Learn the right way to use a male condom and a female condom. HIV is mainly spread by having anal or vaginal sex without a condom or. HIV can spread: during sex (especially anal sex and vaginal sex); through sharing needles for injecting drugs or tattooing; by getting stuck with a needle with an. This means having vaginal, anal, or oral sex without a condom. It makes you more likely to get HIV and other sexually transmitted diseases.