Direct contact with HIV-infected blood occurs when people who use heroin or other injected drugs share hypodermic needles or syringes contaminated with infected blood. Sharing of contaminated needles among intravenous drug users is the primary cause of HIV infection in eastern Europe, particularly in Ukraine, Russia, Belarus, and Moldova. Epidemics of HIV infection among drug users have also emerged in Georgia, Armenia, Azerbaijan, and Kazakhstan in Central Asia
Less frequently, HIV infection results when health professionals accidentally stick themselves with needles containing HIV-infected blood or expose an open cut to contaminated blood. Some cases of HIV transmission from transfusions of infected blood, blood components, and organ donations were reported in the 1980s. Since 1985 government regulations in the United States and Canada have required that all donated blood and body tissues be screened for the presence of HIV before being used in medical procedures. As a result of these regulations, HIV transmission caused by contaminated blood transfusion or organ donations is rare in North America. However, the problem continues to concern health officials in sub-Saharan Africa. Less than half of the 46 nations in this region have blood-screening policies. By some estimates only 25 percent of blood transfusions are screened for the presence of HIV. WHO hopes to establish blood safety programs in more than 80 percent of sub-Saharan countries by 2003.
How do women become infected with HIV?
HIV is spread through contact with blood, semen or other body fluids (except saliva) from a person infected with HIV. This can happen during sex. It can also happen when needles are shared with a person infected with HIV. In the past, HIV was also spread through blood transfusion. Blood donations are now tested for HIV, and HIV-infected blood is destroyed. HIV is not spread by casual contact such as hugging, kissing, holding hands, sitting on toilet seats or sharing clothing.
More than half of women who have HIV got the infection from sexual partners. A woman can be infected by contact with a man or contact with another woman. When a woman has sex with an infected man, she has a high risk of getting HIV if a condom is not used properly. Ask your doctor for instructions on proper use of condoms.
Who is at risk for HIV infection?
In the early days of the AIDS epidemic, HIV infection appeared to be confined to certain groups, including intravenous drug users, men who have sex with other men and persons with hemophilia (a blood-clotting disease that requires treatment with frequent blood transfusions). People with hemophilia got HIV from receiving blood transfusions with donated blood that contained HIV.
These days, HIV infection is much more widespread. Here is a list of people who are at high risk of HIV infection:
Men who have sex with other men.
Anyone who has multiple sex partners.
Anyone who has sex with a prostitute.
Anyone who shares needles using illegal injected drugs.
Anyone who exchanges sex for drugs or money.
Anyone who has a sexually transmitted disease.
Anyone who has had or currently has a sexual partner with any of the above risk factors.
Since most people who are infected with HIV appear healthy, a blood test for the virus is necessary to see who has the infection. People who have a positive blood test for HIV are called HIV-positive. Ask your doctor how to obtain confidential testing for HIV. Your doctor can help you understand what the test results mean.
The only 100% sure way to keep from getting the AIDS virus is to not have sex at all or to have sex only with a partner who does not have HIV infection. Avoiding contact with human blood and other body fluids and not sharing needles are also important steps in avoiding HIV infection.
Is HIV infection different in women and men?
HIV infection is somewhat similar in men and women. For a long time after becoming infected, the person seems healthy. Over many years, the person's immune system gradually becomes weaker until it is unable to fight off other infections. In general, the types of infections that people with HIV get, such as Pneumocystis pneumonia or Kaposi's sarcoma, and their treatments are the same in women and men.
The difference between men and women is that HIV-infected women often have additional problems such as repeated vaginal yeast infections, especially as the immune system becomes weaker. More serious infections, such as PID (pelvic inflammatory disease--an infection of a woman's internal reproductive organs), can be harder to treat because the body can't help in fighting off infections as well. Diseases of the cervix, such as precancer (dysplasia) and cancer, progress faster. They can be harder to treat if a woman has HIV.
What precautions can be taken to avoid getting HIV during sex?
A male latex condom that is used properly helps prevent HIV infection. It also helps to prevent a woman from giving HIV infection to her sexual partner. The male latex condom also helps to protect a woman from other sexually transmitted diseases, such as herpes, gonorrhea, genital warts and syphilis.
The female condom (brand name: Reality) also helps block the spread of HIV. Doctors suggest using a female condom when a male condom can't be used. The diaphragm may not provide protection against HIV. Birth control pills, Injections of medroxyprogesterone acetate (brand name: Depo-Provera) and contraceptive implants (brand name: Norplant) do not protect a woman from getting HIV infection. They only protect her from getting pregnant.
How do babies get HIV from their mothers?
Babies can get HIV infection from their mothers during pregnancy, during the birth process and during breastfeeding.
It is now possible to prevent many cases of HIV in children by giving medicines to the pregnant mother and to her newborn baby. This protection cannot be offered if a pregnant woman does not know she is infected. Many people with HIV feel perfectly healthy at first. The only way to know if you are infected is to have an HIV test. If you are pregnant, ask your doctor for an HIV test as part of your prenatal care. Better yet, if you are thinking about getting pregnant, talk to your doctor about HIV tests for you and your partner.
What should I do if I think I may be infected?
If you think you may be infected with HIV, contact your doctor immediately. Even though there is no cure for the disease, early diagnosis and treatment with medicines can be started to slow the progression of the disease. Your doctor will be able to give you more advice about how to take care of yourself if tests show that you have HIV.