HIV stands for Human Immuno-deficiency Virus. It is a viral infection that can be transmitted sexually. In fact, of the 40 million people infected with HIV in the world the vast majority were infected from having sexual intercourse with another person with the virus.
Once the HIV virus enters the body it attaches onto cells in our immune system that help protect us and keep us healthy. It eventually kills off these cells weakening the immune system so that it is unable to fight off infections and other illnesses.
A person who has been infected with HIV and has the virus is said to be HIV positive. Someone who has been tested for HIV and does not have the virus is HIV negative. Most people, however, are HIV status unknown – that is they have not been tested so cannot say with certainty what their HIV status is.
Once the immune system is weakened by HIV, illnesses that would otherwise be easily fought off can take hold and affect us (these are called opportunistic infections). These include rare kinds of cancers, pneumonia and brain diseases amongst many others. If someone who has the HIV virus develops some of these rare illnesses then they are said to have AIDS. AIDS stands for Acquired Immune Deficiency Syndrome. HIV and AIDS are not the same thing.
A person who is HIV positive can live for many years before being affected by the illnesses that might give them an AIDS diagnosis. In England and Wales there are very effective treatments that work for many people. They help to keep the amount of HIV in someone’s body at a manageable level and help the immune system stay stronger for longer. These drug treatments do have side effects that can be difficult to live with and the treatments need to be taken regularly and at certain times of the day in order to be effective. If treatment is suspended or interrupted, someone may develop a drug resistant form of HIV.
Recent developments in treatment of HIV include Post Exposure Prophylactic treatment (PEP). If someone has been at risk of being infected with HIV (e.g. by having unprotected sex with someone who is HIV positive) they can take a one month course of HIV drug treatments that start within 72 hours of possible exposure to the virus, which can stop HIV taking hold in the body and prevent HIV infection.
However, the outlook has never been better for HIV positive people in the UK. Life expectancy for people with HIV who start treatment before there is too much damage to the immune system is now similar to that of people who do not have the virus. This is not the case in some parts of the world where access to treatment is limited or non-existent and where people are still dying of an AIDS related illness every day.
Transmission of HIV
When a person is infected with HIV, the virus can be found in many of their bodily fluids. However, in fluids like saliva, sweat and urine the levels of virus are so low and the quality of virus so poor that there is absolutely no chance of being infected with HIV by coming into contact with them. The only bodily fluids where the level and quality of HIV is high enough to be infectious are:
- Blood
- Semen
- Vaginal Fluids
- Anal Mucus
- Breast Milk
Coming into contact with these bodily fluids is not in itself a risk in terms of infection. There has to be route of transmission for these fluids to get into our blood stream.
Many of the high-risk activities in terms of possibly becoming infected with HIV are sexual activities. Particularly high-risk activities are vaginal penetrative sex and penetrative anal sex – where the penis enters the vagina or rectum. This applies to both men and women, gay or straight and whether you are the person being penetrated or the person penetrating. Oral sex carries some risk of infection but this is much lower than penetrative sex. The factor that could increase the risk of infection from oral sex is the general state of the mouth and throat. If there is damage from bleeding gums, mouth ulcers or from a bacterial STI (e.g. gonorrhoea) than the risk is increased. Oral sex performed on a man (fellatio) is higher risk than oral sex performed on a woman (cunnilingus).
The following table gives examples of those activities that are no risk in terms of HIV infection; those where there is some risk but it is unlikely that someone will be infected by taking part in these activities; those considered low risk activities and those activities where there would be a high risk of infection.
No Risk
- Kissing
- Shaking Hands
- Hugging
- Sharing cups and glasses
- Being spat at
- Being bitten
- Sharing a toilet
- Massage
- Mutual masturbation
- From swimming pools
Very Small Risk
- Sharing a toothbrush
- Sharing razors
- Oral sex – cunnilingus
- Oral sex – anallingus (rimming)
- Sharing sex toys (vibrators/dildos/butt plugs)
- Needle-stick injury
- Blood transfusion in the UK
Low Risk
- Oral sex – blow jobs
- Penetrative anal sex using a condom
- Penetrative vaginal sex using a condom
High Risk
- Penetrative anal sex without a condom
- Penetrative vaginal sex without a condom
- Sharing needles for IV drug use
- Breast feeding a baby
