If I already have HIV can I get another type of HIV through unprotected sex with someone else positive?

Yes. This is called HIV superinfection.

HIV superinfection is when a person with HIV gets infected with another strain of the virus. The new strain of HIV can replace the original strain or remain along with the original strain.

The effects of superinfection differ from person to person. Superinfection may cause some people to get sicker faster because they become infected with a new strain of the virus that is resistant to the medicine (antiretroviral therapy or ART) they’re taking to treat their original infection.

Research suggests that a hard-to-treat superinfection is rare. Taking medicine to treat HIV (ART) may reduce someone’s chance of getting a superinfection.

Learn more about how to protect yourself, and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

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Can I get HIV by injecting drugs? Other types of drugs?

Yes. Your risk for getting HIV is very high if you use needles or works (such as cookers, cotton, or water) after someone with HIV has used them.

People who inject drugs, hormones, steroids, or silicone can get HIV by sharing needles or syringes and other injection equipment. The needles and equipment may have someone else’s blood in them, and blood can transmit HIV. Likewise, you’re at risk for getting hepatitis B and C if you share needles and works because these infections are also transmitted through blood.

Another reason people who inject drugs can get HIV (and other sexually transmitted diseases) is that when people are high, they’re more likely to have risky sex.

If you keep injecting drugs, you can lower your risk for getting HIV by using only new, sterile needles and works each time you inject. Never share needles or works. For more information on how to lower your risk, see How can I prevent getting HIV from drug use?

What about using other types of drugs?

Drinking alcohol, particularly binge drinking, and using “club drugs” like Ecstasy, ketamine, GHB, and poppers can alter your judgment, lower your inhibitions, and impair your decisions about sex or other drug use. You may be more likely to have unplanned and unprotected sex, have a harder time using a condom the right way every time you have sex, have more sexual partners, or use other drugs, including injection drugs or meth. Those behaviors can increase your risk of exposure to HIV. If you have HIV, they can also increase your risk of spreading HIV to others. Being drunk or high affects your ability to make safe choices.

If you’re going to a party or another place where you know you’ll be drinking or using drugs, you can bring a condom so that you can reduce your risk if you have vaginal or anal sex.

Therapy, medicines, and other methods are available to help you stop or cut down on drinking or using drugs. Talk with a counselor, doctor, or other health care provider about options that might be right for you. To find a substance abuse treatment center near you, check out the locator tools on SAMHSA.gov or AIDS.gov, or call 1-800-662-HELP (4357).

Learn more about how to protect yourself, and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

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Does my HIV positive partner's viral load play a part in my risk of being infected with HIV?

Yes, as an HIV-positive person’s viral load goes down, the chance of transmitting HIV goes down.

Viral load is the amount of HIV in the blood of someone who is HIV-positive. When the viral load is very low, it is called viral suppression. Undetectable viral load is when the amount of HIV in the blood is so low that it can’t be measured.

In general, the higher someone’s viral load, the more likely that person is to transmit HIV. People who have HIV but are in care, taking HIV medicines, and have a very low or undetectable viral load are much less likely to transmit HIV than people who have HIV and do not have a low viral load.

However, a person with HIV can still potentially transmit HIV to a partner even if they have an undetectable viral load, because

• HIV may still be found in genital fluids (semen, vaginal fluids). The viral load test only measures virus in blood.
• A person’s viral load may go up between tests. When this happens, they may be more likely to transmit HIV to partners.
• Sexually transmitted diseases increase viral load in genital fluids.

If you’re HIV-positive, getting into care and taking HIV medicines (called antiretroviral therapy or ART) the right way, every day will give you the greatest chance to get and stay virally suppressed, live a longer, healthier life, and reduce the chance of transmitting HIV to your partners.

If you’re HIV-negative and have an HIV-positive partner, encourage your partner to get into care and take HIV treatment medicines.

Taking other actions, like using a condom the right way every time you have sex or taking daily medicine to prevent HIV (called pre-exposure prophylaxis or PrEP) if you’re HIV-negative, can lower your chances of transmitting or getting HIV even more.

Learn more about how to protect yourself and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

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Is There a Connection Between HIV and Other SDS's?

Yes. Having another sexually transmitted disease (STD) can increase the risk of getting or transmitting HIV.

If you have another STD, you’re more likely to get or transmit HIV to others. Some of the most common STDs include gonorrhea, chlamydia, syphilis, trichomoniasis, human papillomavirus (HPV), genital herpes, and hepatitis. The only way to know for sure if you have an STD is to get tested. If you’re sexually active, you and your partners should get tested for STDs (including HIV if you’re HIV-negative) regularly, even if you don’t have symptoms.

