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How are HIV and sexually transmitted infections (STIs) transmitted? Does having unprotected sex automatically lead to HIV?

How do you get HIV or an STI?

For the transmission of HIV and STIs such as gonorrhea, chlamydia, syphilis, trichomoniasis and hepatitis, there must be an exchange of body fluids. During sex a body fluid, such as blood or semen, can get inside another person. This allows a virus, bacteria or a parasite to go from one body to another. STIs like genital warts, herpes, scabies and pubic lice can be transmitted by skin-to-skin contact.

You can get HIV when

  • you fuck or get fucked without a condom
  • the condom breaks or slips off
  • you give somebody a blowjob and you have damaged gums
  • you swallow sperm
  • you share a sex toy without a condom or disinfecting it
  • when fisting or getting fisted and the person fisting has wounds or small cuts on his hand

STIs are easier transmitted than HIV

Even when you use a condom or don't fuck.

Does having unprotected sex automatically lead to HIV?

Although HIV could be passed on any time unprotected sex with an infected person happens, it doesn’t get passed on every time. It's more likely HIV is transmitted when: 

  • The amount of HIV in someone's blood and other body fluids is high (high viral load). The viral load is very high in the first weeks or months after someone is infected. Taking HIV drugs usually dramatically lowers viral load.
  • Either partner has a sexually transmitted infection. They make it easier for HIV to leave one body and enter another.
  • There is more exposure to the virus: anal sex is higher risk than oral sex. Sharing drug injecting equipment is higher risk than all of them.