Frequently Asked Questions

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I had sex with a guy and I was the top. I came inside him and the condom broke. Should I get PEP? This was anonymous sex and I don't know this man. How much does PEP cost?

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If the condom broke then there is a risk of contracting HIV. While the risk is greatest for the bottom, it is still high-risk for the top because if the bottom has HIV it can be highly concentrated in the lining of his ass which can then enter the tip of your penis.

PEP is free under certain circumstances, for example if you know that the person you were having sex with is HIV positive. If you aren't sure about his status then you may have to pay. In either case, we recommend visiting your local sexual health clinic or the emergency department of your nearest hospital as soon as possible to find out about your options. For PEP to be effective it needs to be started as soon as possible and no later than 72 hours after exposure to HIV.

How long does an HIV test take and when can I get the test results? I had sex without a condom a few weeks ago and I'm really worried.

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A rapid test for HIV at NZAF will give you results in just 20 minutes. Book a free and confidential test now.

Keep in mind evidence of HIV can be detected by some tests as early as 2 weeks after exposure, but it may take up to 3 months. Everyone responds differently to the virus.

Is an HIV test done through a GP 100% accurate? Is it the same as a rapid test that NZAF does?

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GPs do not offer rapid tests. They send people off to a lab and blood is taken there. People then have to wait a few days for results, but these tests are 100% accurate. Our rapid HIV tests are 100% sensitive to HIV, they are FDA approved and 98.9% specific to antibodies, and you will get your result in a few minutes. 

How much does HIV treatment cost? Does it cost more if you are not a citizen?

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HIV treatment in New Zealand is publicly funded and free, regardless of immigration status. However visits to a GP or other health professionals are likely to incur costs.  More information can be found on the Ministry of Health website https://www.health.govt.nz/new-zealand-health-system/eligibility-publicly-funded-health-services/guide-eligibility-publicly-funded-health-services

In NZ, people living with HIV need to be seen by an infectious diseases department or sexual health clinic to initiate medication, as only specialists are able to apply for a special authority for subsidised HIV medication. We advise people to continue to have medication prescribed by their specialist at regular appointments.

Can I apply for a visa to visit or live in New Zealand if I am living with HIV?

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Yes. People with HIV can apply for a visa, but that doesn’t guarantee they will be approved. Their health will be taken into account when assessing their visa application, as will the cost of their HIV treatment.  It is worth noting, however, that HIV is listed as a medical condition deemed to impose significant costs and/or demands on New Zealand's health and/or education services (read more), and therefore any visas approved will be done through a medical waiver process. 

 

Is it ok if I have sex with a boy while I have a girlfriend to see what it is like?

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It’s okay to have sex with a guy.  Always use condoms in order to prevent contracting a sexually transmitted infection and spreading an STI to anyone else.  It’s best to first talk to your girlfriend about having sex outside of the relationship so that you don’t hurt her feelings. You may find it useful to speak a bit more about sexuality. You might want to consider accessing our or another counselling service.

Where in New Zealand can I get free condoms?

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Go here to see if we can send you some free condoms or where you can go to find some.

How risky is oral sex for HIV transmission?

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Extremely low. Risk only increases if there are open and bleeding cuts in the mouth. Read more about what sexual activities place you at risk of contracting HIV.

What’s the difference between HIV and AIDS?

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HIV stands for Human Immunodeficiency Virus and is a virus that attacks the immune system, killing off healthy immune system cells that normally fight off infection. HIV is transmitted through blood, semen, anal mucous, vaginal fluid and breast milk.

AIDS stands for Acquired Immune Deficiency Syndrome and is the term used to indicate complete deterioration and destruction of immune function - the final stage of HIV. People with HIV who are on consistent antiretroviral (ARV) treatment can expect to lead long and healthy lives and may never progress to AIDS.

How long can I expect to live if I contract HIV?

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Remember that an HIV diagnosis doesn’t have to stop you living a full and healthy life. With the right treatment and care, you can expect to live just as long as someone who doesn’t have HIV. HIV shouldn’t stop you doing the things you want to do in your life.

Is HIV present in pre-cum?

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Yes. It is possible for pre-cum to transmit HIV via unprotected anal sex. Transmission through pre-cum during unprotected oral sex is extremely low.

What are the chances of developing resistance to my HIV treatment?

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Antiretroviral Therapy uses three different types of drugs to fight HIV – targeting the virus at different stages of its life cycle. The risk of developing resistance to treatment is low as long as you are adherent and do not have a strain of HIV that is resistant to the treatment that you are on.

