1. What is HIV?
HIV (human immunodeficiency virus) is the virus that causes AIDS. This virus is passed from one person to another through blood-to-blood and sexual contact. In addition, infected pregnant women can pass HIV to their baby during pregnancy or delivery, as well as through breast-feeding. People with HIV have what is called HIV infection. Most of these people will develop AIDS as a result of their HIV infection.
These body fluids have been proven to spread HIV:
- vaginal fluid
- breast milk
- other body fluids containing blood
These are additional body fluids that may transmit the virus that health care workers may come into contact with:
- cerebrospinal fluid surrounding the brain and the spinal cord
- synovial fluid surrounding bone joints
- amniotic fluid surrounding a fetus
2. What is AIDS? What causes AIDS?
AIDS stands for acquired immunodeficiency syndrome. An HIV-infected person receives a diagnosis of AIDS after developing one of the CDC-defined AIDS indicator illnesses. An HIV-positive person who has not had any serious illnesses also can receive an AIDS diagnosis on the basis of certain blood tests (CD4+ counts).
A positive HIV test result does not mean that a person has AIDS. A diagnosis of AIDS is made by a physician using certain clinical criteria (e.g., AIDS indicator illnesses).
Infection with HIV can weaken the immune system to the point that it has difficulty fighting off certain infections. These types of infections are known as “opportunistic” infections because they take the opportunity a weakened immune system gives to cause illness.
Many of the infections that cause problems or may be life-threatening for people with AIDS are usually controlled by a healthy immune system. The immune system of a person with AIDS is weakened to the point that medical intervention may be necessary to prevent or treat serious illness.
Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS. As with other diseases, early detection offers more options for treatment and preventative care.
3. Where did HIV come from?
We do not know. Scientists have different theories about the origin of HIV, but none have been proven. The earliest known case of HIV was from a blood sample collected in 1959 from a man in Kinshasa, Democratic Republic of Congo. (How he became infected is not known.) Genetic analysis of this blood sample suggests that HIV-1 may have stemmed from a single virus in the late 1940s or early 1950s.
We do know that the virus has existed in the United States since at least the mid- to late 1970s. From 1979-1981 rare types of pneumonia, cancer, and other illnesses were being reported by doctors in Los Angeles and New York among a number of gay male patients. These were conditions not usually found in people with healthy immune systems.
In 1982 public health officials began to use the term “acquired immunodeficiency syndrome,” or AIDS, to describe the occurrences of opportunistic infections, Kaposi’s sarcoma, and Pneumocystis carinii pneumonia in previously healthy men. Formal tracking (surveillance) of AIDS cases began that year in the United States.
The cause of AIDS is a virus that scientists isolated in 1983. The virus was at first named HTLV-III/LAV (human T-cell lymphotropic virus-type III/lymphadenopathy- associated virus) by an international scientific committee. This name was later changed to HIV (human immunodeficiency virus).
4. How long does it take for HIV to cause AIDS?
Since 1992, scientists have estimated that about half the people with HIV develop AIDS within 10 years after becoming infected. This time varies greatly from person to person and can depend on many factors, including a person’s health status and their health-related behaviors.
Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS, though the treatments do not cure AIDS itself. As with other diseases, early detection offers more options for treatment and preventative health care.
5. How can I tell if I’m infected with HIV?
What are the symptoms?
The only way to determine for sure whether you are infected is to be tested for HIV infection. You cannot rely on symptoms to know whether or not you are infected with HIV. Many people who are infected with HIV do not have any symptoms at all for many years.
The following may be warning signs of infection with HIV:
- rapid weight loss
- dry cough
- recurring fever or profuse night sweats
- profound and unexplained fatigue
- swollen lymph glands in the armpits, groin, or neck
- diarrhea that lasts for more than a week
- white spots or unusual blemishes on the tongue, in the mouth, or in the throat
- red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
- memory loss, depression, and other neurological disorders
However, no one should assume they are infected if they have any of these symptoms. Each of these symptoms can be related to other illnesses. Again,the only way to determine whether you are infected is to be tested for HIV infection.
Similarly, you cannot rely on symptoms to establish that a person has AIDS. The symptoms of AIDS are similar to the symptoms of many other illnesses. AIDS is a medical diagnosis made by a doctor based on specific criteria established by the CDC.
6. Where can I get tested for HIV infection?
Many places provide testing for HIV infection. Common testing locations include local health departments, offices of private doctors, hospitals, and sites specifically set up to provide HIV testing.
