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Can You Get HIV From. . . ?
So, how do you get HIV? HIV can only be transmitted in certain ways, and the purpose of this page is to explain how you can and can’t become infected with HIV. Creating awareness of HIV transmission routes helps people who are unsure if they have been exposed to HIV or not.
How do you become infected with HIV?
HIV is found in blood and other body fluids of an infected person, such as semen and vaginal fluids. HIV can only be transmitted between two people if one of them is already infected.
HIV cannot live for long outside the body, so to be infected with HIV the body fluids from an infected person must get inside your body (contact with saliva has never been known to transmit HIV). The virus can enter the body via contact with the bloodstream or by passing through delicate parts of the body (mucous membranes), such as inside the vagina, rectum or urethra.
The video below highlights HIV transmission myths and facts using a song.
You can get HIV from...
HIV is found in the sexual fluids of an infected person. For a man, this means the pre-come and semen fluids that come out of the penis before and during sex. For a woman, it means HIV is in the vaginal fluids that are produced by the vagina to keep it clean and to help make intercourse easier.
If a man with HIV has vaginal intercourse without a condom, then HIV can pass into the woman's body through the lining of the vagina, cervix and womb. The risk of HIV transmission is increased if the woman has a cut or sore inside or around her vagina; this will make it easier for the virus to enter her bloodstream. A cut or sore might not always be visible, and could be so small that the woman wouldn't know about it.
If a woman with HIV has sexual intercourse without a condom, HIV could get into the man's body through a sore patch on his penis or by getting into his urethra (the tube that runs down the penis) or the inside of his foreskin (unless this has been removed by circumcision).
Any contact with blood during sex increases the chance of infection. For example, there may be blood in the vagina if intercourse occurs during a woman's period. Some sexually transmitted diseases – such as herpes and gonorrhea – can also raise the risk of HIV transmission.
Receptive anal intercourse (i.e. sex where a man’s penis is inserted into a person’s anus) carries a higher risk of HIV transmission than receptive vaginal intercourse. The lining of the anus is more delicate than the lining of the vagina, so is more likely to be damaged during sex. Any contact with blood during sex increases the risk of infection.
If a man takes the insertive position in anal sex with a man or woman who has HIV, then he too risks becoming infected.
Oral sex with an infected partner carries a small risk of HIV infection. If a person gives oral sex (licking or sucking the penis) to a man with HIV, then infected fluid could get into their mouth. If the person has bleeding gums or tiny sores or ulcers somewhere in their mouth, there is a small risk of HIV entering their bloodstream. The same is true if infected sexual fluids from a woman get into the mouth of her partner.
There is also a small risk if a person with HIV gives oral sex when they have bleeding gums or a bleeding wound in their mouth. However, HIV in saliva alone does not pose a risk.
HIV infection through oral sex alone seems to be very rare, and there are things you can do to protect yourself. For more information visit our Oral sex page.
People who inject drugs are a high-risk group for exposure to HIV. Sharing unsterilised injecting equipment is a very efficient way to transmit blood-borne viruses such as HIV and Hepatitis C. Sharing needles and “works” (syringes, spoons, filters and blood-contaminated water) is thought to be three times more likely to transmit HIV than sexual intercourse. 1 Disinfecting equipment between each use can reduce the chance of transmission, but does not eliminate it entirely. For more information, visit our pages on ' People who inject drugs and HIV', ' Needle exchanges' and ' Harm reduction'.
An infected pregnant woman can pass HIV on to her unborn baby during pregnancy, labour or delivery. HIV can also be transmitted through breastfeeding. This type of HIV transmission is also known as vertical transmission.
If a woman knows she is infected with HIV, there are drugs she can take to greatly reduce the chances of her child becoming infected. For more information, go to our pages about HIV and pregnancy and mother-to-child transmission of HIV.
Blood transfusions and blood products
Some people have been infected through a transfusion of infected blood. These days, all the blood used for transfusions in high-income countries is tested for HIV and HIV infection through blood transfusions is now extremely rare. Yet this is not the case in some middle- and low-income countries, where a lack of adequate blood safety procedures means HIV transmission through blood transfusions continues to occur.
Blood can be separated into its different components, for example: red blood cells, white blood cells, platelets, plasma and immunoglobulins. 2 These are known as blood products. Whilst whole blood can be placed through a rigorous screening process and infected donations discarded, some blood products, such as those used by people with haemophilia, can be heat-treated to make them safe.
