ANSWERS TO QUESTIONS FROM SCHOOL STUDENTS IN INDIA

HOW HIV SPREADS

by Rajan Gupta

  • What are the different ways of acquiring HIV infection?

  • In infected people, the virus is present mainly in the blood, and in the seminal fluids of men, and vaginal secretions and breast milk of women. To transmit HIV from one person to another requires the virus in the blood of an infected person enter into the body of another, or through sex with an infected person, or from an infected mother to her child. The highest risk from sexual transmission is from anal sex, followed by vaginal sex, and a much smaller risk from oral sex. Blood contact can be through transfusion of infected blood or when taking care of of a bleeding HIV+ person; use of needles without proper sterilization for hypodermic injections or for giving tattoos, or by accidental pricks by such contaminated needles which happens mostly if they are not properly disposed.

  • Can an infected person give you HIV/AIDS by poking you with a needle/scratching you with a blade/touching you/or kissing you?

  • A person can give you HIV/AIDS if they puncture your skin with any object that is contaminated with infected blood. However, this has happened in very few cases, maybe in about 10 cases out the 55 million people infected worldwide so far. So the risk of such occurrences is negligible. The chances of getting HIV/AIDS from kissing are also very small. Health official do not worry about these risks as they are so small that if these were the only causes, then HIV would have never spread in the first place.

  • If you refrain from having sex (abstinence), can you still get AIDS?

  • YES. You can still get HIV/AIDS even if you do not have sex with anyone. This can happen if the blood of an infected person enters your body in any one of the following ways. (i) Contaminated needles: A needle that has been used on a HIV/AIDS person is used again on you without proper sterilization; (ii) you, by accident, prick yourself with a needle or a sharp object that has previously been in contact with an infected person's blood. This is a risk especially for nurses and doctors. (iii) Sharing Needles: this is a risk seen mainly in intravenous drug users. (iv) Tattoos: A needle is used to put ink under your skin, thus coming in contact with your blood. (v) Mother to child: When a women gives birth, there is a lot of bleeding, and the child is in contact with this blood. (vi) Breast feeding: an infected mother can give it to her baby through breast milk as the virus is present in breast milk.

  • If a girl has sex with an HIV infected person with the use of condom, can the girl get affected?

  • Latex Condoms prevent the exchange of semen from man to woman (or man in case of homosexual sex) or vaginal fluids from the woman to the man (or woman). The virus is present in the semen if the man is HIV+ and in the vaginal fluids in the woman is HIV+. Risk arises, because sometimes the condom can come off during sex or can tear or is not put on the penis early enough (or inserted into the vagina if a female condom is being used). Any of these failures can lead to exchange of bodily fluids during foreplay and during sex. Thus, while condoms are our only means of making sex safer, they are NOT 100% safe. If couples (married or unmarried) are going to use condoms, it is very important they discuss this matter carefully before getting into an intimate situation and practice using the condom so that they feel comfortable with it.

  • Why does frequent sex before marriage give you AIDS but not so in married life?

  • The risk for HIV does not arise from having sex frequently but from having sex with an HIV infected person. By having sex as often as you want with your marriage partner does not introduce the risk for HIV if neither of you are infected to start with. Similarly, before marriage, having sex with only one partner and that partner having sex only with you does not introduce the risk of HIV. The risk of HIV from pre-marital sex arises because studies show that very often a person who has sex before marriage has sex with many different partners. Since people do not disclose their sexual history, and HIV does not have any special symptoms in the early stages, it is very hard to determine if your partner is infected. So each time you have sex with someone whose sexual history you do not know, the risk for HIV is present. The more sexual partners a person has had, the higher the risk.

  • Is condom 100 percent safe against AIDS?

  • Latex Condoms prevent the exchange of semen or vaginal fluids in which the virus is present. However, sometimes the condom can come off during sex or can tear or are not put early enough and there is exchange of bodily fluids during foreplay. Thus, while condoms are our only means of making sex safer, they are NOT 100% safe.

  • Will using two condoms help protect you from AIDS more than using one condom?

  • The only way in which two condoms work better than one is to reduce the risk of virus going through the latex. On the other hand, unless a person is very careful and the condoms are the right kind, the chances of both of them coming off during sex or getting nicked while putting on (and then tearing during sex) are high. Our best advise is to use a good quality latex condom, and learn how to put it on correctly and at the very beginning of sexual activity -- even before foreplay. Also, one should not use petroleum based lubricants on the condoms as they weaken latex condoms.

  • After sterilization, if you have sex with a HIV+ person, can you still get infected?

