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.
What Is The Risk Of Hiv From Anal Sex
The risk of HIV through unprotected anal intercourse is seen to be extremely high, as much 18 times greater than vaginal intercourse. The reasons for the increased risk are well known and include such factors as:
- The fragility of rectal tissues, which allow the virus direct access into the bloodstream through tiny tears or abrasions
- The porousness of rectal tissues, providing access even when undamaged
- The high concentration of HIV in semen and pre-seminal fluid , which doubles the risk of infection with every one-log rise in the person’s viral load.
Furthermore, the secretion of blood from damaged rectal tissues can increase the risk for the insertive partner, providing the virus a route of transmission through the urethra and tissues that line the head of the penis .
Hiv Risk From A Single Blood Transfusion
Because of careful donor selection criteria, HIV risk from a single blood transfusion has very much reduced due to strict screening measures.
HIV seroprevalence in blood donors is less than 2 percent of the adult American population because of strict screening measures.
Despite this, HIV transmission may still occur due to three reasons:
Blood may be collected during the window period of infection, when the donor is infectious but has not yet developed positive result on the HIV laboratory tests.
Infection with variant strains of HIV that may not be detected by regular screening tests.
However, according to CDC,
the risk of HIV transmission by transfusion was low, even before screening, and has been virtually eliminated by the routine screening of donated blood and plasma.
But, in case HIV positive blood is given to an HIV negative individual, the risk of HIV infection with a single transfusion exceeds that of any other risk. More than ninety percent of recipients transfused with HIV positive blood are found to be infected with the virus.
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Does Hiv Viral Load Affect Getting Or Transmitting Hiv
Yes. Viral load is the amount of HIV in the blood of someone who has HIV. Taking HIV medicine daily as prescribed can make the viral load very lowso low that a test cant detect it .
People with HIV who take HIV medicine daily as prescribed and get and keep an undetectable viral load have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
HIV medicine is a powerful tool for preventing sexual transmission of HIV. But it works only as long as the HIV-positive partner gets and keeps an undetectable viral load. Not everyone taking HIV medicine has an undetectable viral load. To stay undetectable, people with HIV must take HIV medicine every day as prescribed and visit their healthcare provider regularly to get a viral load test. Learn more.
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.
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Bites That Break The Skin
A bite that opens the skin and causes bleeding can lead to the transmission of HIV. However, according to the
goes up with increasing viral load.
Viral load is highest both during the early phase of HIV and without treatment with antiretroviral medications. Taking antiretroviral medications every day can reduce a persons viral load to very low levels that cant be detected through testing.
In this way, antiretroviral medications arent only a treatment, but an important tool for prevention. When HIV cant be detected in the blood, a person living with HIV cant sexually transmit the virus to a partner without HIV.
This principle is called Undetectable = Untransmittable and has been supported by
up to 6 months of taking antiretroviral medications each day to achieve an undetectable viral load.
A persons viral load is said to be durably undetectable when all test results are undetectable for at least 6 months after the first undetectable result.
Theres no need to be afraid of having casual contact with someone who is living with HIV. The virus doesnt live on the skin and cant live very long outside of the body.
Additionally, bodily fluids like saliva, tears, and sweat dont transmit HIV either.
Therefore, casual contact, such as holding hands, hugging, or sitting next to someone who has HIV, wont transmit the virus. Closed-mouth kissing isnt a threat either.
Research Setting And Procedures
The study occurred in a township located 20 km outside of Cape Town’s central business district. Residents are primarily of Xhosa heritage. Neighborhoods were defined as an area ½ km wide that contained at least one shebeen. Using methods described by Weir et al. , we conducted rapid community assessments to identify 10 shebeens separated by 1 km. All shebeens were visited and we interviewed owners, managers, and patrons to confirm that the shebeens served 75 patrons per week. Surveys were conducted by 8 indigenous field workers who spoke both Xhosa and English. The field workers approached persons on the street and individuals socializing and drinking in the shebeens, and asked them if they would complete an anonymous, self-administered survey. Individuals who agreed to participate in the study were given a survey that most completed within 20 minutes. Participants were compensated for their time with a non-monetary item . Surveys were collected inside and outside of the shebeens. All procedures were approved by the Institutional Review Boards of the University of Connecticut, Syracuse University, and the Human Sciences Research Council or South Africa.
