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 doesnt 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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Blood Transmission And Sharing Needles
HIV can be transmitted from one person to another through blood either through intravenous drug use, blood transfusions or organ transplants. Using shared needles and syringes involves a high HIV risk, which is why it is important to keep injection instruments strictly personal. Since all blood products are tested in Finland, blood transfusion has not lead to an HIV infection since 1985.
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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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.
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.
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Male Vs Female Partners
When having vaginal sex without a condom with a partner who has a penis, the vaginal membranes are more likely to tear than the partners penis.
In condomless anal sex with a partner who has a penis, the rectal membranes are also more likely to tear than the partners penis. Microscopic tears create an easier path for HIV and other STIs to enter the body when exposed.
Its possible for a partner with a penis to contract HIV during vaginal and anal sex. If a female partner is living with HIV with a detectable viral load, it can be carried in her vaginal secretions. If her partner has open sores on their mouth or penis, they can create a gateway for vaginal secretions or other bodily fluids with HIV to enter the body.
Uncircumcised men are at higher risk of contracting HIV from condomless sex than circumcised men. The delicate membranes of foreskin can tear during sex, creating a pathway for HIV to enter the body.
Condoms And Dental Dams For Safer Oral Sex
Using a barrier can lower the chance of getting or passing an STI through oral sex.
Visit a local public health unit, sexual health clinic or HIV organization to get free condoms! Some of these places also have free dental dams.
Production of this document has been made possible through a financial contribution from the Public Health Agency of Canada. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.
This resource was adapted from a resource originally published by the Canadian Public Health Association. CATIE thanks YouthCO and the AIDS Coalition of Nova Scotia for reviewing this resource. We also thank the Sex Information and Education Council of Canada and Dr. Ahmed Bayoumi, University of Toronto, for medical review.
Writer: Mallory Harrigan
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Risk Factors In Women
The risk of HIV from unprotected vaginal sex is higher among women for a number of reasons. From a physiological standpoint, the tissues of the vagina are far more susceptible to HIV than those of the penis.
HIV is able to pass through these tissues when the immune system recognizes the invading virus and send defensive cells to “grab and drag” them through the lining to be destroyed.
Instead, HIV turns the table and attacks the very cells meant to help neutralize them. By doing so, the body helps facilitate its own infection. And, because the surface area of the vaginal epithelium is far greater than that of the male urethra, the opportunity for infection is increased, often exponentially.
Other physiological vulnerabilities include:
While the daily use of an HIV drug called pre-exposure prophylaxis can dramatically decrease the risk of HIV in an uninfected partner, there is evidence that works less well in women. Research published in 2016 suggests the level of the active drug molecule in vaginal tissue isn’t near as high as in rectal tissue.
None of this, of course, takes into account any of the social vulnerabilities that can place women at increased risk. These include sexual violence in relationships which not only steals a woman’s chance for self-protection but can result in damage to delicate vaginal tissue.
Multiple Vulnerabilities Increase Risk In Men And Women
Vaginal sex is one of the primary ways a person can become infected with HIV. According to the U.S. Department of Health & Human Services, it accounts for about 6,300 new infections among women each year in the U.S. and about 2,800 new infections among heterosexual men.
Globally, the figures are even more dismaying. While the sexual transmission of HIV in the U.S. is highest among gay and bisexual men , heterosexuals are by far the group most affected worldwide.
This is especially true in Africa where most new infections are among heterosexuals. In these populations, vaginal sex is the predominant route of infection.
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Hiv Transmission Through Sexual Acts
Sexual intercourse with an HIV-infected personTransmission of HIV is primarily through unprotected vaginal or anal intercourse , as well as through oral sex under certain conditions.
How does HIV get into the body during sexual contact? To gain entry into the body of an uninfected person, the HI virus needs to bind or latch onto target cells with specific receptors on its surface. Cells with these special receptors are plentiful in the lining of the genital track and that of the anus.
During unprotected sex with an HIV+ person, the virus binds with the CD4 receptors in the lining of the genital tracks or anal track of the uninfected partner.
Tears in the membrane linings of the genital tracks â especially in the anal-rectal area â also make it easy for the virus to enter the sex partners bloodstream. Because the membrane linings of body cavities â especially in the anal-rectal area, and, to a lesser extent, in the vagina â are very delicate, they can be torn as a result of friction generated during sexual intercourse.
Sexually transmitted infections , such as syphilis, gonorrhoea or herpes, make it very easy for HIV to get into the body. An untreated STI in either partner increases the risk of HIV transmission during unprotected intercourse ten-fold.
Why are women more easily infected by HIV than men?Women are two to four times more likely to get infected with HIV through unprotected vaginal sex than men, due to the following reasons:
How Is Hiv Spread Through Sex
You can get infected from sexual contact with someone who has HIV. Sexual contact that can transmit HIV includes:
- vaginal sex
- anal sex
- oral sex
If you have sex, the best thing you can do to prevent HIV infection is practice âsafer sexâ with any partner who is not proven to be HIV negative . To do so, always use protectionâthis could include using a condom, dental dam, or other latex barrier, and/or PrEP . It is also important to avoid ârough sexâ or other activities that might cause bleeding. If you use lube with a condom, make sure it is water-based, not oil-based. Oil-based lube causes latex condoms to break. See more tips for using condoms note that, if used correctly and consistently, condoms also protect against other sexually transmitted infections and against pregnancy.
