Ways In Which Hiv Is Transmitted
Looking at the third condition for transmission , there are three primary ways in which this can happen:
- Unprotected sexual contact
- Direct blood contact, including injection drug needles, blood transfusions, accidents in health care settings or certain blood products
- Mother to baby
Sexual Routes of Transmission
Sexually, the three main ways that HIV is transmitted are:
- vaginal sex
- anal sex
- oral sex
Vaginal and anal intercourse: For the receptive partner , the mucous membranes of the anus and vagina are very efficient routes into the bloodstream. HIV may also enter either through routine, minute tearing caused during intercourse .
Anal sex is riskier than vaginal sex, because the membranes are thinner, tearing happens more easily, and there is no natural lubrication. But both are efficient routes for the virus.
It is speculated that for the penetrative partner , HIV may infect through the mucous membranes in the meatus . It is believed that uncircumcised men may be at greater risk for HIV for a variety of reasons. For instance, they may not have been told how to correctly use a condom. Because an uncircumcised man has a foreskin and a circumcised man doesn’t have a foreskin, each has to put on a condom differently. Uncircumcised men must pull back on their foreskin before rolling on the condom. Neglecting to pull back the foreskin may make condom failure more likely, although no clear evidence supports this idea.
Non-Sexual Routes of Transmission
Mother to Child Transmission
What If There Is An Actual Or Suspected Exposure To Hiv
The decision to begin a post-exposure prophylaxis for HIV infection is based on the judgment of a health care professional and should be a joint decision with the exposed worker. PEP often involves taking a combination of 2 or 3 antiretroviral drugs for about 4 weeks. PEP can help reduce, but not eliminate, a persons risk of infection. The PEP should begin as soon as possible, as it may be less effective if started more than 72 hours after exposure.
Occupational Groups Risking Exposure to the AIDS Virus
The occupational groups listed below risk exposure to HIV in the workplace. The table that follows suggests preventive measures for these groups. For many situations, using all protective barriers listed in the table is not necessary, but workplaces should always make them available in case of emergency response scenarios.
Surgeons, Nurses and Nurses Aides
Surgeons, nurses and nurses’ aides should take precautions to avoid needlestick injuries, cuts with sharp instruments and exposure through skin lesions to potentially infectious blood and body fluids.
Physicians and Laboratory Workers
These people continuously handle infectious samples. Doctors, in diagnosing HIV patients, carry out physical examinations and collect blood samples. Laboratory technicians analyze potentially infected samples.
Ambulance Workers
Dental Workers
Embalmers
Embalming the bodies of persons with a HIV infection presents a risk because HIV can live for hours in a deceased body.
Cleaners
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.
These include:
- syphilis
- gonorrhea
- herpes
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Ways That Hiv Is Not Transmitted
HIV is not transmitted by day-to-day activities or by contact with objects, food or clothes.
The following list includes just a few examples of questions we get from people worried about catching HIV.
Most of these questions come from a combination of fear and ignorance. They come from a lack of confidence in understanding HIV transmission.
You can NOT catch HIV from:
- Eating any food, cooked or uncooked, with blood on it.
- From a sterile needle at a clinic or other health centre.
- From a human bite.
- From an insect bite including a mosquito bite.
- From an animal.
- From living in the same house as someone who is HIV positive.
- From a sewing needle if you stab your finger.
- From blood on a bus seat that went through your underwear.
- Cleaning nail clippers.
- Using a knife/fork/spoon/cup/plate that an HIV positive person may have used.
- Getting sexual fluid on skin.
- Getting sexual fluid on a cut that has already healed over. A cut has to be open to be a risk of HIV.
The above are all real examples sent as questions to i-Base. They show that ignorance about HIV is still common.
How Can You Get Hiv
HIV is found in the following bodily fluids of someone living with the virus:
- blood
- vaginal fluids
- breastmilk.
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:
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Can You Get Hiv Through Oral Sex
The risk of HIV from oral sex is very small unless you or your partner have large open sores on the genital area or bleeding gums/sores in your mouth.
There is only a slightly increased risk if a woman being given oral sex is HIV-positive and is menstruating. However, you can always use a dental dam to eliminate these risks.
How Does Someone Get Hiv
The most common way people get HIV is through unprotected anal or vaginal sex with someone with HIV who is not aware of their status or not on antiretrovirals , the medications used to treat HIV. According to the U.S. Centers for Disease Control & Prevention , HIV transmission through oral sex is extremely rare.
Sharing used needles, syringes, or other drug preparation equipment increases risk of getting HIV.
HIV can be passed from mother to child during pregnancy, birth and through breastfeeding, although this risk can be almost eliminated with treatment.
HIV is not spread through sharing glasses or plates, food, holding hands, toilet seats, or other casual contact.
You cannot get HIV through closed-mouth or social kissing or saliva.
As important as knowing how HIV is spread, is knowing how it is NOT. HIV is not spread by sharing glasses or plates, food, holding hands, toilet seats, or other casual contact.
You cannot get HIV through closed-mouth or social kissing or saliva.
