HIV Transmission

HIV Transmission

How HIV SpreadsThere is still misunderstanding about how HIV is transmitted from one person to another. Knowing the basics helps you avoid getting the virus if you are HIV-, and avoid passing it on if you are HIV+.

HIV is spread through the following body fluids:

Blood (including menstrual blood) Semen and other male sexual fluids ("pre-cum") Vaginal fluids Breast milk HIV is not spread through these body fluids:

Sweat Tears Saliva (spit) The spread of HIV can be prevented! There are ways to avoid, or at least, reduce contact with the bodily fluids that spread HIV (blood, sexual fluids, and breast milk). This info sheet will explain how.

Methods of TransmissionIn the past, HIV was spread in blood products, such as whole blood or the "factor" used by hemophiliacs. Many people were infected this way. The blood supply is now much more strictly tested and controlled. The odds of being infected from receiving blood or factor in the U.S. are extremely low.

You cannot get HIV from donating blood – a new clean needle is used for each donation.

Some people, primarily healthcare workers, are occasionally infected through needle sticks with infected blood, or through other medical accidents. This is a very tiny percentage of overall infections.

Today, the most common ways HIV is passed from one person to another are:

Re-using and sharing needles Unprotected/unsafe sex (no condoms or other barrier devices) Mother-to-child
Re-using and Sharing NeedlesMany HIV infections occur when people share needles to inject heroin, methamphetamine, or other drugs. This risk can be greatly reduced by cleaning needles with a bleach solution before re-using them. The risk can be eliminated by using fresh needles each time. Many cities now offer free needle exchange programs.

When getting a tattoo or body piercing, always go to a licensed professional and make sure the equipment is autoclaved, not just "sterilized" with alcohol.

Un-protected/unsafe SexEvery sexual act that involves sexual fluids of some kind has at least some risk. Barriers, such as condoms (male and female), dental dams, latex gloves, and even plastic food wrap (such as Saran Wrap), help reduce risk substantially.

Unsafe sex (sex without condoms or barriers) puts you and your partner at risk for HIV or other sexually transmitted diseases (STDs).

Safer sex (sex using condoms or other barriers correctly and consistently) protects you and your partner.

Which common sexual activities are most likely to cause HIV transmission when safer sex isn't used? (Listed from most to least risky.)

Receptive anal sex ("bottoming") remains the most risky activity, due to the likelihood of direct semen-blood contact. But penetrative anal sex ("topping") with someone can result in HIV transmission, too. Vaginal intercourse puts both partners at risk, but HIV is transmitted from men to women much more easily than from women to men. Oral sex can be risky for the person performing it, particularly if he or she swallows semen, vaginal fluids, or menstrual fluids. Sharing sex toys without sterilizing them can be dangerous. Rimming (licking the anus) is very unlikely to result in HIV infection. Mutual masturbation (hand jobs) and fisting (using a hand to penetrate the anus or vagina) are relatively risk-free, as long as your hand has no open cuts or sores. Sexual assault can result in infection if the assailant is HIV+. The risk increases when rape involves anal penetration, force, and/or multiple assailants. Some forced sexual acts involving wounds can place a victim at very high risk.

In major cities, PEP (post-exposure prophylaxis) is often offered to victims of sexual assault. This month-long treatment reduces the likelihood of HIV infection substantially. It is currently only used on a regular basis for victims of sexual assault and for healthcare workers who have been exposed to HIV on the job. PEP must be started as quickly as possible, always within 72 hours of the exposure.

Mother-to-Child TransmissionHIV+ mothers can pass the virus to their babies while pregnant, during birth, or by breastfeeding. New medical techniques have almost eliminated the risk of a baby getting HIV from its mother when precautions are taken. HIV+ mothers should not breastfeed their babies.

Freak TransmissionsThere are a few isolated cases of people infected from using a razor that had just been used by an HIV+ man or in other off-beat ways. To be safe, always avoid direct contact with blood and sexual fluids in any context.

Don't worry too much about freak cases. For instance, there is a documented case of transmission from deep or "French" kissing – in two people who had terrible dental problems. The odds of getting HIV from kissing, even when one person is HIV+, are less than the odds of being struck by lightning.

True versus False Risk of TransmissionHIV cannot be transmitted except when certain bodily fluids are exchanged. You can greatly reduce the risk of transmission by:

Avoiding contact with sexual fluids by always practicing safer sex Abstaining from sex unless you and your partner are both HIV- and in a long-term, monogamous relationship Not using injection drugs, or if you do, always using new or clean needles Finding our your HIV status if you are planning to get pregnant and working with a knowledgeable doctor and obstetrician if you are HIV+ If you protect yourself in these ways, you do not need to be afraid of getting or passing HIV by casual contact. Remember, HIV is not transmitted by:

Hugs Dancing Sharing food or drinks Using a shower, bath, or bed used by an HIV+ person Kissing (between people with no significant dental problems) Sharing exercise equipment