it covers the labia. Use female condoms for vaginal sex if your partner can’t or won’t use a male condom.

• Check the wrapper for tears and to make sure the condom is not too old to use. Open the wrapper carefully. Don’t use your teeth or fingernails. Make sure the condom looks okay to use.
• Put the condom into the vagina up to eight hours before having sex, but before the penis touches the vagina. The condom cannot disappear inside your body.
• It is okay to use water or oil-based lubricants. The lubricant is put on the inside and outside of the condom.
• After sex, remove the condom before standing up. Grasp the outside ring and twist the condom to trap in fluid and gently remove.
• Use a new condom if you want to have sex again or in a different way.

IV Drug Use

Injection drug users who share unclean needles are at great risk of being infected with HIV. Sharing unclean needles allows a direct exchange of blood from one person's body into the bloodstream of another. An injection drug user who has never shared needles will not get HIV from needles, regardless of her or his habit. It's the exchange of blood that causes transmission.

If you inject drugs, talk to your doctor about how to:

• Stop using and injecting drugs
• Enter and complete substance abuse treatment, including relapse prevention

If you cannot or will not stop injecting drugs, take the following steps to lower your risk of getting HIV:

• Never reuse or "share" syringes, water, or drug preparation equipment.
• Only use syringes obtained from a reliable source (such as drug stores or needle exchange programs).
• Use a new, sterile syringe each time to prepare and inject drugs.
• If possible, use sterile water to prepare drugs; otherwise, use clean water from a reliable source (such as fresh tap water).
• Use a new or disinfected container ("cooker") and a new filter ("cotton") to prepare drugs.
• Clean the injection site with a new alcohol swab prior to injection.
• Safely dispose of syringes after one use.

Keep Your Baby From Getting HIV

Since the first case of HIV infection in an infant was found in the early 1980s, many strides have been made to keep mothers from passing HIV to their babies. When medicine is used correctly, a woman who knows of her HIV infection early in pregnancy now has a less than 2 percent chance of delivering an HIV-infected baby. Without treatment, this risk is about 25 percent in the United States.

All women should be tested for HIV during their first prenatal care visit, early in the pregnancy. Treatment, called antiretroviral therapy, works best when it is used early in pregnancy. However, starting treatment during childbirth, or giving the newborn baby an anti-HIV drug after birth can lower the risk of a mother passing HIV to her baby.

Rapid HIV tests can be given during childbirth and the results can be known in less than 45 minutes. Knowing the mother's HIV status also helps the doctor take other steps to prevent passing the virus, such as delivering the baby by Cesarean section and not breaking the mother's water during delivery.

A mother also can pass HIV to her baby through breastfeeding. Women who are infected with HIV should not breastfeed. Instead, give your baby formula or ask your doctor about getting human breast milk for your baby from a milk bank.

Keep Your Kids from Getting HIV

If you are a mom or guardian of a teenager, you need to educate yourself and those you love on how to protect themselves from HIV. Here are some facts to know about teens and HIV.  

• HIV/AIDS is a leading cause of death for Americans between the ages of 25 and 44.
• Most adults with AIDS were likely infected as adolescents or young adults.
• For young women aged 13 to 24, the most common way they get HIV is through unprotected sex with males.
• In a recent survey of high school students, the Centers for Disease Control and Prevention found that 61 percent of the students had sexual intercourse by the 12th grade. Forty two percent of students didn't use a condom the last time they had sex. That's almost half who didn't use a condom and put themselves at risk for HIV.
• Delaying having sex for the first time can help reduce the chances of getting HIV.

Teens want good, solid advice on sexual issues from parents, often mothers. That means you are their best resource! Talking With Kids About Tough Issues is a national initiative by Children Now and the Kaiser Family Foundation to help parents talk with their children earlier and more often about tough issues like HIV/AIDS, sex, and drug abuse. Talking with your kids about HIV can be a tough task, but here are some helpful tips from this campaign to help you along the way:

Bring up the topic with your child. You could start talking about HIV when your child sees or hears a TV ad about HIV. Ask, "Have you heard about AIDS before? What do you think AIDS is?" This way, you can figure out what your child already understands and work from there.

