We’ve all heard about how HIV is transmitted through sex, but understanding how it infects the body is essential to keeping protected. Before transmission can occur between two people, there needs to be an exposure (most often, a sexual encounter between an HIV-positive person and an HIV-negative individual). An exposure is any time there is a chance of infection by an HIV-positive person. More specifically, exposure will most often occur during vaginal or anal sex. An HIV-positive person is only at risk to another individual if there is bodily fluid with enough virus to transmit.
When it comes to sexual transmission, this often includes rectal fluid, vaginal fluid, re-cum, ad semen. The non-sexual transmission will consist of blood, although this most often isn’t attached to sexual contact. These fluids might cause infection when it enters the body of an HIV-negative person. This entrance can include mucous membranes, as well as any sores or cuts on the body. This consists of the anus and rectum, cervix and vagina, urethra, and foreskin on the penis.
Does an Exposure Mean Catching HIV?
Not necessarily, no. Infection isn’t automatic just because exposure to HIV occurs. The fluid needs to come into contact with a mucous membrane to transmit, followed by a difficult journey to infection. In some instances, the body protects against the virus and prevents the disease from continuing. Some medications can also lessen the chance of catching HIV, even with direct exposure. Pre-exposure prophylaxis (PrEP) prevents the virus from replicating in the body by adding high concentrations of drugs near common points of contact. These levels continue to build over time, with 99% prevention rates.
In order to become infected, HIV needs to travel across the cell layer of your body and enter the body on its own. If there is damage to the cell layer (a cut or abrasion, for example), this can facilitate transmission. Damage can also include sexually transmitted diseases, ulcers, sores, or holes within the membrane. Small tears that occur during friction can also facilitate the transfer of HIV.
Other examples of transmission sites can include brushing teeth, flossing, “bottoming” during anal sex, surgery, douching, or enemas.
Viral Load Influence in Transmission
The higher the level of HIV that the cell layer was exposed to, the greater the probability of the virus getting through. If someone has lowered the viral load (the amount of the virus within the body), there is a much lower chance of an HIV-negative person catching the virus. The viral load of a person on treatment is incredibly high during the first 10-12 weeks of infection. It’s also considerably higher during the advanced stages of the HIV disease.
STIs such as chlamydia, herpes, syphilis, and gonorrhea can all impact the levels of an HIV-positive viral load. It essentially brings an increase of the viral load to the site of the STI. Therefore, an individual with multiple STIs is more likely to transmit HIV to their partner, purely because of the higher levels within that area.
Preventative Action Against HIV
Currently, no HIV vaccine is available, but the goal of the vaccine would be a preparation of the immune cells if faced with an attack. PrEP and PEP are two antiviral medications that significantly reduce the likelihood of contracting HIV by decreasing the ability to replicate within the body. A person would have to be HIV-negative for this therapy to work, and they must be taking the medication for seven days before exposure.
There is no way to reduce the risk to zero, but preventative methods are easily the best options for preventing infection. When an individual is uncertain about a partner’s status, barrier methods are the best method of preventing HIV. This means using condoms when engaging in sexual activity and talking to all partners about their status before being intimate.
If you have an ongoing relationship with an HIV-positive person, always speak to your doctor about antiviral medications like PrEP and PEP before moving forward. While HIV can be a scary topic, communication is the easiest way to prevent transmission. Maintaining your sexual health with regular STI screening can also lessen your chance of transmission overall.