How Risky is it?

Don't want to use condoms?

Thoughts on the risk associated with not using condoms, along with strategies for reducing the possible harms of going bareback.

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Using condoms for anal sex is the most effective way to prevent HIV infection. This is as true today as it was at the beginning of the epidemic. Until we discover either a vaccine, a microbicide or another prevention technology that works, condoms remain our best defense against infection.

While most guys in San Francisco use condoms for anal sex, situations can occur when condoms aren't part of the picture. Here's what you can do to reduce the chance of infection:

• Lube reduces friction »» fewer tears »» could protect your ass. 
• If possible, don't be under the influence. Stay aware of what's going in your body.
• Find out your partner's status. For negative guys, the conversation doesn't have to end with a simple "I'm negative." Think about asking when they were last tested and how often they bareback.
• If you're hooking up with someone of the opposite status, have the negative partner on top. While this doesn't eliminate the chance of HIV transmission, being on the bottom makes it 10 times more likely than being on top.
• Also, if you're HIV-negative and hooking up with a positive guy, ask him if he's on meds or what his viral load is. Being on meds and having a low viral load reduces the possibility that transmission could occur - but does not eliminate it.