HIV Infection: Risk Factors and Prevention of Transmission

What is HIV?

HIV is the virus that causes AIDS. With time, HIV infection weakens your ability to fight off serious infections and some cancers. When this happens, HIV infection becomes AIDS. AIDS is a life-threatening but preventable disease.

Who is at risk?

If you are infected with HIV, you can pass the virus to other people even when you may have no signs of illness. The virus will be in your blood and in vaginal and sexual secretions, such as semen. It can be spread by contact with your blood, and it can be spread sexually during foreplay and vaginal, oral, or anal intercourse. Having anal intercourse or sex with numerous partners especially increases the risk of getting AIDS. People close to you, such as friends, family members, and roommates, do not have a higher risk as long as they do not have sexual contact with you or contact with your blood.

HIV can also spread to babies born to a mother infected with HIV. Babies may also get infected if they have breast milk from a mother who is infected.

IV drug users and people receiving blood transfusions can be exposed to the virus through infected blood. However, in the US the risk of getting HIV from blood transfusions has become very rare since testing of donated blood for the virus began in the mid-1980s.

The following groups are at high risk for getting infected with HIV:

• sexually active homosexual men
• men who have sex with both men and women
• men and women with more than 1 sexual partner
• heterosexual women whose partner has sex with more than one partner or with men
• people who share needles (for IV drug use, tattooing, or piercing)
• people who have sex with an HIV-infected partner or with anyone in the above groups if they do not always use a latex or polyurethane condom
• babies born to or breast-fed by HIV-infected mothers
• people given transfusions of blood or blood products in countries where the blood is not tested for HIV

Who should be tested for HIV?

You should be tested for HIV if:

• You are or were in a high-risk group (listed above).
• You have ever had unprotected sex and have not been tested.
• You are or plan to get pregnant.

It is especially important to be tested if you are or plan to get pregnant so you can keep the baby from getting infected. It’s best to be tested before pregnancy, but getting tested during pregnancy is better than not being tested at all. If you are HIV positive, treatment is available to help protect the baby from infection during pregnancy and delivery.

The Centers for Disease Control and Prevention (CDC) recommends HIV tests for everyone 13 to 65 years old at their regular visits with their healthcare provider. The CDC would like the HIV test to be as common and ordinary as a blood count and other routine tests. This is because HIV is a silent infection. You can be infected with HIV for months or years without knowing you are infected. People who know they are HIV positive tend to be careful about not infecting others. But people who don’t know they are infected can infect others without knowing it. Testing everyone in the recommended age group will decrease the number of people getting infected.

Where can I get the test?

Ask your healthcare provider for an HIV test or ask where you can get the test in your community. Many community health centers, family planning clinics, hospitals, STD clinics, and county health departments offer testing. You can call the CDC national 24-hour hotline at 1-800-232-4636 to find a testing center near you. Do not use donating blood as a way of being tested.

What do the test results mean?

In general, a positive HIV test means that you are infected with HIV, and a negative test means that you are not infected with HIV. It is possible to have a negative test if you have been just recently infected. In this case, the test will be positive if it is repeated several weeks or months later. If you have a negative test result but you are at high risk for infection, you may need to have another test in 3 to 6 months. If you are or were at high risk, however, you should talk to your healthcare provider about how often you should be retested. Also ask if it is possible to lower your risk.

If your first test is positive, a second test will be done to confirm that you are infected with the virus. If there are questions about your test results, your healthcare provider will tell you how soon you should be retested and what precautions you should take in the meantime.

How can I prevent giving HIV to others?

If you are infected with HIV, you should take these precautions to avoid spreading the virus to others:

• Avoid high-risk activities, such as unprotected sex and sharing needles. This is the best way to prevent spread of the virus.
• If you are sexually active, always practice safe sex. Don’t expose others to blood and sexual secretions during sex. This means:
  • Use a latex or polyurethane condom every time you have vaginal, oral, or anal intercourse. Be sure to use a condom during foreplay as well.
  • Avoid getting semen, other sexual secretions (such as vaginal secretions), or blood in cuts or in the eyes of your partners.
• Do not use a spermicide containing nonoxynol 9 and do not use condoms coated with this spermicide. Research has found that this chemical can irritate the lining of the vagina and rectum. These irritated areas make it easier for HIV to enter the body.
• If you use a lubricant during sex, use one that is water based. Do not use oil-based lubricants made with petroleum jelly, mineral oil, vegetable oil, or cold cream. They can damage the condom.
• Do not donate blood, plasma, or semen.
• Do not plan to donate organs from your body. If you were previously planning to donate organs, have that statement removed from your driver's license.
• Do not share or reuse IV needles and syringes. Do not self-inject drugs unless directed to do so by your healthcare provider. Do not share needles for tattooing or body piercing. Boiling does not guarantee sterility of needles or syringes.
• Do not use nitrate inhalants (poppers).
• Do not share razors, toothbrushes, or anything that could be contaminated with blood.
• Tell your healthcare providers that you are HIV positive.
• If you are a woman, discuss pregnancy with your healthcare provider before you get pregnant. HIV may be spread to a baby during pregnancy, birth, or breast-feeding. There is medicine you can take during pregnancy to make it less likely that the baby will be infected.

For more information about HIV and AIDS, contact your healthcare provider or the 24-hour CDC hotline at 1-800-232-4636. You can also visit the AIDSinfo Web site at http://aidsinfo.nih.gov.