How Is Hiv Passed During Pregnancy And Childbirth
HIV can be passed from a parent to their child during pregnancy, labour and delivery. Most babies who get HIV through perinatal transmission acquire it during labour and delivery, when they are exposed to blood and vaginal fluid as they pass through the birth canal. Additionally, HIV in the parent’s blood can pass to a fetus through the placenta during pregnancy.
Without HIV treatment, there is a 15% to 30% chance that a baby born to a person living with HIV will acquire HIV during pregnancy or delivery. Taking HIV treatment to maintain an undetectable viral load is the best way to prevent passing HIV to a baby. In fact, research has shown that if a pregnant person starts HIV treatment before pregnancy and maintains an undetectable viral load throughout pregnancy and delivery, they do not transmit HIV to their baby. When treatment is started after conception and taken for the remainder of the pregnancy and delivery there is a low risk of HIV transmission. A short course of HIV medications is also given to the infant immediately after birth to help prevent HIV transmission. Recommendations such as initiation of lifelong HIV treatment as soon as possible after diagnosis for all people living with HIV and the offer of an HIV test during pregnancy have made perinatal transmission extremely uncommon in Canada.
Estimated Hiv Transmission Risk Per Exposure
The estimates below should not be considered definitive but rather serve as a means to understand the relative risk of HIV by exposure type. The numbers are based on a meta-analysis of several large-scale studies which looked specifically at per-exposure risk.
| Exposure | |
| Mother-to-child, on ART with undetectable viral load | 0.1% |
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.
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Ways Hiv Cannot Be Spread
HIV is not spread by:
- Air or water
- Mosquitoes, ticks or other insects
- Saliva, tears, or sweat 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
Myth : If A Couple Has Hiv They Do Not Need To Protect Themselves
Fact: Different strains of HIV exist, and strains can change over time. If a person and their partner have two different strains of HIV, it is possible for them to transmit these to each other. This can lead to reinfection, which can complicate treatment.
Current medications can reduce the levels of this virus in the body so that it is untransmittable. If this happens for both partners, HIV protection may be unnecessary.
A healthcare provider can advise each couple on their situation.
Even if there is no risk of transmitting HIV, other sexually transmitted infections can spread as a result of having sex without a condom or other barrier method.
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What Is The Most Important Information I Should Know About Biktarvy
BIKTARVY may cause serious side effects:
- Worsening of hepatitis B infection. Your healthcare provider will test you for HBV. If you have both HIV-1 and HBV and stop taking BIKTARVY, your HBV may suddenly get worse. Do not stop taking BIKTARVY without first talking to your healthcare provider, as they will need to monitor your health, and may give you HBV medicine.
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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Are Hiv Medicines Used At Other Times To Prevent Hiv Transmission
Yes, HIV medicines are also used for post-exposure prophylaxis and to prevent mother-to-child transmission of HIV.
- Post-exposure prophylaxis PEP means taking HIV medicines within 72 hours after a possible exposure to HIV to prevent HIV infection. PEP should be used only in emergency situations. It is not meant for regular use by people who may be exposed to HIV frequently. For more information, read the ClinicalInfo fact sheet on Post-Exposure Prophylaxis .
- Prevention of mother-to-child transmission of HIV Pregnant women with HIV take HIV medicines for their own health and to prevent mother-to-child transmission of HIV. After birth, babies born to women with HIV receive HIV medicine to protect them from infection with any HIV that may have passed from mother to child during childbirth. For more information, read the ClinicalInfo fact sheet on Preventing Mother-to-Child Transmission of HIV.
Effective Barriers Against Hiv
There are many effective barriers that prevent infection.
Skin: Skin is an excellent barrier against HIV, unless there is an open cut or open wound. Infectious fluid on skin is NOT a route for infection.
Mucous membranes in the mouth, throat and stomach: These membranes are good barriers against HIV infection, so long as there are not cuts, ulcers or sores.
Saliva: Saliva contains proteins and a low salt content that actively reduce its infectiousness. Even when HIV is detected there is too little to cause infection. HIV is not transmitted by kissing including deep kissing. Spit cannot transmit HIV.
Air: HIV is not transmitted by air.
Latex and rubber: Condoms prevent infection from HIV and many other sexually transmitted infections.
Many sexual situations have no risk of transmitting HIV.
These include masturbation , kissing and deep kissing, receiving oral sex and vaginal or anal sex using a condom correctly.
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How Long Can Hiv Survive Outside The Body
Once outside the body, HIV usually cant survive for very long. Coming into contact with blood or semen that has been outside the body doesnt generally pose a risk for HIV transmission.
Similarly, the risk of passing on HIV to someone else if you have a detectable viral load and cut yourself is also very low. Wash away any blood with soap and hot water and cover the wound with a sticking plaster or dressing.
How Hiv Is Spread From Person To Person
In the United States, HIV is mainly spread through anal and vaginal sex without protection and sharing needles, syringes, and drug injection equipment.
Transmission from mother to child:
HIV can be transmitted from mother to child during pregnancy, birth, and breastfeeding. However, advancements in HIV prevention and treatment have made mother-to-child transmission less common.