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Avoid Having Sex During Times That You May Be At Increased Risk
HIV transmission risk is typically very low in sexual activities like oral sex. However, oral sex can still pose a risk. Because HIV can be transmitted through bodily fluids like blood, avoid unprotected oral sex when oral ulcers, bleeding gums, genital sores, and the presence of other STIs. Using protective barriers, such as dental dams and condoms, can significantly reduce the risk of transmission .
Is There More Risk Of Contracting Hiv During Anal Sex
The human immunodeficiency virus, or HIV, is a virus that attacks a specific type of white blood cell in your immune system. By targeting CD4 cells or helper T cells, HIV can make it difficult for your immune system to coordinate a response. Through this mechanism, the virus renders your body more prone to disease and infection.
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How Can You Get Hiv
HIV is found in the following bodily fluids of someone living with the virus:
- vaginal fluids
For you to get HIV, these bodily fluids need to get into your blood through a mucous membrane , via shared injecting equipment, or through broken skin .
There is not enough HIV virus in other bodily fluids, like saliva, sweat or urine, to transmit it from one person to another.
Someone living with HIV who has an undetectable viral load, meaning effective treatment has lowered the amount of virus in their blood to levels where it cannot be detected by a normal blood test, cannot pass on HIV.
A person living with HIV with a detectable viral load can pass the virus to others whether they have symptoms or not.
HIV is most infectious in the first few weeks after infection. At this time many people are unaware of their status.
The main ways you can get HIV are:
How You Become Infected
There is HIV virus in body fluids like vaginal secretions and semen. If those fluids are present, they can enter the bloodstream of someone who doesn’t have HIV through an opening such as a mouth sore or a genital ulcer.
Your chances are higher of getting HIV if you:
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Anal Sex And Hiv Risk
The risk of getting HIV varies widely depending on the type of sexual activity. Anal sex , which involves inserting the penis into the anus, carries the highest risk of transmitting HIV if either partner is HIV-positive. You can lower your risk for getting and transmitting HIV by using condoms correctly and consistently, choosing lower risk sexual activities, taking daily medicine to prevent HIV, called pre-exposure prophylaxis and taking medicines to treat HIV if living with HIV, called antiretroviral therapy . Using more than one of these options at the same time provides even greater protection.
What Is Rectal Fluid
Rectal fluid is the mucus that lines the rectum. Mucus is a slippery secretion produced by certain parts of our body known as the mucous membranes. These membranes are located at the entrances into the body and line the internal passages of many of our organs, including the gastrointestinal tract , the vagina and cervix, and the foreskin and urethra.
Mucus has several functions. A major function is to protect the mucous membranes from germs . It does this by trapping germs and preventing them from coming into contact with the membranes. Mucus also contains substances that can to some extent kill germs.
For some membranes, mucus also acts as a lubricant that prevents friction and tearing of the mucous membrane tissue when objects pass through them. For example, mucus in the vagina reduces friction during sexual intercourse and mucus in the gastrointestinal tract facilitates the passage of food and feces. Mucus in the rectum also helps reduce friction during anal intercourse.
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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.
Viral Load & Medications
If someone has HIV, this does not mean that they are restricted to celibacy. Many people with HIV still continue to have safe, enjoyable sex lives without spreading the virus. Always using a condom or barrier method is an important first step to prevent the sharing of HIV containing fluids.
Antiretroviral therapy : Another way to help decrease the risk of spreading HIV is to lower a personâs viral loadâthe amount of HIV in a personâs blood. Viral loads can be lowered using medications called antiretroviral therapy . These medications can lower the HIV viral load so much that HIV may not even be detectable on a blood testâthis is called an undetectable viral load . When a person’s viral load in undetectable, they have effectively no risk of transmitting the HIV virus to a non-infected partner . Taking these medication will help keep a person with HIV healthy while also helping prevent the spread of HIV to another person. This is not a cure, however. If medication is taken incorrectly or stopped, HIV viral loads will increase again and transmission can occur. Condoms and other barrier methods should still always be used during sex .