It is important to seek testing at a place that also provides counseling about HIV and AIDS. Counselors can answer any questions you might have about risky behavior and ways you can protect yourself and others in the future. In addition, they can help you understand the meaning of the test results and describe what AIDS-related resources are available in the local area.
The CDC National AIDS Hotline can answer questions about testing and can refer you to testing sites in your area. The Hotline numbers are 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
Consumer-controlled test kits (popularly known as “home test kits”) were first licensed in 1997. Although home HIV tests are sometimes advertised through the Internet, currently only the Home Access test is approved by the Food and Drug Administration. (The accuracy of home test kits other than Home Access cannot be verified.) The Home Access test kit can be found at most local drug stores. The testing procedure involves pricking your finger with a special device, placing drops of blood on a specially treated card, then mailing the card in to be tested at a licensed laboratory. Customers are given an identification number to use when phoning for the test results. Callers may speak to a counselor before taking the test, while waiting for the test result, and when getting the result.
7. What are rapid HIV tests?
A rapid test for detecting antibody to human immunodeficiency virus (HIV) is a screening test that produces very quick results, in 30 minutes or less. In comparison, results from the commonly used HIV antibody screening test, the enzyme immunoassay (EIA), are not available for 1-2 weeks.
Two rapid HIV tests have been approved by the Food and Drug Administration (FDA) for use in the United States. OraQuick Rapid HIV-1 Antibody Test (OraSure Technologies, Inc., Bethlehem, Pennsylvania) was approved November 7, 2002, for use by trained personnel as a point-of-care test to aid in the diagnosis of HIV infection. OraQuick is a simple, rapid test that can detect antibodies to HIV in finger-stick whole-blood specimens and provide results in as little as 20 minutes. A second FDA-approved moderate-complexity rapid HIV test, Single Use Diagnostic System for HIV-1 (SUDS) (Murex-Abbott Inc., Norcross, Georgia), remains available in the United States for use with serum or plasma specimens and can produce results in 30 minutes or less. Both tests have been categorized as moderate complexity under the Clinical Laboratory Improvement Amendments of 1988. Both rapid tests are considered to be just as accurate as the EIA.
Both the rapid test and the EIA look for the presence of antibodies to HIV. As is true for all screening tests (including the EIA), a reactive rapid HIV test result must be confirmed before a final diagnosis of infection can be given.
8. Are there other tests available?
The EIA (enzyme immunoassay) is the standard screening test used to detect the presence of antibodies to HIV. The EIA should be used with a confirmatory test such as the Western blot. Tests that detect other signs of HIV are available for special purposes, such as for additional testing of the blood supply and conducting research. Because some tests are expensive or require sophisticated equipment and specialized training, their use is limited. In addition to the EIA, other tests now available include:
- Radioimmunoprecipitation assay (RIPA): A confirmatory blood test that may be used when antibody levels are very low or difficult to detect or when Western blot test results are uncertain. An expensive test, the RIPA requires time and expertise to perform.
- Rapid latex agglutination assay: A simplified, inexpensive blood test that may prove useful in medically disadvantaged areas where there is a high prevalence of HIV infection.
- Dot-blot immunobinding assay: A rapid-screening blood test that is cost-effective and that may become an alternative to conventional EIA and Western blot testing.
- p24 antigen capture assay: Also known as the HIV-1 antigen capture assay. This blood test was added as an interim measure by the Food and Drug Administration (FDA) in 1996 to HIV-antibody testing to protect the blood supply further until other tests become available to detect early HIV infection before antibodies are fully developed. Because some activity of p24 antigen is unpredictable, this test is not useful for helping people find out if they have HIV.
- Polymerase chain reaction (PCR): A specialized blood test that looks for HIV genetic information. Although expensive and labor-intensive, the test can detect the virus even in someone only recently infected. To further protect the blood supply, the FDA has indicated that the development and implementation of tests for HIV genetic material such as PCR is warranted.
The tests commonly used to detect HIV infection actually look for antibodies produced by your body to fight HIV. Most people will develop detectable antibodies within 3 months after infection, the average being 25 days. In rare cases, it can take up to 6 months.
The CDC National AIDS Hotline can provide more information and referrals to testing sites in your area. The Hotline numbers are 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
10. If I test HIV negative, does that mean that my partner is HIV negative also?
No. Your HIV test result reveals only your HIV status. Your negative test result does not tell you whether your partner has HIV.
