Transmission and Prevention

Information Line | Antibodies | HIV FAQ | Transmission | Treatments

Who is at risk of HIV infection?

Anyone can catch HIV. The virus does not discriminate against race, social groups, women, men, homosexual, heterosexual, bisexual, or transgender people. The virus can infect anyone. It is behaviour that puts a person at risk, not the type of person one is or has sex with.

How do you catch AIDS?

This should more accurately be phrased as ‘How do you become infected with HIV?’ HIV is the virus, which is transmitted. AIDS is a later stage condition, which may result from HIV infection.

Transfer of blood or sexual fluids from an infected person into another person’s body (usually by injection or sexual intercourse) is the principal mode of transmission. Once outside the body, HIV is fragile and dies quickly in normal circumstances.

HIV is transmitted by three major means:

a. Blood

By sharing injection equipment, e.g. syringes, water, filters etc, which may contain blood from an infected person. Remember the blood may not be visible.

By receiving infected blood via a blood transfusion or blood products. In Australia, the blood supply has been tested for HIV since 1985. However, if a donation occurred during the window period, the test may not detect HIV. To cover this, the blood donor has to sign a declaration, which states that they haven’t put themselves at risk of acquiring HIV. A person may be at risk if they received a blood transfusion, blood products, or certain vaccinations in another country.

b. Sex

By having vaginal or anal sexual intercourse without a condom. Any other sexual activity when blood, semen, or vaginal fluid from an infected person may pass into the blood stream of another person can lead to infection. Breaks in the skin caused by eczema, sores, or ulcers, could allow infected semen, blood or vaginal fluid to enter the blood stream. Absorption can also occur through the mucous membranes lining of the rectum, male urethra, or female cervical canal.

c. Perinatally

An HIV positive woman may transmit the HIV virus to her child through her breast milk if breast feeding, through the delivery at birth (as the baby is coming into contact with the mother’s blood and vaginal secretions) and/or through the placenta during the pregnancy. However, it is possible for an HIV positive mother to have an HIV negative child. The risk decreases if the mother is on HIV anti-retroviral treatments, has a low or undetectable viral load, does not breast feed and/or has a caesarean section delivery. Risk of transmission increases if the mother is the later stages of infection or if the mother is infected during the pregnancy.

Can HIV be transmitted through oral sex?

Oral sex presents a low risk of transmission of HIV. HIV is not transmitted by saliva (see below ”Can you become infected by kissing?”) however; cuts, ulcers, a STI, or the site of a recently extracted tooth may be a possible route for allowing infected blood, semen, or vaginal fluid into the bloodstream via the mouth. There is virtually no risk of acquiring HIV from receiving oral sex as the exposure is only to saliva. (However, remember that other STI may be transmitted by oral sex).

How infectious is pre-seminal fluid (pre-cum)?

Pre-seminal fluid has been found to contain HIV in infected persons.

For this reason any penetrative sex without a condom must be considered unsafe. This includes coitus interruptus (withdrawing the penis before ejaculation). Any pre-seminal fluid involved in oral sex would pose a theoretical risk of infection, however the actual risk would seem to be low.

Can you become infected by kissing?

Although HIV has been detected in saliva in some HIV positive people, it is in much lower concentrations than in semen, blood or vaginal fluid and therefore is not considered a risk for transmission of HIV. It is believed that some of the proteins in saliva may partially inactivate HIV.

Can you become infected with HIV through mutual masturbation?

Being infected with HIV through masturbation cannot happen as long as there are no open cuts or abrasions on the fingers, hands or on the body that gets in to contact with sexual fluid or blood. The skin is a very affective barrier that keeps anything (including blood and sexual fluid) out of the bloodstream. It is not possible for HIV to enter the bloodstream via intact skin.

Can a person become infected with HIV from receiving or giving a massage?

No! As stated in the previous question, there is no entry point to the blood stream through intact skin. Blood, sexual fluid or vaginal secretions would need to get in to the bloodstream. Blood or sexual fluid would need to get into a significant area of skin loss (such as a bleeding wound), which is extremely unlikely to be occurring from massaging or being massaged.

I have seen a sex worker and am now worried that I may have been exposed to HIV. Can I catch the virus by having sex with a sex worker?

As mentioned, it is not the “type” of person who you have sex with but the behaviour that puts a person at risk. The principles of HIV transmission apply to everyone who you have sex with and the type of sexual behaviour that has occurred.

If safe sex is practised (see below), you will not be at risk.

Can other sexually transmitted infections make you more susceptible to HIV?

The presence of other STIs can make it easier for HIV to enter the blood stream during unprotected sex (or in/on the mouth of a person performing oral sex). Having an STI makes it easier to both infect another and become infected with HIV.