If you are HIV-negative but have an STD, you are about 3 times as likely to get HIV if you have unprotected sex with someone who has HIV. There are two ways that having an STD can increase the likelihood of getting HIV. If the STD causes irritation of the skin (for example, from syphilis, herpes, or human papillomavirus), breaks or sores may make it easier for HIV to enter the body during sexual contact. Even STDs that cause no breaks or open sores (for example, chlamydia, gonorrhea, trichomoniasis) can increase your risk by causing inflammation that increases the number of cells that can serve as targets for HIV.

If you are HIV-positive and also infected with another STD, you are about 3 times as likely as other HIV-infected people to spread HIV through sexual contact. This appears to happen because there is an increased concentration of HIV in the semen and genital fluids of HIV-positive people who also are infected with another STD.

For more information about the connection between HIV and other STDs, see STDs and HIV. To get tested for HIV or other STDs, find a testing site near you.

Learn more about how to protect yourself and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

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HIV Risk Reduction Tool new from the CDC

https://wwwn.cdc.gov/hivrisk/

Another study giving insight on the benefits of starting ART's as soon as possible for future benefit of your immune system

Istock

TREATMENT NEWS

HIV Levels Before Treatment Can Predict This Immune System Indicator

Researchers may have answered a bedeviling chicken-or-egg question about the persistence of HIV during antiretroviral treatment.

April 24, 2017

 

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Researchers may have finally answered a bedeviling chicken-or-egg question about the relationship between the persistence of HIV in the body during antiretroviral (ARV) treatment and the virus-related immune system activation and inflammation that also continues while people are on ARVs. This finding likely adds further weight to the urgency of diagnosing and treating HIV as soon as possible following infection.

HIV hides its genetic material in cells or locations in the body that remain out of reach of ARVs. This result of this overall effect is known as the viral reservoir, the existence of which prevents standard HIV treatment from curing the virus.

Publishing their findings in PLOS Pathogens, researchers from the AIDS Clinical Trials Group (ACTG) studied 101 people with HIV who had plasma and blood-cell samples taken before they started ARVs, one and four years after beginning HIV treatment, and once more between years six and 15 of treatment. All the participants achieved a viral load considered undetectable by standard laboratory measures and maintained this level of viral suppression for an average of seven years, with some doing so for more than a decade.

The participants experienced the steepest decline in measures of HIV’s genetic material (detected with highly sensitive tests) during their first four years on ARVs; afterward, they still experienced a decline, albeit at a slower pace.

Looking at the samples taken before the participants started ARVs, the researchers identified a correlation between levels of HIV and indicators of immune system activation and inflammation. However, this association ceased after the individuals started treatment for the virus. More specifically, the low levels of HIV found in the samples taken while people were on ARVs did not seem to influence the levels of immune system activation and inflammation during that time.

The investigators ultimately concluded that the levels of both immune system activation and HIV in the pretreatment samples predicted the levels of persistence of the virus and immune activation seen in the samples taken when the participants were on ARVs.

“Our findings suggest that damage to the immune system that occurs before people are started on [HIV] treatment leads to continued immune activation, even though the medicines are keeping the virus in check,” the study’s lead author, Rajesh Gandhi, MD, of the Massachusetts General Hospital Division of Infectious Diseases, said in a press release. “This suggests that diagnosing HIV and starting antiretroviral therapy as soon as possible may prevent the elevated immune activation that can lead to health problems, such as heart disease. The results also suggest that new strategies focused on reducing immune activation may need to be added to novel interventions designed to reduce and eventually eliminate HIV.”

