FAQs

Transmission

• How Is HIV Transmitted?

Unprotected sex is the most common way people get infected with HIV in the U.S., followed by sharing needles.

Unprotected sexual contact:

HIV is primarily spread through unprotected sexual contact – vaginal, anal or oral sex. The chances of getting or passing HIV from oral sex are lower than vaginal or anal sex, but there is still a risk. Certain bodily fluids that can be shared during unprotected sex, such as pre-semen, semen, vaginal fluids or blood (including menstrual blood), can contain the virus.

In the genitals and the rectum, HIV may infect the mucous membranes directly or enter through cuts and sores caused during sexual intercourse. Vaginal and anal intercourse is a high-risk practice.

The mouth is an inhospitable environment for HIV (in semen, vaginal fluid or blood), meaning the risk of HIV transmission through the throat, gums and oral membranes is lower than through vaginal or anal membranes. HIV can be transmitted from pre-semen or semen coming into contact with oral problems, such as open sores or bleeding gums. Oral sex (mouth-penis or mouth-vagina) is considered a low-risk practice.

Direct blood contact:

Sharing injection drug needles, blood transfusions, accidents in health care settings or certain blood products may transmit the HIV virus. An injection needle can pass blood directly from one person’s bloodstream to another. It is a very efficient way to transmit a blood-borne virus. Sharing needles is considered a high-risk practice.

Mother-to-baby:

Women who are HIV positive can pass HIV to their babies before or during delivery or through breastfeeding after birth. While small amounts of breast milk do not pose significant threat of infection to adults, it is a viable means of transmission to infants. There are medications that can greatly reduce the chance of an HIV-positive mother passing HIV to her baby.

• Which Bodily Fluids Are Not Infectious?

Saliva, tears or sweat have never been shown to cause an HIV infection. Feces and urine also are not infectious.

• Can I Get HIV From Kissing?

Closed-mouth or “social” kissing is not a risk for transmission of HIV. Deep, open-mouth kissing if both partners have sores or bleeding gums and blood from the HIV-positive partner gets into the bloodstream of the HIV-negative partner. HIV is not spread through saliva.

• Can I Get HIV From Casual Contact?

No. HIV is not transmitted by day-to-day contact in the home, the workplace, schools or social settings. HIV is not transmitted through shaking or holding hands, sitting on toilet seats, hugs, casual kisses, drinking fountains, doorknobs, dishes, drinking glasses, food or pets. HIV is a fragile virus that does not live long outside the body. HIV is not an airborne or food-borne virus.

• Who Is At Risk For HIV Infection?

Often, people do not think of themselves or their partners as being at risk, so they do not worry about using protection or getting tested. But anyone who has had unprotected sex, used injected drugs or has a partner who has done either of these things may be at risk. The CDC estimates that one in five people who are HIV positive do not know it. For more information on HIV infections in Florida, visit the Florida Department of Health at http://www.floridahealth.gov/.

• Will I Be Tested For HIV If I Donate Blood?

When you donate blood, it is tested for HIV and other infections to make sure it is safe for others to receive. This kind of testing is why the blood supply of the U.S. and other developed countries is so safe. Any blood found to be unhealthy in some way is not used. Also, you cannot get infected with HIV from donating blood. If you want to be sure of your HIV status, the best way to find out is not by donating blood but by getting an HIV test. The results from HIV testing are timelier and a provider can link you to the right kind of care and resources if you do test positive.

• How Long After A Possible HIV Exposure Should I Be Tested?

The time it takes for a person who has been infected with HIV to seroconvert (test reactive) for HIV antibodies is commonly called the “window period”. The three-month window period is normal for approximately 95% of the population. The CDC has said that in some rare cases, it may take up to six months for one to seroconvert. If you feel any anxiety about relying on the three-month result, by all means you should have another test at six months.

• How Long Can HIV Survive Outside The Human Body?

The HIV virus is very fragile outside the body, but it can live for a short time depending on the situation and environmental factors. The potency of the virus outside the body diminishes over time. Most household cleaners such as soap, bleach or peroxide will kill it. When cleaning any blood spills, use universal precautions, including wearing latex gloves. To be completely safe, toothbrushes and shaving equipment, which may contain small particles of blood, should not be shared.

• When Do I Know For Sure That I Am Not Infected With HIV?

The tests commonly used to determine HIV infection look for antibodies produced by the body to fight HIV. According to the CDC, most people will develop detectable antibodies within three months after infection. In rare cases, it can take up to six months. The CDC recommends testing at 6 months after the last possible exposure (unprotected vaginal, anal or oral sex or sharing injecting drug needles). It would be extremely rare to take longer than six months to develop detectable antibodies. It is important, during the six months between exposure and the six-month test, to protect yourself and others from further exposures to HIV.

• Can I Get HIV From Getting A Tattoo Or Body Piercing?

There are no known cases in the United States of anyone getting HIV this way. However, it is possible to get HIV from a reused or not properly sterilized tattoo or piercing needle or other equipment, or from contaminated ink. It’s possible to get HIV from tattooing or body piercing if the equipment used for these procedures has someone else’s blood in it or if the ink is shared. The risk of getting HIV this way is very low, but the risk increases when the person doing the procedure is unlicensed, because of the potential for unsanitary practices such as sharing needles or ink. If you get a tattoo or a body piercing, be sure that the person doing the procedure is properly licensed and that they use only new or sterilized needles, ink and other supplies.

• Does My HIV-Positive Partner’s Viral Load Affect My Risk of Getting HIV?

Yes, as an HIV-positive person’s viral load goes down, the chance of transmitting HIV goes down. Viral load is the amount of HIV in the blood of someone who is HIV-positive. When the viral load is very low, it is called viral suppression. Undetectable viral load is when the amount of HIV in the blood is so low that it cannot be measured.

In general, the higher someone’s viral load, the more likely that person is to transmit HIV. People who have HIV but are in care, taking HIV medicines and have a very low or undetectable viral load are much less likely to transmit HIV than people who have HIV and do not have a low viral load.

However, a person with HIV can still potentially transmit HIV to a partner even if they have an undetectable viral load, because

  • HIV may still be found in genital fluids (semen, vaginal fluids). The viral load test only measures virus in blood.
  • A person’s viral load may go up between tests. When this happens, they may be more likely to transmit HIV to partners.
  • Sexually transmitted diseases increase viral load in genital fluids.

If you are HIV-positive, getting into care and taking HIV medicines (called antiretroviral therapy or ART) the right way, every day will give you the greatest chance to get and stay virally suppressed, live a longer, healthier life and reduce the chance of transmitting HIV to your partners.

If you are HIV-negative and have an HIV-positive partner, encourage your partner to get into care and take HIV treatment medicines.

Taking other actions, like using a condom the right way every time you have sex or taking daily medicine to prevent HIV (called pre-exposure prophylaxis(http://www.cdc.gov/hiv/risk/prep/index.html) or PrEP) if you’re HIV-negative, can lower your chances of transmitting or getting HIV even more.