HIV Transmission: Body Fluids, Routes, and Myths

HIV is transmitted only through specific body fluids from a person with detectable viral load:

Infectious Fluids

• Blood
• Semen (including pre-ejaculate)
• Vaginal fluids
• Rectal fluids
• Breast milk

Non-Infectious Fluids

• Saliva, sweat, tears, urine, feces — no documented transmission (viral concentration negligible; inhibitory factors present).

Transmission Routes

1. Sexual: Condomless anal/vaginal intercourse (receptive > insertive). Oral sex — extremely low risk.
2. Blood exposure: Sharing injection equipment (highest efficiency), needlestick injury (0.3%), transfusion (screened out in modern blood supply).
3. Perinatal: Pregnancy, labor/delivery, breastfeeding (without maternal ART + infant prophylaxis).

Zero-Risk Activities

• Hugging, kissing (closed-mouth), sharing utensils, toilets, towels, bedding.
• Insect bites (mosquitoes do not transmit HIV).
• Casual workplace/school contact.

Prevention Pillars

• Condoms (correct, consistent)
• PrEP (pre-exposure prophylaxis)
• TasP (treatment as prevention — undetectable = untransmittable)
• Syringe services programs
• Voluntary medical male circumcision (high-prevalence settings)

Stigma, not casual contact, drives the epidemic. Know your status; test routinely.