HIV is not necessarily transmitted every time there is an exposure. Therefore, your taking an HIV test should not be seen as a method to find out if your partner is infected. Testing should never take the place of protecting yourself from HIV infection. If your behaviors are putting you at risk for exposure to HIV, it is important to reduce your risks.
11. What if I test positive for HIV?
If you test positive for HIV, the sooner you take steps to protect your health, the better. Early medical treatment and a healthy lifestyle can help you stay well. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. There are a number of important steps you can take immediately to protect your health:
- See a doctor, even if you do not feel sick. Try to find a doctor who has experience treating HIV. There are now many drugs to treat HIV infection and help you maintain your health. It is never too early to start thinking about treatment possibilities.
- Have a TB (tuberculosis) test done. You may be infected with TB and not know it. Undetected TB can cause serious illness, but it can be successfully treated if caught early.
- Smoking cigarettes, drinking too much alcohol, or using illegal drugs (such as cocaine) can weaken your immune system. There are programs available that can help you reduce or stop using these substances.
There is much you can do to stay healthy. Learn all that you can about maintaining good health.
Call the CDC National AIDS Hotline to get additional information, order publications, and obtain referrals to local, state, and national resources that may be useful to you. The Hotline numbers are 1-800-342-2437 (English), 1-800-344-7432 (Spanish), and 1-800-243-7889 (TTY).
You also can order publications and get referrals from the CDC National Prevention Information Network (operators of the National AIDS Clearinghouse) by calling 1-800-458-5231.
12. I’m HIV positive. Where can I get information about treatments?
CDC recommends that you be in the care of a doctor or medical service, ideally one with experience treating people living with HIV. Your doctor can provide information and guidance.
Detailed information on specific treatments is available from the Department of Health and Human Services’ AIDSinfo. Information on enrolling in clinical trials is also available at AIDSinfo. You may contact AIDSinfo by phone at 1-800-448-0440 (English and Spanish) or 1-888-480-3739 (TTY).
The CDC National AIDS Hotline can offer practical information on maintaining health and general information about a wide variety of treatments, including antiretrovirals and prophylaxis (preventive therapy) for opportunistic infections. The Hotline can also provide referrals to national treatment hotlines, local AIDS organizations, and HIV/AIDS-knowledgeable health care providers. The Hotline numbers are 1-800-342-2437 (English), 1-800-344-7432 (Spanish), and 1-800-243-7889 (TTY).
13. How many people have HIV & AIDS?
United States: The CDC estimates that in 1999 between 800,000 and 900,000 people were living with HIV or AIDS. Through December 2000, a total of 774,467 cases of AIDS had been reported to the CDC.
Worldwide: Based on estimates from the United Nations AIDS program (UNAIDS), approximately 60 million people have been infected with HIV since the start of the global epidemic. At the end of 2001, an estimated 40 million people were living with HIV infection or AIDS. At the end of 2010, the reported number is an estimated 35 million.
UNAIDS estimates 5.0 million new HIV infections occurred in 2001. This represents about 14,000 new cases per day. An estimated 3.0 million adults and children died of HIV/AIDS in 2001.
There are now medical therapies available to lower the chance of an HIV-infected pregnant woman passing HIV to her infant before, during, or after birth. ZDV (zidovudine, also known as AZT or Retrovir) is the only drug which has been proven to reduce perinatal transmission. In 1998, the U.S. Public Health Services released updated recommendations for offering antiretroviral therapy to HIV positive pregnant women. (Refer to MMWR January 30, 1998 – Vol.47-RR2)
HIV testing and counseling provides an opportunity for infected women to find out they are infected and to gain access to medical treatment that may help to delay disease progression. For women who are not infected, HIV counseling provides an opportunity to learn important prevention information to reduce the possibility of future exposures.
The U.S. blood supply is among the safest in the world. Nearly all people infected with HIV through blood transfusions received those transfusions before 1985, the year HIV testing began for all donated blood.
The Public Health Service has recommended an approach to blood safety in the United States that includes stringent donor selection practices and the use of screening tests. U.S. blood donations have been screened for antibodies to HIV-1 since March 1985 and HIV-2 since June 1992. Blood and blood products that test positive for HIV are safely discarded and are not used for transfusions.
