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HIV Transmission

March 25, 2010

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Are patients in a health care setting at risk of getting HIV?

Although HIV transmission is possible in health care settings, it is extremely rare. Medical experts emphasize that the careful practice of infection control procedures, including universal precautions (i.e., using protective practices and personal protective equipment to prevent HIV and other blood-borne infections), protects patients as well as health care providers from possible HIV transmission in medical and dental offices and hospitals.

For more information on preventing occupational exposure to HIV, refer to the CDC fact sheet, "Preventing Occupational HIV Transmission to Healthcare Personnel."

In 1990, the CDC reported on an HIV-infected dentist in Florida who apparently infected some of his patients while doing dental work. Studies of viral DNA sequences linked the dentist to six of his patients who were also HIV-infected. The CDC has not yet been able to establish how the transmission took place. No additional studies have found any evidence of transmission from provider to patient in health care settings.

CDC has documented rare cases of patients contracting HIV in health care settings from infected donor tissue. Most of these cases occurred due to failures in following universal precautions and infection control guidelines. Most also occurred early in the HIV epidemic, before established screening procedures were in place.

For more information, see "Are health care workers at risk of getting HIV on the job?" or visit the health care worker section of the CDC National Prevention Information Network (NPIN) Web site, or call NPIN at 1-800-458-5231.

Have people been infected with HIV from being stuck by needles in non-health care settings?

No. While it is possible to get infected with HIV if you are stuck with a needle that is contaminated with HIV, there are no documented cases of transmission outside of a health-care setting.

CDC has received inquiries about used needles left by HIV-infected injection drug users in coin return slots of pay phones, the underside of gas pump handles, and on movie theater seats. Some reports have falsely indicated that CDC "confirmed" the presence of HIV in the needles. CDC has not tested such needles nor has CDC confirmed the presence or absence of HIV in any sample related to these rumors. The majority of these reports and warnings appear to be rumors/myths.

CDC was informed of one incident in Virginia of a needle stick from a small-gauge needle (believed to be an insulin needle) in a coin return slot of a pay phone and a needle found in a vending machine that did not cause a needle-stick injury. There was an investigation by the local police and health department and there was no report of anyone contracting an infectious disease from these needles.

Discarded needles are sometimes found in the community. These needles are believed to have been discarded by persons who use insulin or inject illicit drugs. Occasionally the public and certain workers (e.g. sanitation workers or housekeeping staff) may sustain needle-stick injuries involving inappropriately discarded needles. Needle-stick injuries can transfer blood and blood-borne pathogens (e.g., hepatitis B, hepatitis C, and HIV), but the risk of transmission is extremely low and there are no documented cases of transmission outside of a health care setting.

CDC does not recommend routinely testing discarded needles to assess the presence or absence of infectious agents in the needles. Management of exposed persons should be done on a case-by-case basis to determine (1) the risk of a blood-borne pathogen infection in the source and (2) the nature of the injury. Anyone who is injured from a needle-stick in a community setting should contact their health-care provider or go to an emergency room as soon as possible. Antiretroviral medications given shortly after being stuck by a needle infected with HIV can reduce the risk of HIV infection. The health-care provider should then report the injury to the local or state health department. Guidance on non-occupational exposure can be found at Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV in the United States.

Are lesbians or other women who have sex with women at risk for HIV?

Female-to-female transmission of HIV appears to be a rare occurrence. However, there are case reports of female-to-female transmission of HIV. The well-documented risk of female-to-male transmission of HIV shows that vaginal secretions and menstrual blood may contain the virus and that mucous membrane (e.g., oral, vaginal) exposure to these secretions has the potential to lead to HIV infection.

In order to reduce the risk of HIV transmission, women who have sex with women should do the following:

  • Avoid exposure of a mucous membrane, such as the mouth (especially non-intact tissue), to vaginal secretions and menstrual blood.
  • Use condoms consistently and correctly each and every time for sexual contact with men or when using sex toys. Sex toys should not be shared. No barrier methods for use during oral sex have been evaluated as effective by the Food and Drug Administration (FDA). However, natural rubber latex sheets, dental dams, cut open condoms, or plastic wrap may offer some protection from contact with body fluids during oral sex and possibly reduce the risk of HIV transmission.
  • Know your own and your partner’s HIV status. This knowledge can help uninfected women begin and maintain behavioral changes that reduce the risk of becoming infected. For women who are found to be infected, it can assist in getting early treatment and avoiding infecting others.

For more information, refer to "HIV/AIDS among Women Who Have Sex with Women."

Can I get HIV from getting a tattoo or through body piercing?

A risk of HIV transmission does exist if instruments contaminated with blood are either not sterilized or disinfected or are used inappropriately between clients. CDC recommends that single-use instruments intended to penetrate the skin be used once, then disposed of. Reusable instruments or devices that penetrate the skin and/or contact a client's blood should be thoroughly cleaned and sterilized between clients.

View the CDC fact sheet on the sterilization of patient-care equipment and HIV (from the CDC Division of Healthcare Quality Promotion Web site).

Personal service workers who do tattooing or body piercing should be educated about how HIV is transmitted and take precautions to prevent transmission of HIV and other blood-borne infections in their settings.

If you are considering getting a tattoo or having your body pierced, ask staff at the establishment what procedures they use to prevent the spread of HIV and other blood-borne infections, such as the hepatitis B virus. You also may call the local health department to find out what sterilization procedures are in place in the local area for these types of establishments.

Visit the CDC Web site for links to the 50 U.S. state health departments.

Can HIV be transmitted by kissing?

It depends on the type of kissing. There is no risk from closed-mouth kissing.

There are extremely rare cases of HIV being transmitted via deep "French" kissing but in each case, infected blood was exchanged due to bleeding gums or sores in the mouth. Because of this remote risk, it is recommended that individuals who are HIV-infected avoid deep, open-mouth "French" kissing with a non-infected partner, as there is a potential risk of transferring infected blood. Summary:

  • There is no risk of transmission closed-mouth kissing.
  • There is a remote risk from deep, open-mouth kissing if there are sores or bleeding gums and blood is exchanged. Therefore, persons living with HIV should avoid this behavior with a non-infected partner.
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This article was provided by U.S. Centers for Disease Control and Prevention. Visit the CDC's website to find out more about their activities, publications and services.
 
See Also
Quiz: Are You at Risk for HIV?
Ten Common Fears About HIV Transmission
Visit Our "Ask the Experts" Forum on HIV Risk and Transmission
More Frequently Asked Questions About HIV and AIDS

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