How You Get Hiv
HIV is found in the body fluids of an infected person,which includes semen, vaginal and anal fluids, blood, and breast milk. To get HIV, one of these fluids from someone with HIV has to get into your blood.
HIV is a fragile virus and does not survive outside the body for long. HIV is most commonly transmitted through vaginal or anal sex without a condom.
Other ways of getting HIV include:
- using a contaminated needle, syringe or other equipment to inject drugs
- transmission from a mother to her child before, during or shortly after birth however, with medical treatment it is possible to prevent the virus from being passed on by a mother to her child
- through blood transfusions however, since 1985 all blood donated in the UK must be screened for HIV – screening policies in the developing world may not be as rigorous, so there is a possible risk of developing HIV if you receive a blood transfusion in certain parts of the world
- through oral sex or sharing sex toys
HIV cannot be transmitted from:
- being sneezed on by someone with HIV
- sharing baths, towels or cutlery with an HIV-infected person
- swimming in a pool or sitting on a toilet seat that someone with HIV has used
- animals or insects such as mosquitoes
Saliva, sweat and urine do not contain enough of the HIV virus to infect another person.
Hiv Transmission Can Occur After Only One Exposure
Assigning an actual percentage to the “riskiness” of a certain activity is a tricky business. While statistics may suggest that there is only a 1-in-200 chance of getting infected by such-and-such activity, that doesn’t mean you cant get infected after only one exposure.
Instead, a 0.5% “per exposure” risk is meant to indicate that an average of one infection will occur out of 200 people who engage in a particular activity. It doesn’t mean that you need to do something 200 times in order to get infected.
It’s important to remember that risk estimates are based on two factors and two factors alonethat one person has HIV and the other doesn’t. Additional co-factors, such as co-existing sexually transmitted infections , general health, and the infected person’s viral load, can further compound risk until a low-risk activity is suddenly considerably higher.
When Should I Get Tested For Hiv
If you think you could have HIV or are at risk of HIV, talk to your doctor or sexual health clinic about having a test. Some people at high risk need to be tested regularly.
You should get tested for HIV if:
- you have had unprotected sex with a partner whose HIV status is unknown or who has HIV but does not have a measurable amount of virus in their blood
- you have had unprotected sex with a person from a country that has high rates of HIV infection
- your sexual partner has recently travelled to a country that has high rates of HIV infection and may have had unprotected sex there
- you have had unprotected sex with a sex worker in Africa, Eastern Europe, Southeast Asia or Papua New Guinea
- you have ever shared injecting equipment
Early diagnosis is important and can improve the long-term course of the illness.
It is a good idea to talk to your doctor or sexual health clinic about other STIs at the same time.
Your information will be kept confidential unless there are major concerns for your safety or the safety of others. HIV is a notifiable disease, which means laboratory staff need to inform the government about new cases, but this information is also confidential.
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How Hiv Infects The Body
HIV infects the immune system, causing progressive damage and eventually making it unable to fight off infections.
The virus attaches itself to immune system cells called CD4 lymphocyte cells, which protect the body against various bacteria, viruses and other germs.
Once attached, it enters the CD4 cells and uses it to make thousands of copies of itself. These copies then leave the CD4 cells, killing them in the process.
This process continues until eventually the number of CD4 cells, also called your CD4 count, drops so low that your immune system stops working.
This process may take up to 10 years, during which time you’ll feel and appear well.
Page last reviewed: 22 April 2021 Next review due: 22 April 2024
Estimating Transmission Risk By Exposure Type
When discussing HIV risk, it’s important to first establish the four conditions that must take place in order for HIV transmission to occur:
Determining whether an activity is “high risk” or “low risk” is, therefore, dependent upon how efficiently an activity satisfies each of these four conditions.
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How Can To Help Stop The Spread Of Hiv
To lower the risk of getting HIV and other STIs:
- Those who are HIV-negative should consider PrEP. If a possible HIV exposure occurs, PEP may provide emergency protection.
- Use condoms during vaginal and anal sex.
- Get tested and treated for STIs and follow healthcare providers recommended screening schedule.
- Before having sex with someone, ask them to get tested for HIV and STIs.
- Those who inject drugs should get clean needles from a needle exchange.
- Avoid sharing needles for drugs and tattoos.
Talk to a healthcare provider about PrEP if a sexual partner has HIV with a detectable viral load or theres another known risk of contracting the virus. Heres a search tool for finding healthcare providers who prescribe PrEP.
Anyone who thinks they might have contracted HIV needs to get tested immediately. Early treatment can help manage the symptoms, lower the risk of complications, lower the risk of transmitting HIV to a sexual partner, and help people to live a long and healthy life.
