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HIV Transmission: Common Routes & Prevention

HIV transmits via specific body fluids with sufficient viral load: blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, breast milk. NOT saliva, sweat, tears, urine, feces (unless blood-contaminated).

Primary Routes

  1. Unprotected sexual contact: Anal (highest risk), vaginal, oral (very low). Receptive > insertive. STIs increase risk.
  2. Sharing injection equipment: Needles, syringes, cookers, cotton, water—direct blood exposure.
  3. Mother-to-child (vertical): Pregnancy, delivery, breastfeeding. Without intervention: 15–45%. With ART + C-section + no breastfeeding: <1%.
  4. Occupational exposure: Needlestick (0.3% risk), mucous membrane splash (0.09%). PEP within 72 hrs.
  5. Blood transfusion/organ transplant: Extremely rare in screened supplies (NAT testing).

    6. NOT Transmitted By

    • Casual contact (hugging, sharing utensils, toilets).
    • Insects (mosquitoes).
    • Air/water.

    Prevention Toolkit

    • PrEP (tenofovir/emtricitabine): 99% effective for sexual, 74% for injection.
    • PEP: 28-day ART after exposure.
    • Treatment as Prevention (U=U): Undetectable viral load = untransmittable sexually.
    • Condoms, clean needles, voluntary medical male circumcision (60% reduction).

    Know your status; test routinely. Early ART saves lives and prevents transmission.

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