What We Know About Vaginal Sex
When a woman has vaginal sex with a partner who has HIV, HIV can enter her body through the mucous membranes that line the vagina and cervix. Most women who get HIV get it from vaginal sex. Even if a womans male partner withdraws or pulls out before ejaculating, she can still get infected because pre-seminal fluid can carry HIV.
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On average, an HIV-negative woman has about a 1 in 1,250 chance of getting HIV every time she has vaginal sex with a man who has HIV.
On average, a woman with HIV has about a 1 in 2,500 chance of transmitting HIV every time she has vaginal sex with an HIV-negative man.
For an HIV-negative woman, anal sex is about 17 times more risky than vaginal sex for getting HIV from a partner with HIV.
For a woman with HIV, anal sex is about 3 times more risky than vaginal sex for transmitting HIV to an HIV-negative partner.
If the partner with HIV takes HIV medicine as prescribed, and gets and keeps an undetectable viral load , their partner has effectively no risk of getting HIV through sex. See how receptive vaginal sex compares to other sexual activities here.
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On average, an HIV-negative man has about a 1 in 2,500 chance of getting HIV every time he has vaginal sex with a woman who has HIV.
On average, a man with HIV has about a 1 in 1,250 chance of transmitting HIV every time he has vaginal sex with an HIV-negative woman.
See how insertive vaginal sex compares to other sexual activities here.
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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:
- Blood
- 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.
What To Do If You’re Not Sure
HIV hotlines are used to getting calls from people who are afraid they have been infected through casual contact. Perhaps the person was involved in a fight or came into contact with someone who was bleeding. Others may worry about having deep kissed someone who may or may not have HIV.
While the likelihood of infection in these cases would be considered negligible to nil, people will often want a 100% guarantee that they’re going to be fine nothing less will suffice.
In such cases, doctors will usually take the opportunity to perform an HIV test and perform pre- and post-test counseling to better understand what the person knows about HIV and answer any questions they might have.
If there is a risk of actual transmission, however small, the doctor may opt to prescribe a 28-day course of HIV medications known as post-exposure prophylaxis which may avert infection if treatment is started within 72 hours of the suspected exposure.
In cases where the person’s fears seem extreme and unreasonable, counseling may also be needed to address the possibility of AIDS phobia or other possible anxiety disorders.
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What We Know About Oral Sex
The chance an HIV-negative person will get HIV from oral sex with an HIV-positive partner is extremely low. However, its hard to know the exact risk because a lot of people who have oral sex also have anal or vaginal sex. The risk is even lower if the HIV-negative partner is taking medicine to prevent HIV . If the partner with HIV is taking HIV medicine as prescribed and keeps an undetectable viral load , they have effectively no risk of transmitting HIV through sex, including oral sex.
But you can get other sexually transmitted diseases from oral sex. And, if you get feces in your mouth during anilingus, you can get hepatitis A and B, parasites like Giardia, and other bacteria like Shigella, Salmonella, Campylobacter, and E. coli.
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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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 “safer sex” with any partner who is not proven to be HIV negative . To do so, always use protection–this could include using a condom, dental dam, or other latex barrier, and/or PrEP . It is also important to avoid “rough sex” 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 doesn’t 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 don’t share
- daily living with someone who has HIV
For more information, see Sex and Sexuality in the Daily Living section.
Body Fluids That May Contain Bloodborne Pathogens
Infection from bloodborne pathogens are most commonly associated with exposure to the following body fluids:
- Blood. This includes exposure to blood through needlesticks and sharps injuries, as well as skin and mucous membrane exposure. When handling blood, or items contaminated with blood, it is crucial to wear gloves and other personal protective equipment to help prevent infection.
- Semen and vaginal secretions. A disease that likely comes to mind when thinking about infected semen and/or vaginal secretions is HIV. However, studies have found that HBV and HCV can also be transmitted through the semen or vaginal secretions of infected individuals. This doesnt only happen through sexual intercourse. Nurses, doctors, and other healthcare professionals who come into contact with semen and vaginal secretions are at risk of infection, which is why all health workers should use universal precautions.
