HIV/AIDS: Risk Factors and Prevention of Transmission

What is AIDS?

AIDS (acquired immunodeficiency syndrome) is a preventable, life-threatening illness caused by infection with the human immunodeficiency virus (HIV). With time, infection with HIV causes you to lose your ability to fight off serious infections. When this happens, HIV infection becomes AIDS.

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 has been found in blood and 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. Anal intercourse and sex with numerous partners especially increase the risk of getting AIDS. People close to you are not at increased risk if they do not have sexual contact with you or contact with your blood.

HIV can also be spread to babies when they are born to a mother infected with HIV or 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. In North America 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 contracting HIV infection and possible development of AIDS:

• sexually active homosexual men
• bisexual men and their male and female partners
• IV drug users and their sexual partners
• people who share needles (for IV drug use, tattooing, or piercing)
• heterosexual men and women with more than one sexual partner
• people given transfusions of blood or blood products in countries where the blood is not rigorously tested
• 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.

Even though gay and bisexual men are at highest risk for HIV infection, the number of HIV and AIDS cases among women is rising. In 2004 25% of all new HIV/AIDS cases diagnosed were women. Women of color are most likely to be infected with HIV/AIDS. In 2004 (the most recent year for which data are available), HIV infection was

• the leading cause of death for black women (including African American women) aged 25 to 34 years
• the 4th leading cause of death for Hispanic women aged 35 to 44 years.

The only diseases causing more deaths of women were cancer and heart disease.

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 become pregnant (in this case testing is especially important to prevent HIV in the baby (it's best to be tested before pregnancy, but getting tested during pregnancy is better than not being tested at all).

Where can I get the test?

Ask your healthcare provider where you can get the test. Many community health centers, family planning clinics, hospitals, STD clinics, and county health departments offer testing. Call the Centers for Disease Control (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?

If your test is negative, it means you have not been infected with the AIDS virus before 2 to 6 months ago. As long as you do not engage in any high-risk activity and always practice safe sex, you have almost no risk of becoming HIV-infected and developing AIDS. If you are or were at high risk, however, you should discuss with your healthcare provider how often you should be retested.

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:

• Avoiding sexual and other high-risk activities, such as sharing needles, is the best way to prevent spread of the virus. People with HIV can give the virus to others before they know they are infected. Safe sex should always be practiced to help prevent the spread of infection.
• If you are sexually active, you should engage only in safe sex. Avoid exposing others to blood and sexual secretions during sex. This means:
  • Avoid vaginal, oral, and anal intercourse unless latex or polyurethane condoms are used. Be sure to use condoms during foreplay as well.
  • Avoid getting semen, other sexual secretions (such as vaginal secretions), or blood in cuts or in the eyes.
• Do not use a spermicide containing nonoxynol 9 and do not use condoms coated with this spermicide. Research has found that nonoxynol 9 can irritate the lining of the vagina and rectum. These irritated areas make it easier for the HIV to enter the body.
• Do not donate blood, plasma, or semen.
• Do not plan to donate organs, such as corneas. (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 body fluids or blood.
• Tell your healthcare providers that you are HIV positive.
• If you work in a dental, medical, or other healthcare profession and perform invasive procedures or have skin sores, use latex gloves to protect patients from risk of infection.
• Get medical checkups as often as your healthcare provider recommends it or sooner if you have new symptoms that suggest AIDS.
• If you are a woman, discuss pregnancy with your healthcare provider. HIV may be spread to a baby during pregnancy, delivery, or breast-feeding. (Taking the medicine zidovudine (AZT) during pregnancy makes it less likely that the baby will be infected.)

How can I practice safe sex by using condoms?

• Use a latex or polyurethane condom every time you have intercourse or any other intimate genital activity.
• Put the condom on after the penis is erect but before it touches your partner.
• Put the condom on the head of the penis and unroll or pull it all the way to the base of the penis.
• Leave an empty space at the end of the condom to collect semen. Remove any air remaining in the tip of the condom by gently pressing the air out toward the base of the penis.
• If you use a lubricant, 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.
• After ejaculation, carefully withdraw the penis while it is still erect. Hold onto the rim of the condom as you withdraw so the condom doesn't slip off. Dispose of it so that others will not be in contact with the secretions.
• Store new condoms in a cool, dark, dry place.
• If a condom appears sticky, brittle, discolored, or obviously damaged, don't use it.
• Use each condom only once.

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.