HIV and other sexually transmitted diseases (STDs) pass from one person to another through contact of certain bodily fluids. The transmission from one person to another because of what you do - not who you are.

It only takes one contact to transfer HIV or other STDs to another person.

The three main ways that HIV and other STDs transfer from one person to another are:

• By engaging in unsafe sex.
• By sharing drug works.
• From mother to child.

HIV and other STDs do not transfer through casual contact. They also do not transmit at home or in the work place if proper precautions are followed.

It is particularly important for every sexually active adult living with HIV or who has an STD to know the guidelines for safer sex including how to use (male) condoms, dental dams/plastic wrap and female condoms - and to practice safer sex every time. It is a myth to think that it doesn't matter if you have unsafe sex with another person who is HIV positive or who has a sexually transmitted disease.

It helps to rehearse what to say if a partner objects to using safer sex practices.

If are a pregnant mother or a person who shares drugs, there are also methods for avoiding or minimizing the risk of transmission.

Keep in mind that in some states, knowingly transmitting HIV disease to another person may be subject to criminal penalties. There is also the potential for civil liability such as money damages.

A NOTE ABOUT HIV TRANSMISSION AND TREATMENT: If you are on treatment, and your viral load is undetectable, sveral studies have shown that HIV-infected people on treatment who have fully suppressed the virus rarely transmit it to their sexual partners. However, there is no guarantee that there will be no transmission of the virus. The old adage "it is better to be safe than sorry" is particularly useful to keep in mind.

For additional information, see:

• How HIV And Other STDs Pass From One Person To Another  
• Contacts Through Which HIV and Other STDs Does NOT Transfer To Another Person  
• Sex Between Two People Who Are HIV Positive  
• How To Prevent Transmitting HIV If You Are HIV Positive   
• How To Prevent Transmission of HIV and other STDs During Sex
• To find a free HIV test, without giving your name, call: 800.872.2777

HIV and other STDs pass from one person to another through contact of the following body fluids:

• Blood (HIV and other STDs)
• Semen ("Cum") (HIV and other STDs)
• Vaginal fluids (HIV and other STDs)
• Breast milk (HIV)

There are three main means of transmitting HIV between people:

• By engaging in high risk sex. High risk sex is any sexual practice which permits semen (cum) or vaginal fluids to enter another person's anus (ass), vagina or blood stream. There are degrees of risk among different types of sexual activity. Risk can often be reduced.
• By sharing drug works
  • Drug works include needles, syringes, cookers, cotton and water.
  • Drug works are used to share drugs or other substances.
• From a mother to a child
  • Transmission can happen before birth in the womb, during birth, or after birth through breast-feeding.
  • It is possible to minimize the possibility of transmission from a mother to a fetus in the womb, during birth or to a child after birth.

It is also possible to transmit HIV as follows:

• Through a blood transfusion. NOTE: The blood supply in the U.S. is considered to be safe thanks to ongoing testing.
• By biting.
• By sharing blood such as in a ritual involving blood.
• By kissing when there are cuts or sores in the mouth.

HIV and other STDs are not transmitted to another person from any of the following:

• Closed-mouth or "social" kissing with the exception of active herpes which can be transmitted by kissing.
• Many sex acts. For instance, there is no transmission with:
  • Mutual masturbation.
  • Getting another person's cum or vaginal fluids on your skin unless there is a fresh break in the skin.
  • Intercourse with an unbroken, properly applied, consistently used, latex or polyurethane condom.
• Contact by any of the following bodily fluids:
  • Saliva
  • Tears
  • Sweat
• Activities such as:
  • Hugging or Kissing
  • Sneezing
  • Coughing
  • Living with an infected person unless there is contact between skin or mucous membranes and infected blood. 
  • Cuddling
• Casual contact including:
  • Shaking hands
  • Sharing food or water
  • Toilet seats
  • Telephones
  • Water fountains
• Mosquitoes or other insect bites

It is as important to play as safe with a person who is already infected with HIV as it a person who is HIV negative. It is a myth to think that people already living with HIV cannot be reinfected or that it doesn't matter.

In fact:

• A person with HIV can be reinfected.
• For the receiving person, the new virus may be substantially more virulent than the virus he or she has. It may also have be resistant to drugs which the receiving person has not yet used. Drug resistance eliminates those drugs from the arsenal of possible drugs that would help keep the person healthy and alive.

AT HOME

The Centers For Disease Control (CDC) recommends the following:

• Avoid practices that increase the likelihood of blood contact, such as sharing of razors and toothbrushes.
• Needles and other sharp instruments should be used only when medically necessary and handled according to recommendations for health-care settings. For example, do not put caps back on needles by hand or remove needles from syringes. Dispose of needles in puncture-proof containers out of the reach of children and visitors.
• Hands and other parts of the body should be washed immediately after contact with blood or other body fluids.
• Surfaces soiled with blood should be disinfected appropriately.

Make sure that anyone that comes in contact with you, including caregivers, act appropriately.

• Gloves should be worn during contact with blood or other body fluids that could possibly contain visible blood, such as urine, feces, or vomit. (Inexpensive latex gloves are available at drug stores).
• Cuts, sores, or breaks on both the caregiver's and patient's exposed skin should be covered with bandages.

AT WORK

There is no known risk of HIV transmission to co-workers, clients, or consumers from contact at work - even in industries such as food-service establishments.

Food-service workers
All food-service workers should follow recommended standards and practices of good personal hygiene and food sanitation.