How Do You Get Or Transmit Hiv
You can only get HIV by coming into direct contact with certain body fluids from a person with HIV who has a detectable viral load. These fluids are:
- Semen and pre-seminal fluid
- Rectal fluids
- Vaginal fluids
- Breast milk
For transmission to occur, the HIV in these fluids must get into the bloodstream of an HIV-negative person through a mucous membrane open cuts or sores or by direct injection.
People with HIV who take HIV medicine daily as prescribed and get and keep an undetectable viral load have effectively no risk of sexually transmitting HIV to their HIV-negative partners.
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People Who Are At Increased Risk
HIV can affect anyone but people who are at a higher risk include:
- men who have had unprotected sex with men
- women who have had unprotected sex with men who have sex with men
- people who have had unprotected sex with a person who has lived in, or travelled in, Africa
- people who inject drugs
- people who have had unprotected sex with somebody who has injected drugs
- people who have another sexually transmitted infection
- people who have received a blood transfusion while in Africa, eastern Europe, the countries of the former Soviet Union, Asia or central and southern America
Conditions Needed To Transmit Hiv
As serious an infection as HIV is, the virus itself is not all that robust. Others, like the flu and cold viruses, are far more sturdy and can be passed from one person to next by sneezing. HIV cannot. Instead, there four conditions that must take place in order for infection to occur:
- There must be body fluids in which HIV can thrive. For HIV, this meanssemen, blood, vaginal fluids, or breast milk. HIV cannot survive for very long in the open air or in parts of the body where is high acid content .
- There must be a way for body fluids to enter the body. This happens primarily through sexual contact but can also be spread through , accidental blood exposure in healthcare settings, or transmission of the virus from mother to child during pregnancy.
- The virus must be able to reach vulnerable cells inside the body. Skin contact with a body fluid is not enough.It needs to enter the bloodstream through a break in the skin or penetrate vulnerable mucosal tissues of the vagina or rectum. The depth and size of the penetration also matter, with a deep cut being riskier than a scrape.
- There must be sufficient amounts of virus in the body fluid. This is why saliva, sweat, and tears are unlikely sources of infection since the enzymes in these fluids actively break down HIV and its genetic structure.
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How Can You Tell If You Have Hiv
The only way to know for sure if you have HIV is to get tested. You cant rely on symptoms to tell whether you have HIV.
Knowing your HIV status gives you powerful information so you can take steps to keep yourself and your partner healthy:
- If you test positive, you can take medicine to treat HIV. By taking HIV medicine daily as prescribed, you can make the amount of HIV in your blood very lowso low that a test cant detect it . Getting and keeping an undetectable viral load is the best thing you can do to stay healthy. If your viral load stays undetectable, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
- If you test negative, there are more HIV prevention tools available today than ever before.
- If you are pregnant, you should be tested for HIV so that you can begin treatment if you’re HIV-positive. If an HIV-positive woman is treated for HIV early in her pregnancy, the risk of transmitting HIV to her baby can be very low.
Use the HIV Services Locator to find an HIV testing site near you.
HIV self-testing is also an option. Self-testing allows people to take an HIV test and find out their result in their own home or other private location. You can buy a self-test kit at a pharmacy or online, or your health care provider may be able to order one for you. Some health departments or community-based organizations also provide self-test kits for free.
How Is Hiv Transmitted Through Needles
HIV isnt transmitted only through sexual contact. Sharing needles also puts a person at higher risk of contracting HIV.
When a needle is injected into a persons body, it breaks the skin barrier. If the needle has already been injected into another person, it can carry traces of their blood, along with any infections they have. The contaminated needle can introduce these infections into the second persons body.
Researchers dont know if having an undetectable viral load reduces the risk of HIV transmission through shared needles, but its reasonable to assume it may provide some risk reduction.
HIV can affect anyone. Whatever their age, gender, sexuality, ethnicity, or race, everyone should take steps to protect themselves. But due to socioeconomic factors, some demographic groups have higher HIV transmission rates and generally are more affected by HIV.
According to the CDC , the general demographic traits most affected by HIV are:
Transgender women are also highly impacted by HIV transmissions as a population, reports the CDC .
These groups are disproportionately affected by HIV, but they arent inherently at greater risk of contracting HIV. An individuals personal risk depends on their behaviors, not on their age, gender, sexuality, ethnicity, race, or any other demographic factor.
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To Prevent Hiv Infection Couples Try Testing Together
In other words, particular versions of the virus, with particular DNA sequences, are most likely to pass from a woman to a man. This reduces the chance an infection occurs during sex.