Resistance to treatment most often arises when the level of HIV treatment in your blood is not high enough to fully suppress the virus. This can happen if medication is not taken as prescribed resulting in a spike in viral load. When this happens, newly replicated viruses that have genes that make them resistant to treatment are selected to survive and continue to replicate. Another way of developing resistance is if you have unprotected sex or share needles with another person who has a resistant strain of HIV and is not undetectable. The strain of HIV that they have would have to be resistant to the treatment that you are on for it to be able to replicate in your body, even if you are taking your medication as prescribed.

What’s the difference between a CD4 count and viral load count?

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A viral load count is a measure of the number of HIV particles in your blood at a given point in time. Low and undetectable viral loads reduce your chance of passing HIV on. 

A CD4 count is a measure of the number of CD4 cells in the blood. HIV attacks these cells so they are no longer able to do their job fighting infection and therefore conversely to viral loads, the fewer CD4 cells a person has, the more susceptible they become to a wide range of infections. 

Can I still enjoy a drink while on treatment?

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Yes. Unlike many medications, HIV medications do not interact negatively with alcohol.

What’s the difference between PrEP and PEP?

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PrEP and PEP are both HIV medications taken by people who do not have HIV. 

PrEP (Pre-Exposure Prophylaxis) is an HIV medication for people who are HIV negative - taken to reduce the risk of acquiring HIV by up to 99%.

PEP (Post-Exposure Prophylaxis) is a medication given to people who may have been exposed to HIV. Although PEP is not foolproof, if taken within 72 hours of being exposed to HIV, it is likely to reduce the chances of contracting HIV. For PEP to be most effective, it needs to be taken as soon as possible after an episode of unprotected anal sex.

Do party drugs react with HIV treatments?

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Recreational drugs can have a detrimental effect on your health, and therefore work against your efforts to get to, or stay at an undetectable level. There is also evidence of some drug interactions with HIV medications. For example, amphetamines (such as crystal meth) can be present at 3 to 22 times their normal levels in the bloodstream when mixed with an HIV protease inhibitor drug called ritonavir (Norvir). That's because ritonavir acts as a booster and slows the breakdown of your HIV medication so that it lasts longer, but it can have the same effect on any other drugs you might take. Drugs can also affect your memory, making it more likely that you might forget to take your medication at the right time. If you know you’re going to be partying, plan ahead and carry your treatment on you. Set alarms on your phone or use the app to remind you when it’s time to take your meds. Consider talking to your HIV specialist as they might advise further precautions.

Should I be worried about the toxicity levels found in HIV treatments?

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Treatments for HIV these days are far less toxic than they once were and side effects much less of a concern. There are some side effects associated with treatment that will be experienced differently by different people. Managing any side effects that do arise is something your HIV specialist will help you with. The research now shows that the benefits of being on treatment, and preferably as early as possible, far outweigh any issues related to toxicity. If you are worried about this, talk to your HIV specialist.

Do I still have to disclose my HIV-positive status even if my viral load is undetectable?

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New Zealand law requires people living with HIV to take ‘reasonable precautions’ to avoid passing on HIV. The only case to ever come before the courts in New Zealand was for vaginal intercourse. It found that condoms are needed to be used as a precaution. That means that legally, if you are not using condoms during penetrative sex, you must disclose your HIV status. There has not been a case in New Zealand to test whether an undetectable viral load would be considered ‘reasonable precaution’.

How long does it take to get to undetectable?

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Everyone responds uniquely to treatment. If you have been on treatment for 6 months or more, and you are taking your medication as prescribed, you have a good chance of significantly reducing your viral load. However, the exact amount of time it takes to get to undetectable will be different for everyone. Not everyone will be able to obtain an undetectable viral load.

What if my partner and I are both positive and undetectable? Can we have sex without condoms?

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Yes, however having sex without a condom always carries the risk of STIs, particularly if you are having sex with other guys as well as your regular partner.

There is also a very small risk that when two people living with HIV have sex without a condom that reinfection will occur, if one partner has a strain of HIV that is resistant to the treatment that the other guy is on. However, if you’re taking HIV medication and have an undetectable viral load you can’t pass on HIV, and therefore this won't be an issue.

If my viral load is undetectable, can I stop taking my meds?

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No. Remaining on treatment is key to keeping your viral load under control and stopping the HIV virus from replicating. If you stop taking your medication even for a week or two, you give HIV the opportunity to replicate more quickly, increasing your viral load and the risk of developing resistance to your treatment.