Infection in health-care settings
Hospitals and clinics should take precautions to prevent the spread of blood-borne infections. These measures include using sterile surgical instruments, wearing gloves, and safely disposing of medical waste. In high-income countries, HIV transmission in health-care settings is extremely rare. However, cases continue to occur in some middle- and low-income countries where safety procedures are not so well implemented.
Health-care workers have on rare occasions become infected with HIV by being stuck with needles containing HIV-infected blood. A few people have also become infected by HIV-infected blood getting into the bloodstream through an open cut, or splashing onto a mucous membrane (e.g. the eyes or the inside of the nose). There have been only a very few documented instances of patients acquiring HIV from an infected health-care worker. We have more information about healthcare workers and HIV infection.
Tattoos / piercing
Anything that potentially allows another person's blood to get into your bloodstream carries a risk. If the equipment has not been sterilised, there could be a risk of HIV from tattoos or piercings if the previous person was infected with HIV.
In most developed countries there are hygiene regulations governing tattoo and piercing parlours to ensure all instruments used are sterile. If you are thinking of having a tattoo or piercing, ask staff at the shop what procedures they take to avoid HIV infection.
The risk of each transmission route
A 2014 study ranked which transmission route is most likely to cause HIV infection, each time someone is exposed to it. The study showed that blood transfusions carry the greatest risk, followed by mother-to-child transmission and then sexual activities. Of the sexual activities studied, receptive anal intercourse carried the highest risk, with oral sex having the lowest risk. 3
However, all of these risks can be eliminated if all blood transfusions are screened for HIV; all HIV-positive mothers and their infants receive antiretroviral treatment; and all sexually active HIV-positive people use condoms, and are on treatment!
You cannot get HIV from. . .
To become infected with HIV you must get a sufficient quantity of the virus into your body. There is HIV in saliva, but the virus is only present in very small quantities and as such has never been known to transmit HIV from kissing.
Unless both partners have large open sores in their mouths, or severely bleeding gums, there is no HIV transmission risk from mouth-to-mouth kissing.
Sneezing, coughing, sharing glasses/cups, etc
HIV is unable to reproduce outside its living host (i.e. a human). HIV does not survive long in the open air, and this makes the possibility of this type of environmental transmission remote. No environmental transmission has been recorded.
This means that HIV cannot be transmitted through spitting, sneezing, sharing glasses, cutlery, or musical instruments. Moreover, HIV transmission cannot occur via swimming pools, showers or by sharing washing facilities or toilet seats.
Studies conducted by many researchers have shown no evidence of HIV transmission through insect bites, even in areas where there are many cases of HIV and AIDS, and large populations of insects such as mosquitoes. The lack of such outbreaks, despite considerable efforts to detect them, supports the conclusion that you can't get HIV from insects.
HIV only lives for a short time and cannot reproduce inside an insect. So, even if the virus enters a mosquito or another sucking or biting insect, the insect does not become infected and cannot transmit HIV to the next human it feeds on or bites.
Injecting drugs with sterile needles
Injecting with a sterile (clean!) needle and works will not transmit HIV, as long as clean equipment is used each time and none of it is shared. However, there are still many other risks associated with injecting drugs. If a person is on drugs (including alcohol) then their judgement may be clouded, making them more likely to become involved in risky sexual behaviour, which increases the chance of exposure to HIV.
AVERT has more information on the risks involved with injecting drugs and HIV.
If used correctly and consistently, condoms are highly effective at preventing HIV transmission. A small minority believe condoms are not adequate protection and that 'some very small viruses can pass through latex'. Scientific tests have disproved this theory. 4
Condoms are effective at preventing HIV during both vaginal and anal sex and can help to reduce the risk of HIV from oral sex too. Further information can be found on the condoms page.
It is important not to get carried away and believe the myths around how HIV is transmitted. Myths and rumours are really damaging to people living with HIV because they can increase fear and anxiety, stigma and discrimination.
- 1. UNAIDS/UNODC (2010) ' Facts about Drug Use and the Spread of HIV', [PDF]
- 2. NHS Blood and Transplant (2012) ' Components of Blood'
- 3. Patel. P., et al (2014, April) ' Estimating per-act HIV transmission risk: a systematic review' AIDS Journal
- 4. CDC (2003) ' Male latex condoms and sexually transmitted diseases', Fact sheet for public health personnel [PDF]
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