Punitive Laws And Overcrowding
Punitive laws lead to the incarceration of people living with HIV and otherwho are disproportionately represented in prisons worldwide as a result.626364
For example, sex workers are at a high risk of incarceration as around 98 countries criminalise sex work or aspects of sex work.65 Likewise, 67 countries criminalise same sex activity, increasing this risk for men who have sex with men.66 In addition, 68 countries have HIV-specific laws that prosecute people living with HIV for a range of offences.67
Research in US prisons has found that young lesbian, gay, bisexual and transgender people are disproportionately imprisoned and experience bias during pre-trial detention and sentencing. Lesbian or bisexual women represent around a third of all female prisoners in the US, despite making up just 3.4% of the general population.68
In places with weak criminal justice systems, people who are detained may have to wait for long periods during the investigation of a crime, while awaiting trial and before sentencing. It is estimated that around 14 million people are imprisoned each year due to arbitrary and excessive use of pre-trial detention.69 These delays increase peoples likelihood of HIV and other infectious diseases while in prison.7071
In sub-Saharan Africa, 86% of countries for which data is available have prison occupancy rates over 100%.74 Overcrowding makes HIV services harder to access and increases the risk of violence and abuse.75
Is Deep Kissing A Route Of Hiv Transmission
Deep or open-mouthed kissing is a very low risk activity in terms of HIV transmission. HIV is only present in saliva in very minute amounts, insufficient to cause infection with HIV. There has been only one documented case of someone becoming infected with HIV through kissing a result of exposure to infected blood during open-mouthed kissing. If you or your partner have blood in your mouth, you should avoid kissing until the bleeding stops.
Were More Closely Connected Than You Might Think
The reality is that there are fewer gay and bi guys than there are straight men and women. So when youre meeting a guy for casual sex, the pool of people you have to choose from is smaller. This makes gay and bi guys much more closely connected, sexually, than the rest of the population. It also allows HIV and other STIs to spread quickly among us.
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Can I Transmit Hiv To My Baby During Pregnancy Or Breastfeeding
An HIV-infected pregnant woman can pass the virus on to her unborn baby either before or during birth. HIV can also be passed on during breastfeeding. If a woman knows that she is infected with HIV, there are drugs she can take to greatly reduce the chances of her child becoming infected. Other ways to lower the risk include choosing to have a caesarean section delivery and not breastfeeding.
Hiv And Maternal Transmission
HIV can be passed from mother to child during pregnancy, delivery, or through breastfeeding. If left untreated throughout these stages, there is a 15-45% chance of an HIV positive mother transmitting the virus to their child . However there are treatment options to prevent this from happening.
If pregnancy occurs and there has been potential HIV exposure, ask a healthcare provider about getting tested for HIV as early as possible. Taking medications called antiretroviral therapy as prescribed can reduce the viral load so that the baby has a very low chance of contracting HIV .
A person with HIV should not breastfeed their child, as breast milk can transmit HIV. Even if a person is taking ART and their viral loads are undetectable, they should still not breastfeed.
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What Does Prep Do
PrEP is a medication that helps to reduce the risk of HIV transmission by preventing the virus from multiplying or growing within the body. PrEP is a combination of two drugs which help to fight off infection and also stop HIV from reproducing within a healthy host.
Before a person can be prescribed PrEP by their doctor, they must first be tested for HIV. PrEP is intended to be taken before a person is exposed therefore, if they already have HIV, they need to seek another HIV treatment as opposed to PrEP.
PrEP must be taken daily for at least seven days before it is effective at preventing HIV transmission through anal sex. This is because PrEP tends to collect in the colorectal tissue first before it is more present in other bodily tissues. However, it is still recommended that condoms are used during intercourse for additional protection.
How Long Can Hiv Survive Outside The Body
Once outside the body, HIV usually cant survive for very long. Coming into contact with blood or semen that has been outside the body doesnt generally pose a risk for HIV transmission.
Similarly, the risk of passing on HIV to someone else if you have a detectable viral load and cut yourself is also very low. Wash away any blood with soap and hot water and cover the wound with a sticking plaster or dressing.
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Hiv Among Bisexual People In The Us
Despite making up the largest part of the LGBTQ community, bisexual people continue to be erased in many ways. And, as weve discussed above, invisibility and erasure often lead to worse health outcomes.
The CDC does not include data specific to bisexuals in its HIV data. Although men, women, and people of all genders can identify as bisexual, data about sexual HIV transmission is often recorded as either heterosexual or male to male, even if one or both people involved in the transmission are bisexual. Because data is aggregated by mode of transmission and not a persons identity, bisexual people are often unseen within HIV data.
Bisexual people are much less likely than gay men or lesbians to disclose their sexual orientation to their sexual health care providersnot because they dont want to, but because they often feel like their sexuality is misunderstood or because providers may assume that they are either exclusively straight or exclusively gay. One 2013 study found that 39% of bisexual men and 33% of bisexual women did not disclose their bisexuality to their health care provider, compared to only 13% of lesbians and 10% of gay men.