Healthcare Workers
All health care workers should follow CDC recommended standards to prevent infection transmission. To learn more, see:www.cdc.gov/ncidod/dhqp/gl_hcpersonnel.html

Personal service workers
All personal service workers such as hairdressers, barbers, cosmetologists, and massage therapists should follow CDC recommended guidelines, including the same cleaning procedures that are recommended for health care institutions. To learn more, see: www.cdc.gov/ncidod/dhqp/gl_hcpersonnel.html

Instruments that are intended to penetrate the skin
Instruments that are intended to penetrate the skin (such as tattooing and acupuncture needles, ear piercing devices) should be used once and disposed of or thoroughly cleaned and sterilized. 

Instruments not intended to penetrate the skin but which may become contaminated with blood 
Instruments not intended to penetrate the skin but which may become contaminated with blood (for example, razors) should be used for only one client and disposed of or thoroughly cleaned and disinfected after each use.

WHEN SHARING DRUGS

When sharing drugs, it is advisable not to share equipment.

If you do share, always use a clean needle or syringe. (For example, clean with bleach). For information about How To Clean Injecting Drug Works,click here.

If cost is an issue, check to find out if a government entity such as the city, county or state has a clean needle program that provides needles and syringes for free or for low cost. To find need exchange programs by state, see the website of the North American Syringe Exchange Network: http://www.nasen.org .

If there is no program, find out if you live in a state in which you can purchase needles/syringes over the counter. If not, perhaps your doctor will write you a prescription.

TO PREVENT TRANSMITTING HIV FROM MOTHER TO CHILD

HIV transmission from mother to child during pregnancy, labor and delivery, or breast feeding has the medical name "perinatal transmission."

During Pregnancy

During pregnancy, the risk of transmitting HIV to the baby can be substantially lowered by the use of antiretroviral drugs such as zidovudine (ZDT) which is marketed in the United States as Retrovir.

Antiretroviral drugs can be given during pregnancy.

When to start (if at all) depends on a combination of factors including the mother's health and possible side effects to her, the risk of passing HIV to the baby, and the possibility of the drugs causing harm to the baby.

Labor/Birth

At the least, antiretrovirals are given to the mother when labor starts. 

The baby is also given a small dose of antiretrovirals soon after birth.

Delivery

There is a greater risk that HIV will be transmitted from a mother to her baby in natural childbirth than in a Caeserian-section ("C-Section") birth. With a C-Section, the baby is protected against direct contact with the mother's blood and other bodily fluids.

Recent research indicates that for many women who take antiretroviral combination therapy during pregnancy, having a C-Section isn't a significant factor in preventing the transmission of HIV from mother to baby.

Breast Feeding

HIV is found in breast milk. Even a mother who has taken antiretroviral drugs can pass HIV to the baby through breastfeeding.  Of course, this can be prevented by not breast feeding and instead using safe breast milk substitutes (formula).

While it may seem counterintuitive, it appears that the risk from breast feeding can be reduced by using a technique referred to as "exclusive feeding." With this technique, the baby is solely breastfed. Mixing is avoided. For example, a breastfed baby is not given formula, glucose water or traditional medicine.

Kissing and Hugging

HIV cannot be passed to your child by kissing or hugging.

If you are pregnant and HIV positive: Consult your doctor or other health care provider as soon as you can to assure you engage in the safest practices for you and your child.

SEXUAL ACTIVITIES

See the next section.

Almost all sexual acts involve some degree of risk of transmitting HIV and other STDs to someone else. The degree of risk varies with the act.

For example, safer sex activities include closed mouth kissing and mutual masturbation. There is negligible risk if you perform fellatio (a "blow job"). There is low risk if you have intercourse with an unbroken, properly applied, latex or polyurethane condom for men. It is unsafe to receive shared sex toys without a condom or disinfection.

To prevent transmitting HIV and other STDs during sex, take the time to study the contents of our chart which describes the risk, if any, involved with each sexual activity and shows where various activities are on the continuum between Safe and Unsafe. Decide for yourself what risks you are willing, and not willing, to take. To see the chart, click on: Sexual Activities: Level Of Risk Of HIV and Other STDs Transmission. 

If something unexpected comes up, keep in mind the basic rule: Any sexual practice that does not let a person's semen, blood, or vaginal fluids get into someone else's body through the anus, rectum, vagina, penis, and mouth is generally considered "safer" sex.

For your own safety, and the well being of the person or people with whom you have sex, it is advisable to make it an unbreakable rule to only engage in safer sex activities all the time. This is particularly true when alcohol and/or drugs are involved. Being high is no excuse.

It may help to think in terms of risk and reward. Just about all life's activities have some risk involved. Without consciously thinking, you're always weighing the risk against the possible reward. Bring that thinking to the fore when it comes to sex.

It can be difficult to resist strong desires that surface in the heat of the moment, particularly if alcohol or drugs are involved. Drugs and alcohol have been known to impair judgment and to break down inhibitions.

If you are HIV positive, keep in mind that by engaging in unsafe sex you are literally putting another person's or your own life at risk simply for a few moments of pleasure. Also keep in mind that you could possibly be charged for a criminal act that could land you in jail for a very long time for knowingly infecting someone else.

If despite everything you know, you make a mistake: Don't beat yourself up, and don't use it as an excuse to stop engaging in safer sex. Use it as a call to do better next time - and the time after that - and the time after that.

It is easier to practice safer sex if you discuss the subject with a partner before having sex. It can help to rehearse what to say and not say in different circumstances.

For information about condoms, dental dams/plastic wraps, and female condoms, including how to use them correctly, see the articles linked to in To Learn More below.