An estimated 1 in 450,000 to 1 in 660,000 donations per year are infectious for HIV but are not detected by current antibody screening tests. In August 1995, the FDA recommended that all donated blood and plasma also be screened for HIV-1 p24 antigen. The improvement of processing methods for blood products also has reduced the number of infections resulting from the use of these products. Currently, the risk of infection with HIV in the United States through receiving a blood transfusion or blood products is extremely low and has become progressively lower, even in geographic areas with high HIV prevalence rates.
HIV transmission can occur when blood, semen (including pre-seminal fluid, or “pre-cum”), vaginal fluid, or breast milk from an infected person enters the body of an uninfected person.
HIV can enter the body through a vein (e.g., injection drug use), the anus or rectum, the vagina, the penis, the mouth, other mucous membranes (e.g., eyes or inside of the nose), or cuts and sores. Intact, healthy skin is an excellent barrier against HIV and other viruses and bacteria.
These are the most common ways that HIV is transmitted from one person to another:
- by having sexual intercourse (anal, vaginal, or oral sex) with an HIV-infected person
- by sharing needles or injection equipment with an injection drug user who is infected with HIV
- from HIV-infected women to babies before or during birth, or through breast-feeding after birth
HIV also can be transmitted through transfusions of infected blood or blood clotting factors. However, since 1985, all donated blood in the United States has been tested for HIV. Therefore, the risk of infection through transfusion of blood or blood products is extremely low. The U.S. blood supply is considered to be among the safest in the world. (For more information, see “How safe is the blood supply in the United States?“, question #15.)
Some health-care workers have become infected after being stuck with needles containing HIV-infected blood or, less frequently, after infected blood contact with the worker’s open cut or through splashes into the worker’s eyes or inside their nose. There has been only one instance of patients being infected by an HIV-infected health care worker. This involved HIV transmission from an infected dentist to six patients. (For more information, see “Are health care workers at risk of getting HIV on the job?” and “Are patients in a dentist’s or doctor’s office at risk of getting HIV?“), questions #28 and #29.
HIV is not casually transmitted, so kissing on the cheek is very safe. Even if the other person has the virus, your unbroken skin is a good barrier. No one has become infected from such ordinary social contact as dry kisses, hugs, and handshakes.
Open-mouth kissing is considered a very low-risk activity for the transmission of HIV. However, prolonged open-mouth kissing could damage the mouth or lips and allow HIV to pass from an infected person to a partner and then enter the body through cuts or sores in the mouth. Because of this possible risk, the CDC recommends against open-mouth kissing with an infected partner.
One case suggests that a woman became infected with HIV from her sex partner through exposure to contaminated blood during open-mouth kissing. The July 11, 1997, Morbidity and Mortality Weekly Report contains an article on this case.
Yes, it is possible for you to become infected with HIV through performing oral sex. There have been a few cases of HIV transmission from performing oral sex on a person infected with HIV. While no one knows exactly what the degree of risk is, evidence suggests that the risk is less than that of unprotected anal or vaginal sex.
Blood, semen, pre-seminal fluid, and vaginal fluid all may contain the virus. Cells in the mucous lining of the mouth may carry HIV into the lymph nodes or the bloodstream. The risk increases
- if you have cuts or sores around or in your mouth or throat;
- if your partner ejaculates in your mouth; or
- if your partner has another sexually transmitted disease (STD).
If you choose to have oral sex, and your partner is male,
- use a latex condom on the penis; or
- if you or your partner is allergic to latex, plastic (polyurethane) condoms can be used.
Research has shown the effectiveness of latex condoms used on the penis to prevent the transmission of HIV. Condoms are not risk-free, but they greatly reduce your risk of becoming HIV-infected if your partner has the virus.
If you choose to have oral sex, and your partner is female,
- use a latex barrier (such as a dental dam or a cut-open condom that makes a square) between your mouth and the vagina. Plastic food wrap also can be used as a barrier.
The barrier reduces the risk of blood or vaginal fluids entering your mouth. For more information about latex condoms, female condoms, and plastic (polyurethane) condoms, see “Facts about Condoms and Their Use in Preventing HIV Infection.”
If you have additional questions or are concerned about personal behaviors that may have put you at risk, call the CDC National AIDS Hotline at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
Yes, it is possible for you to become infected with HIV through receiving oral sex. If your partner has HIV, blood from their mouth may enter the urethra (the opening at the tip of the penis), the vagina, the anus, or directly into the body through small cuts or open sores. While no one knows exactly what the degree of risk is, evidence suggests that the risk is less than that of unprotected anal or vaginal sex.