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How Is Hiv Recognized
Doctors use laboratory tests to confirm HIV infection. The Elisa and Western Blot analyses identify people who have been exposed to HIV. These tests determine if the blood contains particular antibodies that result from contact with the virus. They do not identify who among a group of infected individuals will develop the disease. The presence of antibodies or HIV markers means the person has been infected with HIV but no one can predict when and if they will get AIDS related symptoms.
Doctors diagnose AIDS by blood tests and the presence of specific illnesses such as pneumocystis carinii pneumonia or Kaposi’s sarcoma. These diseases overcome the weakened immune system and are responsible for the high death rate among AIDS patients.
Sharing Injection Drug Equipment
Sharing needles for injecting drugs most efficiently transmits HIV. This is because used needles and syringes can still contain blood, which can carry the virus.
An older study found that HIV can survive up to 42 days in syringes, depending on the temperature.
HIV isnt the only virus that can be transmitted by sharing injection drug equipment. The viruses that cause hepatitis B and hepatitis C can be transmitted in this way as well.
There are also some less common ways that HIV can be transmitted. Lets take a look at some of them below.
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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.
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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Where Is Hiv Found In The Body
Looking at the first two conditions for HIV transmission , let’s examine some of the so-called “bodily fluids” that can contain HIV.
Infectious “Bodily Fluids”
HIV can be transmitted from an infected person to another through:
- Blood
- Vaginal secretions
- Breast milk
Blood contains the highest concentration of the virus, followed closely by semen, followed by vaginal fluids. These are the three basic fluids that infect adults with HIV.
The risk from these fluids can be worsened or lessened depending on how they get into someone else’s body, which we will discuss below.
Breast milk can contain a high concentration of the virus, but in this situation, transmissibility depends on who and how. An adult can ingest a small amount of breast milk at minimal risk. But an infant, with its very small body and newly forming immune system, consumes vast quantities of breast milk relative to its body weight. Therefore an infant is at risk from breast milk, whereas an adult probably is not.
Possibly Infectious “Bodily Fluids”
HIV might be transmitted from an infected person to another through:
- pre-seminal fluid
Pre-seminal fluid is a clear fluid that lubricates men’s urethras. It is produced by a different gland than semen. Pre-seminal fluid can contain small amounts of HIV, and so there is a potential risk. However, in practice, the risk is much, much lower than that from blood, semen or vaginal fluid. As in all transmission situations, risk depends on where the fluid is going.
- Urine
How Do People Get Hiv
HIV spreads when infected blood or body fluids enter the body. This can happen:
- during sex
- through sharing needles for injecting drugs or tattooing
HIV also can pass from mother to child during pregnancy, childbirth, or breastfeeding.
HIV is NOT spread through:
- pee, poop, spit, throw-up, or sweat
- coughing or sneezing
- sharing eating utensils or drinking glasses
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Means And Requirements For Hiv Transmission
People may become infected with HIV if they engage in specific risk behaviors or if they are exposed through needlestick injuries . Other blood contact with mucous membranes or non-intact skin provides a possible, but not probable, chance of transmission.
HIV is transmitted through:
- Unprotected anal, vaginal, and oral intercourse
- Sharing needles or other injection equipment
- A mother passing the virus to her baby either before or during birth
- An infected woman breastfeeding her infant
- Accidental needlestick injuries, or infected body fluid coming into contact with the broken skin or mucous membranes of another person
- A transfusion prior to 1986 of HIV-infected blood or blood products
In extremely rare cases, HIV can be transmitted by sharing razors or toothbrushes, if infected blood from one person was deposited on the toothbrush or razor and the blood entered the bloodstream of another person.
The transmission of HIV depends upon:
- The availability of the infectious agent in sufficient quantity
- The viability of the infectious agent
- Thevirulence of the infectious agent
- The ability of the infectious agent to reach the bloodstream, mucous membranes, or broken skin of a potential host
One of the predictors of the infectious level of an HIV-positive person is viral load, which is how much HIV is present in the bloodstream. Studies show a clear connection between higher viral load in the blood and increased transmissibility of HIV.
Test Your Learning
What Is Art And How Does It Help Prevent Hiv
Antiretroviral therapy is a combination of medicines that slows down the effects of HIV in your body and can help you stay healthy for many years. It can also lower or even stop your chances of giving HIV to anyone else.
ART lowers the amount of HIV in your body sometimes to the point where HIV wont show up on standard blood tests. If your HIV viral load is so low that certain tests cant see it, its called undetectable. When someone has an undetectable viral load, they cant spread HIV to others during sex.
Its important to remember that even with an undetectable viral load, HIV is still present in your body. If you stop treatment your viral load can go up, making it possible to pass HIV to others you have sex with. Your doctor or nurse can help you find the treatment thats best for you to help keep your viral load low, so you can stay healthy.
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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 “body 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 Hiv Be Prevented
To reduce the risk of getting HIV, people who are sexually active should:
- use a condom every time they have sex
- get tested for HIV and make sure all partners do too
- reduce their number of sexual partners
- get tested and treated for STDs having an STD increases the risk of HIV infection
- consider taking a medicine every day if they are at very high risk of getting infected
For everyone:
- Do not inject drugs or share any kind of needle.
- Do not share razors or other personal objects that may touch blood.
- Do not touch anyone else’s blood from a cut or sore.
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