Abstract

Antiretroviral therapy (ART) reduces levels of HIV-1 and immune activation but both can persist despite clinically effective ART. The relationships among pre-ART and on-ART levels of HIV-1 and activation are incompletely understood, in part because prior studies have been small or cross-sectional. To address these limitations, we evaluated measures of HIV-1 persistence, inflammation, T cell activation and T cell cycling in a longitudinal cohort of 101 participants who initiated ART and had well-documented sustained suppression of plasma viremia for a median of 7 years. During the first 4 years following ART initiation, HIV-1 DNA declined by 15-fold (93%) whereas cell-associated HIV-1 RNA (CA-RNA) fell 525-fold (>99%). Thereafter, HIV-1 DNA levels continued to decline slowly (5% per year) with a half-life of 13 years. Participants who had higher HIV-1 DNA and CA-RNA before starting treatment had higher levels while on ART, despite suppression of plasma viremia for many years. Markers of inflammation and T cell activation were associated with plasma HIV-1 RNA levels before ART was initiated but there were no consistent associations between these markers and HIV-1 DNA or CA-RNA during long-term ART, suggesting that HIV-1 persistence is not driving or driven by inflammation or activation. Higher levels of inflammation, T cell activation and cycling before ART were associated with higher levels during ART, indicating that immunologic events that occurred well before ART initiation had long-lasting effects despite sustained virologic suppression. These findings should stimulate studies of viral and host factors that affect virologic, inflammatory and immunologic set points prior to ART initiation and should inform the design of strategies to reduce HIV-1 reservoirs and dampen immune activation that persists despite ART.

Author summary

HIV-infected individuals who are receiving antiretroviral therapy continue to have low but persistent amounts of virus in blood as well as high levels of immune activation. Elevated immune activation has been linked to medical complications, like heart disease. Whether activation is being driven by or driving HIV persistence is not known. To answer this question, we measured levels of HIV, inflammation and immune activation in 101 HIV-infected individuals before and during long-term antiretroviral therapy. We found that pre-treatment levels of HIV correlated with on-treatment measures of HIV persistence. HIV levels correlated with inflammation and activation before starting therapy but not during long-term treatment, suggesting that virus persistence is not driving or driven by immune activation or inflammation. Higher levels of activation and inflammation before therapy were associated with higher levels during treatment, indicating that immune events that occurred before treatment initiation had long-lasting effects despite sustained control of the virus. These findings should stimulate studies of genetic or viral factors that affect levels of virus, activation and inflammation prior to treatment, and should inform the design of strategies to reduce HIV persistence and dampen harmful immune activation and inflammation in people who are on long-term treatment.

To read the entire study from PLOS's journal, click here.

To read a press release about the study, click here.

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Can I get HIV from Oral sex?

The chance that an HIV-negative person will get HIV from oral sex with an HIV-positive partner is extremely low.

Oral sex involves putting the mouth on the penis (fellatio), vagina (cunnilingus), or anus (anilingus). In general, there’s little to no risk of getting or transmitting HIV through oral sex.

Factors that may increase the risk of transmitting HIV through oral sex are ejaculation in the mouth with oral ulcers, bleeding gums, genital sores, and the presence of other sexually transmitted diseases (STDs), which may or may not be visible.

You can get other STDs from oral sex. And, if you get feces in your mouth during anilingus, you can get hepatitis A and B, parasites like Giardia, and bacteria like Shigella, Salmonella, Campylobacter, and E. coli.

For information on how to lower your risk of getting HIV or other STDs from oral sex, see Oral Sex and HIV Risk.

Learn more about how to protect yourself and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

Can I get HIV having vaginal sex?

Yes. Either partner can get HIV through vaginal sex, though it is less risky for getting HIV than receptive anal sex.

When a woman has vaginal sex with a partner who’s HIV-positive, HIV can enter her body through the mucous membranes that line the vagina and cervix. Most women who get HIV get it from vaginal sex.

Men can also get HIV from having vaginal sex with a woman who’s HIV-positive. This is because vaginal fluid and blood can carry HIV. Men get HIV through the opening at the tip of the penis (or urethra); the foreskin if they’re not circumcised; or small cuts, scratches, or open sores anywhere on the penis. See the Prevention Q&As for information on how to lower your risk of getting HIV from vaginal sex.

Learn more about how to protect yourself and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

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Can I get HIV through anal sex?

Yes. In fact, anal sex is the riskiest type of sex for getting or transmitting HIV.

HIV can be found in certain body fluids—blood, semen (cum), pre-seminal fluid (pre-cum), or rectal fluids—of a person who has HIV. Although receptive anal sex (bottoming) is much riskier for getting HIV than insertive anal sex (topping), it’s possible for either partner—the top or the bottom—to get HIV. The bottom’s risk is very high because the lining of the rectum is thin and may allow HIV to enter the body during anal sex. The top is also at risk because HIV can enter the body through the opening at the tip of the penis (or urethra); the foreskin if the penis isn’t circumcised; or small cuts, scratches, or open sores anywhere on the penis. See the Prevention Q&As for information on how to lower your risk of getting HIV from anal sex.

Learn more about how to protect yourself and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

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How well does HIV live outside the body?

