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FACTS_HIVAIDS

 

HIV is an infection that can be, among other ways, transmitted during sex, and also by a variety of sexual practices. It is classified as a chronic infection because there is currently no cure. There are medications that reduce the amount of virus in the body and the course of the infection, and which prevent the person living with HIV from developing what we call AIDS. The treatment is usually called antiretroviral drugs, ARVs, antiretroviral treatment, or HAART which stands for Highly Active Antiretroviral Therapy.

The HIV virus attacks cells in the body’s immune system by weakening or shutting down the functions that regulate the body’s defense against different infections, and against tumor cells. The virus enters the cells and fuses with the existing gene pool.

The HIV infection develops slowly, and even if you have caught HIV you can still feel well for a long time before the virus’s effects on the immune system start to show. Even if the infection has not been detected, the virus can still be transmitted to others.

The amount of HIV virus in the blood varies from person to person and over time. The immune system may initially restrain the HIV virus, and the amount of virus is therefore kept at a relatively constant level. Since the virus attacks cells in the immune system, however, the system grows weaker over time. This leads to the person living with HIV becoming more sensitive to other infections. An untreated HIV infection means that the within around 5-12 years the immune defense will drop to such low levels that the body is unable to fight off infections as it usually would. This is what we call AIDS, and if no medicine is taken when the person reaches this phase, the body will be unable to cope and the person will eventually die. As we mentioned, however, there are antiretroviral drugs available in Sweden.

HOW IS HIV PASSED ON?

HIV is transmitted through bodily fluids such as blood, sperm and pre-cum, vaginal secretions and breast milk. Another route is between mother and fetus during pregnancy. The virus is primarily absorbed through the body’s mucous membranes, which are found in the mouth (throat), vagina, urethra, the anus and the eyes, for example. Transmission can also take place intravenously, i.e. the virus can be caught directly in the blood. The most common ways of transmitting HIV are:

  • Unprotected vaginal and anal sex
  • Through infected blood, for example through blood transfusions and transplants
  • Through infected blood when sharing syringes and needles
  • During pregnancy, childbirth and breastfeeding if the mother has HIV

In Sweden, the most common way of transmitting the virus is through unprotected anal and vaginal sex. HIV can be passed on through oral sex between mouth and penis, but this is not very common. As the HIV virus is found in sperm, it is often when sperm has been involved in oral sex that the virus is passed on. A small proportion of all reported cases in Sweden have been transmitted through oral sex. Generally speaking, HIV is a virus that is not transmitted particularly easily, but it’s impossible to be certain if or when it will be passed on. It is, however, difficult to talk about risk in percentages, as the risk of transmission depends on all kinds of different factors. For example, susceptibility to HIV increases considerably if you are carrying an untreated STI.

Remember that HIV cannot be passed on through undamaged skin. Contact such as fondling, cuddling and deep kissing are therefore not dangerous, provided no open wounds are involved. You can also use the same toilet, swim, have a sauna and sleep together (and we mean sleep!) without passing on HIV.

No one has caught HIV from a blood transfusion in Sweden since 1985, when all donated blood started being tested.

Condoms provide effective protection against transmitting HIV. A condom worn correctly during anal and vaginal sex means that all parties can enjoy the sex without worrying about catching or passing on HIV. During oral sex between penis and mouth, the risk of transmission can be reduced by avoiding getting sperm in your mouth. If you want to be even more safe, you are of course welcome to use a condom during oral sex too. The risk of catching HIV during oral sex between a vagina or an anus and a mouth is virtually non existent, provided no blood is involved. Read more about safer sex under the Better Sex tab.

GETTING TESTED

There are two different tests available on the Swedish market at the moment (Jan 2013). One is a rapid test with either 20 minutes or 60 seconds result; the other is a conventional blood test. It can take up to three months for a test to show whether or not you have HIV. So if you think you may have caught HIV on a specific occasion, you have to wait three months before an HIV test can show with certainty whether or not the infection was passed on. If you are worried, you can go and get tested earlier even though the result may not be 100 % accurate.

A conventional HIV test is a blood test taken from the crook of the arm. The test results come in 7-10 days. You agree with the clinic how you want to be informed, but the clinics generally prefer telling you face to face.

