Since the advent of effective drugs to keep HIV in check, this immune-system-attacking disease, which claimed a particularly large number of lives in the 1980s and 1990s, has lost much of its terror. The concept of Safer Sex 3.0 contributes to the fact that sex today is much less risky than it was 10 years ago. This article tells you what you need to know about Safer Sex 3.0.
PrEP- Effective protection during sex
When HIV first emerged and within a very short time led to countless infected (in 2021, about 38.4 million people were considered infected) and dead (the United Nations estimate about 41 million deaths), medicine was initially faced with a mystery. All too quickly, HIV was judged to be a gay disease. And it took a long time before it was realised that not only homosexual men could become infected.
Medicine and its long road to effective HIV therapy
It was not until 1996 that increasingly effective antiretroviral drugs were developed. Initially as a three-drug combination, later as a two-drug combination. The lifelong highly active antiretroviral therapy (HAART) can almost completely prevent AIDS (acquired immunodeficiency s syndrome). This therapy also reduces the viral load to less than 200 viral copies per millilitre of blood in 95 per cent of those treated. So that they are no longer infectious and viral transmission can be prevented. The high effectiveness of HIV therapy has led to a German treatment guideline since 2015. Which advises that every person diagnosed with HIV should receive antiretroviral therapy. In 2019, this was implemented for 93 per cent of all known HIV-infected people.
Protection through condoms, PrEP & therapy – Safer Sex 3.0
Despite all the medical progress, a sense of responsibility and caution is required when engaging in sexual activity. Because HIV is still not curable and an infection all too often means exclusion and discrimination for those affected. In the meantime, however, there is the concept of Safer Sex 3.0. . Which shows that there are three ways to protect oneself efficiently against an HIV infection.
In order to understand why condoms, prophylaxis or HIV therapy are helpful, it is important to know that in the vast majority of cases the transmission of HIV occurs during sexual intercourse through the transmission of body fluids such as blood or semen. The virus enters the body through the smallest injuries to the mucous membranes. The goal must therefore be either to block the transmission pathway. Or to prevent the virus from spreading in the body by means of medication.
In the meantime, experts know three effective methods of protecting oneself from HIV. Namely, through the good old condoms, with the help of HIV prophylaxis PrEP (pre-exposure prophylaxis). Which has been covered by health insurance since 2019. And via protection through therapy, which means that the medication of an HIV-positive partner prevents transmission. However, the three methods should not be considered individually. Although the “Safer Sex 3.0” method is called pre-exposure prophylaxis, all three prevention strategies are equally valuable and complement each other. For those who want to have sex, it is important to find the measure or combination of measures that they consider practicable. There is no such thing as a one-size-fits-all solution to safer sex.
Condoms provide multiple protection
Awareness campaigns have long focused on the issue of HIV. This is understandable because of the high health risk posed by HIV infection. It was only over the years that the horizon was broadened to include the risk of contracting STIs (sexually transmitted infections) through unprotected sexual intercourse. Pre-exposure prophylaxis (PrEP) protects against HIV, but not against other sexually transmitted infections. This is how the addition in the approval text is to be understood. That the therapy is only permissible in combination with safer sex practices (such as condom use).
Originally, condom use has coined the term safer sex because condoms are able to make sexual intercourse safer. But not completely safe, with regard to the risk of transmission of HIV and other STIs. With a condom, you can protect your own health as well as that of your sex partner. In combination with PrEP, the risk can be reduced even further. Although many people find condoms uncomfortable, they still offer the most effective protection against HIV infection and other STIs. Such as gonorrhoea, syphilis or chlamydia. Awareness campaigns such as iwwit (I know what I’m doing) have made it their mission to inform people about the effectiveness of condoms and to promote their use.
Pre-Exposure Prophylaxis PrEP – permanent or “event”-oriented use
PREP involves taking HIV medication (emtricitabine and tenofovirdisoproxil are approved in the EU) as a preventive measure, so to speak, before a risk contact. If you decide to take PrEP, you can either take the tablets regularly over a longer period of time or limit the intake to the time around a sexual contact. Scientific studies have shown that PrEP is just as effective in protecting against HIV as a condom when certain rules are followed.
The disadvantage of PrEP (and also retroviral HIV therapy) is that it is effective in protecting against HIV infection, but not against other sexually transmitted diseases. This fact also makes it clear how important a combination of the different prevention methods is. What PrEP cannot do, perhaps the condom can.
Protection through therapy – Help your own and your (sex)partners’ health
In some relationships and in many sexual contacts, one of the people involved is HIV-positive. This naturally increases the risk for the HIV-negative partner to become infected with HIV. However, there is reason to give the all-clear if the HIV-positive person is in therapy and regularly takes his or her HIV medication. In this case, the medication suppresses the multiplication of the virus, so that the patient is below the detection limit and is no longer infectious due to the low viral load. This means that the patient can no longer pass on HIV to his or her partner.
The prerequisite for protection through therapy is, however, that the HIV-infected person takes their medication regularly and that it works. To check this, the HIV-positive person has to go for a check-up every three months. In fact, there is not a single case worldwide in which transmission of HIV was successful under these conditions. A check-up with regard to STIs should also be carried out regularly, because HIV therapy does not protect against other sexually transmitted STIs.
Behaviour in case of positive HIV and STI tests
Particularly, people who have numerous changing sexual contacts should have particularly extensive health checks carried out. This way, you minimise the risk of becoming infected yourself and unknowingly infecting others. If you have been diagnosed with HIV or an STI, you should reduce your sexual contacts as much as possible and only engage in sexual activity again once the STI has been treated until it is cured. In the case of HIV infection, therapy should be started.
Negative partners should also be tested for HIV and STIs regularly, at least once a year. This way, you can be sure that you are healthy and can be sexually active without any major concerns. In principle, everyone should always take responsibility for themselves and their partner(s) when it comes to health. No matter how good the Safer Sex 3.0 concept is, it will only be successful in protecting us from HIV and STIs if everyone participates and acts responsibly.
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