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• Avoid all high-risk sex practices such as vaginal, anal and oral sex without a condom. Avoid casual sex, sex with a commercial sex worker (prostitute), sex with a partner who shares needles and syringes with other drug users, and sex with a person whose sexual history is unknown.
• Never allow semen, vaginal fluids, blood or menstrual blood to come into contact or enter the vagina, anus, penis, mouth or broken skin. Wash your hands with soap and water if they have been in contact with semen or other body fluids. Rinse your mouth with cold (not hot) water if in contact with semen and don't brush your teeth immediately afterwards (a toothbrush can cause damage and bleeding - an easy entrance for the virus).
• Avoid sex when either partner has open sores on the genitals or any sexually transmitted infections (STIs).
• Avoid anal or rough vaginal intercourse. Do not do anything that could tear the skin or moist lining of the genitals, anus or mouth and cause bleeding.
• Do not perform oral sex when you have a cold, a sore throat, open sores in your mouth or if you have brushed your teeth in the few hours before intended oral sex. Avoid oral sex if there are sores on your partner's genitals.
• It is a good rule not to share dildos, vibrators and other sex toys. But if you must share them, make sure that you use condoms on the dildo and sex toy.
• If you perform oral sex on a man (called fellatio) you should always use a condom. Although the risk of HIV transmission through oral sex is low, it appears that fellatio is the riskiest kind of oral sex if the partner performing the fellatio receives semen into his or her mouth. If the taste of latex, particularly of condoms that are pre-lubricated, are repellent to people who want to use condoms during oral sex, they should bear in mind that there are fruit- and mint-flavoured condoms available for oral sex. However, you should always make sure that they are of a good quality before you buy them.
• If you want to perform oral sex on a women (called cunnilingus), a dental dam (or latex sheath placed over the vagina) will make sure you do not get vaginal fluid or menstrual blood into your mouth. Non-porous plastic wraps, such as non-microwavable plastic wrap (e.g. Glad Wrap) can also be placed over the vagina. Or a condom can be cut open for this purpose. Although cunnilingus holds a low risk of HIV transmission (if the skin is intact and if the woman is not menstruating), other STIs can be transmitted in this way.
• The majority of STIs occur when infected mucous membranes come into contact with uninfected mucous membranes. When performing oral sex (both fellatio and cunnilingus), the herpes simplex virus and the infective agents that are present if one has gonorrhoea and syphilis infections in one's lips, mouth or throat can cause infections of the genitals - and vice versa.
• While oral-anal sex (called anilingus or "rimming") does not appear to carry a high risk for HIV infection unless there is blood present, the possibility of contracting the hepatitis B virus, the herpes simplex virus, the cytomegalovirus and a number of different parasites from oral-anal sex is very high indeed. A latex sheath (dental dam), Glad Wrap or a spliced-open condom should be used to cover the anal area.
• If one has open wounds on one's fingers, one should wear a condom over one's finger before inserting it into the vagina or anus of one's partner.
• If you practise vaginal and anal fisting (inserting the whole fist into the vagina or anus), you should use latex gloves during the process. You should also take care of your nails because sharp edges can tear gloves and condoms.
• Avoid alcohol and illicit drugs because they can impair your immune system as well as your judgement. If you use drugs, don't share needles, syringes and drug-preparation equipment such as cookers. Adopt alternative sexual practices that are less likely to result in infection by HIV, other viruses or infection-causing agents.

Safe practices that are still enjoyable include the following:

• hugging, cuddling and body-to-body rubbing
• erotic massage
• petting
• thigh rubbing
• kissing
• bathing or showering together
• masturbating alone
• masturbating together
• sexual fantasies
• phone sex
• using personal sex toys
• thigh sex (a healthy skin provides a protective barrier against the virus. It is therefore not possible to get HIV from direct contact with semen placed on the body but not in the body.)

(Health24, updated January 2008)

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