Frequently "Un-Asked" Questions on World AIDS Day 2021

Updated: Dec 2, 2021


On this 33rd World AIDS Day IAWH is approaching things a little differently. This year’s theme is Ending the HIV Epidemic: Equitable Access, Everyone’s Voice.


Instead of a regular blog or a historical retrospective on how far medical research has come in developing treatments for HIV and a cure for AIDS, we are providing you with a set of frequently un-asked questions about women's health and HIV. These are questions that you might be too shy or embarrassed to ask your health care provider or your friends and family. Each answer provided below is evidence-based and we provide you with links for further exploration and learning.


1. Can I contract HIV from a doorknob, urine or blood on a toilet seat, or any other public/shared surface?

No.

HIV can be transmitted through a number of bodily fluids, including:

  • blood

  • semen

  • pre-ejaculate (or pre-cum)

  • rectal fluids

  • vaginal secretions

  • breast milk

Although HIV can be transmitted via bodily fluids, the virus must enter directly into your bloodstream for infection to occur. So even if there is urine, blood, or other bodily fluids on a surface that you touch, there is almost a negligible chance of transmission. Learn more about HIV transmission from Healthline.


2. What is considered “at - risk” behavior for transmitting or contracting HIV?

The Center for Disease Control and Prevention (CDC) puts at - risk behaviors into three categories.

Parenteral –

Sexual –

  • Receptive Anal Intercourse

  • Insertive Anal Intercourse

  • Receptive Penile-Vaginal Intercourse

  • Insertive Penile-Vaginal Intercourse

  • Receptive Oral Intercourse

  • Insertive Oral Intercourse

Other –

  • Biting

  • Spitting

  • Throwing bodily fluids (saliva, semen)

  • Sharing sex toys

Visit the HIV Risk Behaviors page to learn just how risky these behaviors are.


3. How soon after “at - risk” behavior should I be tested?

If you believe you’ve been exposed to HIV, or have a high risk of being exposed to HIV, visit a healthcare professional within 72 hours.


You may be offered an antiretroviral treatment called post-exposure prophylaxis (PEP), which can reduce your risk of contracting HIV. PEP is typically taken once or twice daily for 28 days.

PEP has little or no effect if taken more than 72 hours Trusted Source after exposure to HIV, according to the Centers for Disease Control and Prevention (CDC). The medication isn’t usually offered unless it can be started within the 72-hour window.


If you think you may have been exposed to HIV make an appointment with a healthcare professional as soon as possible.


4. What is PrEP and does it actually prevent HIV infection?

PrEP stands for (pre-exposure prophylaxis). It is a medical therapy administered via pill/tablet that can be prescribed to HIV negative adults or adolescents regularly engage in high - risk behavior to prevent the transmission of HIV.


If you think you may have been exposed to HIV through sex without a condom, or due to a broken condom, make an appointment with a healthcare professional as soon as possible.

PrEP is prescribed to HIV-negative adults and adolescents who are at high risk for getting HIV through sex or injection drug use. PrEP may benefit you if you are HIV-negative, you have had anal or vaginal sex in the past 6 months, and you:

  • have a sexual partner with HIV (especially if the partner has an unknown or detectable viral load),

  • have not consistently used a condom, or

  • have been diagnosed with an STD in the past 6 months.

PrEP is also recommended for people who inject drugs and have an injection partner with HIV, or who share needles, syringes, or other injection equipment.

The once-daily pill reduces the risk of getting HIV from sex by more than 90%. Among people who inject drugs, it reduces the risk by more than 70%. Learn more about PrEP on the HIV.gov PrEP page.


5. Can women who have sex with other women transmit or contract HIV from sexual activity?

Yes, but it is rare.


Women who have sex only with women (WSW) might think they are safe from HIV. This type of HIV transmission is rare. If you are a woman and your female partner has HIV, you can get it if you have cuts, bleeding gums, or sores in your mouth and you give oral sex. It is also possible to spread HIV through menstrual blood and shared sex toys.


A woman who has sex with women is also vulnerable for transmission of HIV if:

  • You inject or your partner injects drugs with someone who has HIV.

  • You have or your partner have sex with a man who has HIV.

  • You are trying to get pregnant and use semen that has not been tested for HIV or sexually- transmitted infections (STIs).

To learn more about risks associated with WSW visit the U.S. Department of Health and Human Services Women and HIV page.


6. Are Trans-women more vulnerable to contracting HIV?

According to the HIV Infection, Risk, Prevention, and Testing Behaviors Among Transgender Women, 2019 – 2020 report, 4 in 10 transgender women surveyed in seven major U.S. cities have HIV. Interviews conducted in 2019 through early 2020 with 1,608 transgender women living in Atlanta, Los Angeles, New Orleans, New York City, Philadelphia, San Francisco, and Seattle found that 42% of respondents with a valid HIV test result had HIV.


Sixty-two percent of Black transgender women and 35% of Hispanic/Latina transgender women had HIV, compared to 17% of white transgender women. Furthermore, nearly two-thirds of the women surveyed lived at or below the poverty level, and 42% had experienced homelessness in the past 12 months.


7. If I am HIV positive can I give birth to an HIV negative baby?

Having a healthy pregnancy and preventing mother-to-child HIV transmission starts with several steps that the Center for Disease Control and Prevention (CDC) and HIV.gov outline below:

  • If you are HIV positive, the sooner you start treatment the better—for your health and your baby’s health and to prevent transmitting HIV to your partner.

  • If you don’t have HIV, but you or your partner engage in behaviors that put you at risk for HIV, get tested again in your third trimester.

  • You should also encourage your partner to get tested for HIV.

An HIV-positive mother can transmit HIV to her baby at any time during pregnancy, childbirth, or breastfeeding.


If you are a woman with HIV and pregnant, treatment with a combination of HIV medicines (called antiretroviral therapy or ART) can prevent transmission of HIV to your baby and protect your health.


Visit the Preventing Mother-to Child Transmission page for more information.


8. Can I have a “regular” sex life living with HIV? How do I protect an HIV negative partner?

If you take HIV medicine and get and keep an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex STILL there are other considerations, such as:

  • Encouraging your partner to take PrEP (pre-exposure prophylaxis) - a medicine that HIV negative people at risk for HIV can take to prevent HIV (talk with your healthcare provider).

  • Use condoms every time you have sex.

  • Choose to engage in sexual activities that are low risk for transmission.

  • Get tested for other STDs.

  • Never share needles or other drug injection equipment.

  • Learn about PEP (post-exposure prophylaxis) - medicine people take to prevent HIV after a possible exposure (talk with your healthcare provider).

You can learn more about this advice and more by visiting the CDC Protecting Others page.


9. What does the term Viral Load mean?

The term viral load refers to the amount of HIV in a sample of blood. Viral load (VL) is reported as the number of HIV RNA copies per milliliter of blood. An important goal of antiretroviral therapy (ART) is to suppress a person’s VL to an undetectable level—a level too low for the virus to be detected by a VL test.


You can refer to the HIV/AIDS glossary to learn more definitions of HIV related terms.


10. Where can I go for an HIV test?

Visit the GET TESTED site to learn where you can get free testing for HIV, Hepatitis, and Sexually Transmitted Infections.


 

This blog was written with support from Shadan Rahmani, first-year Public Health Scholar from American University in Washington, DC.

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