If you have unprotected sex with someone who is infected, it doesnât mean that you will be infected, too. But there is always a chance, especially if your partner is not on effective HIV medicines. Using condoms and PrEP reduces your risk.
HIV is NOT spread by:
- hugging or massage
- sex toys you donât share
- daily living with someone who has HIV
For more information, see Sex and Sexuality in the Daily Living section.
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Oral Sex With A Vagina
The risk of transmission through oral sex with a vagina is very low because the mouth is an unfriendly environment for HIV. Saliva breaks down the virus, and the mucous membranes in the mouth are more protective than anal or vaginal tissue. The minimal risk of transmission from oral sex with a vagina is only for the person performing the oral sex, as their mouth is in contact with vaginal fluid. However, there is little data documenting HIV transmission via oral sex from an infected vagina to an uninfected person.
Performing oral sex on a vagina during menstruation increases the risk, because blood has more HIV than vaginal fluid.
A person receiving oral sex is generally not at risk as that person is coming into contact only with saliva, which does not transmit HIV. The presence of other sexually transmitted infections can increase the risk of HIV transmission during oral sex.
How Is Hiv Not Transmitted
HIV is not transmitted by saliva, tears, sweat, urine or feces. HIV does not survive well outside the human body. It cannot be transmitted through casual contact with a person who has HIV, or through objects such as toilet seats, doorknobs or dishes used by a person who has HIV.
In the past, some people got HIV after receiving a blood transfusion or organ or tissue transplant. However, Canada implemented HIV screening for all blood and tissue donations in 1985.
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Should I Have Oral Sex
Talking to your partner about protection before you start having oral sex will help make things easier. This may feel embarrassing but taking responsibility for protecting yourself and your partner is an important part of having sex. If you find it too awkward to talk about then you may not be ready to have oral sex just yet.
You should never give or receive oral sex just because you feel forced into it. Dont be pressured into any sex act by comments like it doesnt mean weve had real sex youll still be a virgin, or if you dont want sex at least go down on me, or its not as risky as having intercourse. If one of you isnt comfortable with the decision it can ruin the whole experience. Oral sex should be fun for both of you.
Our article Am I ready for sex? will help you work out what is right for you.
What Should I Do If I Need To Clean Up Blood
HIV does not usually survive long outside of the body, but contact with blood should be avoided.
Hepatitis C can survive in dried blood at room temperature for several weeks, and hepatitis B can survive in dried blood for around a week outside the body.
To clean up blood that has been spilled, wear rubber gloves and mop up the liquid using bleach and warm water . Use warm, soapy water to clean away blood spilled on someones body.
Put the waste, used gloves and bloodied clothes in a plastic bag, seal and throw away.
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How To Practice Safe Sex
Using condoms regularly and correctly is the best way to prevent the transmission of HIV and other sexually transmitted infections. Condoms act as barriers against semen and vaginal fluids. Always use latex condoms never use lambskin or homemade condoms, which offer little to no protection.
Still, even sex with a condom is not 100 percent risk-free. Misuse and breakage can be problems. People who are sexually active should consider getting HIV tests along with other STI testing. This can help each person understand the risk of transmitting or contracting the virus.
If one person has HIV and the other doesnt, the CDC reports that using condoms alone may lower the risk of contracting the virus by 80 percent.
For people who do not have HIV who have a sexual partner living with HIV, the use of pre-exposure prophylaxis can help reduce the risk of transmission through sex. When used daily along with other preventive measures, PrEP can reduce the risk of transmission by as much as 92 percent, according to the
. Combining condoms with antiretroviral therapy can provide even more protection. Possible exposure may also be remedied with post-exposure prophylaxis treatment.
According to the , this approach includes a combination of:
- HIV testing
- 28-day course of antiretroviral therapy for HIV
- follow-up care
Its important to note that antiretroviral therapy as a part of PEP treatment for HIV is most effective when started within 72 hours of exposure to HIV.
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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Can Hiv Pass From Mothers To Their Babies
Infection can pass from pregnant women living with HIV to their babies in the womb and during birth. Taking HIV medications during pregnancy and childbirth dramatically lowers the risk of a baby becoming infected with HIV.
After birth, transmission can occur through breast milk. The highest risk may be in the early months after birth. It is recommended that new mothers who are living with HIV formula-feed their babies rather than breast-feed.
If you are a woman living with HIV and you intend to become pregnant, or you find out that you have during your pregnancy, talk to your provider immediately about ways to minimize the chances that your baby will become infected, too.
How Is Hiv Spread Through Blood
You can become infected if you have contact with the blood of someone who has HIV. Blood-borne infection with HIV can occur through:
- sharing injection equipment when using drugs
- getting tattoos or body piercings with unsterilized needles
- accidental needle sticks
- splashing blood in your eyes
HIV is NOT spread by blood passed through insect bites.
If you inject drugs, the best thing to do is to use new or sterilized injection equipment every time. You can also take a daily medication called pre-exposure prophylaxis to lower your risk of HIV. Learn more about PrEP.
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