Is it possible to become undetectable if I am not on meds?

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By far the majority of people need HIV medication to get their viral load down and keep it there.  A very small percentage of people living with HIV have successfully managed their viral load without medication. This group, referred to as ‘elite controllers’, are estimated to make up less than half of 1% of all people living with HIV.

Once the viral load is undetectable, does it stay that way forever?

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No. Viral loads can go up and down. Small blips are not uncommon even if you are taking your medication as prescribed. Regular monitoring of your HIV viral load is an important part of your treatment regimen.

If I do start HIV treatment and can’t tolerate it, can I stop?

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There are a range of treatment options, so if you are experiencing issues it is very likely that there will be another treatment that is better for you. This is something you will want to discuss with your HIV specialist. Always keep in mind that not adhering to your treatment carries the risk of developing resistance to certain HIV drugs – meaning your treatment options may be reduced. Any changes to medication need to be managed carefully under the guidance of your specialist.

Does having an STI impact on viral load?

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Being undetectable does not protect you or your partner(s) from other STIs and if an HIV-negative person has an STI they are at higher risk of getting HIV. There is also evidence that STIs can increase the viral load of someone living with HIV who is not on treatment. However, the presence of an STI does not increase the possibility of transmission if the HIV-positive person is on effective antiretroviral therapy.

What are the signs/symptoms of having HIV?

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Not everyone who gets HIV will experience any short-term symptoms. So, symptoms or not, it's important to test twice a year - or more often if you haven't been playing safe.  In some people, symptoms may occur from two to four weeks after HIV infection and may include flu-like symptoms that are easily confused with other infections, such as fatigue, fever, night sweats, sore throat, swollen lymph nodes, headache, loss of appetite or skin rash. These symptoms usually last less than two weeks although they can last as long as 10 weeks. If you‘ve recently had unprotected anal sex and experience any of these symptoms, you should have an HIV test with NZAF, your emergency room, GP or sexual health service.

Also, keep in mind that not all doctors will recognise the symptoms of HIV. If you see a doctor because you have one of the symptoms listed above, it’s important to explain that you feel at risk of HIV and ask to be tested, even if they don't suggest it. Don't assume you will be tested for HIV just because they take your blood. Ask to be sent a copy of the results.

How long does it take for PrEP to be effective?

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If you're using daily PrEP to provide protection during anal sex, you need to take it daily for 7 days prior to any sex without condoms to ensure that the levels of the drug have built up to provide enough protection.  You also need to continue taking it daily for 28 days following the last episode of anal sex without condoms for maximum protection.

Cisgender gay and bisexual guys can also start it with a double dose (two pills at once, and continue with single pill every 24 hours), and the protective effect should kick in after two hours. If you keep having sex then keep taking a PrEP pill each day. After you’re done having sex, keep taking a pill each for two days after the last episode of sex.  

I was chatting to a guy on Grindr and he said it's safe to have sex without a condom because he's on PrEP. Is it really safe?

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It's great that he's taking action to reduce his risk of getting HIV by using PrEP, but him being on PrEP is not a 100% guarantee that he hasn't got HIV. He may, for example, have stopped taking it for a period of time and unknowingly acquired HIV. So you're still at risk unless you're taking action to protect yourself either by using condoms or taking PrEP yourself. Keep in mind that PrEP doesn't protect against other STIs like syphilis, gonorrhoea or Hep C, and you won't always know if someone has another STI because they can have no symptoms. Using condoms is the best option for protecting against both HIV and other STIs, but if you struggle with condoms then PrEP at least will provide protection from HIV.

What's the deal with cock piercings and condoms? Is it still safe to have sex with a cock piercing if you use a condom?

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That's an interesting question as piercings are quite common these days. The best advice we can give on this is that you or your partner should remove the piercings before having anal sex. This is because there is a chance that the metal might break through the latex of the condom. Some might argue that the jewellery is smooth and won't tear the condom, but we reckon with metal against latex it's not worth the risk. Be aware too that piercings need time to heal after you first get them so sexual activity during the healing period should be avoided.

Is it very easy to get HIV if I have ulcers in my mouth and give a blow job to a guy I just met? Assuming he is positive...

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Oral sex is very low risk for HIV transmission. It's important to manage the risks as much as possible, and still enjoy sex. A couple of things to consider to keep that risk to a minimum is not letting them cum in your mouth and checking for cuts or ulcers either in the mouth or on the penis, as they become potential entry points for HIV to enter into your blood stream. So yes, if you have ulcers in your mouth and you get his cum or pre-cum on those ulcers there is some risk.

