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I just found out I’m HIV positive
Do I have HIV or need to test?
I just found out I’m HIV positive
The risk of HIV transmission is related to different factors. These include:
- Which body fluids are infectious.
- How infection occurs – often called the ‘routes of infection’.
- Other risk factors including viral load, type of sex, genetics etc.
Only some bodily fluids have the potential to be infectious.
- Sexual fluids (semen and vaginal fluid).
- Mucus from the vagina and anus.
- Breast milk is infectious to a baby but is unlikely to be infectious to an adult.
- Tears may be infectious but this is more a theoretical caution than a likely route of actual transmission.
Saliva, spit, urine and faeces are not infectious for HIV.
There then has to be a route for another person to become infected.
Common routes include:
Contact with the mucous membranes of genital or anal tissue. A mucous membrane is a type of tissue that is a less effective barrier than skin. The inner foreskin is also a mucous membrane.
Ulcers, sores, tears or micro abrasions (microscopic cuts) on genital tissue (to the vagina, penis or anal lining).
Any direct route into the bloodstream including cuts in your mouth. Sharing needles and injecting equipment has one of the highest risks of transmitting HIV. This is because there is a direct blood-to-blood route.
HIV is not transmitted by day-to-day activities or by contact with objects, food or clothes.
The following list includes just a few examples of questions from people worried about catching HIV.
Most of these questions come from a combination of fear and ignorance. They come from a lack of confidence in understanding HIV transmission.
You can NOT catch HIV from:
- Eating any food, cooked or uncooked, with blood on it.
- From a sterile needle at a clinic or other health centre.
- From a human bite.
- From an insect bite including a mosquito bite.
- From an animal.
- From living in the same house as someone who is HIV positive.
- From a sewing needle if you stab your finger.
- From blood on a bus seat that went through your underwear.
- Cleaning nail clippers.
- Using a knife/fork/spoon/cup/plate that an HIV positive person may have used.
- Getting sexual fluid on skin.
- Getting sexual fluid on a cut that has already healed over. A cut has to be open to be a risk of HIV.
Effective barriers against HIV
There are many effective barriers that prevent infection.
Skin: Skin is an excellent barrier against HIV, unless there is an open cut or open wound. Infectious fluid on skin is not a route for infection.
Mucous membranes in the mouth, throat and stomach: These membranes are good barriers against HIV infection, so long as there are not cuts, ulcers or sores.
Saliva: Saliva contains proteins and a low salt content that actively reduce its infectiousness. Even when HIV is detected it is unlikely to be in sufficient quantity to cause infection. HIV is not transmitted by kissing including deep kissing. Spit cannot transmit HIV.
Air: HIV is not transmitted by air.
Latex and rubber: Condoms prevent infection from HIV and many other sexually transmitted infections.
Many sexual situations have no risk of transmitting HIV.
These include masturbation (by yourself or with a partner), kissing and deep kissing, receiving oral sex and vaginal or anal sex using a condom correctly.
No. If you are in contact with sexual fluid it is better to wipe this off with a dry cloth. One study reported that infection rates were higher in people who washed after sex.
Douching can spread the virus further and soap and water may make a vulnerable membrane an easier barrier to get through.
Lemon or lime juice, even diluted, will increase the risk of transmission as it damages tissue.
It is quite common for one partner to test positive and the other negative, even if they have been having sex without condoms.
Mostly this is explained by luck and the role of other risk factors. Over time, most people will catch HIV if they continue to be at risk.
Even though you have been exposed and not infected, you can still catch HIV in the future.
Now you know your partners HIV status you can still stay together and have sex safely. You can prevent infection by using condoms when having sex and not sharing needles or blood products with your partner.
The risk of transmission also drops dramatically if and when your partner uses HIV treatment for their own health.
This is an exciting new area of research.
The link between viral load and the risk of transmission has been known for at least ten years.
More recent studies have strengthened the link between an undetectable viral load and a reduced risk of transmission.
These are mostly heterosexual studies. There is little or no data on the impact of risk from anal sex (gay or straight). Much of the follow up in these studies is also from people who still use condoms.
An undetectable viral load does not mean zero risk but it does dramatically reduce the risk.
There has been at least one case of HIV transmission reported from anal sex with an HIV positive insertive partner who had an undetectable viral load and no STIs.
Some people have multiple exposures to HIV, from either one person or several partners, and still do not get HIV.
Sometimes this is related to genetic factors, only some of which are understood. Most of the time it is just related to luck.
Although immune responses to HIV can develop in some people after frequent exposure, this is not well understood. Using condoms as protection against infection is still recommended.
Even people with a high level of genetic protection can still become infected.
In heterosexual vaginal or anal sex, if other factors are equal, a woman has a biologically higher risk of infection compared to a man.
The surface area of the vagina or anus is far greater than the surface area of the penis.
The risks of tears to the vagina or anus during sex is greater as the these inner linings are more delicate than the skin on the penis.
The length of time of exposure of the vagina or anus to semen is greater than the time the penis is exposed to the vaginal fluid or rectal mucosa.
The risk for anal sex, if other factors are equal, is greater for a receptive partner compared to an insertive partner.
The surface area inside of the anus, is larger than the surface area of the penis.
The risks of tears to the anus during sex is greater as the membrane on the inside of the anus is more delicate than the skin on the penis.
Pre-cum and cum will stay in the receptive partner for longer than the insertive partner is in contact with rectal tissue and mucosa.