What are the main routes of HIV transmission?
- These are the main ways in which someone can become infected with HIV:
- Unprotected penetrative sex with someone who is infected.
- Injection or transfusion of contaminated blood or blood products, donations of semen (artificial insemination), skin grafts or organ transplants taken from someone who is infected.
- From a mother who is infected to her baby; this can occur during pregnancy, at birth and through breastfeeding.
- Sharing unsterilised injection equipment that has previously been used by someone who is infected.
Can I be infected if my partner doesn't have HIV?
- No. Like all sexually transmitted infections, HIV cannot be created, only passed on. If you are sure that your partner does not have HIV, then there is no risk of contracting it even if you do have unprotected sex (whether it be vaginal, anal or oral). However, pregnancy and other sexually transmitted diseases remain a risk, so you should still use a condom or other suitable form of birth control wherever possible.
How safe is oral sex?
- Although it is possible to become infected with HIV through oral sex, the risk of becoming infected in this way is much lower than the risk of infection via unprotected sexual intercourse with a man or woman.
- When giving oral sex to a man (sucking or licking a man's penis) a person could become infected with HIV if infected semen got into any cuts, sores or receding gums they might have in their mouth.
- Giving oral sex to a woman (licking a woman's vulva or vagina) is also considered relatively low risk. Transmission could take place if infected sexual fluids from a woman got into the mouth of her partner. The likelihood of infection might be increased if there is menstrual blood involved or if the woman is infected with another sexually transmitted disease.
- The likelihood of either a man or a woman becoming infected with HIV as a result of receiving oral sex is extremely low.
What are the chances of becoming infected with HIV if he doesn't come inside me?
- Whilst research suggests that high concentrations of HIV can sometimes be detected in pre-cum, it is difficult to judge whether HIV is present in sufficient quantities for infection to occur. To guard against the possibility of infection with HIV or any other STD it is best to practise safer sex, i.e. sex with a condom.
Is deep kissing a route of HIV transmission?
- Deep or open-mouthed kissing is a very low risk activity in terms of HIV transmission. HIV is only present in saliva in very minute amounts, insufficient to cause infection with HIV.
- There has been only one documented case of someone becoming infected with HIV through kissing; a result of exposure to infected blood during open-mouthed kissing. If you or your partner have blood in your mouth, you should avoid kissing until the bleeding stops.
Are lesbians or other women who have sex with women at risk for HIV?
- Lesbians/bisexual women are not at high risk of contracting HIV through woman-to-woman sex. Very few women are known to have passed HIV on to other women sexually.
Is unprotected anal intercourse more of an HIV risk than vaginal or oral sex?
- Unprotected anal intercourse does carry a higher risk than most other forms of sexual activity. The lining of the rectum has fewer cells than that of the vagina, and therefore can be damaged and cause bleeding during intercourse. This can then be a route into the bloodstream for infected sexual fluids or blood. There is also a risk to the insertive partner during anal intercourse, though this is lower than the risk to the receptive partner.
Does 'fingering' during sex carry a risk of HIV transmission?
- Inserting a finger into someone's anus or vagina would only be an HIV risk if the finger had cuts or sores on it and if there was direct contact with HIV infected blood, vaginal fluids or semen from the other person.
Is there a connection between HIV and other STDs (sexually transmitted diseases)?
- HIV and other STDs can impact upon each other. The presence of STDs in an HIV infected person can increase the risk of HIV transmission. This can be through a genital ulcer which could bleed or through genital discharge.
- An HIV negative person who has an STD can be at increased risk of becoming infected with HIV through sex. This can happen if the STD causes breaks in the skin (e.g. syphilis or herpes), or if it stimulates an immune response in the genital area (e.g. chlamydia or gonorrhoea). Nevertheless, HIV transmission is more likely in those with ulcerative STDs than non-ulcerative.
- Using condoms during sex is the best way to prevent the sexual transmission of diseases, including HIV.