With the rapid test, the blood sample is taken from the finger and you get a result within either one or 15-20 minutes. So you have to be prepared to get an answer when you go to the clinic to get tested. Remember that it can take up to three months before HIV can be detected even in a test with rapid result. So it’s only the waiting time between the sample and result that is speeded up, you don’t have to wait 7-10 days to get the results. Venhälsan, The Gay Mens Health Clinic in Stockholm, along with a couple of other clinics currently offers testing with quick results. Getting tested is an excellent opportunity to talk about safer sex and get answers to any questions you may have.

TREATMENT

There is no cure for HIV. Unlike bacteria, which can multiply of their own accord, a virus enters the body’s cells and uses the host cell to multiply. It is therefore hard to combat the virus without damaging the host cell. It is the body’s immune system that fights and keeps viral infections in check. There is currently no vaccine against HIV.

Even though there is no cure for the HIV infection, the course of the illness can be slowed through treatment. The drugs reduce the level of virus in the blood by making it more difficult for it to reproduce. The more HIV virus in the blood, the faster the immune system is thought to weaken. Treatment therefore aims to reduce the amount of HIV virus in the blood. This is thought to slow the development of AIDS since lower virus levels mean the immune system is not weakened as quickly, and the reduced virus levels give the immune system a chance to recover to some extent. The doctor’s instructions must be carefully followed during treatment. Since the virus cannot be eliminated completely, treatment with antiretroviral drugs is lifelong.

Thanks to effective antiretroviral drugs, a person who starts treatment today can bring down their virus levels so much that they aren’t even measurable. When the virus levels are so low there is also less risk of HIV being transmitted to others, which can bring extra peace of mind for people in a relationship with someone who doesn’t have the virus. Do keep in mind that the viral load changes over time, just because the viral load was low at the last check up, it does not mean that is is low now. A regular infection like a cold or an untreated STI may increase your viral load.

Modern drugs can have a range of mild or more severe side effects. The risk of side effects increases the more drugs that are combined. Sometimes the side effects can be so severe that treatment has to be put on hold.



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Main Topics

 

Selling Sex  Här finns allt du behöver veta för att sälja sex bekvämare och säkrare. Texterna bygger på intervjuer med personer som sålt sex så det är verkligen på riktigt.

 

Facts  Under den här rubriken har vi samlat en massa fakta om sexköpslagen, kondomer och hiv. Allt är självklart granskat av Venhälsan och Rose Alliance.

 

Testing & PrEP  Det är bra att testa sig regelbundet för hiv och könssjukdomar, gärna var tredje månad om du säljer sex regelbundet, även när du använder kondom.

 

Alcohol & Drugs  Bra och korrekt information om alkohol, droger och rådgivning kan vara svårt att hitta. Därför har vi samlat det viktigaste informationen här.

 

Support & Info  Ibland behöver man hjälp med det stora, ibland med det lilla. Här har vi samlat det lilla stöd som finns för er som säljer sex.

 

Selling Sex /
The sex itself

Overview Just like sex means many different things to different people, selling sex is also very different for different people. Some do it because they enjoy it, or because it’s the best alternative they can find. Others do it for financial reasons, because they have mental health issues, or because they are forced to. Whatever the reason, it’s always good to have some advice on how to make the sex act feel better. The tips below come from people who have experience of selling sex. Anal sex If you are being penetrated, there are ways of making anal sex feel better, even if you are not sexually excited. Most importantly, try to relax your body and not be tense. Some find it easier to “warm up” first with a little lubricant and a finger, for example. Some positions give you more control of the situation. This can be a good idea, especially with a new customer or a large penis. One position that gives you better control is if you “ride” the customer. Which positions are comfortable also depend on the shape of the penis. Find what works for you. You decide the tempo, even if someone has paid you for sex. If you want to stop having sex, do so. You always have the right to stop. Just give the money back and leave. If you are doing the penetrating, it’s important to have the right condom size. You can read more about different sizes of condoms under “Facts”. There is only one way […]
 

