Table of ContentsView AllTable of ContentsCausesSex Risk FactorsInjecting Drug UsePregnancyNeedlestick InjuriesBlood TransfusionsFrequently Asked QuestionsNext in HIV/AIDS GuideWhat Tests Can Diagnose HIV?
Table of ContentsView All
View All
Table of Contents
Causes
Sex Risk Factors
Injecting Drug Use
Pregnancy
Needlestick Injuries
Blood Transfusions
Frequently Asked Questions
Next in HIV/AIDS Guide
This article is part ofHealth Divide: HIV, a destination in our Health Divide series.
HIV (human immunodeficiency virus)is a virus that can be passed from one person to the next through body fluids like semen, blood, vaginal secretions, and breast milk. HIV is most often transmitted during sex but can also be passed through shared needles. HIV can also be transmitted from the carrying parent to child during pregnancy, childbirth, or whilebreastfeeding.
Unlikely routes of transmission include blood transfusions, tattooing, and body piercing.
Other factors can increase the risk of transmission. Some of which are specific to certain groups because social factors, like discrimination andstigma, uniquely position them to be more likely to test HIV positive. These groups include Black people, Latinx people, trans people (especially trans women),men who have sex with men (MSM), and injecting drug users.
Witthaya Prasongsin / Getty Images
By progressively targeting and killing these cells, the body becomes less and less able to fight infections that it would otherwise be able to defend itself against.
When the immune defenses are compromised, serious and potentially life-threateningopportunistic infectionscan develop. This is the stage of infection commonly known asAIDS (acquired immune deficiency syndrome).
Even though HIV is transmitted through body fluids, not all body fluids are capable of transmitting the virus. Some fluids like saliva and urine contain high levels of enzymes or acids that prevent HIV from thriving. Once outside of the body, the virus isunable to survive for very long(and usually not at levels where transmission is likely).
Moreover, the virus must come in contact withmucosal tissues(such as found in the rectum or vagina) or enter the body through broken skin—and in sufficient quantities—to establish an infection.
HIV can be transmitted via:BloodSemenVaginal fluidsRectal secretionsBreast milkHIV is not transmitted via:SalivaSweatTearsShared utensilsToilet seatsPool or bath waterMosquito bites
HIV can be transmitted via:BloodSemenVaginal fluidsRectal secretionsBreast milk
Blood
Semen
Vaginal fluids
Rectal secretions
Breast milk
HIV is not transmitted via:SalivaSweatTearsShared utensilsToilet seatsPool or bath waterMosquito bites
Saliva
Sweat
Tears
Shared utensils
Toilet seats
Pool or bath water
Mosquito bites
Can You Get a Tattoo While Pregnant?
Sexual Risk Factors
According to the Centers for Disease Control and Prevention (CDC), the per-act risk of HIV from sex is as follows:
Risk of HIV From Bareback Sex
Additional Risk Factors
These per-act statistics may make it seem as if your general risk of HIV is extremely low, but they don’t paint the complete picture. Other risk factors can amplify the risk, sometimes dramatically.
Among the risk factors to consider:
Signs and Symptoms of HIV in Women
The sharing of needles, syringes, and other drug paraphernalia is an effective way to pass HIV from one person to the next. The transmission of the virus is especially high when a person has a high viral load.Other practices such as “booting” or “kicking” (in which blood is drawn into the syringe and then injected) further amplify the risk.
According to the CDC, the risk of HIV from sharing needles is 63 per 10,000 exposures (0.63%).In certain countries, like Russia, injecting drug use is the predominant mode of HIV transmission, not sex.
Even beyond exposure to HIV-contaminated blood, people who are under the influence of drugs are more likely to engage in risky sexual behaviors, including unprotected sex, sex with multiple partners, or trading sex for money or drugs.
