Vaginal And Anal Intercourse
The HI virus can be transmitted through unprotected vaginal sex without a condom. Vaginal fluids, semen, pre-ejaculation fluid and blood are all possible transmitters. Vaginal dryness caused by menstruation, pregnancy, breastfeeding or ageing reduces the safety of intercourse. Sores and sexually transmitted infections increase the risk of HIV infection. A water- or silicone-based lubricant prevents sores and dryness of mucous membranes, prevents the condom from breaking during intercourse and increases pleasure of intercourse.
HIV is most easily transmitted through unprotected anal sex without a condom, because the mucous membrane of the rectum is fragile and can easily develop sores. The HI virus can be found in semen, pre-ejaculation fluid and the rectum wall. Also the tip of the glans and the end of the urethra can chafe. In addition to using a condom, it is important to use enough lubricant while having anal sex. Lubricant reduces the risk of sores and of the condom breaking and thus reduces the risk of catching an HIV infection.
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How Is Hiv Transmitted
HIV is transmitted between humans through the exchange of certain types of bodily fluids. Bodily fluids that can transmit HIV include blood, semen, breast milk, and vaginal fluids .
Not all body fluids can transmit HIV. The following cannot transmit HIV:
- Exchanging saliva, like through closed-mouth kissing or sharing drinks/utensils
- Coming in contact with an HIV positive personâs tears, sneezes, or sweat
- Ordinary physical contact, such as hugging, hand shaking, or touching shared objects like cutlery, cups, or toilet seats .
- Air or water
- Pets and insects cannot carry the virus and infect you, because transmission of HIV is only between humans .
While care needs to be taken in some situationsâlike when having sex or when open injuries are presentâthis certainly does not mean that it is unsafe to be around people with HIV. Think of how you interact with the vast majority of peopleâbodily fluids are not exchanged. Harboring discriminatory thoughts only perpetuates a fearful stigma against someone with HIV, which only hurts the person who has it.
HIV is often transmitted through sexual activity and drug use in adults in the United States . Maternal transmissionâfrom mother to childâis how the infection is spread to infants .
Will Treating Stds Prevent Me From Getting Hiv
No. Its not enough.
If you get treated for an STD, this will help to prevent its complications, and prevent spreading STDs to your sex partners. Treatment for an STD other than HIV does not prevent the spread of HIV.
If you are diagnosed with an STD, talk to your doctor about ways to protect yourself and your partner from getting reinfected with the same STD, or getting HIV.
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What Is An Std
STD stands for sexually transmitted disease, also called sexually transmitted infections . STDs are infections that spread from person to person through sexual activity, including anal, vaginal, or oral sex. STDs are caused by bacteria, parasites, and viruses.
Many health care providers use the term infection instead of disease, because a person with an infection may have no symptoms but still require treatment. When untreated, an STI can become a disease.
HIV is a sexually transmitted infection, but it can progress to a disease called acquired immunodeficiency syndrome when HIV infection is untreated with HIV medicines. Other examples of STDs are chlamydia, gonorrhea, human papillomavirus infection, and syphilis.
There Needs To Be Enough Virus
The concentration of HIV determines whether infection will occur. In blood, for example, the virus is very concentrated. A small amount of blood is enough to infect someone. The concentration of virus in blood or other fluids can change, in the same person, over time. People who take HIV medications as prescribed can have very low quantities of HIV present in bodily fluids, greatly reducing the risk of transmitting HIV to their partners.
It is important to note that HIV is a very fragile virus that will die quickly when exposed to light and air. Exposure to small amounts of dried blood or other infectious fluids is not a realistic risk for HIV transmission.
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All Exposures Are Not Equal
The results of several meta-analyses suggest that some types of sex carry on average a higher risk of HIV transmission than others. Below are estimates from meta-analyses that have combined the results of studies conducted in high-income countries. For types of sex where meta-analysis estimates do not exist, numbers from individual studies are provided.
A meta-analysis exploring the risk of HIV transmission through unprotected anal sex was published in 2010.1 The analysis, based on the results of four studies, estimated the risk through receptive anal sex to be 1.4%. This risk was similar regardless of whether the receptive partner was a man or woman.
