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How Exactly Is HIV Transmitted?

Here’s what you need to know.
HIV transmission
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At the end of 2019, an estimated 38 million people are living with the Human Immunodeficiency Virus or HIV, and it continues to be a global health issue to this day. A sexually transmitted disease (STD), HIV is a virus that attacks your immune system—the number one defense for when you get sick. As a result, someone with HIV finds it harder to heal even from something as common as the flu. Unlike other sexually transmitted diseases that are caused by bacteria or parasites and can be treated with antibiotics, once you have HIV, you have it for life. Still, with access to HIV prevention and care, this disease is manageable, and it’s possible to live a long, healthy life even after a positive diagnosis.

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Each “stage” of HIV comes with its own set of symptoms. In this order, here are the three stages of HIV: acute infection stage, chronic infection stage (or clinical latency), and for some, AIDS. In the first few weeks after you’re infected, you may show flu-like symptoms—fever and random aches, chills, headache, sore throat, nausea, swollen lymph nodes, rashes, and an upset stomach—and without regular testing, it can be hard to detect. These can last for a few weeks and disappear for years. HIV enters the next stage after about a month and it’s possible not to display any symptoms. Similar, non-specific symptoms such as headaches, aches, fevers, diarrhea, nausea, weight loss, fatigue, rashes, and more can occur, though. People can stay in this stage for a decade!

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Some people may develop AIDS, but it’s important to note that people who take their medicine responsibly sometimes do not go into the third stage.

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HIV transmission: How HIV is transmitted

Most people who are infected with HIV get it through having unprotected vaginal sex or anal sex and sharing needles, syringes, and similar tools with someone who already has it.

According to the CDC, the riskiest way to get HIV is through anal sex—specifically if you’re the receptive partner (more commonly referred to as “the bottom”). This is because the HIV can enter the body through the rectum’s super thin lining. Of course, this doesn’t mean that the insertive partner (the top) is “safe”; HIV can enter through the tip of the penis or through the foreskin (if the person isn’t circumcised). When it comes to vaginal sex, either partner can get infected. This is how most women get HIV—through the mucous membranes that line the vagina and cervix. Men who get HIV through vaginal sex are infected because vaginal fluids and blood can carry the virus.

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As mentioned, the other way HIV is transmitted is through sharing syringes, needles, and other equipment to inject drugs, hormones, steroids, and more. These can have other people’s blood—and that’s how HIV is carried. This also puts you at risk for getting other kinds of infections.

It’s also possible for children to get HIV—the most common way is through mother-to-child transmission. This happens during pregnancy, birth, or through breastfeeding, though it’s not as common as it used be because of advances in HIV prevention.

HIV transmission: How HIV is *not* transmitted

There are still many misconceptions about HIV—including how a person gets infected. To provide clarity about the virus, you should know that HIV cannot survive outside the human body and cannot be reproduced without a human host. So no, it cannot be transmitted through sweat, tears, or even saliva. This means you cannot get it through hugging or shaking hands with someone who’s HIV positive or through sharing utensils or toilets. Mosquitoes and other insects are also unable to carry the virus. HIV isn’t transmitted through intimate activities like closed-mouth kissing or touching either. 

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HIV transmission: Bodily fluids that can carry HIV

We already know that blood can carry HIV, but what other bodily fluids can it survive in? Here’s a list:

  • pre-seminal fluid (pre-cum)
  • semen (cum)
  • rectal fluids
  • vaginal fluids
  • breast milk

And even then, these need to be in contact with a damaged tissue or mucous membrane (found inside the vagina, rectum, penis, mouth) or be directly injected into the bloodstream—like through a needle or syringe—for transmission to happen.

To know more about HIV, check out this article on the common symptoms found in women. 

Sources: CDC, WHO