HIV Prevention

Currently there is no vaccine for the human immuno-deficiency virus (HIV). This means that we all have to take preventative steps to avoid HIV infection. This includes educating yourself, avoiding risky behaviors  and knowing your HIV status. Since the virus is spread through blood and other body fluids, the only way to avoid the virus is by avoiding activities which involve contact with these fluids. Such activities can include sexual contact (vaginal, anal or oral), drug abuse, childbirth, occupational exposure, and blood transfusion.

Sexual contact

Sexual contact with an HIV-positive partner is the most common route of HIV infection. During sexual activities. HIV-containing body fluids can enter the HIV-negative partner’s bloodstream through sores, cuts, or even unnoticeable breaks in the skin. This risk is increased when either partner has an additional sexually transmitted disease. Abstaining from sex is the best way to avoid HIV infection via sexual contact. If you choose to be sexually active, you should always wear a latex condom and make sure it is used correctly. For example, to prevent condom breakage use water-based lubrication and use a new condom for each sex act (this may include multiple sex acts with the same partner in the same night). Remember that condoms are the best way of preventing transmission of any STD, and are close, but not 100% effective in preventing HIV infection. Limiting the number of sexual partners will also decrease your risk of HIV contraction if you are sexually active. Another key to combating this epidemic is being aware of your HIV status and that of your partners before you engage in sexual activities. Communication cannot be stressed enough. If you are sexually active, make it your responsibility to get tested and to ask about the HIV status of your partners. Testing is the only way to know if you or a partner is HIV-positive.

Pre-exposure prophylaxis

Prophylaxis is any measure taking to prevent disease. Recently, a pre-exposure prophylaxis drug called TRUVADA was approved for HIV prevention in high risk individuals. This drug is designed especially to lower HIV-1 infection in high risk individuals who also practice safe sex. For example, this includes HIV-negative partners in a sexual relationship with an HIV-positive partner. Individuals taking TRUVADA are recommended to be counseled regularly on safe sex practices and receive HIV testing every 3 months. Just like any antiretroviral therapy, this drug must be taken on a strict schedule in order to be effective. Poor adherence may build a drug-resistant form which could infect the seronegative person. For more information on this method of HIV prevention, visit http://start.truvada.com/.

Drug use

HIV can also be spread by sharing needles or other equipment primarily in the use of intravenous drugs. Blood from one individual can adhere to the needle and enter another person’s blood stream when the needle is injected. One way to avoid this route of exposure is to treat the drug addiction. There are countless resources and treatment options for those who are addicted to intravenous drugs. In addition, in several of the major cities in the US and abroad there is a needle and syringe exchange program (NSP, SEP) which provides clean needles free of charge. One can also purchase disposable needles from most pharmacies to throw away after use. As always, non-injection methods are a safer option. Intravenous and non-intravenous drug users are are also at higher risk for HIV infection because being impaired under the influence of drugs reduces your ability to make safe decisions, which may lead to anonymous or unprotected sex. To avoid this situation, do not have sex while drunk or high.

Pregnancy

If an untreated HIV-positive woman becomes pregnant, there is a 25% chance that the virus will spread to the baby either during pregnancy, during birth or through breastfeeding since mother and baby share fluids during these times. If you are a woman who is HIV-positive you should consider abstaining from sex or being extra careful about using condoms while sexually active because research shows you are twice as likely to pass the virus to your male partners. If you do not know your HIV status and become pregnant, get tested as soon as possible. Luckily, antiretroviral therapy (ART) for HIV-positive mothers can reduce the risk of transmission of HIV from mother to child to less than 2%. Making healthy choices such as eating right, not smoking or drinking, getting prenatal care and staying rested can also lessen the risk of transmission from mother to child. HIV-positive mothers will not be able to breastfeed. If you are HIV-positive and want to have children, ask your doctor about different ways to accomplish this without putting a sexual partner at risk, avoid passing the virus to your child, and how to manage a pregnancy while HIV-positive.

Occupational exposure

Healthcare workers are often at risk for contracting HIV while at their daily jobs. If the proper preventative measures are taken, this risk can be greatly minimized. While contaminated needle injuries account for the majority of occupational exposure cases, workers can also be infected if contaminated blood splashes into their eyes, nose, mouth, or an open wound. All workers should be properly trained before starting to work with potentially hazardous materials. Furthermore, the best way to prevent occupational exposure to HIV and other blood-borne diseases is to treat all blood-containing items as contaminated. Workers should always wear the appropriate personal protective equipment such as gloves, masks and gowns. After working with blood or other body fluids, it is extremely important to dispose of all contaminated materials properly and wash your hands thoroughly. In the event of an accidental exposure, post-exposure prophylaxis (PEP) can be taken to reduce viral infection. Unfortunately, PEP must be administered 72 hours after the exposure, is very expensive, and causes multiple serious side effects.

Blood transfusions and organ transplants

Since 1985, when HIV testing became readily available, all donated blood and organs in the United States and many other countries has been routinely checked for HIV. Donated blood is tested for HIV in two ways – by detecting if the blood contains antibodies against HIV, and detecting if the blood contains genetic material from the virus. Any blood, blood products, or organs which test positive are safely disposed of and are never used for transfusion procedures. Unfortunately, some people who are newly infected with HIV will test negative. Because of this, blood and organ donors are also screened for their inherent risk factors (how likely they are to become HIV-positive even if they are not currently) and prevented from donating if they are found to be at too high of a risk. If a donor’s blood tests positive, he/she will be notified, and prevented from making further donations. Since the procedures for taking blood donations are regulated with high safety, there is no risk for acquiring HIV by giving blood.

Getting tested for HIV

Besides being educated on how HIV can be spread and avoiding high risk scenarios, effective HIV prevention also involves knowing your HIV status. The CDC recommends that everyone between the ages of 13 and 64 get routinely tested once a year. However, if you engage in risky behavior the recommendation for testing frequency can increase. The CDC also recommends HIV testing for pregnant women in their first trimester and sometimes recommends re-testing in their third trimester. Always be open with your healthcare provider about your activities and behaviors, and ask their suggestion about testing frequency. To find a nearby HIV testing site you can search below.