Purpose of This Module

This module describes how HIV is and is not transmitted and describes some of the factors that affect a person’s risks for acquiring HIV infection.

HIV Transmission

HIV is spread through three main modes. These modes of transmission are as a result of exposure to body fluids (blood, semen, vaginal fluids, and breast milk) of infected individuals. Specifically, HIV can be transmitted through:

1. Sexual contact:

• Vaginal sex
• Anal sex
• Oral sex

2. Blood contact:

• Injections/needles (sharing needles, IV drugs, drug paraphernalia, or injury from contaminated needles or other sharp objects)
• Cutting tools (using contaminated skin-piercing instruments, such as scalpels, needles, razor blades, tattoo needles, circumcision instruments)
• Transfusions (receiving infected blood or blood products) or transplant of an infected organ
• Contact with broken skin (exposure to blood through cuts or lesions)

3. Mother-to-child transmission (MTCT):

• Pregnancy
• Delivery
• Breastfeeding

Although any exposure through one of these methods can lead to HIV infection, not every exposure results in transmission of the infection.

How HIV is NOT transmitted

Many myths exist about how HIV is transmitted, and many myths are culturally specific. It is important that people realize that HIV is actually quite difficult to transmit. For example, it is far less transmissible than hepatitis B or some other STIs. HIV is NOT transmitted through:

• Ordinary social or casual contact
• Donating blood
• Shared clothing
• Touching
• Shared food or dishes
• Dry kissing
• Shaking hands
• Toilet seats
• Insect bites
• Massaging another person
• Sexually stimulating a partner using your hand (although a risk may exist if blood, semen, or vaginal fluids come in contact with broken skin)
• Masturbation 
• Living with a person with HIV

In addition, HIV is not transmitted through tears, sweat, saliva, vomit, feces, or urine. Although these substances can contain HIV, they do not contain the virus in amounts significant enough to cause infection. Extensive, continuing studies of new HIV infections over the last 20 years in many countries have not uncovered any cases of infection through these substances. To date, there is no documentation of HIV transmission through these substances. Blood, semen, vaginal secretions, and breast milk are the only body fluids through which HIV transmission has been documented.

It is theoretically possible to transmit the virus through deep kissing if the gums have open sores or are bleeding, but this is highly unlikely. Even so, transmission in this case would be through blood rather than through saliva.

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