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Q: What bodily fluids transmit HIV
from one person to another?
A: HIV is transmitted through
blood, semen, pre-semen (pre-ejaculate), vaginal fluids, and
breast milk. These fluids need to enter the bloodstream. Saliva
is not generally considered risky, but cuts, sores, or blisters
in the mouth increase the likelihood of transmission (i.e.,
HIV infection). Other bodily fluids such as sweat, tears,
or urine are not risky.
Q: If I'm negative and my partner
is negative, do we need to practice safer sex?
A: If both partners are truly HIV negative,
there is no risk for HIV transmission. However, other sexually
transmitted diseases should be considered such as herpes,
venereal warts (HPV), gonorrhea, chlamydia, and syphilis.
The issue of trust needs to be carefully addressed and discussed
if a decision to not use condoms is being considered.
Q: If I'm positive and my partner
is positive, do we need to practice safer sex?
A: Researchers are concerned that re-infection
with HIV may be possible and could cause the disease to progress
more rapidly. Also, there is a possibility that a virus that
is resistant to certain medications can be transmitted to
another person with HIV, which means future treatment options
may be limited.
Q: Do all condoms prevent the spread
of HIV?
A: Condoms made from latex or polyurethane,
when used correctly, can prevent transmission of HIV, other
sexually transmitted diseases, and pregnancy. Female condoms
are available as well as the more common ones for men. Condoms
made from animal skin, such as sheepskin, have tiny pores
(holes) and are not good protection against HIV and other
sexually transmitted diseases. When condoms fail, it is usually
from human error. Be sure to squeeze the tip before putting
the condom on a fully erect penis, and roll the condom completely
on. Water-based lubricants help to prevent breakage. Oil-based
lubricants, such as petroleum jelly and hand lotion, can cause
condoms to break.
Q: Am I at risk if I have anal sex
and I'm the insertive partner (top)?
A: Although the receptive partner (bottom)
is at greater risk of acquiring HIV, the virus can also be
transmitted to the insertive partner (top). HIV can enter
through the urethra, if blood is transmitted from the anus.
HIV transmission is also more likely if either partner has
already contracted another sexually transmitted disease.
Q: I'm negative and my partner is
positive, but has an undetectable viral load. Do we need to
use condoms?
A: Having an undetectable viral
load (amount of virus in the blood) probably decreases
the risk of transmission. However, measurable amounts of virus
may be in semen or vaginal secretions. There is still a risk
if condoms are not used.
Q: Am I at risk if I am heterosexual?
A: For several years, the numbers of
heterosexuals acquiring HIV through sex has been increasing.
HIV can be transmitted from a man to a woman and vice versa.
Latex condoms can prevent the spread of HIV.
Q: Is oral sex risky?
Oral sex is considered "low-risk",
but it is not risk free. Oral sex is less risky than anal
or vaginal intercourse. Research on oral transmission of HIV
is limited. Many anecdotal cases, and some documented cases,
have been reported from people who most likely acquired HIV
through oral sex. The person receiving oral sex (the person
not using his or her mouth) is at minimal risk with this activity.
Here are some things to keep in mind:
- HIV is transmitted
through bodily fluids. If semen or vaginal secretions are
transmitted, there is some degree of risk of acquiring HIV.
- A higher viral
load probably increases the likelihood of transmission.
- Condoms, dental
dams, and avoiding the 'head' of the penis will prevent
transmission.
- Cuts, sores,
and blisters in the mouth increase the likelihood of transmission.
Q: Is kissing risky?
Kissing does not pose a risk of acquiring
HIV. However, it is generally good practice to avoid deep
kissing if either partner has cuts, sores, or blisters in
the mouth.
Q: Aren't the treatments today good?
Do I really have anything to worry about?
A: It is true that research has come
a long way and HIV medications have increased the quality
and length of life for people living with HIV. That doesn't
mean living with HIV is easy. Here are some things you may
not realize:
- HIV medications
have side effects, ranging from chronic nuisances to more
serious conditions, such as pancreatitis
and fat abnormalities.
- Dosing schedules
are usually complicated and often require unwanted lifestyle
changes. At present, these drugs need to be taken for life.
- Most of the
medications available today have only been approved since
about 1995. We do not know the longer-term effects of these
medications.
- The number of
different medications are limited. Many people are currently
resistant to the drugs. People are still getting sick and
dying from AIDS.
- Consider disclosure.
How would you deal with telling your family and friends?
How would this disease affect your relationships, dating,
and sex?
- IT IS BETTER
TO STAY UNINFECTED!
Q: Besides sex, what are other ways
that HIV is transmitted?
A: HIV is also transmitted through
needle sharing and perinatally (from mother to baby). Accidental
needle sticks account for a small number of HIV cases. Blood
transfusions are no longer a threat since screening for HIV
is routine. Casual contact, drinking fountains, swimming pools,
and insect bites do not transmit HIV.
Q: Where can I go for more information
about HIV transmission and prevention?
The AIDS Foundation San Francisco has
a great Web site with information on HIV
transmission, safer sex, and prevention. Check it out.
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