"HIV is transmitted when blood or sexual fluid from an infected person somehow gets into the bloodstream of another person", says clinicial psychologist Clinton Gahwiler from Aids Training Information and Counselling Centre in Plumstead.
"Counsellors are often presented with the question – ‘I have done this or that – Am I at risk?’ If blood or sexual fluids from a person with unknown status had a chance to get into your bloodstream, the answer is 'yes'."
What would be needed for the virus to be transmitted are three things: direct contact with penetrative sex, risky behaviour and a mixing of body fluids.
HIV is present in blood, semen, vaginal fluid and breast milk in varying concentrations. It is present in sweat, saliva and tears only if contaminated with the above bodily fluids. The virus does not survive well outside its host and there have so far been no proven cases of people contracting the virus from environmental sources, such as toilet seats. It cannot reproduce outside of its host.
Are there behaviours or indicators that contribute to putting you at risk for contracting HIV?
Reason for risk:
A. Possible transmission of HIV through the mixing of blood
B. Possible transmission of HIV through the mixing of sexual fluids
|High risk behaviours||A||B|
|Unprotected sexual intercourse||Yes||Yes|
|Unprotected anal intercourse||Yes||Yes|
|Sharing intravenous and tattooing needles or having a partner who is an IV drug user||Yes||No|
|Drinking alcohol||Yes, if it leads to high risk needle sharing||Yes (heightens chance of high risk sexual behaviour and forgetting to use a condom)|
|Using drugs||Yes, it can lead to high risk needle sharing behaviour, tattooing, piercing||Yes (heightens chance of high risk sexual behaviour and forgetting to use a condom)|
|Previous infection with a sexually transmitted infection (STI)||No||Yes (previous STIs heighten the likelihood of contracting them again)|
|Partner with a previous infection with a STI||No||Yes (past risky behaviour increases likelihood of being HIV positive)|
|Multiple partners without practising safer sex||Yes||Yes (if someone has had many sexual partners and one of them was HIV positive, it increases your risk of contracting HIV)|
|Oral sex||Yes (if either partner has open sores, risk is increased)||Yes (if either partner has open sores, risk is increased)|
|Low risk behaviours||A||B|
|Kissing||Yes (unless both partners have open sores in their mouths)||No|
|Heavy petting and mutual masturbation||Yes (the only risk is if you have sores or open cuts on your fingers or you bite your partner and break the skin)||Yes (the only risk is if you have sores or open cuts on your fingers and get vaginal fluid or sperm into them)|
|Intercourse using a condom||Yes (if used correctly, a condom provides adequate protection against STIs, but there is always the possibility that it could break)||Yes (if used correctly, a condom provides adequate protection against STIs, but there is always the possibility that it could break)|
|Sexual intercourse within a monogamous sexual relationship with someone who is free of STIs||Yes. The only risk here is if your partner turns out to be less than faithful.||Yes. The only risk here is if your partner turns out to be less than faithful.|
Abstinence and masturbation are probably the only no risk sexual behaviours. But sticking to this is not always possible or realistic. The possibility of contracting HIV has impacted on people's sexual behaviours and lifestyle. Gone are the days where pregnancy or herpes was the worst possible consequence of risky sexual behaviour. Having sex without a condom in the 21st century could be like signing your own death warrant or playing Russian Roullette.
"Every day there are 4 700 South Africans who become infected with HIV – a condom can go a long way to ensure that you are not one of them," says Gahwiler.
It is important to ensure the correct use of condoms. They need to be of good quality; not expired or must not have been in the direct sun.
Only water-based lubricants should be used and in adequate quantities.
Femidoms also provide good protection.
Tattoo needles and needles for piercing have to be sterile. During traditional health practices one also needs to ensure that only sterile needles or blades are used.
It is also important to make sure that your dental health is always good. It is more important to clean your teeth after sex than before.
(Article reviewed by Dr Ashraf Grimwood, Cape Town GP with a special interest in HIV/Aids)