Along with creating barriers to health care, biphobia among the general population can often lead to compromised sexual health for bisexual people, as well.
Tattoos And Body Piercings
- There are no known cases in the United States of anyone getting HIV this way.
- However, it is possible to get HIV from tattooing or body piercing if the equipment used for these procedures has someone elses blood in it or if the ink is shared. This is more likely to happen when the person doing the procedure is unlicensed because of the potential for unsanitary practices such as sharing needles or ink.
- If you get a tattoo or a body piercing, be sure that the person doing the procedure is properly licensed and that they use only new or sterilized needles, ink, and other supplies.
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Lymph Node Joint And Muscle Pain
HIV that attacks the body will begin to decrease the immune system or immunity. Pain occurs in the joints, muscles, and lymph nodes. Because the lymph nodes are part of the immune system.
Most likely to experience inflammation and swelling during infection. Until finally there is a pain in the armpits, groin, and neck.
- Ulcers in the mouth
- Night sweats
- Nausea or vomiting
Men may underestimate the initial symptoms and delay seeing a doctor until the symptoms worsen, by which time the infection may have developed.
The fact that some men do not seek timely treatment may be the cause of this virus affecting men more severely than women.
Rape And Sexual Abuse
While some sex in prisons is consensual, rape and sexual abuse is used to exercise dominance over other prisoners.4647 Roughly 25% of prisoners suffer violence each year, while 4 to 5% experience sexual violence and 1 to 2% are raped.48
Allegations of sexual abuse in prisons in the USA are increasing according to a Department of Justice study. The report found that between 2009 and 2011, administrators reported about 25,000 allegations of sexual victimisation in prisons, jails and other adult correctional facilities. Prison staff were allegedly responsible for 49% of reported incidents.49
Prosecution for crimes committed by staff is extremely rare. Over three quarters of staff responsible for sexual misconduct were allowed to resign before an investigation concluded or were dismissed. Around 45% were referred for prosecution but only 1% of perpetrators were convicted. The US government has warned states that they may lose some federal funding if they do not take steps to detect and reduce sexual assaults of prisoners.50 Female prisoners are also vulnerable to sexual assault, including rape by both male prisoners and male prison staff. They are also at risk of sexual exploitation and may engage in sex for the exchange of goods.51
They arrested and they beat me, asking questions. They didnt sexually abuse me, but they asked me to have sex with them. They said they would release me if I did, and I said no
– A Zambian female prisoner53
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Hiv Information Education And Communication
Prisoners and prison staff need to be educated about HIV and AIDS and how to prevent HIV transmission, with special reference to the likely risks of transmission within prison environments and to the needs of prisoners after release.103
Even in high-income countries, information, education and communication programmes for prisoners about HIV and other STIs are not impacting levels of new infections. Sessions that include topics beyond HIV, such as employment and housing concerns, have been shown to have high success in changing risk behaviours, and peer-based interventions have been successful, yet very few prisons implement these type of programmes.104
High levels of illiteracy among prisoners can also complicate IEC programmes. For example, 70% of prisoners in the USA have the literacy levels of a nine-year-old.105 As a result, prisoners often cannot understand the HIV prevention information they are given. This emphasises the importance of tailoring programmes to meet prisoners specific needs or they will be ineffective.
Peer education by prisoners in Ghana
A programme in Ghana recruits prisoners who are literate, have good communication skills and can maintain confidentiality as peer educators. The peer educators receive five days of training on HIV prevention, stigma and discrimination, STIs, sexual and gender-based violence and facilitation skills.
How To Prevent The Spread Of Hiv
People living with HIV can use the following to prevent transmitting it to others:
- Pre-exposure prophylaxis : This is a daily pill that contains two antivirals called tenofovir and emtricitabine. When a person takes it daily, PrEP can reduce the risk of acquiring HIV through sex by
- of a recent potential HIV exposure.
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Is It True That Gay Men Are More At Risk For Hiv Than Other People
Although anyone can be at risk for HIV, some people can be more at risk depending upon the types of sexual practices and drug use they are engaging in. Being gay does not necessarily mean you are at higher risk, but certain activities gay men sometimes participate in might put them at greater risk. Overall, the gay male population in Canada has higher rates of HIV infection than some other populations. Stigma and homophobia can affect a person’s ability to access information about safer sex specifically for gay men.
Diagnosis In Men Vs Women
Doctors diagnose HIV in both men and women by testing a blood or saliva sample, although they could also test a urine sample. This test looks for antibodies produced by the person to fight the virus. The test typically takes around 3 to 12 weeks to detect antibodies.
Another test looks for HIV antigens, which are substances that the virus produces immediately after transmission. These antigens cause the immune system to activate. HIV produces the p24 antigen in the body even before antibodies develop.
Usually, both the antibody and the antigen tests are done in labs, but there are also home tests that people can take.
Home tests may require a small sample of blood or saliva, and their results are quickly available. If the test is positive, it is essential to confirm the results with a doctor. If the test is negative, a person should repeat it after a few months to confirm the results.