Can I become infected with HIV through normal social contact/activities such as shaking hands/toilet seats/swimming pools/sharing cutlery/kissing/sneezes and coughs?
- No. HIV is not an airborne, water-borne or food-borne virus, and does not survive for very long outside the human body. Therefore ordinary social contact such as kissing, shaking hands, coughing and sharing cutlery does not result in the virus being passed from one person to another.
Can I become infected with HIV from needles on movie/cinema seats?
- There have been a number of stories circulating via the Internet and e-mail, about people becoming infected from needles left on cinema seats and in coin return slots. These rumours appear to have no factual basis.
- For HIV infection to take place in this way the needle would need to contain infected blood with a high level of infectious virus. If a person was then pricked with an infected needle, they could become infected, but there is still only a 0.4% chance of this happening.
- Although discarded needles can transfer blood and blood-borne illnesses such as Hepatitis B, Hepatitis C and HIV, the risk of infection taking place in this way is extremely low.
Is there a risk of HIV transmission when having a tattoo, body piercing or visiting the barbers?
- If instruments contaminated with blood are not sterilized between clients then there is a risk of HIV transmission. However, people who carry out body piercing or tattooing should follow procedures called 'universal precautions', which are designed to prevent the transmission of blood borne infections such as HIV and Hepatitis B.
- When visiting the barbers there is no risk of infection unless the skin is cut and infected blood gets into the wound. Traditional 'cut-throat' razors used by barbers now have disposable blades, which should only be used once, thus eliminating the risk from blood-borne infections such as Hepatitis and HIV.
Are healthcare workers at risk from HIV through contact with HIV positive patients?
- The risk to healthcare workers being exposed to HIV is extremely low, especially if they follow universal healthcare precautions. Everyday casual contact does not expose anyone, including healthcare workers, to HIV. The main risk is through accidental injuries from needles and other sharp objects that may be contaminated with HIV.
- It has been estimated that the risk of infection from a needlestick injury is less than 1 percent. The risk posed by a needlestick injury may be higher if it is a deep injury; if it is made with a hollow bore needle; if the source patient has a high viral load; or if the sharp instrument is visibly contaminated with blood.
Am I at risk of becoming infected with HIV when visiting the doctor or dentist?
- Transmission of HIV in a healthcare setting is extremely rare. All health professionals are required to follow infection control procedures when caring for any patient. These procedures are called universal precautions for infection control. They are designed to protect both patients and healthcare professionals from the transmission of blood-borne diseases such as Hepatitis B and HIV.
If blood splashes into my eye can I become infected with HIV?
- Research suggests that the risk of HIV infection in this way is extremely small. A very small number of people - usually in a healthcare setting - have become infected with HIV as a result of blood splashes in the eye.
Can I become infected with HIV through biting?
- Infection with HIV in this way is unusual. There have only been a couple of documented cases of HIV transmission resulting from biting. In these particular cases, severe tissue tearing and damage were reported in addition to the presence of blood.
Can I be infected with HIV through contact with animals such as dogs and cats?
- No. HIV is a Human Immunodeficiency Virus. It only affects humans. There are some other types of immunodeficiency viruses that specifically affect cats and other primates, namely the Feline Immunodeficiency Virus (FIV) and Simian Immunodeficiency Virus (SIV). These viruses are of no risk to humans.
Can I get HIV from a mosquito?
- No, it is not possible to get HIV from mosquitoes. When taking blood from someone mosquitoes do not inject blood from any previous person. The only thing that a mosquito injects is saliva, which acts as a lubricant and enables it to feed more efficiently.
Can HIV be transmitted in household settings?
- HIV is overwhelmingly transmitted through sexual contact, through intravenous drug use, through infected blood donations and from mother to child during pregnancy, birth and breastfeeding. HIV is not transmitted through everyday social contact. There have however been a few cases in which it is thought that family members have infected each other through ways other than those stated above.