If you choose to have oral sex,
- use a latex condom on the penis; or
- if you or your partner is allergic to latex, a plastic (polyurethane) condom can be used.
Research has shown the effectiveness of latex condoms used on the penis for preventing the transmission of HIV. Condoms are not risk-free, but they greatly reduce your risk of becoming HIV-infected if your partner has the virus.
If you choose to have oral sex and you are female,
- use a latex barrier (such as a cut-open condom that makes a square or a dental dam) between their mouth and the vagina. Plastic food wrap can also be used as a barrier.
The barrier reduces the risk of blood entering the body through the vagina. For more information about latex condoms, female condoms, and plastic (polyurethane) condoms, see “Facts about Condoms and Their Use in Preventing HIV Infection.”
If you have additional questions or are concerned about personal behaviors, call the CDC National AIDS Hotline at 1-800-343-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
Yes, it is possible to become infected with HIV through vaginal intercourse. In fact, it is the most common way the virus is transmitted in much of the world. HIV can be found in the blood, semen, pre-seminal fluid, or vaginal fluid of a person infected with the virus. The lining of the vagina can tear and possibly allow HIV to enter the body. Direct absorption of HIV through the mucous membranes that line the vagina also is a possibility.
The male may be at less risk for HIV transmission than the female through vaginal intercourse. However, HIV can enter the body of the male through his urethra (the opening at the tip of the penis) or through small cuts or open sores on the penis.
Risk for HIV infection increases if you or a partner has a sexually transmitted disease (STD). See also “Is there a connection between HIV and other sexually transmitted diseases?”, question #24.
If you choose to have vaginal intercourse, use a latex condom to help protect both you and your partner from the risk of HIV and other STDs. Studies have shown that latex condoms are very effective, though not perfect, in preventing HIV transmission when used correctly and consistently. If either partner is allergic to latex, plastic (polyurethane) condoms for either the male or female can be used.
For more information on latex condoms, the female condom, and plastic (polyurethane) condoms, see “Facts about Condoms and Their Use in Preventing HIV Infection.”
If you have additional questions or are concerned about personal behaviors, call the CDC National AIDS Hotline at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
Yes, it is possible for either sex partner to become infected with HIV during anal sex. HIV can be found in the blood, semen, pre-seminal fluid, or vaginal fluid of a person infected with the virus. In general, the person receiving the semen is at greater risk of getting HIV because the lining of the rectum is thin and may allow the virus to enter the body during anal sex. However, a person who inserts his penis into an infected partner also is at risk because HIV can enter through the urethra (the opening at the tip of the penis) or through small cuts, abrasions, or open sores on the penis.
Having unprotected (without a condom) anal sex is considered to be a very risky behavior. If people choose to have anal sex, they should use a latex condom. Most of the time, condoms work well. However, condoms are more likely to break during anal sex than during vaginal sex. Thus, even with a condom, anal sex can be risky. A person should use a water-based lubricant in addition to the condom to reduce the chances of the condom breaking.
For more information on latex condoms, see “Facts about Condoms and Their Use in Preventing HIV Infection.”
If you would like more information or have personal concerns, call the CDC National AIDS Hotline at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
Studies have shown that latex condoms are highly effective in preventing HIV transmission when used consistently and correctly. These studies looked at uninfected people considered to be at very high risk of infection because they were involved in sexual relationships with HIV-infected people. The studies found that even with repeated sexual contact, 98-100 percent of those people who used latex condoms correctly and consistently did not become infected.
For more information on latex condoms and on the female condom and plastic (polyurethane) condoms, see “Male Latex Condoms and Sexually Transmitted Diseases”.
If you have other questions about condoms or reducing risks for HIV, call the CDC National AIDS Hotline at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
Yes. Having a sexually transmitted disease (STD) can increase a person’s risk of becoming infected with HIV, whether the STD causes open sores or breaks in the skin (e.g., syphilis, herpes, chancroid) or does not cause breaks in the skin (e.g., chlamydia, gonorrhea).
If the STD infection causes irritation of the skin, breaks or sores may make it easier for HIV to enter the body during sexual contact. Even when the STD causes no breaks or open sores, the infection can stimulate an immune response in the genital area that can make HIV transmission more likely.
In addition, if an HIV-infected person also is infected with another STD, that person is three to five times more likely than other HIV-infected persons to transmit HIV through sexual contact.
