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PREVENTING TRANSMISSION OF HIV INFECTION: UNDERSTANDING HOW HIV IS SPREAD: PRINCIPLES OF CONTAGION-EFFICIENCY OF TRANSMISSION:
LIKELY RISKS
Because the types of contact are so specific and the numbers of the virus in some body fluids are so low, HIV is not transmitted efficiently. Certain kinds of contact transmit HIV more efficiently than others. This section will discuss efficiency of transmission in terms of the likelihood that a given type of contact will transmit HIV. The types of contact that transmit the virus most efficiently are those with the highest risk for infection.
This section discusses the ways in which HIV may be transmitted. The risks are scientifically established, though actual transmission in these ways is rare. The risk might be compared to the risks of being hit by a car when crossing the street, of having an accident while driving to work, or of being struck by lightning in a thunder storm.
Safer sex (with condoms and with spermicide, or sexual contact that does not involve getting semen, blood, or vaginal fluid from one person's body into another's) with people known to have HIV infection or with people who have a high risk of HIV infection: Though safer sex is known to be safer, no one believes it is completely safe. Exactly how safe it is, no one knows.
Nonsafe heterosexual sex with multiple partners, especially if partners are anonymous, intravenous drug users, gay or bisexual men, or prostitutes in cities with high rates of HIV infection: No one knows exactly what the risk of nonsafe sex with multiple partners is; the risk depends entirely on whether your partners are likely to be infected. Other studies show that the risk of infection might be higher.
Breast-feeding: No one knows exactly how large a risk breastfeeding is. The transmission might be bi-directional, that is, the mother may infect the baby or the baby may actually infect the mother. An infected rnother may infect the baby because HIV is also found in breast milk. An infected baby may also rarely infect the mother: some babies infected by blood transfusions before 1985 or by contaminated syringes in Russia appear to have infected their mothers during breast-feeding.
Needlestick injury, primarily for health care workers: One in 250 needlestick injuries has transmitted the virus to the person stuck. It appears that rare patients may acquire HIV infection from infected health care workers as well: We know of one dentist who transmitted HIV to five patients. Just how the transmission occurred, however, is unclear.
Blood transfusion, artificial insemination, or organ transplantation from an infected donor: Between 1978, when HIV infection first appeared, and 1985, when the Red Cross began screening all blood for HIV, this was a high risk if the donated blood contained HIV. About 90 percent of the people who received HIV-contaminated blood became infected with HIV. Now the blood supply is almost, but not completely, clear of HIV: probably between one in forty thousand and one in two hundred thousand units slips past the HIV screening process. The same scenario held for hemophiliacs, who are treated with a blood product called clotting factor that is pooled from the blood of several thousand donors. Between 1978 and 1985, 30 to 70 percent of hemophiliacs who were treated became infected with HIV. Currently, not only are all blood donors screened, but the clotting factor is treated so that any HIV that does slip through is destroyed before transfusion.
Unprotected oral sex: No one know just how much of a risk unprotected oral sex is. On one hand, there are a few stories about people becoming infected with HIV through oral sex. On the other hand, the researchers who gather statistics on risk can find only occasional people who have oral sex exclusively (in other words, they never have anal or vaginal sex), so few studies confirm those stories. Certainly infected semen in the mouth could transmit the virus through any cuts or sores. Infected menstrual blood in the mouth could do the same. Infected vaginal fluids in the mouth are less likely to transmit HIV but are theoretically able to as well.

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HIV