National AIDS Coordinating Agency (NACA)
HIV Transmission
Can one get infected with HIV from blood transfusion from a health facility?

NO, all blood in Botswana is tested for HIV and other infections and is safe to use. Botswana has reduced its blood discard rate from about 9% in 2004 to 2.7% in 2006. Therefore, the risk of infection through transfusion of blood or blood products is extremely low.

Can I be infected if my partner does not have HIV?

No. Like all sexually transmitted infections, HIV cannot be 'created', only passed on. If you are sure that your partner does not have HIV, then there is no risk of acquiring it, even if you do have unprotected sex (whether it be vaginal, anal or oral). However, pregnancy and other sexually transmitted infections (if your partner has one) remain a great risk, so you should still use a condom or other suitable form of birth control wherever possible.

Can I get HIV from kissing?

On the Cheek:  

HIV is not transmitted casually, so kissing on the cheek is very safe. Even if the other person has the virus, your unbroken skin is a good barrier. No one has become infected from such ordinary social contact as dry kisses, hugs, and handshakes.

Open-Mouth Kissing:    

Open-mouth kissing is considered a very low-risk activity for the transmission of HIV. HIV is only present in saliva in very minute amounts, insufficient to cause infection with HIV. However, prolonged open-mouth kissing could damage the mouth or lips and allow HIV to pass from an infected person to a partner and then enter the body through cuts or sores in the mouth.

Which body fluids transmit HIV?

These body fluids have been shown to contain high concentrations of HIV: blood, semen, vaginal fluid, breast milk and other body fluids containing blood
The following are additional body fluids that may transmit the virus that health care workers may come into contact with:

• fluid surrounding the brain and the spinal cord
• fluid surrounding bone joints
• fluid surrounding an unborn baby

HIV has been found in the saliva and tears of some persons living with HIV, but in very low quantities. It is important to understand that finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid. HIV has not been recovered from the sweat of HIV-infected persons. Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV.

Does 'fingering' during sex carry a risk of HIV transmission?

Inserting a finger into someone's anus or vagina would only be an HIV risk if the finger had cuts or sores on it and if there was direct contact with HIV infected blood, vaginal fluids or semen from the other person. There might also be a risk if the person doing the fingering had HIV and their finger was bleeding.

Is there a connection between HIV and other STIs (sexually transmitted infections)?

HIV and other STIs can impact upon each other. The presence of STIs in an HIV infected person can increase the risk of HIV transmission. This can be through a genital ulcer which could bleed or through increased genital discharge.
An HIV negative person who has an STI can be at increased risk of becoming infected with HIV through sex. This can happen if the STI causes ulceration or breaks in the skin (such as syphilis or herpes), or if it stimulates an immune response in the genital area (for instance chlamydia or gonorrhoea). HIV transmission is more likely in those with ulcerative STIs than non-ulcerative.
Using condoms during sex is the best way to prevent the sexual transmission of infections, including HIV.

Can I become infected with HIV through normal social contact/activities such as shaking hands/toilet seats/swimming pools/sharing cutlery/kissing/sneezes and coughs?

The answer is a big NO. HIV is not an airborne, water-borne or food-borne virus, and does not survive for very long outside the human body. Therefore ordinary social contact such as kissing, shaking hands, coughing and sharing cutlery does not result in the virus being passed from one person to another.

Is there a risk of HIV transmission when having a tattoo, body piercing or visiting the barbers?

If instruments contaminated with blood are not sterilized between clients then there is a risk of HIV transmission. However, people who carry out body piercing or tattooing should follow procedures called 'universal precautions', which are designed to prevent the transmission of blood borne infections such as HIV and Hepatitis B.

When visiting the barbers there is no risk of infection unless the skin is cut and infected blood gets into the wound. Traditional razors used by barbers now have disposable blades, which should only be used once, thus eliminating the risk from blood-borne infections such as Hepatitis and HIV.

If blood splashes into my eye, or I get some in my mouth, can I become infected with HIV?

Research suggests that the risk of HIV infection in this way is extremely small. A very small number of people - usually in a healthcare setting - have become infected with HIV as a result of blood splashes in the eye.

Blood in the mouth carries an even lower risk. The lining of the mouth is very protective, so the only way HIV could enter the bloodstream would be if the person had a cut, open sore or area of inflammation somewhere in their mouth or throat (if the blood was swallowed). Even then, the person would have to get a fairly significant quantity of fresh blood (i.e. an amount that can be clearly seen or tasted) directly into the region of the cut or sore for there to be a risk. HIV is diluted by saliva and easily killed by stomach acid once the blood is swallowed.