Give just the facts. Offer honest, correct information that's right for the child's age and development. To an 8-year-old you might say, "AIDS is a disease that makes people very sick. It's caused by a virus, called HIV, which is a tiny germ." An older child can absorb more detailed information. Pre-teens should also understand how HIV is spread and that condoms help protect people from getting AIDS. If you have not yet talked about sex, don't bring it up during initial discussions about AIDS. It's not a good idea for your child's first information about sex to be associated with such a serious disease. When the time is right, talk to older children about what they can do to stay safe from HIV. Be specific. Use the ABCs and other steps as a guide to HIV prevention.

Correct misunderstandings. Children's misconceptions about AIDS can be scary, so it's important to correct them as soon as possible. Be sure to check back with your child and see what she or he remembers. Understanding AIDS, particularly for young children, takes more than a single conversation.

Build your child's confidence. Praising your children frequently, setting realistic goals, and keeping up with their interests are effective ways to build self-esteem. When kids feel good about themselves, they are much more likely to withstand peer pressure to use drugs or to have sex before they are ready. So they are less likely to put themselves at risk for AIDS.

Be ready to talk about death. When talking with your kids about AIDS, questions about death may come up. Explain death in simple terms. You could say that when someone dies, they don't breathe, eat, or feel hungry or cold, and you won't see them again. Although very young children won't be able to understand such finality, that's okay. Just be patient and repeat the message whenever appropriate. Never explain death in terms of sleep. It may make your child worry that if he falls asleep, he'll never wake up. Offer reassurance. If appropriate, tell your child that you are not going to die from AIDS and that he won't either. Stress that while AIDS is serious, it can be prevented.

Additional Resources on Prevention:

Publications

1.     Addressing HIV, Other Sexually Transmitted Diseases, and Pregnancy Prevention — This publication discusses the mission, goals, and strategies that the Centers for Disease Control and Prevention's Division of Adolescent and School Health is using to combat unintended pregnancy, HIV, and other sexually transmitted infections among youth.

   http://www.cdc.gov/HealthyYouth/sexualbehaviors/pdf/Addressing_HIV.pdf

2.     Delivery Options for HIV Positive Pregnant Women — This publication discusses delivery options for pregnant women with HIV and what they can do to lower the risk of passing HIV to their babies during delivery.

   http://aidsinfo.nih.gov/contentfiles/DeliveryOptions_FS_en.pdf

3.     Drugs, Alcohol and HIV/AIDS: A Consumer Guide — Drug and alcohol use can increase your risk of becoming infected with HIV. This publication provides resources for people who want to stop alcohol and drug abuse.

   http://www.kap.samhsa.gov/products/brochures/pdfs/HIVBroch(General).pdf

4.   HIV and AIDS: Are You at Risk? — This brochure explains what HIV/AIDS is, how to know if you have it, what testing is done, and how to protect yourself from being infected.

   http://www.cdc.gov/hiv/resources/brochures/at-risk.htm

5.   HIV and Its Transmission — This publication discusses how HIV is transmitted. It examines transmission rates in different environments such as business and home settings and discusses the effectiveness of condoms.

   http://www.cdc.gov/hiv/resources/factsheets/transmission.htm

6.     HIV During Pregnancy, Labor and Delivery, and After Birth — This series of fact sheets explains how a mother who has HIV can lower the risk of passing the virus to her baby during and after pregnancy.

   http://aidsinfo.nih.gov/ContentFiles/Perinatal_FS_en.pdf

7.   HIV Infection in Adolescents and Young Adults in the U.S. — This fact sheet summarizes statistics about HIV infection in adolescents and how it is most commonly transmitted in this age group. It discusses the difficulties facing health professionals who treat adolescents for HIV infection, and explains the role of NIAID in conducting clinical studies involving adolescents.

