Transmission

How is HIV transmitted?

HIV is transmitted through:

Are you sure that these are the only ways that HIV can be transmitted?
  • unprotected sexual contact, primarily through unprotected vaginal or anal intercourse with someone living with HIV. Worldwide, sexual intercourse is the leading mode of HIV transmission. Oral sex is very unlikely to result in the transmission of HIV but risk increases if the mouth or genitals have cuts and/or sores.
  • exposure to infected blood. The most efficient means of HIV transmission is the introduction of HIV-infected blood into the bloodstream, particularly through transfusion of infected blood. Most blood-to-blood transmission now occurs as a result of multiple use of contaminated injection equipment during injecting drug use. Use of improperly sterilized syringes and other medical equipment in health-care settings can also result in HIV transmission. The UN Medical Services are required to take all the necessary precautions and use only new or sterilized equipment. We in the UN system are unlikely to become infected this way, if using UN system medical facilities and those facilities approved by the UN system. Extra precautions should be taken, however, when using medical facilities not approved by the UN, as the UN cannot ensure the safety of blood supplies or injection equipment obtained elsewhere. It is always a good idea to avoid direct exposure to another person's blood--to avoid not only HIV but also hepatitis and other blood-borne infections.
  • transmission from a mother with HIV infection to her child, during pregnancy, during delivery, or as a result of breastfeeding.
    Are you sure that these are the only ways that HIV can be transmitted?

    Yes. HIV is the most carefully studied infection in history. Overwhelming evidence indicates that you cannot become infected or infect others in any of the following ways:

    • Shaking hands, hugging or kissing
    • Coughing or sneezing
    • Coming into contact with saliva
    • Using a public telephone
    • Visiting a hospital
    • Opening a door
    • Sharing food, eating- or drinking-utensils
    • Sharing toothbrushes
    • Using drinking fountains
    • Using toilets or showers
    • Using swimming pools
    • Getting a mosquito or insect bite
    • Working, socializing or living side by side with people living with HIV

    Is it safe for an uninfected person to work with people who are living with HIV, and vice versa?

    Yes. HIV cannot be transmitted as a result of casual contact. It is perfectly safe to work with people living with HIV or with people whose HIV has progressed to AIDS. UN personnel policies strictly prohibit discrimination against personnel living with HIV. The United Nations HIV/AIDS Personnel Policy ensures a safe workplace while protecting the dignity and human rights of all personnel.

    HIV cannot be transmitted as a result of casual contact. It is perfectly safe to work with people living with HIV or with people whose HIV has progressed to AIDS.

    Is it safe to hire people living with HIV to work in our homes?

    Yes. As HIV can only be transmitted through unprotected sex and blood transfusion or use of non-sterilized injection equipment, or from mother to child, there is no reason why a person living with HIV should not be hired, just as there is no reason why a person living with HIV should feel that they could not be employed in someone's home. Remember that HIV cannot be transmitted through hugging, kissing, playing with your children, using a common toilet, sharing drinking or eating utensils, preparing food for your family or other household work.

    UN policy is very clear that HIV should not be a factor in recruitment or determining employment. Screening for HIV is not mandatory for employment and no one living with HIV is required to disclose his or her status. The ILO also encourages this standard for all employers worldwide. UN personnel who hire people to work in their homes should also follow the same policy.

    The UN recommends that all such personnel have access to prevention, as well as care and treatment services. As your home is also a workplace please make information about HIV readily available to employees that you hire either directly or through local organizations. You can share what you know with your household employees, and encourage them to get tested and learn more about HIV.

    MOTHER-TO-CHILD TRANSMISSION

    Is it okay for me to have a baby if I'm living with HIV?

    For many HIV-positive people, deciding whether to have a child can be extremely difficult. An important first step is to consult your doctor to obtain the latest information and to get advice and counselling in order to make healthy decisions. If you are a male living with HIV, consider the potential impact on your female partner's health. If she is HIV-negative it is important that she remain HIV-free because becoming infected during pregnancy increases the risk of HIV transmission to the foetus. If she is HIV-positive too, the baby could contract HIV during pregnancy, birth or breast-feeding. Every year, hundreds of thousands of children become infected with HIV during pregnancy, delivery, or as a result of breastfeeding. Fortunately, some of the antiretroviral drugs that have proven so effective for the treatment of HIV infection itself are also effective in significantly reducing the risk of HIV transmission from mother-to-child.

    Effective prevention of mother-to-child transmission includes several components. If you are pregnant, you should receive antenatal care from a qualified health-care provider. Most antenatal doctors will offer you an HIV test; if yours does not, you should request one. If you test HIV-positive in the antenatal setting, you will be counselled about your reproductive options.

    Reducing the risk of mother-to-child transmission A pregnant woman who is HIV-positive can pass the virus on to her baby in the womb or during childbirth, or postnatally through breastfeeding. Studies in industrialized countries indicate that the entire prevention package--voluntary counselling and testing, comprehensive antenatal care and associated counselling, adequate antiretroviral therapy with the most effective regimen, and counselling on breast-feeding alternatives--can reduce the risk of mother-to-child transmission to a rare event. With these measures, the risk of mother-to-child transmission can be reduced to as low as 2%. When it comes to postnatal transmission, if possible, a woman living with HIV should avoid breast-feeding and use only breastmilk replacements if these are safe and available. In no case--whether the woman is living with HIV or not--should a woman mix breast-feeding with formula feeding or other foods as this can actually weaken the baby's own ability to fight infections. If a woman living with HIV must breast feed, she should do so exclusively for the first six months and then switch to replacement feeding.

    Ultimately, only you can decide whether to have a child if you are living with HIV. This can be a particularly difficult choice if you are pregnant because you have been raped. If you receive care through a UN-affiliated medical provider, you can rest assured that you will receive the information, counselling and support you need to make an informed choice. Having children remains an option for people living with HIV. For many people, children provide great joy and a sense of purpose in their lives, and it is important that we support the right of people living with HIV to be parents.

    For more information on mother-to-child transmission, please refer to http://www.who.int/hiv/pub/guidelines/pmtct/en/ and http://www.who.int/hiv/topics/vct/toolkit/additional_resources/children/en/index3.html.

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