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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.
What Medication Is Available
There are currently two medications approved by the FDA for PrEP: Truvada and Descovy.
Both of these medications can be up to 99% effective at HIV prevention when taken correctly. However, the notable difference between these medications is that Descovy is currently only approved for use in cisgender males and transgender females, while Truvada is approved for all genders.
PrEP does not have any significant health effects even with long-term use, but you may experience some side effects, such as:
- Abdominal pain
- Changes in weight
Some more severe side effects that may occur can be kidney issues, liver problems, or bone density loss. But these often occur in people who had health issues prior to taking PrEP. Ultimately, it is between you and your doctor to determine whether or not PrEP is the best choice for you.
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Oral Sex Is Least Likely To Result In Hiv Transmission
The risk of transmission through oral sex is much lower than through anal or vaginal sex. This is because the oral cavity contains a thick epithelial layer, a low number of CD4 target cells, and antiviral antibodies.
A 2008 meta-analysis by Baggaley and others of 10 studies aimed at calculating the risk of HIV transmission through oral sex found that only 4 of the studies reported a non-zero estimate of risk from unprotected oral intercourse. For this reason, the CDC describes the chance of HIV transmission through oral sex as low.
Strategies To Reduce Risk
As with any other mode of HIV transmission, prevention requires a combination of strategies to more effectively:
- Reduce the infectivity of the HIV-positive partner
- Reduce the susceptibility of the HIV-negative partner
Current evidence has shown that the consistent use of antiretroviral therapy in the HIV-infected partner completely eliminates the risk of HIV transmission when viral activity is suppressed to undetectable levels.
The effectiveness of the strategy known as Treatment as Prevention , is evidenced by the PARTNER1 and PARTNER2 studies in which not a single HIV infection occurred among 1,770 gay and heterosexual mixed-status couples despite engaging condomless anal or vaginal sex.
The studies, which ran from 2010 to 2018, showed unequivocally that undetectable equals untransmittable in a real-world setting.
The use of pre-exposure prophylaxis , whereby the uninfected partner is prescribed a daily dose of the HIV drug Truvada, can also reduce risk. Studies have shown that when taken daily, PrEP reduces the risk of getting HIV from sex by about 99%.
Although these figures may suggest that condoms are no longer needed, neither TasP nor PrEP can prevent other sexually transmitted diseases.
Moreover, according to the Centers for Disease Control and Prevention , only 59.8% of Americans with HIV are able to achieve an undetectable viral load. Without complete viral suppression, TasP is rendered useless, placing the uninfected partner at risk.
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Whats The Risk For Types Of Oral Sex
Oral sex ranks very low on the list of ways HIV can be transmitted. Its more likely to transmit HIV through anal or vaginal sex. Its also possible to transmit the virus by sharing needles or syringes used for injecting drugs or tattooing.
However, the risk of contracting HIV through oral sex is not zero. The truth is, you can in theory still contract HIV this way. Theres just been from years of research to show that it has happened.
Why is it hard to get data?
Its difficult to know the absolute risk of transmitting HIV during oral sex acts. Thats because many sex partners who engage in oral sex of any type also engage in vaginal or anal sex. It may be difficult to know where the transmission occurred.
Fellatio carries some risk, but its low.
- If youre giving a blowjob. Receptive oral sex with a male partner who has HIV is considered exceptionally low-risk. In fact, a 2002 study found that the risk for HIV transmission through receptive oral sex was statistically zero.
- If youre receiving a blowjob. Insertive oral sex is an unlikely method of transmission, too. Enzymes in the saliva neutralize many viral particles. This may be true even if the saliva contains blood.
There are no documented cases of HIV being transmitted between partners through cunnilingus .
Anilingus , or rimming, has some risk, but it is negligible. Its especially low for receptive partners. In fact, the lifetime risk of transmitting HIV during rimming is