Reducing Your Personal Hiv Risk
The purpose of understanding relative risk is to establish the means by which to reduce your personal risk of infection or the risk of transmitting HIV to others. Oftentimes, it takes little to mitigate risk. For example, the consistent use of condoms correlates to a 20-fold decrease in HIV risk, while choosing insertive fellatio over insertive anal sex results in a 13-fold decrease. Conversely, the presence of an STI or genital ulcer increases the risk of HIV by anywhere from 200% to 400%.
Arguably the most important factor in assessing the likelihood of HIV transmission is the infected person’s viral load. Data suggests that the risk of an HIV-infected person with an undetectable viral load transmitting the virus is essentially zero.
The strategy called treatment as prevention strongly supports the use of antiretroviral therapy to reduce the infectivity of a person with HIV. It also reinforces the need for early testing to mitigate risk in mixed-status couples.
Knowing your serostatus and that of your partner allows you to make an informed choice on how to better protect yourselveswhether it be to abstain from high-risk activities, use condoms, or explore pre-exposure prophylaxis as a means to reduce the HIV-negative partner’s susceptibility to infection.
Ways Hiv Can Be Transmitted
How is HIV passed from one person to another?
Most people who get HIV get it through anal or vaginal sex, or sharing needles, syringes, or other drug injection equipment . But there are powerful tools that can help prevent HIV transmission.
Can I get HIV from anal sex?
You can get HIV if you have anal sex with someone who has HIV without using protection .
- Anal sex is the riskiest type of sex for getting or transmitting HIV.
- Being the receptive partner is riskier for getting HIV than being the insertive partner .
- The bottoms risk of getting HIV is very high because the rectums lining is thin and may allow HIV to enter the body during anal sex.
- The top is also at risk because HIV can enter the body through the opening at the tip of the penis , the foreskin if the penis isnt circumcised, or small cuts, scratches, or open sores anywhere on the penis.
Can I get HIV from vaginal sex?
You can get HIV if you have vaginal sex with someone who has HIV without using protection .
Can HIV be transmitted from a mother to her baby?
HIV can be transmitted from a mother to her baby during pregnancy, birth, or breastfeeding. However, it is less common because of advances in HIV prevention and treatment.
Can I get HIV from sharing needles, syringes, or other drug injection equipment?
You are at high risk for getting HIV if you with someone who has HIV. Never share needles or other equipment to inject drugs, hormones, steroids, or silicone.
Ways Hiv Is Not Spread
Get the true facts about HIV transmission.
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The human immunodeficiency virus, or HIV, has existed in the United States since at least the 1970s, but myths and misconceptions about how it’s transmitted still persist.
Most people know that the virus is commonly spread through sexual contact and intravenous drug use. But what other behaviors are and are not risk factors?
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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.
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.
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Diagnosis Of Hiv Infection
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Tests to detect antibodies to the HIV virus in a sample of blood or saliva
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Tests to detect HIV RNA in a sample of blood
Early diagnosis of HIV infection is important because it makes early treatment possible. Early treatment enables infected people to live longer, be healthier, and be less likely to transmit HIV to other people.
Doubts Persist Even When Risk Is Statistically Zero
Despite increased public awareness about HIV, there remains a lot of confusion about how you can get infected and how you cannot. For example, even though people understand that you can’t get HIV from utensils, there are many who will experience a twinge of concern if they learned that the chef of their favorite restaurant has HIV.
HIV has a way of spurring anxieties in even the best of us and, with it, our sense of reason. Relieving those anxieties often requires us to do more than just lay out the rules. Instead, we need to understand what conditions are required for an infection to take place and why things like hugging, touching, sneezing, or kissing simply do not satisfy those conditions.
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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.
The Lowdown On Dental Dams
Dental dams are barriers used to prevent the transmission of viruses during oral sex. Placing this latex barrier between your mouth and your partners genitals can help to prevent STIs. Dental dams can be used for both cunnilingus and rimming .
