Unprotected vaginal/front-hole sex has a high risk of STD and HIV transmission for both partners. The risk is greater for the person being penetrated. Condoms, PrEP, and maintaining an undetectable viral load (for people who are HIV+) are extremely effective forms of protection against HIV transmission. PEP is an effective means of protection against HIV after possible exposure. Condoms are the only method that can prevent both pregnancy and STDs/HIV when used alone.
Withdrawal before ejaculation seems to be more effective in reducing transmission during vaginal/front-hole sex than anal sex, but condoms and PrEP are still the most effective. While the risk of getting pregnant from pre-cum is low, it can still happen.
Along with recommended frequent HIV and STD testing, women and trans men should also make sure to get screened for HPV-related cervical cancer as recommended by their provider during their regular gynecological health check-up.
For more tips on practicing safer sex, check out Safer Sex for Trans Bodies.
What pregnancy prevention options work for trans people?
Pregnancy can be prevented in many different ways including using condoms, taking a pill, and other long-acting prevention methods. For some trans people, thinking about pregnancy can remind us of our bodies in ways that might not always be comfortable, but it’s important to be aware of the options available to you if there’s a possibility that you could become pregnant.
Taking a pregnancy test, talking about pregnancy with a partner, or starting birth control can be difficult for many reasons. But doing so can help you take control of your sexual health.
If you are taking hormones, relying on testosterone or estrogen for birth control is not effective. If you are concerned that birth control will interfere with your hormone therapy, check out Planned Parenthood's list that includes hormone-free options. When in doubt, talk to a health care provider who can help guide you to the option that works best for you.
Do HIV medications or PrEP conflict with trans hormones?
Not all trans people take hormones as part of gender identity-related health care but many do. There are no known interactions between any forms of hormone replacement therapy and PrEP.
Check out this one minute video from Greater Than AIDS for more.