Selling Sex /
Before you meet

There are some things to think about before meeting a buyer, no matter if it is your first time selling sex or if you have done it before. First, think about what you are okay with doing, what rules and limits feel good for you. What types of sex are you okay with selling? Is kissing okay or not? How will you start talking about safer sex? When you know the answers to those questions, you can make a deal with a buyer. Not before. And stick with the rules you have made for yourself, even if the buyer wants to pay more for things you have decided you do not want to do. When it comes to safety, we have collected some tips from people who have sold sex. If the buyer sounds drunk or high on the phone, or if they are drunk or high when you meet, you may want to leave. Do not meet buyers when you have taken drugs or drunk alcohol, it will be more difficult for you to see if a situation is dangerous. Find out as much information about the buyer as you can before you meet, and save the information. Call a friend before meeting the buyer, and tell your friend the address, the phone number and other information about the buyer, and how long you will be meeting them. Call your friend afterwards too. Make sure that your mobile phone battery is charged and that you have money on your phone card. Have some cash in your […]
 

Selling Sex /
To stop selling sex

For some people, it takes an active decision to stop selling sex. Others may just phase it out gradually, with no problems. For the money? Most people who sell sex do it for the money. Because we need money for rent, food and othr things, it’s difficult to stop selling sex if you can not get money from somewhere else. If you feel that you want to stop selling, but you need the money, you need to start thinking about the situation and make a plan. It’s good to think about your alternatives. Could you study and get student loans? Are there any jobs around that you are interested in and qualified for? If a first step is to become less financially dependent on selling sex, you could set a goal that half your money could come from selling and half from somewhere else, until you reach the day when you can get all your money from somewhere else. But of course, if you do not have complete grades, or a residence permit, it’s difficult to start studying. And it’s not easy to get a job, even if you have experience and education. If you sell sex to finance a dependency on alcohol or drugs, it’s important to work on those problems. It’s not easy to become free of alcohol or drugs, but it is possible if you want to and work hard. En.rodaparaplyet.org has information on alcohol, drugs and counseling, if you want to drink less or take less drugs, or stop completely. Click […]
 

Facts /
Condoms

Using a condom is an effective way of reducing the risk of HIV transmission and of many other types of STIs. Condoms give you the freedom to have great sex with anyone you fancy, regardless of whether or not you live with HIV. Some may choose not to use a condom in a relationship, while others might feel it’s an interruption in a steamy situation. However, a condom is a good way of showing that you take care of yourself and  that you respect the people you have sex with. What do you personally think is good about using a condom? GENERALLY Condoms come in different sizes, fits, flavors and materials. Try different brands, sizes and materials and see what feels best for you.  Lubrication makes anal sex much more comfortable. Remember only to use a water or silicone-based lubricant with a condom. Condoms aren’t only for penises, they also fit a wide variety of toys for safer sex there as well. Remember to change condoms if more than one person is being fucked by the same penis or dildo. Always bring your own condoms in a variety of sizes when you meet a buyer. Do not reply on the buyer in this case. Then you know that the condoms are “fresh” (look at the back for expiry date) and undamaged. If you keep condoms in your wallet, replace them every month or if the protective wrapping is damaged. Also, if you are the bottom, make sure that the buyer keeps the condom on the […]
 

Facts /
Lubrication

  No matter if you have anal or vaginal sex, lubrication usually makes the sex more comfortable. It’s reducing the risk of minor wounds and injuries on the mucous membranes inside the ass or vagina. Lube can, of course be used for other types of sex as well. Silicon-based lube also makes an excellent massage oil. Cremes that contain fat (such as ointments, skin lotions, massage oils and other oils), weaken latex condoms and can make them break easily. Instead, it’s better to use either a water or silicon-based lubricant if you’re using a condom. Water-based lubricants are thick and may dry out after a while, so you’ll need to apply more as needed. Silicon-based lubes are thinner, don’t dry out and last a long time, even if you don’t use a lot. Both can be washed off with soap and water, even though silicon lubes are slightly harder to rinse off. If you prefer to use oil based cremes you can always use plastic condoms, they are not usually avaliable in regular stores so you might have to order them online. You can buy lube at the pharmacy, online and at some supermarkets. Sex shops and condom shops generally have a bigger selection. Feel your way and try out different kinds of lube, and see what’s best for you.
 