It is recommended that pregnant mothers test for HIV and begin treatment immediately if the mother is diagnosed. The risk of transmitting HIV to the baby is less than 1% if a mother with HIV takes HIV medicine daily as prescribed throughout pregnancy and childbirth, and gives HIV medicine to her baby for 4 to 6 weeks after giving birth. It is also recommended in the United States that mothers do not breastfeed their child after birth.
Rare cases of HIV transmission include:
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What Are The Other Possible Side Effects Of Biktarvy
Serious side effects of BIKTARVY may also include:
- Changes in your immune system. Your immune system may get stronger and begin to fight infections that may have been hidden in your body. Tell your healthcare provider if you have any new symptoms after you start taking BIKTARVY.
- Kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys. If you develop new or worse kidney problems, they may tell you to stop taking BIKTARVY.
- Too much lactic acid in your blood , which is a serious but rare medical emergency that can lead to death. Tell your healthcare provider right away if you get these symptoms: weakness or being more tired than usual, unusual muscle pain, being short of breath or fast breathing, stomach pain with nausea and vomiting, cold or blue hands and feet, feel dizzy or lightheaded, or a fast or abnormal heartbeat.
- Severe liver problems, which in rare cases can lead to death. Tell your healthcare provider right away if you get these symptoms: skin or the white part of your eyes turns yellow, dark tea-colored urine, light-colored stools, loss of appetite for several days or longer, nausea, or stomach-area pain.
The most common side effects of BIKTARVY in clinical studies were diarrhea , nausea , and headache . Tell your healthcare provider if you have any side effects that bother you or dont go away.
Do Condoms Stop Hiv Being Passed On
Yes.Using a condom correctly prevents contact with semen or vaginal secretions , stopping HIV from being passed on. The virus cannot pass through the latex of the condom.
Condoms should only be used with a water-based lubricant as oil-based lube weakens them.
People with HIV who are on effective treatment and have an undetectable viral load cannot pass on HIV through any of their body fluids.
Its also important to remember that if you have sex without a condom other sexually transmitted infections can be passed on.
Sex without a condom can also result in pregnancy if other contraception is not being used.
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Contaminated Blood Transfusions And Organ/tissue Transplants
- receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This risk is extremely small because most countries test blood products for HIV first.
If adequate safety practices are not in place, healthcare workers can also be at risk of HIV from cuts made by a needle or sharp object with infected blood on it. However, the risk of occupational exposure, is very low in most countries.
If you think you have been exposed to HIV, the only way to find out if you have HIV is to have an HIV test.
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.
References
C. Arkelle
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What Should I Tell My Healthcare Provider Before Taking Biktarvy
- All your health problems. Be sure to tell your healthcare provider if you have or have had any kidney or liver problems, including hepatitis virus infection.
- All the medicines you take, including prescription and over-the-counter medicines, antacids, laxatives, vitamins, and herbal supplements. BIKTARVY and other medicines may affect each other. Keep a list of all your medicines and show it to your healthcare provider and pharmacist, and ask if it is safe to take BIKTARVY with all of your other medicines.
- If you are pregnant or plan to become pregnant. It is not known if BIKTARVY can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking BIKTARVY.
- If you are breastfeeding or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1800FDA1088.
How Is Hiv Passed Through Needles And Other Drug Use Or Body Work Equipment
HIV can be passed through blood that remains in used needles or other drug injection equipment, even if the amount of blood is so small it cant be seen. When a used needle containing blood with HIV breaks the skin of another person, HIV can get directly into their bloodstream. Once inside the bloodstream it can then cause a permanent infection. In the same way, HIV can be passed on by reusing unsterilized equipment for tattooing or piercing and through accidental needlestick injuries.
Sharing needles or other equipment used to inject drugs is the most common way that HIV is transmitted through broken skin. When a person injects drugs, blood can get into the needle/syringe or on other equipment they are using to inject or prepare their drugs. When someone uses a needle/syringe that has already been used by another person, there is a possibility that blood containing HIV is present. When a person prepares and injects drugs using shared equipment, blood that may contain HIV can directly enter their bloodstream through the broken skin. This is an efficient mode of transmission because the immune cells are the only natural defence against this type of HIV transmission. A larger amount of residual blood in the needle/syringe or other equipment and a higher amount of HIV in the blood can both increase the risk of injection-related HIV transmission.
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What Happens Once Hiv Gets Into The Body
Once HIV gets into the body, it needs to infect immune cells and make copies of itself to cause a permanent infection.
HIV cannot replicate on its own it needs to take over cells within the body to replicate. To do this it targets specific immune cells called CD4 T cells as well as other immune cells. HIV enters and takes control of the cell and starts to replicate. New copies of the virus are released into the blood that can then infect more immune cells.
If the virus can replicate for one to three days without being stopped, it can then spread to other parts of the body and establish a permanent infection. The bodys immune system defences are sometimes able to defeat HIV before it spreads and causes a permanent infection. Taking pre-exposure prophylaxis or post-exposure prophylaxis can also stop HIV from replicating and being able to establish a permanent infection.
About two-thirds of people newly infected with HIV experience symptoms of acute infection such as fever, chills, a rash, muscle aches, sore throat, swollen lymph nodes, fatigue, night sweats and mouth ulcers, which may last from a few days to a few weeks.
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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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 .