HIV Transmission

What's the Problem?

The human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). There is still no cure for AIDS, and an estimated 40,000 Americans contract HIV every year. With recent advances in treatment, more people with HIV and AIDS are living longer. However, as a result of these recent advances, a sense of complacency has developed among some individuals at risk for acquiring HIV. There is still a tremendous need for HIV prevention efforts aimed at reducing risky behaviors and preventing infection with the virus, as well as a need for prevention efforts that help those living with HIV reduce risky behaviors to prevent transmission to others.

Who's at Risk?

Anyone who engages in risky behaviors is at risk for contracting HIV. Risk behaviors include having unprotected sex with multiple partners and sharing injecting-drug equipment and needles. HIV may be passed from one person to another when infected blood, semen or vaginal secretions come in contact with a person's broken skin or mucous membranes (a mucous membrane is wet, thin tissue found in the mouth, eyes, nose, vagina, rectum and opening of the penis).

Can It Be Prevented?

HIV transmission can be prevented by eliminating risky behaviors. To prevent HIV transmission, an individual should:

• avoid unprotected sex with individuals who are living with HIV or who do not know their HIV status (i.e. whether they are HIV positive or HIV negative),
• use condoms with partners during every sex act,
• practice monogamy (i.e. partners do not have sex with anyone but each other) or abstain from sex entirely, and
• avoid sharing injection drug equipment.

However, there are barriers to learning HIV status and reducing risky behaviors, such as homophobia, social stigma, lack of awareness of testing facilities, no knowledge of rapid HIV tests, false perception of risk, perceived lack of support systems and fear of partner abuse or rejection if asked to wear a condom or get tested for HIV.

The Bottom Line

To prevent HIV transmission:

• Use condoms correctly and consistently. For individuals whose sexual behaviors place them at risk, correct and consistent use of the male latex condom can reduce the risk of HIV transmission. However, no protective method is 100% effective, and condom use cannot guarantee absolute protection.
• Do not share needles and syringes used to inject drugs, steroids, or vitamins, or for tattooing or body piercing.
• Do not share equipment ("works") used to prepare drugs for injection. This places people at risk for contracting HIV, hepatitis, and other viruses.
• Do not share razors, toothbrushes, or other personal items that may be contaminated with infected blood.

Case Example

Pedro is a 27-year-old Latino male and an undocumented farm worker. He is married with a family in Mexico. After work, Pedro goes to the local bar with his co-workers and occasionally engages in unprotected sex with local men and women. One day, Pedro goes to the pharmacy because of a stinging sensation when he urinates. The pharmacist tells him to go to the local health clinic where he tests positive for gonorrhea. He is also offered a rapid HIV test. Pedro tests positive for HIV and is advised to speak with the counselor who often visits his migrant workers' camp. The counselor refers him to local treatment and information services, a local support group and offers prevention education and counseling services.

Pedro's wife joins him from Mexico and doesn't understand why Pedro insists on using a condom during intercourse. Pedro tells his wife that he is living with HIV. He explains how he contracted the virus, and that there are ways to prevent her from acquiring the virus should she choose to stay with him.

This example highlights cultural values to take into consideration:

• Machismo, which is often perceived as a negative value
• Strong family and religious values
• Because he is the insertive partner, Pedro does not identify himself as gay or bisexual.