Facts /
The Femidom

  Femidom is a trademarked brand, but is used as a general term for the female condom, or receiver’s condom. The partner on the receiving end inserts it, rather than the person doing the penetration. Femidoms are either made of latex or plastic. In some ways they look quite similar to regular condoms. The femidom has an outer ring that prevents it from slipping into the the vagina or rectum. Some also have a softer inner ring that holds it in place inside the body. Inserting a femidom takes a bit of practice, whether you’re inserting it by hand or threading it over the penis or dildo and carefully “penetrate” it into place. If you’re using a femidom with an inner ring, you may need to assist with your hands. A femidom can be used in either the anally or in the vagina. It is an effective way of reducing the risk of HIV or STI transmission. The femidom is an excellent alternative to a regular condom, and gives the receiver a chance to take control of their body and the degree of safe sex. A femidom can be inserted in advance, which is great if you’re cruising, for example. Never have sex with both a condom and a femidom as they can chafe each other and break. Use plenty of lube, both when inserting it and inside the femidom itself. This will increase both your comfort and your safety!
 

Testing & PrEP /
PrEP, a new protection against HIV

Maybe you only use condoms sometimes, or seldom, or don’t use them at all. Maybe you want to lower your risk of getting HIV, but condoms don’t always work for you. In that case, PrEP can be something that can help you. Using PrEP means taking a medicine that lowers the risk of getting HIV. PrEP stands for pre-exposure prophylaxis. The medicine is named Truvada, but there are also cheaper versions with other names from different companies. If you want to use PrEP, you have to be completely sure you do not have the HIV virus. PrEP gives a very high level of protection, but not 100%. Forgetting a pill = less effective protection. Take your pills every day. PrEP does not protect against chlamydia, gonorrhea or syphilis. Condoms are the only thing that lower the risk of getting sexually transmitted diseases. PrEP can have side effects. It is important to get check-ups while taking the medicine. Ask your doctor to check up the current recommendations from “Referensgruppen för antiviral terapi”. PrEP is an approved medical product in Sweden, and it is part of the high-cost protection system. This means that you never pay more than SEK 2 200 per year for prescription medicine. Right now, in January 2018, it is extremely difficult to get PrEP through the health care system, but this may change. Check en.sexperterna.org for up-to-date information. Some tips: It’s easy to forget to take your medicine. Here are some ways to help you remember: Set a daily alarm on your mobile phone. […]
 

Testing & PrEP /
Introduction

Condoms provide by far the best protection against sexually transmitted infections (STIs), but they still don’t provide 100% protection. Even if you always use a condom, it may be a good idea to get tested for STIs. There are different STIs and they can affect you in different ways. Untreated STIs have a negative impact on the body, sometimes without the person noticing. If you have an STI it could also increase your susceptibility to other STIs and HIV. So it’s a good idea to get tested regularly, even if you don’t have any signs or symptoms of an infection. By getting tested, you take control of your own health. For people selling sex, we recommend to get tested every three months.  Safer sex means making a conscious effort to minimize the risk of transmitting STIs. Keeping an eye on your own health is a good start. If you know you have an STI you can do something about it – such as get treatment, but you can also avoid passing it on. Many STIs have no visible symptoms, so many people don’t realize they have one, but they can still be bad for your health and be passed on to others. Most infections can be cured and are easy to treat if they’re discovered in time. Untreated STIs also increase susceptibility to HIV. Testing can also put your mind at ease. If you’re worried or just want to check, go and get tested! Everyone has an HIV status, but not everyone is certain what […]
 

Testing & PrEP /
PEP

  PEP (Post Exposure Prophylaxis) can be a savior in an emergency when things don’t according to plan, like a condom splitting. PEP is a relatively effective treatment that reduces the risk of HIV being transmitted, but it does not offer 100 % protection. PEP can be given if an HIV negative has had unprotected sex with an HIV positive person in the past 36 hours. The sooner you get PEP, the better. The PEP treatment is not a single pill but a 30 day treatment. Afterwards you are recommended to get tested after six weeks, 12 weeks and 6 months. PEP treatment is available Venhälsan at Södersjukhuset in Stockholm and the ER at Karolinska Sjukhuset in Huddinge. For availability in other cities, ask your local health care or send us an e-mail for more info. 
 