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Can Hiv Be Transmitted Through Oral Sex
Yes, but the risk is relatively low.
HIV is transmitted through seminal and vaginal fluids, including menstrual fluids. The virus can enter the body through the bloodstream or by passing through delicate mucous membranes, such as inside the vagina, rectum or urethra.
If a person gives fellatio and has bleeding gums, a cut, or an ulcer inside their mouth, HIV could enter their bloodstream through infected fluid. This could also happen if infected fluid from a woman gets into the mouth of her partner during oral sex.
Using a condom during sex, including oral and anal sex, is the best way to prevent sexually transmitted infections , including HIV. Avoid using an oil-based lubricant, such as Vaseline or baby oil, because they can weaken the condom and increase the risk of it splitting.
You can use a dental dam to cover the anus or female genitals during oral sex. A dental dam is a latex or polyurethane square, measuring about 15cm by 15cm. It acts as a barrier to help stop STIs passing from one person to another.
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/aids From A Toilet Seat
For an answer to this common question, here’s longtime HIV expert Nancy Breuer:
“HIV is in blood, semen, vaginal fluids, and breast milk. To create an infection, one of these four body fluids with HIV in it must come into immediate and direct contact with the bloodstream or a mucous membrane of another person.
“I include the word ‘immediate’ because the virus cannot survive for long outside the body. Oxygen destroys the virus. If any one of these four body fluids were on a toilet seat, oxygen would probably have destroyed it before anyone else approached it, and a person sitting on a toilet seat does not expose the bloodstream or a mucous membrane to the fluid on the seat, so there is no potential mode of transmission.
“If you find a toilet seat with blood or another potentially infectious body fluid on it, make sure that the seat is properly cleaned before anyone else uses it, for reasons of general hygiene. But do not be concerned about the possible transmission of HIV in that setting.”
Transmission: Where Does The Hiv Virus Live
The HIV virus is present in body fluids. Body fluids which can contain significant amounts of HIV are not usually of concern to everyday people amniotic fluid, cerebrospinal fluid and synovial fluid around bone joints, for example, are of concern only to healthcare workers that are involved in invasive surgical procedures.However, the HIV virus is present in the following body fluids in infectious quantities:
- Blood and blood products
- Vaginal and cervical secretions
- Breast milk.
An HIV-positive person may have HIV in very small amounts in other body fluids such as tears, saliva and blister fluid, but usually not in enough amount to be infectious. Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV.
It is via the exchange of bodily fluids containing HIV virus that person-to-person transmission can occur. The main routes of HIV transmission are through:
- Unprotected sexual contact with an infected person
- Sharing needles with an infected person
- From an infected mother to child during pregnancy, during birth or after birth while breastfeeding.
You are at risk if:
- You have sex without condoms
- You have many sex partners and do not use condoms
- Your sex partner has/have sex with other persons without using condoms
- You share unsterilized needles for intravenous drug use
Nobody is immune to the HIV virus. Anyone engaging in above activities is at risk of infection.
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Is There A Pill That I Can Take To Prevent Getting Hiv
Since 1996, the federal government has recommended that health care workers that are exposed to HIV through needle stick injuries be provided with antiretroviral medications to help prevent the possibility of HIV infection. For a short period of time after exposure to HIV, virus particles are present only in certain cells of the body. If HIV replication can be slowed during that time, the virus may not be able to establish permanent infection in the person’s body. The sooner treatment is started, the more likely it is to interrupt HIV transmission. A combination of three antiretroviral drugs must be taken within 72 hours after exposure and must be taken daily for 28 days. This is generally referred to as post-exposure prophylaxis or PEP.
In 2005, the CDC issued guidelines for the use of anti-HIV therapies for individuals exposed to HIV through high risk sexual activities or needle sharing among injection drug users. The guidelines recommend this approach only in very limited circumstances:
It is important to note that PEP is not a simple “morning after pill” for those who have had unprotected sex. To be effective, a combination of three antiretroviral drugs must be taken within 72 hours after exposure and must be taken daily for 28 days.