- Whilst HIV transmission between family members and members of the same household is possible, it occurs in extremely low numbers and documented cases are very rare.
Can I become infected with HIV if I inject drugs and share the needles with someone else, without sterilising them?
- There is a possibility of becoming infected with HIV if you share injecting equipment with someone who has the virus. If HIV infected blood remains within the bore (inside) of the needle or in the syringe and someone else then uses it to inject themselves, that blood can be flushed into the bloodstream. Sharing needles, syringes, spoons, filters or water can pass on the virus. Disinfecting equipment between uses can reduce the likelihood of transmission, but does not eliminate it.
Can I transmit HIV to my baby during pregnancy or breastfeeding?
- An HIV-infected pregnant woman can pass the virus on to her unborn baby either before or during birth. HIV can also be passed on during breastfeeding. If a woman knows that she is infected with HIV, there are drugs she can take to greatly reduce the chances of her child becoming infected. Other ways to lower the risk include choosing to have a caesarean section delivery and not breastfeeding.
Does donating blood or having a blood transfusion mean that I am putting myself at risk from HIV?
- Some people have been infected through a transfusion of infected blood. In most countries, however, all the blood used for transfusions is now tested for HIV. In those countries where the blood has been tested, HIV infection through blood transfusions is now extremely rare. Blood products, such as those used by people with haemophilia, are now heat-treated to make them safe.
Can HIV be transmitted outside of the body?
- Whilst HIV may live for some time outside of the body, HIV transmission has not been reported as a result of contact with spillages of blood, semen or other bodily fluids. Just because someone comes into contact with tiny quantities of HIV in dried blood, it does not follow that infection will occur.
- Scientists agree that HIV does not survive well in the environment, making the chance of environmental transmission remote. To obtain data on the survival of HIV, laboratory studies have required the use of artificially high concentrations of laboratory-grown virus. Although these concentrations of HIV can be kept alive for days or even weeks under controlled conditions, studies have shown that drying of these high concentrations of HIV reduces the amount of infectious virus by 90 to 99 percent within several hours.
- Since the HIV concentrations used in laboratory studies are much higher than those actually found in blood or other specimens, drying of HIV-infected human blood or other body fluids reduces the theoretical risk of environmental transmission to that which has been observed, essentially zero. Incorrect interpretation of conclusions drawn from laboratory studies have unnecessarily alarmed some people.
Does circumcision protect against HIV?
- There is very strong evidence showing that circumcised men are about half as likely as uncircumcised men to acquire HIV through heterosexual sex. However, circumcision does not make a man immune to HIV infection, it just means that it's less likely to happen.
If I am taking antiretroviral drugs and have an 'undetectable' viral load, am I still infectious?
- Even if your tests show that you have very low levels of HIV in your blood, the virus will not have been totally eradicated and you are still capable of infecting others. Some drugs do not penetrate the genitals and do not disable HIV as effectively there as they do in the blood. This means that while you may have little active virus showing up on blood tests, there may still be quite a lot of HIV in your semen or vaginal fluids. Transmission may be less likely when you have a low viral load, but it is still possible so you should always take appropriate precautions.
Some Common FAQs
Can I get AIDS from drinking from the same glass or eating from the same dish as a person with AIDS (PWA)?
- No. Studies document that in households where a Person Living With AIDS (PLHA) resides, family members who use the same utensils for eating show no signs of infections. The virus does not survive well outside the body, and is killed by the detergents and hot water used during normal dish washing.
Can I get HIV/AIDS from using the drinking fountain or telephone?
- No. HIV/AIDS is not transmitted through air, food or water or by touching any object handled, touched, or breathed upon by a PWA. HIV/AIDS cannot be acquired from public restroosm, drinking fountains or telephones.
- You say that semen, blood and mother-to-fetus are the documented modes of transmission. What about saliva, tears, sweat and urine?