Alcohol & Drugs /
Support & Advice

 The social services in your town or district (kommun in Swedish) can also help you prevent and stop drug abuse. You can ask them for counselling and other social support. Often, your kommun can also offer anonymous counselling over the telephone. Call your kommun’s contact number (look for the word växel in Swedish) and tell them what you want help with, and they can help you get further support. You can also visit AA (Alcoholics Anonymous) or NA (Narcotics Anonymous) who sometimes have special meetings for homosexuals, bisexuals and transgender people. Click on their links for more information in English. You can find more information about where to find help and support at More information about alcohol and other drugs can be found here.  Information for young people on Drugsmart.
 

Alcohol & Drugs /
Viagra

  Viagra is a medicine that you need a doctor’s prescription for. It is meant for people who have a problem getting their penis hard and/or keeping it hard. For other people, it can give the opposite effect, or give an erection that is so hard you need a doctor to get it down. Viagra can be deadly in combination with poppers, or with medicines for heart problems or vascular (blood vessel) problems. It is a bad idea to buy Viagra copies, so called generic Viagra, on the Internet. If you have erection problems or want to keep your penis hard for a long time, talk to a doctor. Do not self-medicate. There are many different reasons for erection problems. Often, mental and social issues affect your ability to get sexually excited or to get your penis hard and keep it hard. A cockring can help with keeping it hard. If you often have problems with this, talk to a doctor who can see if there are any physical reasons, and give you medical help if you need it. There are many different medicines that are said to be similiar to Viagra. Your doctor can help you choose the right one for you. Always follow the dose recommended by the doctor. Support Have you thought about drinking less alcohol, taking less drugs, or stopping completely? Are you using a medicine in a destructive way? Are you worried that a friend is drinking too much? Sometimes it is a good idea to talk to a professional […]
 

Alcohol & Drugs /
Other drugs

  It is not a good idea to take drugs before you meet a customer. Drugs make your judgment worse. Never accept anything from a customer or anyone else, because you can never know what you are actually being given. Have you thought about drinking less alcohol, taking less drugs, or stopping completely? Are you using a medicine in a destructive way? Are you worried that a friend is drinking too much? Sometimes it is a good idea to talk to a professional who can give advice and support.  Amphetamine Amphetamine is a chemical drug that stimulates the central nervous system. It can be found as pills or as a powder, and it can be swallowed, snorted (inhaled through the nose) or injected. When you take amphetamine, your brain gets an increase in the synaptic activity of dopamine and noradrenaline. This gives you feelings of intensity, heightened energy and self-confidence. Amphetamine also speeds up your heart rate and gives you higher blood pressure. During the high, you often stop thinking about eating and sleeping, and get a higher sex drive and more energy to start with. If you use amphetamine often, the positive feelings will go away, and instead you will feel withdrawal symptoms and extreme tiredness. It can be very different how much amphetamine there is in the pills or the powder, and this can lead to unwanted overdoses. If you overdose, you risk collapsing or dying because of the effect on your heart and breathing. Amphetamine and alcohol together leads to worse health. If […]
 

Support & Info /
CHAT WITH US

CHAT WITH US People who have sold sex have very different experiences of it. And the experience of selling sex can change and be different from time to time. If you have questions about selling sex and your health, send us an email, please use nicklas@rfslstockholm.se. Your email will go to Nicklas Dennermalm, who is project manager at RFSL Stockholm. He will help you get answers to your questions by consulting a network of sex workers and experts. 
 

Support & Info /
Skåne

  Advice, support, counseling for LGBTQ people who have sold or bought sexual services. Sex for money is more common among gay men, lesbians, bisexuals and trans people of all genders. But it is often something we do not talk about with anyone. Sex for money can make you extra exposed to risks. Things can get worse if you keep everything secret, and if you do not know where to get help if you encounter problems. If you need advice, support or treatment – contact us. Every Monday between 2 p.m. and 4 p.m. we have a live chat on our web page to answer your questions. Other times, we answer as soon as we can. There might be other opening hours during the summer and during the holidays.  Chat, call or email us!   We provide: • free condom subscriptions • anonymous HIV testing with quick results • support and advice on safer sex • counselling/ treatment • help if you want to contact other authorities or places for support • advice and support via chat    RFSL Rådgivningen Skåne Drottninggatan 36 (map) 040-6119951