Know the Risks

If you are sexually active, or have been thinking about becoming sexually active, it’s good to know that different activities have different risks for sexually transmitted and blood-borne infections (STBBIs), including HIV. Sharing needles and other kinds of drug equipment also has risks. At Nine Circles, we don’t judge your choices. We operate from a harm reduction approach, empowering you to make informed choices based on accurate information and a range of options. Here are some common questions we hear:

What is Sex?

Any kind of intimacy can be considered sexual activity. Whether it’s oral sex (receiving or giving), vaginal sex, anal sex (top/bottom), BDSM (bondage, discipline, dominance and submission), needle play, or any other form of skin to skin contact, it counts as sex!

What are sexually transmitted and blood-borne infections (STBBIs)? 

  • A sexually transmitted infection (STI) is an infection which is passed from one person to another through sexual contact, e.g. vaginal, oral or anal sex.
  • A blood borne infection (BBI) is an infection which is passed from one person to another through blood to blood contact. Some blood borne infections such as HIV and Hepatitis B may also be transmitted through sexual contact.

How often should I be tested?

You should be tested on a regular basis, as it’s quite common to show no symptoms for many STBBIs. This helps avoid future complications from untreated infections. We think it’s best for all adults to be tested for HIV every 5 years. Some people may come in more frequently for STBBI testing if they have had recent encounters they are concerned about, have suggestive symptoms, share drug use equipment or are having unprotected sex with multiple partners.

How can STBBIs be transmitted?

Depending on the type of STBBI, you can get an infection from:

  • Skin to skin contact
  • Exposure to sex fluids, blood or open sores

What are the transmission risks for HIV?

Just because you are exposed to blood or sex fluid from an HIV positive partner DOES NOT mean that you will acquire HIV. As with other STBBIs, not every exposure results in HIV transmission. Many factors influence the possibility of infection after an exposure.

See the HIV Transmission Equation:

HIV Transmission Equation

Do you know about PrEP & PEP?

Post-Exposure Prophylaxis (PEP)

  • Anyone who thinks they may have been exposed to HIV should contact a health care provider immediately.
  • Post-exposure prophylaxis (PEP) is when you are prescribed HIV drugs after an actual or suspected exposure to HIV.
  • PEP is a regimen of HIV drugs that needs to be taken every day for 4 weeks.
  • PEP should be taken as soon as possible after a suspected exposure to HIV as it is most effective within 72 hours.

Pre-Exposure Prophylaxis (PrEP)

What is PrEP?
  • Pre-Exposure Prophylaxis (PrEP) is a way for an HIV-negative person at risk of HIV infection to reduce their risk.
  • One form of PrEP involves taking the anti-HIV medication Tenofovir DF 300 mg/Emtricitabine 200 mg (brand name = Truvada) on a daily basis.
  • Tenofovir/Emtricitabine (Truvada) for PrEP has been approved by Health Canada.
How much does PrEP cost?
  • The cost of Tenofovir/Emtricitabine (Truvada) ranges from $250-$1000/month depending on the brand.
  • This cost is NOT covered by Manitoba Pharmacare, but may be covered by some third party/private insurance companies.
  • The cost is covered for people who have First Nations & Inuit Health Branch benefits.
How should PrEP be used or prescribed?
  • PrEP should be used together with other prevention strategies like condoms.
  • Before starting PrEP, a detailed assessment of risks and benefits should be done by a health care provider.
  • PrEP requires daily adherence to the medication and HIV/STI testing, urine and blood work monitoring every three months.
  • There are potential side effects to the medication.
  • There are risks for developing drug resistance if a person becomes infected with HIV while taking PrEP.
For more Information on PrEP:

To learn more about the basics of STBBIs, as well as information on prevention and treatment, visit CATIE