Not having (abstaining from) sexual intercourse is the most effective way to avoid STDs, including HIV. For those who choose to be sexually active, the following HIV prevention activities are highly effective:
- Engaging in sex that does not involve vaginal, anal, or oral sex
- Having intercourse with only one uninfected partner
- Using latex condoms every time you have sex
For more information on latex condoms, the female condom, and plastic (polyurethane) condoms, see “Facts about Condoms and Their Use in Preventing HIV Infection.“
For more information about the connection between HIV and other STDs, see “The Role of STD Testing and Treatment in HIV Prevention.”
If you have additional questions about STDs, or have personal concerns, call the CDC National STD Hotline at 1-800-227-8922.
At the start of every intravenous injection, blood is introduced into needles and syringes. HIV can be found in the blood of a person infected with the virus. The reuse of a blood-contaminated needle or syringe by another drug injector (sometimes called “direct syringe sharing”) carries a high risk of HIV transmission because infected blood can be injected directly into the bloodstream.
In addition, sharing drug equipment (or “works”) can be a risk for spreading HIV. Infected blood can be introduced into drug solutions by
- using blood-contaminated syringes to prepare drugs;
- reusing water;
- reusing bottle caps, spoons, or other containers (“spoons” and “cookers”) used to dissolve drugs in water and to heat drug solutions; or
- reusing small pieces of cotton or cigarette filters (“cottons”) used to filter out particles that could block the needle.
“Street sellers” of syringes may repackage used syringes and sell them as sterile syringes. For this reason, people who continue to inject drugs should obtain syringes from reliable sources of sterile syringes, such as pharmacies. It is important to know that sharing a needle or syringe for any use, including skin popping and injecting steroids, can put one at risk for HIV and other blood-borne infections.
The CDC recommends that people who inject drugs should be regularly counseled to
- stop using and injecting drugs.
- enter and complete substance abuse treatment, including relapse prevention.
For injection drug users who cannot or will not stop injecting drugs, the following steps may be taken to reduce personal and public health risks:
- Never reuse or “share” syringes, water, or drug preparation equipment.
- Only use syringes obtained from a reliable source (such as pharmacies or needle exchange programs).
- Use a new, sterile syringe to prepare and inject drugs.
- If possible, use sterile water to prepare drugs; otherwise, use clean water from a reliable source (such as fresh tap water).
- Use a new or disinfected container (“cooker”) and a new filter (“cotton”) to prepare drugs.
- Clean the injection site prior to injection with a new alcohol swab.
- Safely dispose of syringes after one use.
If new, sterile syringes and other drug preparation and injection equipment are not available, then previously used equipment should be boiled in water or disinfected with bleach before reuse. More information on reducing HIV risks associated with drug infection is contained in the “HIV Prevention Bulletin: Medical Advice For Persons Who Inject Illicit Drugs” (May 9, 1997).
Injection drug users and their sex partners also should take precautions, such as using condoms consistently and correctly, to reduce risks of sexual transmission of HIV. For more information on condoms, see “Facts about Condoms and Their Use in Preventing HIV Infection.”
Persons who continue to inject drugs should periodically be tested for HIV.
A risk of HIV transmission does exist if instruments contaminated with blood are either not sterilized or disinfected or are used inappropriately between clients. CDC recommends that instruments that are intended to penetrate the skin be used once, then disposed of or thoroughly cleaned and sterilized.
Personal service workers who do tattooing or body piercing should be educated about how HIV is transmitted and take precautions to prevent transmission of HIV and other blood-borne infections in their settings. If you are considering getting a tattoo or having your body pierced, ask staff at the establishment what procedures they use to prevent the spread of HIV and other blood-borne infections, such as hepatitis B virus. You also may call the local health department to find out what sterilization procedures are in place in the local area for these types of establishments.
The risk of health care workers getting HIV on the job is very low, especially if they carefully follow universal precautions (i.e., using protective practices and personal protective equipment to prevent HIV and other blood-borne infections). It is important to remember that casual, everyday contact with an HIV-infected person does not expose health care workers or anyone else to HIV. For health care workers on the job, the main risk of HIV transmission is through accidental injuries from needles and other sharp instruments that may be contaminated with the virus. Even this risk is small, however. Scientists estimate that the risk of infection from a needle jab is less than 1 percent, a figure based on the findings of several studies of health care workers who received punctures from HIV-contaminated needles or were otherwise exposed to HIV-contaminated blood.