Dental dams can be purchased. They can also be made from condoms and gloves. Its very easy to make a dental dam from a latex or polyisoprene condom. Just cut the tip off the condom and then cut down one side. Now you have a dental dam ready to use.
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Is There Anything You Can Do To Prevent Other Forms Of Transmission
There is!
Avoid sharing drug injection equipment, like needles and syringes, which can expose someone to blood infected with HIV.
Keep any alcohol intake or drug use in check. If needed, consider seeking help for substance use, which is linked to a higher risk of HIV and other STIs.
If you or your partner have concerns or are in need of support, reach out to a doctor or other healthcare professional for help with:
- HIV and other STI testing
- treatment and prevention medications
Transmission: Heightened Risk With The Presence Of Other Sexually Transmitted Diseases
Having a sexually transmittable disease will make you more susceptible to become infected with HIV, especially when such a disease has caused wounds, blisters, and ulcerations of the genitals.
In addition, when a person has both HIV infection and another sexually transmittable disease, the amount of HIV in the body fluids is greatly increased. This makes it more likely that HIV is transmitted during sex. For more information on STDs, click here .
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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
Where Did Myths About Hiv Come From
The early 1980s were a scary time for people living with HIV. By the spring of 1983, scientists had identified the virus responsible for a mysterious illness called acquired immune deficiency syndrome , but they didnt understand how it passed from person to person.
Initially, some researchers speculated this new infection could be passed through casual contact or even through the air, like tuberculosis. Others theorized it might be hitching a ride with mosquitoes or other insects, like malaria.
But the damage had already been done. Myths about HIV transmission had already taken root, and these myths continue to make life difficult for the 1.1 million people living with HIV today in the United States.
Today we have a solid scientific understanding of HIV transmission. We know that HIV can only be transmitted in very limited circumstances, such as sexual contact or needle sharing. And we have a much better understanding of the way that viral loadthat is, the amount of HIV in a persons bloodstreaminfluences their chances of passing on the virus.
You can use this information to educate yourself, your friends, and your community about the real risk of HIV transmission.
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Which Bodily Fluids Can Pass Hiv
Bodily fluid is a blanket term that refers to any of the liquids floating around inside the human body. Were talking blood, sweat, tears, semen, vaginal fluids, urine, and all the rest.
HIV does not spread throughout the body evenly. Some bodily fluids have it, but most dont. In fact, HIV can only be transmitted to another person through these three types of bodily fluids:
- blood
- sexual fluid
- breast milk
Thats it.
HIV cannot be passed from person to person via other fluids like tears, saliva, vomit, or feces. This is an incredibly important point about HIV transmission that is often misunderstood.
For decadesand still todaypeople have worried they might catch HIV from a toilet seat, perhaps by touching the urine or fecal matter of an HIV-positive person. This absolutely does not happen.
People have also worried they might catch the virus from the saliva of an HIV-positive person who kisses them or spits on them. In fact, this fear is so pervasive that some states have made it a felony for people with HIV to spit at or bite someone else. Those laws are based on outdated science.
The only way it would be possible to transmit HIV through saliva is if the HIV-positive person had bleeding gums or sores, and somehow that bloody saliva got into the bloodstream of the HIV-negative person. However, experts agree that the risk of this happening is so statistically tiny that its not worth worrying about.
So, to recap:
Can Analingus Result In Hiv Transmission
For this answer, we turn back to Bob Frascino, M.D.:
“Although there have been no documented cases of acquiring HIV from rimming or being rimmed, there are a number of other significant STIs that can easily be transmitted through rimming, including hepatitis A, herpes, and intestinal parasites. You can decrease the risk by using a dental dam barrier .
“As for whether to rim or not, only you can decide what level of risk you are willing to take. At least now you have the facts.”