  • Sterilization is a surgical procedure by which the tube that carries the sperm in males (vasectomy) or the fallopian tubes in females (tubal ligation) are cut or blocked. This is done as a birth control method for people who do not want to have any more children but want to continue having sex. HIV is transferred during sex and its transmissibility is not changed depending on whether a person is sterilized or not. Sterilization does NOT stop the production of seminal fluids in men or vaginal discharge in women (these are the wet, lubricating fluids that are secreted during sexual arousal and even normally). So having sex after sterilization with a HIV positive person without using a latex condom is very risky and can transmit HIV infection.

  • Can a child in the womb get infected with HIV if the mother is infected already?

  • As far as we know, almost all children get infected when a women gives birth and not while the child is in the womb. At birth there is a lot of bleeding, and the child comes in contact with this blood. A second way after birth is due to breast feeding. An infected mother can give HIV to her baby is she gives the child her breast milk as the virus is present in breast milk.

  • Can delivering a baby via a Caesarean section lead to AIDS?

  • Delivering a baby by a caesarean section greatly reduces the risk of infection from mother to child as compared to a natural delivery. For this reason, caesarean birth is a method used to deliver babies if the mother is known to be HIV+. If the mother is not infected then there is no need for caesarean delivery. Also, in countries where there is lack of adequate medical facilities like in parts of Africa and Asia, there is a risk of transmission to both the mother and child if unsterilized instruments are used during caesarean delivery.

  • Can a pregnant women with HIV/AIDS pass on the infection to her child?

  • Yes. During a natural delivery, there is tearing of tissue and muscles inside the mother. As a result, the infant is exposed to a lot of maternal blood as it passes through the cervix and the vagina. This contact with maternal blood puts the infant at risk for HIV infection.

  • Can masturbation give AIDS?

  • Masturbation DOES NOT transmit HIV/AIDS. Here it is worthwhile for explain what masturbation is. It is the process by which a boy (or a girl) stimulate themselves sexually and have an orgasm. Since only one person is involved, there is no transmission of HIV. Sometimes two people can carry out the same acts as in masturbation and excite each other. This is called mutual masturbation. This behavior does carry a small risk of HIV infection if bodily fluids of one person (who is infected with HIV) are rubbed against or come in contact with the genitals or mouth of their sexual partner.

  • Can a father give HIV/AIDS to his child?

  • A new born child does not acquire HIV/AIDS from the father. The way in which a father can give HIV/AIDS is to first give it to the mother before the child is born, and then the infected mother can give it to the child at the time of birth.

  • Why didn't, throughout history, kings with large harems get infected?

  • There are two reasons. First, HIV is virus that has emerged very recent, so kings throughout history were lucky as there was no HIV before 1900. Second, HIV cannot spread within a group of people (which includes a harem) if no person within that group has sex with anyone outside, or does not get infected by blood contact. Kings in old days were very strict in making sure that no women in their harem could have sex with anyone other than the king. The punishment was usually death. This was their way of protecting themselves from disease, disloyalty, and unwanted pregnancies.

  • How does blood get infected with HIV/AIDS?

  • When the virus enters the body either through contact with infected blood or through mucous membranes during sex with an infected person, it has a certain amount of time (about an hour on average) to find a host cell before it dies. As it moves through the bodily fluids (blood) it can come in contact with the right kind of cell that can serve as its host. When this happens, HIV punctures the cell wall, enters, and begins its reproduction cycle.

  • If blood cells are the hosts for HIV/AIDS, how does sex cause it?

  • HIV is present in a number of bodily fluids other than the blood even though its host cells are mainly found in the blood and lymph fluids. For example, in the women it is also present in the vaginal secretions and breast milk and in men in the seminal fluid. Since there is the exchange of vaginal secretions from woman to man (woman) and seminal fluid from man to woman (man) during sex, sex can transmit HIV from a man to a woman (man) or from a woman to a man (woman). Also, sometimes there is bleeding during sex, and since there is a higher concentration of HIV in blood, such bleeding increases the chances of transmission.

  • How long does it take for a person to become infected with HIV/AIDS?

  • The infection begins as soon as the HIV virus enters the blood system of a human being and starts replicating by infecting the CD4 cells. From that time onwards, once the viral reproduction cycle starts, the infection is established and we have no way of clearing it completely from the system. The infection is thereafter lifelong.

  • Is HIV/AIDS hereditary?

  • NO. It is acquired through sex with an infected person or if the blood of an infected person enters the body of another person through cuts, punctures or by transfusion.

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    Rajan Gupta