No meta-analysis estimates currently exist for insertive anal sex but two individual studies were conducted to calculate this risk. The first, published in 1999, calculated the risk to be 0.06% .2 However, due to the design of the study, this number likely underestimated the risk of HIV transmission. The second study, published in 2010, was better designed and estimated the risk to be 0.11% for circumcised men and 0.62% for uncircumcised men.3
A meta-analysis of 10 studies exploring the risk of transmission through vaginal sex was published in 2009.4 It is estimated the risk of HIV transmission through receptive vaginal sex to be 0.08% .
A meta-analysis of three studies exploring the risk from insertive vaginal sex was estimated to be 0.04% .4
What Can You Do To Prevent Getting Stis
If you have HIV, the best thing you can do to stay healthy is to take HIV medicine exactly as prescribed and get and keep an undetectable viral loada level of HIV in your blood so low that a standard lab test cant detect it. People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load can live long and healthy lives and will not transmit HIV to their HIV-negative partners through sex.
But even if you are taking HIV medicine and your viral load is undetectable, it will not prevent you from getting other STIs, such as gonorrhea, chlamydia, or syphilis.
The only 100% effective way to avoid getting other STIs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting other STIs:
- Reduce the number of people you have sex with.
- Dont drink alcohol or use drugs before and during sex.
Use condoms correctly every time you have sex.
- Use a new condom for every act of vaginal, anal, and oral sex throughout the entire sex act .
- Condoms are highly effective in preventing STIs, but not foolproof. Read this fact sheet from the Centers for Disease Control and Prevention on how to use condoms consistently and correctly.
Get the vaccines that are recommended.
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Other Types Of Transmission
In the past, HIV was spread by transfusion with blood products, such as whole blood or the “factor” used by hemophiliacs. Many people acquired HIV this way. The blood supply is now much more strictly tested and controlled in most countries. The odds of acquiring HIV from receiving blood or blood factor in countries like the US, the UK, and Canada are extremely low. For example, statistics from the US show that a person is more likely to be killed by a lightning strike than they are to acquire HIV from a blood transfusion. However, not every country screens all blood donations for HIV.
It is also possible to get HIV from skin grafts or transplanted organs taken from people living with HIV. Again, the risk is considered very low, as these “bodily products” must be strictly tested in the same way as blood products. Semen donations collected by sperm banks for artificial insemination are also considered “bodily products” and rigorously tested in high-resource countries. Private semen samples that are not processed by sperm banks or similar organizations may not have been tested. It is important for anyone receiving a private donor’s sperm for artificial insemination to have the donor tested for HIV.
If you are getting breast milk from a milk bank, it is important to ask if the bank tests the milk for HIV. Also, if your baby is getting breast milk from a wet nurse, it is important to make sure that she tests negative for HIV before giving her milk to your baby.
Body Piercings And Tattoos
While theoretically feasible, the risk of HIV from body piercings and tattoos is low due to the licensing and strict regulation of practitioners within the industry. For its part, the CDC insists that the risk of HIV transmission is low to negligible.
Among unlicensed practitioners who do not adhere to industry sterilization and hygiene practices, the risk is potentially higher, although it is unclear by how much.
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Experts Say The Homophobic Stigmas Around Monkeypox Must End
In an interview with the NPR podcast, All Things Considered, Dr. Anthony Fauci, the chief medical advisor to Pres. Biden, mentioned that monkeypox cases have occurred in men who have sex with other men. However, its not only a disease affecting the LGBTQIA+ community. Two children have gotten the disease.
Fauci, who was on the front lines of the HIV crisis, which also disproportionately harmed the LGBTQIA+ community, urged that the government must fight homophobic stigmas surrounding monkeypox.
Forciersays that this myth wont only lead to people thinking they are in the clear if they are not a man who has sex with men. She says it is reminiscent of the HIV hysteria in the 1980s, which was also incorrectly thought of as a disease only affecting gay people.
It is inaccurate and stigmatizing to label any disease as belonging to or caused by a group of people, Forcier says.
Forcier emphasizes that monkeypox is caused by a virus, not people. She stresses that viruses are all around us.
Sometimes, with exposure, cause infection, Forcier says. Monkeypox is a virus, and unlike people, monkeypox does not discriminate.
The reason monkeypox has mostly affected gay men to date is in line with typical viral spread.