The restriction is less when women have sex with an HIV-positive man. And, most likely, reduced even further when men have sex with men. So the chance of an infection increases in both situations.
As HIV replicates inside a person, mutations are introduced into its DNA. This results in a large number of different HIV versions swarming about the body each with its own genetic code.
But when HIV is transmitted through sex, usually only a single version of the virus establishes a long-term infection. So the process is almost like a filter, letting only certain viruses through.
This made scientists wonder: Is there something special about the HIV versions making it through the filter?
To figure this out, a team at Microsoft Research and Emory University analyzed data from a decades-long study on HIV transmission between “discordant” heterosexual couples in Zambia. These are couples in which one person is HIV-positive and the other is HIV-negative.
Why Hiv Spreads Less Easily In Heterosexual Couples
HIV particles invade a human immune cell. When HIV is transmitted through sex, only the strongest versions of the virus establish long-term infection. Chris Bjornberg/ScienceSourcehide caption
HIV is sexist.
A woman is twice as likely to catch the virus from an infected partner in a heterosexual relationship than a man is.
And homosexual men are at even greater risk. They’re more than 20 times as likely to get infected from an HIV-positive partner than partners in a heterosexual relationship.
Now scientists at Microsoft Research and the Zambia-Emory HIV Project have a clue about why these disparities exist.
Only the strongest, most evolutionary “fit” versions of the virus tend to infect a man when he has sex with an HIV-positive woman, scientist report Thursday in the journal Science.
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Can You Get Hiv From A Blood Transfusion
Receiving a blood transfusion or other products made from blood is safe in the UK as all blood products have been screened for infections such as HIV since 1985.
In countries that dont have strict checks on the safety of their blood supply, receiving contaminated blood can pass the virus on. This can also happen in countries that dont screen other blood products, organs or sperm.
Giving blood has never been a risk.
How Is Hiv Spread From Person To Person
HIV can only be spread through specific activities. In the United States, the most common ways are:
- Having vaginal or anal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV. Anal sex is riskier than vaginal sex.
- Sharing injection drug equipment , such as needles, with someone who has HIV.
Less common ways are:
- From mother to child during pregnancy, birth, or breastfeeding. However, the use of HIV medicines and other strategies have helped lower the risk of mother-to-child transmission of HIV to 1% or less in the United States.
- Getting stuck with an HIV-contaminated needle or other sharp object. This is a risk mainly for health care workers. The risk is very low.
HIV is spread only in extremely rare cases by:
- Having oral sex. But in general, the chance that an HIV-negative person will get HIV from oral sex with an HIV-positive partner is extremely low.
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How Do You Get Hiv From Sex
HIV is transmitted through semen , vaginal fluid, blood, and anal mucus. During sex without a condom the bodily fluids from one person can pass into the body of their sexual partner. This can happen through the mucous membranes of the penis, vagina and rectum, or sores in the mouth and throat.
You can only get HIV from someone who is living with HIV and has a detectable viral load.
Sex Toys Fingering Fisting And Hiv
Sex toys, such as dildos, come into direct contact with rectal/vaginal fluids and mucous membranes. This means sharing an uncleaned dildo or other toy can pass on HIV. Using sex toys on your own has no risk.
There is no direct risk of HIV from fingering or fisting , but be aware of being rough. Damage to anal/vaginal tissues, especially if there is any bleeding, will increase risk of HIV transmission if you then have anal, vaginal or oral sex later.
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What Is The Chance Of Getting Hiv From One Encounter
Anal sex is the most risky sex act in terms of HIV transmission, if an HIV-negative top the insertive partner and an HIV-positive bottom have unprotected sex, and the chances of the top contracting the virus from a single encounter are 1 in 909 . In the case of 62 percent, the rate would be higher.
What About Breastfeeding
chance that they will pass on the virus to their infant during labor, delivery, or breastfeeding. This is due to contact with relevant body fluids.
Antiretroviral therapy can reduce the chances of transmission to below 5%. The recommend that people with HIV combine exclusive breastfeeding with the use of antiretroviral therapy.
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How Can I Protect Myself
The best way to protect yourself from HIV is to not have sex and not share needles.
If you decide to have sex, reduce your risk of getting HIV by:
- using a condom every time you have sex
- getting tested for HIV and making sure all partners do too
- reducing the number of sexual partners you have
- getting tested and treated for STDs having an STD increases the risk of HIV infection
Understanding how HIV spreads can help you make safer choices about sex. Talk to your doctor if you have any questions about HIV and if you want to get tested.