Although there are PREP studies occurring in both the United States and in other countries, no drug has been licensed for PREP at this time.
Necessary Conditions For Hiv Infection
HIV is a relatively fragile virus, which is not spread by casual contact. HIV is not easy to catchit must be acquired. In order for HIV to be transmitted, three conditions must occur:
- There must be an HIV source.
- There must be a sufficient dose of virus.
- There must be access to the bloodstream of another person.
Body Fluids That Can Transmit HIV
Anyone infected with the virus is potentially a source of HIV infection. Transmission occurs primarily through infected blood, semen, vaginal secretions, or breast milk. Sweat, tears, saliva, urine, and feces are not capable of transmitting HIV unless visibly contaminated with blood.
In settings such as hospital operating rooms, other fluids such as cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, and amniotic fluid may be considered infectious if the source is HIV positive. These fluids are generally not found outside the hospital setting. Therefore, the most common body fluids considered potentially infectious for HIV are blood, semen, vaginal secretions, and breast milk.
Sufficient Dose
The concentration and amount of HIV necessary for infection to occur is called a sufficient dose.
Blood
Access to another persons bloodstream involves behaviors or circumstances that place someone at risk for infectious fluid entering their bloodstream. The most common of the risk behaviors are unprotected sexual intercourse with an infected person and use of contaminated equipment for injecting drugs.
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Body Fluids That Transmit Hiv
What body fluids transmit HIV?
Only certain body fluids from a person who has HIV can transmit HIV. These fluids include
- blood,
- vaginal fluids, and
- breast milk.
These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream for transmission to occur. Mucous membranes are found inside the rectum, vagina, penis, and mouth.
Risk Assessment: Sample Scenarios
Transmission questions can often not be answered in a black-or-white fashion, . The answer will usually involve the following questions, going back to the conditions necessary for HIV transmission to occur:
- What is the substance
- Can it possibly contain HIV in sufficient quantity to cause infection?
- Where is it going in the body?
The following are some examples of common situations and how the information about transmission can help you assess your risk.
Case 1
A man performed oral sex without a condom on another man. His partner ejaculated in his mouth. He doesn’t know his partner’s HIV status.
Was the virus present? We don’t know, because we don’t know if the partner was infected.
Was there enough concentration? There was semen present, which has a high concentration.
Could HIV make it into the bloodstream? If HIV were present, it could enter the body by infecting mucous membranes in the mouth, or through open cuts or sores.
What was the level of risk? If the partner was not HIV positive, there is no risk. On the other hand, if the partner were HIV positive, there would be a potential risk because of the semen coming into contact with the mouth. Considering that there are few reported cases of transmitting HIV through oral sex, the risk in this situation is relatively low.
Case 2
A woman has found out that her previous drug partner is HIV-positive. They only shared needles once. She thinks that he got infected after they stopped seeing each other.
Case 3
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Prevent The Spread Of Bloodborne Pathogens With Aftermath
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How Do You Get Hiv From Semen Or Vaginal Fluid
Body fluids including semen and vaginal secretions can contain HIV. If a person has HIV and a detectable viral load, HIV can passed on to someone if their semen or vaginal secretions get into the body of a sexual partner during vaginal or anal sex.
If a man has HIV and a detectable viral load, one of his body fluids where the virus is found is his semen.
If he has a detectable viral load and his semen gets into the body of his sexual partner during sex, then HIV can get into the other persons bloodstream.
Pre-cum also contains HIV this is why there is a risk of infection even if a man pulls out of his partner before he ejaculates.
If a woman has HIV and she has a detectable viral load, one of her body fluids where the virus is found is in her vaginal secretions.
If these come into contact with a penis during sex, then HIV could be transmitted. The virus in her secretions can enter through the delicate skin of the penis or foreskin.
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