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Preventing Hiv Among Prisoners
Despite the high risk of HIV transmission among prisoners, HIV prevention and treatment programmes are often limited in prisons and other closed settings. Those that do exist also rarely link to national HIV prevention programmes.
In 2012, a comprehensive package of 15 key HIV interventions for prisoners was put forward by the United Nations Office on Drugs and Crime and includes:
- HIV testing and counselling
- treatment, care and support
Some of the main interventions to prevent HIV among prisoners, and their effectiveness, are detailed below.
What Are My Chances Of Contracting Hiv
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What is HIV?
Human immunodeficiency virus attacks and weakens the immune system, making an individual more vulnerable to serious illness. Untreated HIV can lead to AIDS, which occurs when the immune system is so weak it becomes susceptible to serious infections and some cancers.
Theres an epidemic of HIV in the United States and around the world. According to the Centers for Disease Control and Prevention , more than 1.1 million people in the United States are living with HIV, and 1 in 7 of them arent aware of it. An estimated 39,782 people in the country were diagnosed with HIV in 2016 alone.
HIV transmission occurs in many different ways, including through condomless sex and by sharing needles. Risk of transmission varies depending on several factors including:
- sexual practices and the HIV status of sexual partners
- sharing needles for drug use or tattoos
- use of PrEP, PEP, condoms, or having an undetectable viral load
Its important to understand the risk level based on actual factors in preventing the transmission of HIV.
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How Often Should A Man Get Tested
Sexually active men should get routine tests for HIV.
Men who are sexually active should get tested for HIV at least once in their lifetime as part of their routine health care.
The CDC recommend that everyone between the ages of should take an HIV test.
The CDC also recommend that people with specific risk factors should take a test at least once a year . This recommendation applies to gay and bisexual men, and men who have sex with men, and users of injectable drugs.
Besides these formal recommendations, everyone who may have been exposed to HIV or had sex without a condom should also take a test.
Hiv Treatment As Prevention
People with HIV can take ART to lower their chance of transmitting HIV to others.
ART reduces the quantity of HIV in the body, or viral load, and keeps it at a low level.
The term viral load refers to the number of HIV copies per milliliter of blood.
Healthcare professionals define successful viral suppression as having a viral load of less than of HIV per milliliter of blood. Achieving and maintaining viral suppression significantly reduces the risk of HIV transmission.
Other ways to prevent HIV transmission include:
- using a condom or other barrier method during sex
- reducing the number of sexual partners
- getting vaccinated against other STIs, such as HPV and hepatitis B
- avoiding using injectable drugs, if possible
- if using injectable drugs, avoiding sharing needles and syringes
- following all workplace safety protocols
People can speak with a doctor to learn more about their individual risk of contracting HIV.
Anyone concerned about HIV exposure should contact a healthcare professional or a local emergency room to get testedand receive PEP.
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Contaminated Blood Transfusions And Organ/tissue Transplants
- receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This risk is extremely small because most countries test blood products for HIV first.
If adequate safety practices are not in place, healthcare workers can also be at risk of HIV from cuts made by a needle or sharp object with infected blood on it. However, the risk of occupational exposure, is very low in most countries.
If you think you have been exposed to HIV, the only way to find out if you have HIV is to have an HIV test.
Is Unprotected Anal Intercourse More Of An Hiv Risk Than Vaginal Or Oral Sex
Unprotected anal intercourse does carry a higher risk than most other forms of sexual activity. The lining of the rectum has fewer cells than that of the vagina, and therefore can be damaged more easily, causing bleeding during intercourse. This can then be a route into the bloodstream for infected sexual fluids or blood. There is also a risk to the insertive partner during anal intercourse, though this is lower than the risk to the receptive partner.
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Treatment Care And Support
A 2016 systematic review of 11 studies on ART adherence among prisoners found 54.6% of prisoners included in these studies were successfully adhering to ART.96
Provision of ART for prisoners varies greatly between countries. For example, in South Africa in 2016, 97% of prisoners living with HIV are currently on treatment and there is an 84% TB cure rate in these settings.97 By contrast, in Russia just 5% of prisoners living with HIV are on ART.98
To increase treatment adherence in prisons, confidentiality must be guaranteed and positive relationships with prison health staff are essential. A study from Namibia also identified insufficient access to food, and a lack of knowledge about how HIV is transmitted and managed as barriers to good adherence.99
Most prisoners are going for days and months without proper food… this has led to a deterioration of health for most prisoners, especially those living with HIV. Some are not provided with regular counselling and treatment which further compromises their health.
– A prison guard at Chikurubi Maximum Prisons, Zimbabwe100
A study of around 1,000 adults living with HIV who had previously been in prison in Connecticut in the USA found retention in care declined over time after release . Those who were re-incarcerated were more likely to be retained in HIV care than those who were not. However, being re-imprisoned was not associated with viral suppression, suggesting the care they were receiving in prison was ineffective.102