For more information on universal precautions or occupational risks of HIV exposure, call the CDC National Prevention Information Network (operators of the National AIDS Clearinghouse) at 1-800-458-5231.
Although HIV transmission is possible in health care settings, it is extremely rare. Medical experts emphasize that the careful practice of infection control procedures, including universal precautions, protects patients as well as health care providers from possible HIV infection in medical and dental offices.
In 1990, the CDC reported on an HIV-infected dentist in Florida who apparently infected some of his patients while doing dental work. Studies of viral DNA sequences linked the dentist to six of his patients who were also HIV-infected. The CDC has as yet been unable to establish how the transmission took place.
Further studies of more than 22,000 patients of 63 health care providers who were HIV-infected have found no further evidence of transmission from provider to patient in health care settings.
For more information on universal precautions or occupational risks of HIV exposure, call the CDC National Prevention Information Network (operators of the National AIDS Clearinghouse) at 1-800-458-5231.
30. Should I be concerned about getting infected with HIV while playing sports?
There are no documented cases of HIV being transmitted during participation in sports. The very low risk of transmission during sports participation would involve sports with direct body contact in which bleeding might be expected to occur.
If someone is bleeding, their participation in the sport should be interrupted until the wound stops bleeding and is both antiseptically cleaned and securely bandaged. There is no risk of HIV transmission through sports activities where bleeding does not occur.
31. Can I get HIV from casual contact (shaking hands, hugging, using a toilet, drinking from the same glass, or the sneezing and coughing of an infected person)?
No. HIV is not transmitted by day-to-day contact in the workplace, schools, or social settings. HIV is not transmitted through shaking hands, hugging, or a casual kiss. You cannot become infected from a toilet seat, a drinking fountain, a door knob, dishes, drinking glasses, food, or pets.
A small number of cases of transmission have been reported in which a person became infected with HIV as a result of contact with blood or other body secretions from an HIV-infected person in the household. Although contact with blood and other body substances can occur in households, transmission of HIV is rare in this setting. However, persons infected with HIV and persons providing home care for those who are HIV-infected should be fully educated and trained regarding appropriate infection-control techniques.
HIV is not an airborne or food-borne virus, and it does not live long outside the body. HIV can be found in the blood, semen, or vaginal fluid of an infected person. The three main ways HIV is transmitted are
- through having sex (anal, vaginal, or oral) with someone infected with HIV.
- through sharing needles and syringes with someone who has HIV.
- through exposure (in the case of infants) to HIV before or during birth, or through breast feeding.
For more information about HIV transmission, see “Facts about the Human Immunodeficiency Virus and Its Transmission.”
For more information about providing home care or living with a person who is HIV-infected, call the CDC National Prevention Information Network (operators of the National AIDS Clearinghouse) at 1-800-458-5231 and ask for the publication “Caring for Someone with AIDS: Information for Friends, Relatives, Household Members, and Others Who Care for a Person With AIDS at Home.”
32. Can I get infected with HIV from mosquitoes?
No. From the start of the HIV epidemic there has been concern about HIV transmission of the virus by biting and bloodsucking insects, such as mosquitoes. However, studies conducted by the CDC and elsewhere have shown no evidence of HIV transmission through mosquitoes or any other insects — even in areas where there are many cases of AIDS and large populations of mosquitoes. Lack of such outbreaks, despite intense efforts to detect them, supports the conclusion that HIV is not transmitted by insects.
The results of experiments and observations of insect biting behavior indicate that when an insect bites a person, it does not inject its own or a previously bitten person’s or animal’s blood into the next person bitten. Rather, it injects saliva, which acts as a lubricant so the insect can feed efficiently. Diseases such as yellow fever and malaria are transmitted through the saliva of specific species of mosquitoes. However, HIV lives for only a short time inside an insect and, unlike organisms that are transmitted via insect bites, HIV does not reproduce (and does not survive) in insects. Thus, even if the virus enters a mosquito or another insect, the insect does not become infected and cannot transmit HIV to the next human it bites.
There also is no reason to fear that a mosquito or other insect could transmit HIV from one person to another through HIV-infected blood left on its mouth parts. Several reasons help explain why this is so. First, infected people do not have constantly high levels of HIV in their blood streams. Second, insect mouth parts retain only very small amounts of blood on their surfaces. Finally, scientists who study insects have determined that biting insects normally do not travel from one person to the next immediately after ingesting blood. Rather, they fly to a resting place to digest the blood meal.