If you’re living with human immunodeficiency virus (HIV), you may wonder whether you got it from vaginal sex. Or, if you’re HIV-negative and partnered with someone who’s HIV-positive, you may want to know whether the disease can spread through vaginal sex. HIV transmission can occur through anal sex, but it can happen from vaginal sex too. And some factors can increase the risk of HIV infection from vaginal sex.

Learn more about HIV risk from vaginal sex, including what can increase the risk of the disease spreading and effective ways to protect yourself and your partner.

Anyone Can Get HIV

Having unprotected sex involving a penis penetrating a vagina with someone who is HIV-positive increases your risk of contracting HIV, regardless of your or their sex or sexual orientation.

According to the Centers for Disease Control and Prevention (CDC), 70 percent of new estimated HIV infections in 2021 were among men who reported male-to-male sexual contact. However, the CDC reported that 22 percent of new HIV infections in 2021 were among people who’d had heterosexual contact (male-female sexual contact). Of these, 6 percent were men and 16 percent were women, per the CDC.

The Importance of Education, According to myHIVteam Members

Many myHIVteam members who engage in heterosexual contact talk about the importance of education around HIV prevention. “As a white, heterosexual, female that is educated (master’s degree in social work), I find myself in the minority group of HIV/AIDS (according to statistics). My closest friends know my status and I have had to teach them about HIV/AIDS because they are like me in regards to demographics and think they are ‘safe,’” one myHIVteam member wrote.

“I lived like I was married, in a nine-year relationship,” another member said. “After six years, I tested positive. Still won’t get a straight answer from my now ex-boyfriend. I just wish more people can be educated on the spreading of HIV.”

You Can Get HIV Through Vaginal Sex

Although unprotected anal intercourse with an HIV-positive person carries the highest risk for HIV transmission, HIV can also be transmitted through vaginal sex.

Females May Be at Greater Risk From Vaginal Sex

Research has shown that the risk of getting HIV through vaginal sex is different for receptive or insertive vaginal sex. In other words, the risk is slightly different depending on whether you’re the person receiving or inserting the penis into the vagina.

For example, one study cited by Stanford Medicine found that the risk of HIV transmission was 0.04 percent for insertive vaginal sex and 0.08 percent for receptive vaginal sex. This means the person receiving the penis in vaginal sex has a two-times higher risk.

Certain Factors Increase HIV Risk From Vaginal Sex

While vaginal sex is relatively low-risk in terms of HIV transmissions, it’s important to keep in mind that some exposures carry more risk than others. And the more exposures you have, the greater the risk of infection.

Factors that increase risk of HIV infection after exposure through vaginal sex include:

• Having a higher viral load (the amount of virus the HIV-positive person has)
• Having a sexually transmitted infection (STI)
• Having an uncircumcised penis (foreskin is still intact)
• Being on your period (menstruating) or having other vaginal bleeding
• Having abrasions or tears, such as from long or rough sex or from douching

For example, a woman’s risk of getting HIV from vaginal sex is eight times higher if she has an STI, according to Stanford Medicine — especially an STI that causes ulcers or certain vaginal conditions, such as bacterial vaginosis. This means that a female with a vaginal STI who has unprotected vaginal sex with an HIV-positive partner has an HIV-infection risk closer to 1 percent.

Older women may be at greater risk due to thinning or dryness of the vagina that happens as a normal part of aging, according to HIVinfo.NIH.gov.

High viral load, like in the early stages of HIV infection, can also increase the risk of HIV infection. For example, the risk of HIV transmission from having receptive vaginal sex with an HIV-positive person who has recently been infected can be up to 2 percent, according to Stanford Medicine.

Having an uncircumcised penis increases a person’s risk of becoming infected with HIV through vaginal sex. This is because the foreskin is more susceptible to HIV infection. Studies in Africa showed that undergoing circumcision can, in some cases, reduce a man’s risk of HIV infection through vaginal sex by about 70 percent.

You Can Reduce Your Risk

Although the risk of passing or receiving an HIV infection through vaginal sex is low, it’s important to remember the risk increases the more times you’re exposed. For example, according to Stanford Medicine, if a woman has unprotected receptive vaginal sex 100 times with a man who is HIV-positive, the woman’s risk of HIV infection increases over time to about 10 percent. The risk will be even higher if other risk factors are at play, like an STI.

You can take steps to reduce your risk of HIV from vaginal sex. Below are ways to protect yourself, according to the CDC:

• Use a condom every time you have vaginal sex, and use lube to help keep the condom from slipping or breaking.
• Opt for less risky sex, like oral sex, or sexual activities that don’t involve vaginal fluid, blood, or semen. HIV is not spread through saliva, such as from kissing.
• Get tested for sexually transmitted diseases (STDs) and seek treatment if you test positive for one.
• Take PrEP (preexposure prophylaxis), a medicine for people at risk of HIV that is highly effective at preventing HIV infection from sex.
• Make sure your partner is getting treated and staying on HIV treatment if they’re HIV-positive to reduce the viral load you’re exposed to.
• Choose not to have sex — for certain periods of time or at all.

Talk to Your Doctor About Risks

People with HIV and their partners have the right to a healthy and enjoyable sex life, free of anxiety and stigma. Recent research has shown that people with HIV who have undetectable viral load, such as from taking PrEP, don’t transmit HIV through condomless sex. However, many health care providers continue to promote protected sex and advise against risk-taking behaviors among people with HIV and undetectable viral load.

More research may be needed before health experts change their guidance regarding HIV-transmission risk with a partner who has an undetectable viral load. Talk to your doctor about what this could mean for you. It’s also crucial to verify that you or your partner do in fact have undetectable virus before taking any risks. As one myHIVteam member wrote, “If we are close enough to sleep together, we are close enough to see your numbers in print.”

It’s best to play it safe, but that doesn’t mean you can’t enjoy sex. Talk to your doctor about your risk of HIV from vaginal sex and ways to have a healthy, pleasurable sex life given your personal circumstances.

Talk With Others Who Understand

On myHIVteam, the social network for people with HIV and their loved ones, more than 41,000 members come together to ask questions, give advice, and share their stories with others who understand life with HIV.

Have you wondered if you got HIV from vaginal sex? What risk factors do you have, or what do you do to reduce your risk? Share your experience in the comments below, or start a conversation by posting on your Activities page.