HIV and Injecting Drug Use in MSM and Trans Women
Why Gay Men Have an Increased Risk of HIV
Pregnancy and Breastfeeding
In the United States, birthing parent-to-child transmission of HIV is rare, thanks to routine prenatal screening and the use of antiretroviral drugs which can reduce the risk of transmission to less than 1%.Even if a birthing parent arrives at the hospital with no prior prenatal care, an intravenous infusion of antiretroviral drugs used in combination with a cesarean section can greatly reduce the risk of transmission.
In the United States, parents are advised not to breastfeed if they have HIV and to bottle-feed instead.In developing countries, the benefits of exclusive breastfeeding (in terms of nutrition and the building of immunity) are seen to outweigh the risks in resource-poor communities.
In 2014, only 33 reported cases of birthing parent-to-child transmission of HIV were reported in the United States.
Pregnancy Risks Among Black Women With HIVDespite the low number of mother-to-child transmissions in the United States, the risk among Black women is eight times greater than in White women and seven times greater than in Latinx women.Moreover, 62% of children living with HIV are born to Black mothers with HIV.
Pregnancy Risks Among Black Women With HIV
Despite the low number of mother-to-child transmissions in the United States, the risk among Black women is eight times greater than in White women and seven times greater than in Latinx women.Moreover, 62% of children living with HIV are born to Black mothers with HIV.
Needlestick injuries(sometimes referred to as sharps injuries) can expose a person to tainted blood or body fluids. The risk is of concern for doctors, nurses, and other healthcare workers who are vulnerable to blood-borne infections from patients.
Even so, the CDC suggests that the risk is low due touniversal precautionsthat are designed to reduce the risk of disease transmission to healthcare workers. Today, the per-incidence risk of HIV from a needlestick injury is roughly 0.23%.
What Is Considered an Open Wound for HIV Transmission?
In fact, according to the CDC, there were only three confirmed cases of HIV out of an estimated 2.5 million blood transfusions from 1999 to 2013.
Similarly, state regulations governing the licensing of tattoo and piercing parlors have also made these procedures unlikely causes of HIV. To date, there are no documented cases of HIV transmission from eithertattooing or body piercing. The CDC considers the risk negligible.
A Word From Verywell
Understanding the causes and risk factors of HIV can help you develop strategies to protect yourself whether you have HIV or don’t. This first step is getting diagnosed and knowing your HIV status.
Most people get HIV through sex, namely vaginal or anal sex. HIV can also be passed through shared needles or needlestick injuries in healthcare settings. Mothers with HIV can pass the virus to their babies during pregnancy(although this is less common in the United States due to the routinetestingandtreatmentof mothers during perinatal care).
You cannot get HIV from kissing, touching, hugging, toilet seats, shared utensils, or mosquito bites.In the past, there was a risk of getting HIV from a blood transfusion, but this rarely occurs in the United States due to routine blood screening.Tattooing and piercing can theoretically transmit HIV, but there has yet to be a documented case of this occurring in the United States.
The risk of getting HIV is higher for:People who engage in sex without condomsPeople with multiple sex partnersInjecting drug users who share needlesBlack and Latinx peopleTrans people, especially trans womenMen who have sex with men (MSM)Having sex with someone who shares needles or has multiple sex partnersHaving another sexually transmitted infection (STI)
The risk of getting HIV is higher for:
Theoretically, you can, but there are few documented cases of this occurring. This is partly because the environment in the mouth is hostile to the virus and the tissues of the mouth aren’t as susceptible as some other areas of the body.Even so, other STIs can be passed through oral sex, but they may be avoided withcondomsordental dams.
There are multiple factors that contribute to this. Transphobia, homophobia, and HIV stigma contribute to high rates of denial, secrecy, and depression. This, in turn, increases the risk of substance or alcohol abuse and risk-taking behaviors. Black people also experience higher rates of criminalization and homelessness in comparison to the general population. These factors are additive and result in a higher likelihood of testing positive for HIV in one’s lifetime. The extreme vulnerability of rectal tissues and smaller gay and trans sexual networks due to the reasons stated above also contribute.
How HIV/AIDS Is Diagnosed
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