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Not Every Hiv Exposure Leads To An Infection
Although the most effective way to prevent the sexual transmission of HIV is to avoid exposure to fluids that contain the virus, the reality is that not all exposures result in infection. After an exposure, HIV still needs to complete a difficult journey before it can spread throughout the body. In some cases, HIV is not able to complete this journey and infection does not occur. The likelihood of infection depends on many factors.
I Am Hiv Positive How Can I Prevent Passing Hiv To Others
Take HIV medicines daily. Treatment with HIV medicines helps people with HIV live longer, healthier lives. ART can’t cure HIV, but it can reduce the amount of HIV in the body . One of the main goals of ART is to reduce a person’s viral load to an undetectable level. An undetectable viral load means that the level of HIV in the blood is too low to be detected by a viral load test. People with HIV who maintain an undetectable viral load have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
Here are some other steps you can take to prevent HIV transmission:
- Use condoms correctly every time you have sex.
- Talk to your partner about taking PrEP.
- If you inject drugs, don’t share your needles, syringes, or other drug equipment with your partner.
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Occupational Exposure To Bloodborne Pathogens
Occupational exposure means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infected materials that may result from the performance of an employees duties.
Exposure incident means a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or OPIM that results from the performance of an employees duties. Examples of non-intact skin at risk include skin with dermatitis, hangnails, cuts, abrasions, chafing, or acne.
Occupational groups that have been widely recognized as having potential exposure to HBV/HCV/HIV include, but are not limited to, healthcare employees, law enforcement, fire, ambulance, and other emergency response, and public service employees.
The following requirements are mandated by Washington Administrative Code Chapter 296-823, Occupational Exposure to Bloodborne Pathogens. They are enforced by the Department of Labor and Industries Division of Occupational Safety and Health . Please check with your agencies to make sure you are in compliance with the requirements of this rule. Failure to comply may result in citations or penalties.
The following standards and rules are specifically for the state of Washington, however many states have similar standards and compliance with the occupational exposures rules outlined here are effective in minimizing risk of bloodborne pathogens including HIV, HCV, and HBV.
Test Your Knowledge
Other Types Of Hiv Risks
Another less-common way HIV is transmitted in the United States is needlestick injury. This typically happens when a health care worker is accidentally jabbed by a used needle or syringe that contains HIV-positive blood. Again, this is very rare.
Thirty years ago, blood transfusions and organ donations were an especially dangerous way that some people acquired HIV. Nowadays, donated blood and organs are routinely tested.
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Hiv: How Its Not Transmitted
The following are nine ways the virus is not spread:
Kissing and touching. Social kissing and hugging pose no risk of transmission, Sha says. Also, being sexual with someone without exchanging infected body fluids does not spread the virus. The only time deep kissing is a risk is when the person infected with HIV has open sores or oral bleeding, Sha notes.
Sharing a living space. Any casual contact with someone who has HIV, including sharing a bathroom, is safe. However, Sha tells patients not to share razor blades or toothbrushes. If someone who is infected nicks himself while shaving or has bleeding gums, it could increase risk of transmission.
Sharing food or utensils. The virus cannot survive on surfaces, so sharing utensils and other household items will not spread HIV. You can even share a meal with someone who is infected without worry. Transmission has been associated with mothers pre-chewing food for their babies, when infected blood from the mouth mixes with the food. Known as pre-mastication, it is a common practice in Africa, but not typically done in the United States, Sha says.
Saliva, sweat, or tears. An infected persons saliva, sweat, and tears do not put you at risk.
Water fountains. Sipping from a water fountain after someone who has HIV used it is considered casual contact and will not lead to transmission.
Mosquitoes and other insects. The virus is not viable in insects or ticks, Sha says.
Ways Hiv Is Not Transmitted
How well does HIV survive outside the body?
HIV does not survive long outside the human body , and it cannot reproduce outside a human host. It is not transmitted
- Through saliva, tears, or sweat.
- Through other sexual activities that dont involve the exchange of body fluids .
- Through the air.
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