   http://www.niaid.nih.gov/factsheets/hivadolescent.htm

8.   HIV Infection in Infants and Children — This publication gives information on the scope of the problem of HIV in children, transmission, prenatal HIV transmission, and diagnosis. Additional information is provided regarding the progression of the disease, signs and symptoms of pediatric HIV disease, treatment of children and adolescents with HIV/AIDS, and AIDS-related psychosocial issues.

   http://www.niaid.nih.gov/factsheets/hivchildren.htm

9.     HIV Testing and Pregnancy — This publication provides information on HIV testing during pregnancy, the benefits of being tested, and where to go to learn about HIV testing policies in your state.

   http://www.aidsinfo.nih.gov/ContentFiles/HIVTestingandPregnancy_FS_en.pdf

10.     How to Protect Yourself From AIDS — This publication gives an overview of HIV/AIDS and how to lower your risk of getting HIV by using female and male condoms. This publication also gives information on how to get tested for HIV.

    http://www.fda.gov/opacom/lowlit/aids.pdf

11.   Mother-to-Child (Perinatal) HIV Transmission and Prevention — This fact sheet discusses the incidence of mother-to-child HIV transmission during pregnancy, labor and delivery, and breastfeeding. It also discusses how mothers that are infected with HIV can lower the risk of perinatal transmission and barriers to prevention efforts.

    http://www.cdc.gov/hiv/topics/perinatal/resources/factsheets/perinatal.htm

12.   NIDA InfoFacts: Drug Abuse and the link to HIV/AIDS and Other Infectious Diseases — This publication describes what HIV is, how HIV is spread, and how other infections caused by IV drug use can also make a person susceptible to HIV infection.

    http://www.nida.nih.gov/Infofacts/drugabuse.html

13.   Prevention Challenges — This fact sheet outlines the major biological and social factors that make women more vulnerable to becoming infected with HIV.

    http://www.cdc.gov/hiv/topics/women/challenges.htm

14.   Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings — The purpose of this report is to increase HIV screening among patients, including pregnant women, in health care settings to detect HIV cases earlier and refer them to treatment services.

    http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm

15.   The Role of STD Detection and Treatment in HIV Prevention - CDC Fact Sheet — Testing and treatment of sexually transmitted diseases (STDs) can be an effective tool in preventing the spread of HIV among people with high risk factors. This publication discusses how HIV prevention programs can be developed through an understanding of the relationship between STDs and HIV infection.

    http://www.cdc.gov/std/hiv/STDFact-STD&HIV.htm

16.     Understanding HIV Prevention — This publication answers some common questions about how you can prevent spreading HIV if you are HIV-positive.

    http://aidsinfo.nih.gov/contentfiles/UnderstandingHIVPrevention_FS_en.pdf

17. HIV & AIDS (Copyright © Nemours Foundation) — This guide for parents explains what HIV and AIDS are, how HIV is spread, signs and symptoms of infection, diagnosis, treatment, complications of HIV/AIDS, and long-term care of children with HIV/AIDS. It also includes advice on how to talk to your children about HIV/AIDS and its prevention.

    http://kidshealth.org/parent/infections/std/hiv.html

18. HIV and AIDS: How to Reduce Your Risk (Copyright © AAFP) — This publication explains what HIV is, how you can lower your risk of getting it, and how and where you can be tested.

    http://familydoctor.org/online/famdocen/home/common/sexinfections/hiv/005.html

19. HIV/AIDS (Copyright © UNICEF) — This web site explores the problem of HIV/AIDS among young people throughout the world. It discusses why HIV/AIDS is such a problem in this population and what needs to be done to protect them. It includes articles on what UNICEF is doing to prevent HIV/AIDS, reports on real programs for young people, and global statistics.