Saliva: A study done at Massachusetts General Hospital in 1985 disclosed of 85 saliva samples taken from men who tested positive for the Human Immunodeficiency Virus (HIV) antibody (some with a diagnosis of HIV/AIDS) one saliva sample tested positive for HIV, but did not contain enough viral material to cause infection. Further studies reveal that we produce, in the mucosa of the mouth and in the saliva, an HIV inhibitory agent.
Tears: A similar study was conducted to measure the HIV content of tears. The results determined that the virus could be isolated, but not in concentrations high enough to cause infection.
Sweat: There are no recorded studies of viral material found in sweat.
Urine: HIV is found in urine, but no recorded studies document this as the mode of infection.
Can I get HIV/AIDS from eating in a restaurant where a waiter/waitress or cook has HIV/AIDS?
- HIV/AIDS cannot be transmitted through the air or by handling food. The guidelines developed by the Centers for Disease Control (CDC) regarding HIV/AIDS and food service workers state that employees are always expected to observe strict health guidelines. They are to take proper precautions and wear gloves if they have an open wound which may cause food contamination.
Can I get HIV/AIDS by touching someone who has HIV/AIDS?
- The modes of transmission are constant. Transmission is sexual (semen or cervical secretions to blood), parenteral (blood to blood), by sharing needles, and perinatal (blood to blood, mother to fetus). There is no evidence that HIV/AIDS is spread by any form of casual contact.
Can I isolate a person with AIDS to prevent the spread of the disease?
- Medical opinion indicates that HIV/AIDS is spread only two ways: blood to blood and semen/cervical secretions to blood. It is not airborne and there not spread by casual contact. There is no logical reason to quarantine or isolate a PWA.
If I donate blood, should I worry about becoming infected with HIV/AIDS?
- No. Sterile needles are used to draw blood from each blood donor. After one use, this equipment is discarded.
What is the test used to determine if a person is positive for HIV?
- The current HIV test - called the ELISA test - was developed in the Spring of 1985 to protect the national blood supply. All donated units of blood are currently tested for the presence of HIV. The test, though highly sensitive, was never intended to be a diagnostic tool. Consequently, a second antibody test was developed, the Western Blot. If a person's ELISA test is positive, the second test is conducted. REMEMBER: If an individual tests positive for the presence of HIV antibodies, it does not mean that the indvidual will develop AIDS. IT simply means that the individual, at some point in time, was exposed to and infected by the virus that causes AIDS.
Can I be antibody positive and healthy?
- YES. It is possible for individuals to be antibody positive and healthy. For every three cases of AIDS, it is estimated there are ten cases of HIV-related symptoms, and many more cases of persons who are antibody positive without symptoms.
Where can I get tested?
How much does it cost?
How long does it take for antibodies to show up in my system after the initial exposure to HIV?
- Anywhere from two weeks to six months.
Because it takes from two weeks to six months for HIV antibodies to develop, if I test negative, how do I know I am really negative for HIV infection?
- If from the time of testing an individual uses precautions during sexual activity (latex condoms) or abstains from sexual activities, and avoid sharing needles, when you rests in six months and the test result is negative, you can be assured of a true negative antibody status. You should always remember that a negative test result does not make you immune to HIV infection.
How can I keep from getting infected?
- Education about HIV/AIDS is the KEY. HIV/AIDS is not a highly contagious disease and is not easy to catch. But, there is no cure at this time for HIV infection or AIDS. Abstinence from high risk activities is the only 100% effective way. However there are several things that can be done to reduce the risk of infecting yourself if you cannot abstain. If you are sexually active, research has shown that the use of a latex condom helps to reduce the risk, although it is not 100% effective. To help to prevent the latex condom from breaking, use a water based lubricant (non-petroleum). Do not share needles. If needles must be re-used, as in home health care, they should be cleaned with a 100% bleach and water. Bleach will kill the virus. Remember that HIV is transmitted through four primary body fluids: blood, semen, vaginal secretions, and mother's breast milk. Avoid activities where there is an opportunity for these fluids from an infected person can enter your blood stream.