Some viruses like to spread via clusters of people, whether that is a home, school, or nursing home, she says.
How To Be Safe When Coming Into Contact With Infected Blood
A condom will act as a barrier against any contact with blood during sex.
As well as sex, sharing equipment for injecting drugs is a way blood can get into someones body. This can be avoided by using fresh needles and not sharing needles, syringes and other equipment.
If a woman has HIV, her menstrual blood also carries a risk of transmission if she has a detectable viral load.
If youre HIV negative and taking pre-exposure prophylaxis youll be protected against getting HIV if you come into contact with infectious blood.
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What You Need To Know About The Links Between Hiv And Stds
Many people think that STDs are a harmless “fact of life.” Since most STDs can be cured, people think, “Doctors give you medicine and that’s the end of it, right?” Well, not quite! Having an STD can increase your chances of getting HIV, the virus that causes AIDS.
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. If taken as prescribed, HIV medicine can reduce a persons HIV viral load very low level, which keeps the immune system working and prevents illness. This is called viral suppression, defined as having less than 200 copies of HIV per milliliter of blood.
HIV medicine can also make the viral load so low that a standard lab test cant detect it. This is called having an undetectable level viral load. Almost everyone who takes HIV medicine as prescribed can achieve an undetectable viral load, usually within 6 months after starting treatment.
As noted above, people with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load can live long and healthy lives and will not transmit HIVto their HIV-negative partnersthrough sex.
HIV medicine is a powerful tool for preventing sexual transmission of HIV. But it works only if 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 as prescribed and visit their health care provider regularly to get a viral load test. Learn more.
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How Is Hiv Not Spread
HIV is not spread by:
- Air or water
- Mosquitoes, ticks, or other insects
- Saliva, tears, sweat, feces, or urine that is not mixed with the blood of a person with HIV
- Shaking hands hugging sharing toilets sharing dishes, silverware, or drinking glasses or engaging in closed-mouth or social kissing with a person with HIV
- Drinking fountains
- Other sexual activities that dont involve the exchange of body fluids .
- Donating blood
How Can You Protect Yourself From Hiv And Stds
- Avoid or put off having sex. If you do have sex, use a male latex or female condom every time.
- Latex male condoms and female condoms, when used the right way every time, are very effective in preventing HIV and many other STDs. Condoms may prevent the spread of other STDs like HPV or genital herpes, only when the condom covers the infected areas or sores.
- Talk with your partner about HIV and STDs.
- Don’t share drug “works”
- Get STD and HIV counseling and testing.
To find out if you might have an STD, visit your doctor or clinic as soon as you can.
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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.
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 cannot be detected through testing.
In this way, antiretroviral medications are not only a treatment, but an important tool for prevention. When HIV cannot be detected in the blood, a person living with HIV cannot sexually transmit the virus to a partner without HIV.
This principle is called Undetectable = Untransmittable .
It can take 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.
There are a couple reasons that STIs can raise HIV risk. First, the symptoms of many STIs include genital inflammation, sores, or ulcers. These can all increase the chance of transmitting the virus from one person to another.
Second, like HIV, transmission of STIs is associated with some of the same types of behaviors, such as engaging in sex without a condom or other barrier method.
Some research has also indicated that certain STIs may be more with HIV transmission than others. These STIs include:
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Stis And Blood Hiv Burden
A related question is the effects of STIs on blood viral burden. As noted above, genital ulcers significantly increase the amount of viral RNA shed in both the male and female genital tracts . Buchaz et al. reported increased HIV in blood in people with primary and secondary syphilis . Dyer et al. found an increase in blood viral burden in men with genital ulcers and urethritis. Celum et al. found a modest reduction of HIV in blood from treatment of HSV-2 with acyclovir. Lingappa et al. reported that acyclovir could reduce progression of HIV disease in people dually infected with HIV and HSV-2. These results suggest a systemic effect of HSV-2 infection.
Antiretroviral therapy is highly effective at suppressing HIV-1 replication in the blood, including in people with STIs. In a meta-analysis of 14 studies looking at the effects of STI infection on HIV-1 blood viral load, Champredon and colleagues concluded that co-infection with an STI correlates with a 0.11 log10 increase in HIV-1 viral load suggesting that when an individual is suppressed on ART, STIs have little effect on blood viral load .