Sexuality is as diverse as people are. And anything goes – as long as it’s fully consensual and no legal boundaries are overstepped. And however you live out your sexuality, if you’re aware of the risks and take the right action, you can stay healthy.
- The key takeaways
- Important
- Multiple sexual partners
- Having sex with people from groups with above-average levels of HIV or other STIs
- Situations involving an increased risk of HIV infection
- Sexual practices and high-risk situations
- Other situations with transmission risk
The key takeaways
The risks of contracting HIV or another sexually transmitted infection depend on the situation. The three most important factors that put you at higher risk are:
- Multiple sexual partners
- Having sex with people from groups in which HIV, other sexually transmitted infections (STI), and hepatitis B and C are more prevalent than average
- Certain sexual practices
You can protect your health from risks by getting vaccinated, taking other protective measures and getting tested.
Important
If you’ve been in an HIV risk situation, you should immediately go to the accident and emergency department at a hospital. There, medical staff will check to see whether emergency HIV treatment, or PEP, is necessary. PEP must be taken within 48 hours, and ideally as soon as possible. PEP is not a ‘morning after pill’ and there’s no guarantee that it’ll work. It’s meant for emergencies as a last resort, for example if a condom breaks during sex.
The following are considered high-risk situations for HIV: • Any rape • Anal sex between men without a condom or PrEP • Anal or vaginal sex without a condom or PrEP with people from or in countries where HIV is particularly prevalent • Exception: people living with HIV who are receiving effective HIV therapy can no longer transmit the virus.
Find an accident & emergency department for PEP now
Multiple sexual partners
The more sexual partners you have, the higher the likelihood of spreading sexually transmitted infections. What matters is not just your number of sexual partners, but also that of each of your sexual partners. There is a higher risk in the following situations:
- Group sex
- Sex parties or clubs
- Paid sex
Having sex with people from groups with above-average levels of HIV or other STIs
Some groups of people are more affected by certain sexually transmitted infections (STIs) than others. The following are more affected by HIV, other STIs, and hepatitis B and C:
- Gay, bisexual, queer, and other men who have sex with men
- People from countries with higher incidence of HIV or hepatitis B and C
- People who inject or snort drugs
- Sex workers
- Clients who pay for sex
- Trans people
Situations involving an increased risk of HIV infection
In the following cases, with anal or vaginal sex, there is an increased risk of HIV infection if you don’t use a condom, or if the condom rips, and you’re not using PrEP:
- You have sex with someone who doesn’t know their current HIV status. They could be living with HIV without being aware of it.
- You have sex with someone from a group with a high rate of HIV infection. See the list above.
- You have sex with someone from a country which has high HIV prevalence](https://en.wikipedia.org/wiki/List_of_countries_by_HIV/AIDS_adult_prevalence_rate).
- The person you have sex with is living with HIV, but their therapy is not yet sufficiently effective to prevent HIV transmission.
People living with HIV who are receiving effective therapy do not transmit the virus. Having sex with someone in this situation does not pose any risk. This is known as U=U (undetectable = untransmittable).
Sexual practices and high-risk situations
The more sexual partners you have, the higher the likelihood of spreading sexually transmitted infections. If you have a lot of different sexual partners, you also have a higher risk. If you have sex with sex workers, you come into contact with a wide sexual network, which also increases your risk of infection.
Risk of:
- STIs
- HIV (if you have sex with people from groups that are particularly affected, or if you have sex in countries where HIV is particularly widespread.)
What helps:
- Getting vaccinated where possible and recommended
- Condom and internal condom (protection from HIV)
In countries with high prevalence of HIV, the transmission risk is higher.
Risk of:
- HIV
What helps:
- Condom and internal condom
Contaminated sex toys or sharing sex toys with others (particularly anal toys) can lead to smear infections. This is when germs from the vagina or anus get on to the surface of the toys and are passed on to others. If blood gets on a sex toy, see the information in the next paragraph.
Risk of:
- Syphilis, gonorrhoea, chlamydia, herpes, genital warts (HPV)
What helps:
- Hygiene
- HPV vaccination
If mucous membranes come into contact with blood, there’s a high risk of hepatitis B and C infection. Bleeding is more likely during anal sex – for example during fisting (when the fist is inserted into the anus), when using large anal sex toys, or when engaging in BDSM (Bondage, Discipline, and Sadism, Masochism). This involves consensual violent sexual acts. Blood transports viruses. However, direct contact with menstrual blood involves a negligible infection risk.
Risk of:
- Hepatitis B and C
What helps:
- Latex gloves when engaging in fisting
- Sufficient lube
- If having sex with more than one person: change latex gloves for each person and don’t share lube
- Vaccination against hepatitis B
Other situations with transmission risk
When injecting (anabolic steroids or drugs), snorting using straws (e.g. cocaine), if paraphernalia (syringes, needles, tubes, bottles, filters, thinners or spoons) is shared.
Risk of:
- HIV (injecting)
- Hepatitis B and C (injecting and snorting)
What can help:
- Use your own paraphernalia (don’t share with others)
Sex in combination with alcohol or drug use can have an adverse effect on precautions and lead to greater transmission risk because protection gets forgotten or doesn’t seem that important.
Risk of:
- HIV
- All sexually transmitted infections
What helps:
- The better your precautions without the influence of alcohol or drugs (e.g. choosing the right condoms, having sufficient lube to hand), the higher the likelihood that they’ll work when under the influence of alcohol and drugs.
And if you use drugs (inject, snort):
- Find out about the risks of substance use. Do a drug check to see what you’re consuming.
- Avoid substances you’ve never used before or if you don’t know where they’ve come from.
Chemsex is defined as group sexual activity while taking stimulant drugs. Chemsex sessions often last for several hours or days and involve sex with multiple partners. This increases the likelihood of transmitting all sexually transmitted infections. If substances are injected or snorted, there is also a risk of HIV and hepatitis B and C.
Risk of:
- All sexually transmitted infections
What helps:
- People who engage in chemsex and are not living with HIV are advised to take a medication-based prophylaxis (PrEP) to avoid an HIV infection.
- If you engage in chemsex and are already living with HIV, make sure you continue to take your medication regularly during the chemsex session to prevent transmission of the virus to others.
HIV, hepatitis B and C, and syphilis can be passed on to the child during pregnancy and childbirth. In Switzerland, however, the risk is very low as tests are carried out during pregnancy. In the event of an infection, the health professional will talk to the mother about ways of protecting her child from infection.
Risk of:
- HIV
- Hepatitis B and C
- Syphilis
What helps:
- Talk to a medical professional about sexually transmitted infections
- Get tested during pregnancy
Oral sex and sexual practices involving fingering don’t entail any HIV risk. But you can still be infected with other STIs. If you only masturbate on your own, there’s no transmission risk – as long as you don’t share sex toys and accessories with others.