HIV does not survive long outside the human body (such as on surfaces), and it cannot reproduce outside a human host. It is not spread by

• Mosquitoes, ticks, or other insects.
• Saliva, tears, or sweat that is not mixed with the blood of an HIV-positive person.
• Hugging, shaking hands, sharing toilets, sharing dishes, or closed-mouth or “social” kissing with someone who is HIV-positive.
• Other sexual activities that don’t involve the exchange of body fluids (for example, touching).

Learn more about how to protect yourself and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

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How HIV is transmitted?

You can get or transmit HIV only through specific activities. Most commonly, people get or transmit HIV through sexual behaviors and needle or syringe use.

Only certain body fluids—blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk—from a person who has HIV can transmit HIV. These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (from a needle or syringe) for transmission to occur. Mucous membranes are found inside the rectum, vagina, penis, and mouth.

In the United States, HIV is spread mainly by

• Having anal or vaginal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV.
  • For the HIV-negative partner, receptive anal sex (bottoming) is the highest-risk sexual behavior, but you can also get HIV from insertive anal sex (topping).
  • Either partner can get HIV through vaginal sex, though it is less risky for getting HIV than receptive anal sex.
• Sharing needles or syringes, rinse water, or other equipment (works) used to prepare drugs for injection with someone who has HIV. HIV can live in a used needle up to 42 days depending on temperature and other factors.

Less commonly, HIV may be spread

• From mother to child during pregnancy, birth, or breastfeeding. Although the risk can be high if a mother is living with HIV and not taking medicine, recommendations to test all pregnant women for HIV and start HIV treatment immediately have lowered the number of babies who are born with HIV.
• By being stuck with an HIV-contaminated needle or other sharp object. This is a risk mainly for health care workers.

In extremely rare cases, HIV has been transmitted by

• Oral sex—putting the mouth on the penis (fellatio), vagina (cunnilingus), or anus (rimming). In general, there’s little to no risk of getting HIV from oral sex. But transmission of HIV, though extremely rare, is theoretically possible if an HIV-positive man ejaculates in his partner’s mouth during oral sex. To learn more about how to lower your risk, see Oral Sex and HIV Risk.
• Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This was more common in the early years of HIV, but now the risk is extremely small because of rigorous testing of the US blood supply and donated organs and tissues.
• Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when infected blood from a caregiver’s mouth mixes with food while chewing. The only known cases are among infants.
• Being bitten by a person with HIV. Each of the very small number of documented cases has involved severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken.
• Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids.
• Deep, open-mouth kissing if both partners have sores or bleeding gums and blood from the HIV-positive partner gets into the bloodstream of the HIV-negative partner. HIV is not spread through saliva.

Learn more about how to protect yourself and get information tailored to meet your needs from CDC’s HIV Risk Reduction Tool (BETA).

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I doubt they were gone that long!

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NEWSFEED

Adult Film Industry Back to Work After an HIV-Related Shutdown

A performer tested positive but did not contract HIV on-set and did not expose coworkers to the virus, says a trade association.

April 20, 2017

 

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It’s back to work for the adult-film industry after it was determined that a performer who tested HIV positive on Saturday contracted the virus socially—as opposed to on-set—and had not exposed fellow performers to HIV, according to a press release from the Free Speech Coalition (FSC), a trade association for the industry.

The FSC’s Performer Availability Screening Services (PASS) ensures the health and safety of performers, including guidelines for HIV testing. As such, after the performer tested HIV positive, the FSC on April 15 placed adult-film production on a cautionary hold until the risk to other performers could be ascertained and the initial HIV test could be confirmed. That hold has now been lifted.

According to the FSC press release, the performer had attempted to return to work after a 25-day break. After the positive HIV test result, the performer worked with PASS to reconstruct a genealogy of all the sexual contacts in the performer’s professional and personal life. All partners were notified.

“While we understand that production holds are difficult for performers as well as producers, they are essential to the safety and integrity of the performer pool,” said Eric Paul Leue, FSC executive director, in the press release. “A production hold is the sign of a functional system protecting adult performers. The PASS system has once again successfully prevented any transmission of HIV on a regulated adult set, as it has for over 10 years. We are working with the performer to get them to the resources and treatment to help manage their status and appreciate their commitment, honesty and participation.”

To learn more about HIV transmission and risk, visit that section of the POZ Basics, which includes and interactive lesson. You can also take our quiz “Do You Know How HIV Is Transmitted?”

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• #Free Speech Coalition
 
• #HIV testing
 
• #pornography
 
• #transmission

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