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HIV and AIDS CausesHIV transmission requires contact with a body fluid that contains the virus or infected cells. HIV can be spread through contaminated blood, semen, vaginal secretions, or breast milk. Although low concentrations of HIV may be present in saliva, tears, and urine, transmission from these fluids is extremely rare. High-risk activitiesSex with an infected partnerThe most common cause of HIV transmission is unprotected sex (vaginal, anal, or oral) with an infected partner. The virus can enter the body through the lining of the vagina, vulva, penis, rectum, or mouth. People who already are infected with another sexually transmitted disease (STD) are at greater risk of contracting HIV. Infected bloodHIV can be spread through infected blood. In 1985, hospitals and blood banks in the United States began screening the blood supply for HIV antibodies. Because donated blood and blood components are now screened and treated with heat to destroy HIV, the risk of transmission through contaminated blood transfusions is extremely small. Transmission through organ or tissue transplants is also rare. It's possible for HIV to be transmitted through improperly sterilized dental or surgical equipment. Contaminated needlesHIV can be spread by illegal drug users who share contaminated needles and syringes with a person infected with HIV. Although healthcare workers can become infected through an accidental needle stick with an HIV-contaminated needle or medical device, such occurrences are extremely rare. Antiretroviral drugs after needle stick accidents reduce the likelihood of becoming infected. Mother to childHIV-infected women can transmit HIV to their babies during pregnancy, birth, or breastfeeding. The rate can be as high as 30%. Treating a pregnant woman with HIV drugs and delivering the baby by cesarean section reduce the likelihood that the baby will become infected with HIV to 1%. Most pregnant women in the United States are screened for HIV and HIV treatment is available. This is not the case in developing nations. Low or no-risk activitiesOther body fluidsThere is no evidence that HIV can be spread through sweat, tears, coughing, sneezing, urine, or feces. Although HIV has been found in the saliva of infected people, the concentrations are extremely low and saliva contains chemicals that can help kill HIV. HIV may spread by contact with saliva if the lining of the mouth has open sores. Casual contactHIV is not spread through casual contact, including shared food utensils, household items, towels and bedding, swimming pools, telephones, or toilet seats. It is, however, possible to spread HIV through contaminated personal items (such as razors, toothbrushes, and nail clippers). Insect bitesHIV is not spread by biting insects (such as bedbugs, fleas, or mosquitoes). PreventionBecause there is no cure or vaccine to prevent HIV infection, preventative measures are essential. Safer sex behaviors significantly reduce but do not eliminate the risk of acquiring HIV infection. According to the CDC, condoms lubricated with spermicides are no more effective than other lubricated condoms in protecting against the transmission of HIV infection. Because there is a slight risk of acquiring the infection if a condom breaks, abstinence is the only way to prevent sexual transmission of HIV. To protect themselves, monogamous couples may decide to get tested for HIV infection. To decrease the risk of spreading HIV to another person: - Avoid unprotected anal intercourse.
- Clean all blood spills.
(Wipe the surface, and then decontaminate it with a 1:10 dilution of bleach or FDA approved disinfectant.) - Cover all wounds.
- Don't breastfeed.
- Don't donate blood, blood products, body organs, or sperm.
- Don't share needles or syringes to inject illegal drugs.
- Don't share personal items (such as razors, toothbrushes, and nail clippers).
- If pregnant, ask about taking antiretroviral drugs to protect unborn children.
- Notify all healthcare workers that you are HIV infected.
- Use protection during sex (oral, vaginal, or anal).
To decrease the risk of becoming infected with HIV from another person: - Avoid oral, vaginal, or anal contact with semen from HIV-infected individuals.
- Avoid unprotected anal intercourse with a person suspected of being infected with HIV.
- Don't share needles or syringes to inject illegal drugs.
- Don't share personal items (such as razors, toothbrushes, and nail clippers) with an HIV-infected person.
- Use protection during sex with multiple partners or with people who have multiple partners.
- Use protection during sex with people suspected of being infected with HIV or who use illegal drugs.
People who suspect they may have been exposed to HIV should be tested and call their doctors immediately to discuss whether they should start taking antiretroviral drugs. Post exposure prophylaxis (PEP) requires people to take two or three medications for several weeks after exposure. The medications lower the risk of infection but have serious side effects. It is important for people to discuss the pros and cons of early treatment with their healthcare providers. Several studies are currently examining the effectiveness of such early antiretroviral therapy.
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