How does HIV spread during sex?

Safer Sex

To spread HIV during sex, HIV infection in blood, sexual fluids or other body fluids must be transmitted to someone. Sexual fluids come from a man's penis or from a woman's vagina, before, during, or after orgasm. HIV can be transmitted when infected fluid gets into someone's body.
You can't spread HIV if there is no HIV infection. If you and your partner are not infected with HIV, there is no risk. However, an "undetectable viral load does NOT mean "no HIV infection." If there is no contact with blood, sexual fluids or other body fluids, there is no risk. HIV needs to get into the body for infection to occur. Safer sex guidelines are therefore ways to reduce the risk of spreading HIV during sex
Sexual Activities: unsafe sex has a high risk of spreading HIV. The greatest risk is when blood or sexual fluid touches the soft, moist areas (mucous membrane) inside the rectum, vagina, mouth, nose, or at the tip of the penis. These can be damaged easily, which gives HIV a way to get into the body.
Sexual intercourse (vaginal or rectal) without protection is very unsafe. Sexual fluids enter the body, and wherever a man's penis is inserted, it can cause small tears that make HIV infection more likely. The receptive partner is more likely to be infected, although HIV might be able to enter the penis, especially if it has contact with HIV-infected blood or vaginal fluids for a long time or if it has any open sores.

What steps can be used as general guidelines to safe sex?

#1: Most sexual activity carries a certain amount of risk of spreading HIV. To reduce this risk, people should ensure that blood or sexual fluid does not get into their body. Cuts, sores, or bleeding gums increase the risk of spreading HIV. Rough physical activity also increases the risk. Even small injuries provide an opportunity for HIV to get into the body.

#2: Use a barrier to prevent contact with blood or sexual fluid. Remember that the body's natural barrier is the skin. An intact or unbroken skin is sufficient barrier. If you don't have any cuts or sores, your skin will protect you against infection. However, in rare cases HIV can get into the body through healthy mucous membranes. The risk of infection is much higher if the membranes are damaged. The most common artificial barrier is the male and female condom.
#3: Lubricants can increase sexual stimulation hence sexual pleasure. They also reduce the chances of condoms or other barriers breaking. Oil-based lubricants such as Vaseline, oils, or creams can damage condoms and other latex barriers. Be sure to use water-based lubricants.

#4: Oral sex has some risk of transmitting HIV, especially if sexual fluids get in the mouth and if there are bleeding gums or sores in the mouth. Pieces of latex or plastic wrap over the vagina, or condoms over the penis, can be used as barriers during oral sex.

#5: Safe sexual activities have no risk for spreading HIV. Abstinence (never having sex) is totally safe. Sex with just one partner is safe as long as neither one of the partners is infected and if neither one of the partners ever has sex or shares needles with anyone else.
#6: Fantasy, masturbation, or hand jobs (where your body fluids are kept to yourself), sexy talk, and non-sexual massage are also safe. These activities avoid contact with blood or sexual fluids of other people; therefore there is no risk of transmitting HIV.
#7: To be safe, everybody must assume that their sex partners are infected with HIV. How can anybody tell if someone is infected by how they look? They could be lying if they tell you they are not infected, especially if they want to have sex with you. Some people got infected from their steady partners who were unfaithful "just once". Even someone who got a negative test result might be infected. They might have been infected after they got tested for HIV, or they might have gotten the test too soon after they were exposed to the virus.
#8: Some people who are infected with HIV don't see the need to follow safer sex guidelines when they indulge in sexual activity with other infected people. However, it still makes sense to "play safe". If you don't, you could be exposed to other sexually transmitted infections such as herpes or syphilis. If you already have HIV, these diseases can be more much more serious. You might get "re-infected" with a different strain of HIV. The new version of HIV might not be responsive to the medications you are taking. It might also be resistant to other antiretroviral drugs. It is not clear how risky it is for two HIV-positive people to have unsafe sex. However, following the steps for safer sex will reduce the risk.

#9: Using alcohol or drugs before or during sex greatly increases the chances of disregarding safer sex guidelines. People must be very careful if they have used any alcohol or drugs.

#10: Decide how much risk you are willing to take. Know how much protection you want to use during different kinds of sexual activities. Before you have sex, think about safer sex, talk to your partner about your stand, and don’t let alcohol or drugs or an attractive partner cheat you or make you forget to protect yourself.


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