    http://www.unicef.org/aids/

20. HIV/AIDS During Pregnancy (Copyright © APA) — This web page from the American Pregnancy Association answers questions about how HIV affects pregnancy.

    http://www.americanpregnancy.org/pregnancycomplications/hivaids.html

21. How to Use a Condom (Copyright © ASHA) — This web site provides a list of dos and don'ts in regards to using a male condom. The site also features an animation, which shows the proper way to put on and remove a condom.

    http://www.ashastd.org/condom/condom_overview.cfm

22. National HIV and STD Testing Resources — This web site features useful information and resources on HIV testing, including a national database of HIV testing sites, frequently asked questions on HIV/AIDS and HIV testing, and resources for people who test positive for HIV. It also provides basic information about HIV and AIDS, behaviors that place a person at risk for HIV infection, and HIV testing.

    http://www.hivtest.org

23. Safer Sex Guidelines (Copyright © AIDS InfoNet) — This publication explains how HIV is spread through sexual contact and provides guidelines for lowering your risk of HIV infection during sexual activity.

    http://www.aidsinfonet.org/fact_sheets/view/151?lang=eng

24. Talking to Your Kids (Copyright © ASHASTD) — This step-by-step guide outlines what a parent should do to initiate a conversation about HIV/AIDS with their children, present facts, and clarify misunderstandings that their children may have about HIV/AIDS.

    http://www.ashastd.org/parents/parents_overview.cfm

25. Talking With Kids About HIV and AIDS (Copyright © KFF) — This resource explains the importance of providing sexual education to children. This publication also provides advice on how a parent can approach the subject of sex in a comfortable and age-appropriate way.

    http://www.talkingwithkids.org/aids.html

Organizations

1.   AIDS.gov
2.   Division of Acquired Immunodeficiency Syndrome (DAIDS), NIAID, NIH, HHS
3.   Divisions of HIV/AIDS Prevention, CDC, HHS
4.   National Prevention Information Network, CDC, HHS
5. AIDS InfoNet
6. American Social Health Association
7. Center for AIDS Prevention Studies, ARI, UCSF

= Indicates Federal Resources

Additional Resources on Prevention & Pregnancy:

Publications

1.     HIV During Pregnancy, Labor and Delivery, and After Birth — This series of fact sheets explains how a mother who has HIV can lower the risk of passing the virus to her baby during and after pregnancy.

   http://aidsinfo.nih.gov/ContentFiles/Perinatal_FS_en.pdf

2.   HIV Infection in Infants and Children — This publication gives information on the scope of the problem of HIV in children, transmission, prenatal HIV transmission, and diagnosis. Additional information is provided regarding the progression of the disease, signs and symptoms of pediatric HIV disease, treatment of children and adolescents with HIV/AIDS, and AIDS-related psychosocial issues.

   http://www.niaid.nih.gov/factsheets/hivchildren.htm

3.     HIV Testing and Pregnancy — This publication provides information on HIV testing during pregnancy, the benefits of being tested, and where to go to learn about HIV testing policies in your state.

   http://www.aidsinfo.nih.gov/ContentFiles/HIVTestingandPregnancy_FS_en.pdf

4.   Mother-to-Child (Perinatal) HIV Transmission and Prevention — This fact sheet discusses the incidence of mother-to-child HIV transmission during pregnancy, labor and delivery, and breastfeeding. It also discusses how mothers that are infected with HIV can lower the risk of perinatal transmission and barriers to prevention efforts.

   http://www.cdc.gov/hiv/topics/perinatal/resources/factsheets/perinatal.htm

5.   Rapid HIV Testing — This web site lists resources on rapid HIV testing.

   http://www.cdc.gov/hiv/rapid_testing/

6.   Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings — The purpose of this report is to increase HIV screening among patients, including pregnant women, in health care settings to detect HIV cases earlier and refer them to treatment services.

   http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm

7. HIV/AIDS During Pregnancy (Copyright © APA) — This web page from the American Pregnancy Association answers questions about how HIV affects pregnancy.