Can you get infected at the doctor’s, dentists or by ear piercing, electrolysis, acupuncture or tattooing?

Not if professional infection control guidelines are followed. If you have any procedure, which pierces the skin, ask how equipment is sterilised between clients. All professional service providers are required to follow strict infection control guidelines set by the NSW Health Department. If you have any doubts, check that your practitioners use either disposable or sterile equipment for each client, and that they follow infection control procedures.

Can you become infected by pricking yourself on a hypodermic needle – say by standing on it or otherwise piercing the skin?

The risk of acquiring HIV from a discarded needle and syringe is very low. To date there are no documented cases of this happening. The reasons for this low risk of transmission are:

• The used needle and syringe are usually very small, therefore holding no or very little potential infectious fluid
• It may be some time since the needle was used, therefore any viral matter present has died
• There may be no blood in the syringe
• If there were blood in the syringe, it would have congealed and could not be injected out of the needle
• The injury from the needle may not be deep
• In Australia, only a small percentage of people who inject drugs are infected with HIV

Other blood borne viruses are more easily transmitted than HIV, such as Hepatitis B and C; however, there are still no documented cases of transmission of these viruses from discarded needles. Seek medical advice if you are concerned.

Can you get infected by blood transfusion or by blood products?

Since 1 May 1985, the Red Cross Blood Bank has screened all blood in Australia for HIV antibodies. Any infected blood found is destroyed. In addition, donors must sign a declaration that they are not at risk of infection, and anyone not prepared to sign the declaration cannot donate. This makes the risk of infection from a blood transfusion extremely low. To date this has occurred only once in Australia since screening began and this was related to the donor being in the window period. Blood or blood products in any other country may not be as safe.

When blood products (such as plasma or Factor 8) are manufactured, in the unlikely event that there is a virus present, it would be inactivated during heat treatment. This means, there is no possibility that HIV could be transmitted from blood products manufactured since 1985.

Anyone who had a transfusion or received blood products before 1 May 1985 is advised to have an HIV test.

If blood which may be infected is spilt, how can the area be disinfected?

Wear gloves to clean up the spill. Use paper towels if possible. Then wash the area with detergent, clean the cloth in the normal way and put gloves and paper towels into a plastic bag for disposal.

Can you get infected by household contact such as kissing or hugging, coughing or sneezing, or by sharing toilet seats, glasses, cutlery, towels, books or other implements?

No! You cannot become infected with HIV through general social contact. It would be unwise, however, to share razor blades or toothbrushes as blood might be present and able to pass through cuts or breaks in your skin, which may be a risk for other blood-borne diseases.

Can you get infected in swimming pools, spas, hot tubs or saunas?

No! Chlorine or salt water will destroy the virus. In water, the virus would be diluted which also means there will be no risk of transmission.

How do children get HIV?

If mothers are infected, infants can become infected during pregnancy or at birth. The virus can be transmitted through breast milk. Children are not at risk during normal home, school, or playground activities even when HIV infected children are present. Children should be made aware of the risks of contact with blood and should be instructed not to touch or play with discarded needles or syringes. Games such as “blood brothers” are not advised.

In the past (before 1985) children became infected during transfusions of blood products (such as Factor 8 to treat haemophilia).

What is “safe sex”?

Safe sex is any sexual practice, which does not allow infected blood, semen, or vaginal or anal secretions to pass into the blood stream of another person.

Wearing a condom during sexual intercourse is the most effective protection. Condom breakage can occur if not used properly. Remember to squeeze the air or of the tip of the condom to leave room for the ejaculate. Always use water based lubricants (e.g. wet stuff, KY). NEVER use oil based lubricants, (such as moisturisers, baby oil, or Vaseline), since these lubricants weaken the condom's latex and increase risk of breakage. If a condom does break douching (flushing the area with water) is not advised as this may increase the risk of infection by weakening the lining of the rectum or vagina. Condoms should be stored as recommended and used before the expiry date, which is printed on the wrapper. Store condoms away from direct sunlight preferably in a cool place.

Nonoxynol-9 is a spermicide contained in many vaginal gels, creams, foams, suppositories, sponges and films. It is also added to some condoms. It was promoted as a means of preventing HIV, but recent studies have found that frequent use may in fact increase the risk of HIV transmission. The use of nonoxynol-9 is not recommended for anal or vaginal sex to prevent HIV, other STIs, or pregnancy.

How long does the virus stay active outside the body?

We know that the virus is fragile and cannot survive long outside the human body in normal conditions. HIV is extremely sensitive to external temperatures, dilution, drying etc.

Albion Street Centre
150 - 154 Albion Street Surry Hills NSW 2010 Australia
Telephone: +61 2 9332 9600 Fax: +61 2 9331 3490