What should you do if you rip your foreskin during rough anal sex?

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Ouch! Any trauma should be checked out by a medical professional.

Whenever I see guys pumping themselves in cruise clubs or porn movies they seem to have no problem in gradually masturbating successfully with a load of jizz cumming out. I tend to find that the only way for me to cum is to use lubricant. I can get a hard erection quick enough but it annoys me that I can't cum after pumping, so I use quite a bit of lubricant which makes it happen within 30 secs. Is it normal to only be able to cum after lubricating?

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It is really important to remember that everybody is different when it comes to sex. What is 'normal' for one person doesn't necessarily relate to everyone, and the guys on the screen are the exception and not the rule. Bodies will produce different amounts of cum and can take time in 'refilling'. The use of lube can increase the sensation and sensitivity and ultimately the level of arousal, so experiment with different amounts. Try not to measure yourself on the quantity to determine your quality. As always if you want to talk further, give us a call.

I have just started to finger myself. I tried it once without lube and once with shower gel in the shower. Is it normal if I feel irritated afterwards? The only thing is I didn't get pleasure out of it? How deep am I meant to go?

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Firstly, go buy some lube or get us to send you some. The shower gel you're using could have harsh chemicals in it which might be why your asshole feels irritated - soaps can interfere with natural bacteria and irritate sensitive membranes.You should get some pleasure from rubbing around the anus, and then from the prostate, which is about a thumb's length inside your ass towards your bellybutton.

If both partners have tested negative for HIV and other STIs, is it safe to have bareback sex?

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Relying on negative HIV status to prevent HIV is risky. It requires constant, open communication with your partner(s), and regular testing. And even then, it won't necessarily work. Condoms or PrEP, however, are very effective at preventing HIV, regardless of the HIV status of your partner(s).

The short answer is that it's not very safe - because you can never be 100% sure of somebody's HIV status (or even your own status), for the following reasons: First, it can take up to three months from the date of infection for HIV to show up in a test. So, even if you both tested negative yesterday, it's possible that one of you does have HIV and it hasn't shown up on the test. Second, HIV is most infectious in the few weeks after somebody catches it. So if a guy caught HIV a few weeks ago he won't know it yet because it often has no symptoms and it my not show up that early on a test. He'll also be highly infectious at this stage, with a very high chance of passing it on. This is actually how most HIV in New Zealand is passed on - from guys who don't know yet that they have it yet. 

I have trouble staying hard when I top with a condom on. I'm also circumcised and with a condom I can't feel a lot. Can you suggest some ways to increase the feeling / keep me hard longer?

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There are lots of ways to help with this; number one, have you got the right size? We have 49mm, 56mm (standard size) and 60mm condoms we can send out, so if you would like to try some different kinds for free, flick us an email at [email protected] Secondly, thickness can play a part. Have a play around with some non-latex condoms, as they're super thin and may make a difference for you. The final thing to do is simply put a small bit of lube on the head of your penis before rolling on the condom. Better lubricating the inside can make a huge difference; just have a play around first before you fuck, as you want to make sure you don't use too much and risk your condom slipping off.  If you're still struggling after trying these options you could consider PrEP, the daily pill that prevents HIV. It's as effective as condoms for preventing HIV but it doesn't provide any protection from other STIs like gonorrhoea or syphilis.

He spat on the condom as lube - is there a risk of HIV infection?

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HIV is not spread through saliva, even when used as lubricant for anal sex. However, if he had oral herpes this could be transmitted to your anus.

Spit is generally not a great lubricant though, so this could lead to anal bleeding. We'd recommend getting a water-based lube from the pharmacy or supermarket (or in the free condom packs we give out!)

Can you contract HIV from kissing?

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No. Kissing on the mouth is extremely low risk for HIV transmission; The only time it would be possible is if both people had open wounds in their mouths that were bleeding and kissed for a long, long time.

I have met a new man and he is HIV positive. I'm HIV negative. If I wear a condom to have anal sex with him is it safe for me?

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Yes. Condoms and water based lube, when used consistently and correctly, are highly effective in preventing the sexual transmission of HIV. If your new man has an undetectable viral load the risk is reduced even further.

What type of condom is inside the free condom packs that you provide?

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The condoms in our free condom and lube packs are Gold Knight 56mm ultra thin as well as a lube. We also have Moment 49 mm narrow fit condoms and Shield XL 60mm for a larger fit.

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