   http://www.americanpregnancy.org/pregnancycomplications/hivaids.html

8. National HIV and STD Testing Resources — This web site features useful information and resources on HIV testing, including a national database of HIV testing sites, frequently asked questions on HIV/AIDS and HIV testing, and resources for people who test positive for HIV. It also provides basic information about HIV and AIDS, behaviors that place a person at risk for HIV infection, and HIV testing.

   http://www.hivtest.org

= Indicates Federal Resources

Additional Resources on Keeping Your Kids from Getting HIV:

Publications

1.     Addressing HIV, Other Sexually Transmitted Diseases, and Pregnancy Prevention — This publication discusses the mission, goals, and strategies that the Centers for Disease Control and Prevention's Division of Adolescent and School Health is using to combat unintended pregnancy, HIV, and other sexually transmitted infections among youth.

   http://www.cdc.gov/HealthyYouth/sexualbehaviors/pdf/Addressing_HIV.pdf

2.   HIV Infection in Adolescents and Young Adults in the U.S. — This fact sheet summarizes statistics about HIV infection in adolescents and how it is most commonly transmitted in this age group. It discusses the difficulties facing health professionals who treat adolescents for HIV infection, and explains the role of NIAID in conducting clinical studies involving adolescents.

   http://www.niaid.nih.gov/factsheets/hivadolescent.htm

3. Children and HIV and AIDS (Copyright © UNICEF) — This site provides a brief overview of the impact of HIV/AIDS on children worldwide and discusses what can be done to prevent the spread of HIV among youth.

   http://www.unicef.org/aids/index_introduction.php

4. HIV & AIDS (Copyright © Nemours Foundation) — This guide for parents explains what HIV and AIDS are, how HIV is spread, signs and symptoms of infection, diagnosis, treatment, complications of HIV/AIDS, and long-term care of children with HIV/AIDS. It also includes advice on how to talk to your children about HIV/AIDS and its prevention.

   http://kidshealth.org/parent/infections/std/hiv.html

5. HIV/AIDS (Copyright © UNICEF) — This web site explores the problem of HIV/AIDS among young people throughout the world. It discusses why HIV/AIDS is such a problem in this population and what needs to be done to protect them. It includes articles on what UNICEF is doing to prevent HIV/AIDS, reports on real programs for young people, and global statistics.

   http://www.unicef.org/aids/

6. Sex and Puberty (Copyright © Nickelodeon) — This web site offers tips on how to talk about the subject of sex and how to foster a relationship based on open comunication with your kids. Tips are also given on talking to kids about HIV/AIDS.

   http://www.nick.com/all_nick/everything_nick/kaiser/sex.html

7. Talking to Your Kids (Copyright © ASHASTD) — This step-by-step guide outlines what a parent should do to initiate a conversation about HIV/AIDS with their children, present facts, and clarify misunderstandings that their children may have about HIV/AIDS.

   http://www.ashastd.org/parents/parents_overview.cfm

8. Talking to Your Kids About Sex (Copyright © AACAP) — Talking to your children about love, intimacy, and sex is an important part of parenting. This article gives parents important guidelines for how to do this effectively.

   http://aacap.org/page.ww?name=Talking+to+Your+Kids+About+Sex&section=Facts+for+Families...

9. What Is the Role of the Family in HIV Prevention? (Copyright © University of California) — This publication discusses the influence that families have and how that influence can be used to help prevent risky behavior that may lead to HIV infection.

   http://www.caps.ucsf.edu/pubs/FS/family.php

Organizations

1.   CDC-INFO
2.   Divisions of HIV/AIDS Prevention, CDC, HHS
3.   National Prevention Information Network, CDC, HHS
4. AIDS InfoNet
5. KidsHealth®
6. Planned Parenthood Federation of America

= Indicates Federal Resources

Content last updated March 4, 2009.