Questions and Answers About Sexually Transmitted Infections, Including HIV
Yes. In particular, infections that cause sores on the genitals such as chancroid and syphilis increase a person's risk of becoming infected if exposed to HIV. Other STIs, too, can increase the risk of HIV infection.
For best protection, a condom should be used with every act of sex. In some cases, however, occasional use can be protective. For example, if a person has a regular, faithful partner and has one act of sex outside of the relationship, using a condom for that one act can be very protective. For people who are exposed to STIs, including HIV, frequently, however, using a condom only some of the time will offer limited protection.
If exposed to STIs, women are more likely to become infected than men due to biological factors. Women have a greater area of exposure (the cervix and the vagina) than men, and small tears may occur in the vaginal tissue during sex, making an easy pathway for infection.
HIV cannot be transmitted through casual contact. This includes closed mouth kissing, hugging, shaking hands, and sharing food, clothing, or toilet seats. The virus cannot survive long outside of the human body. Mosquitoes cannot transmit HIV, either.
No, these rumors are false. Some condoms are covered with a wet or a powder-like material such as spermicide or cornstarch, but these are materials used for lubrication, to make sex smoother.
No. Instead, this practice only risks infecting the person who has not yet had sex.
Genital hygiene is important and a good practice. There is no evidence, however, that washing the genitals prevents STI infection. In fact, vaginal douching increases a woman's risk of acquiring STIs, including HIV, and pelvic inflammatory disease. If exposure to HIV is certain, treatment with antiretroviral medications (post-exposure prophylaxis), where available, can help reduce HIV transmission. If exposure to other STIs is certain, a provider can treat presumptively for those STIs—that is, treat the client as if he or she were infected.
Current evidence is conflicting as to whether pregnancy increases a woman's chances of infection if exposed to HIV. If she does become infected with HIV during pregnancy, however, the chances that HIV will be transmitted to her baby during pregnancy, delivery, and childbirth may be at their highest because she will have a high level of virus in her blood. Thus, it is important for pregnant women to protect themselves from HIV and other STIs through condom use, mutual faithfulness, or abstinence. If a pregnant woman thinks that she may have HIV, she should seek HIV testing. Resources may be available to help her prevent transmitting HIV to her baby during pregnancy, delivery, and childbirth.
Pregnancy will not make the woman's condition worse. HIV/AIDS may increase some health risks of pregnancy, however, and may also affect the health of the infant. Women with HIV are at greater risk of developing anemia and infection after vaginal delivery or caesarean section. The level of risk depends on such factors as a woman's health during pregnancy, her nutrition, and the medical care she receives. Also, the risk of these health problems increases as HIV infection progresses into AIDS. Further, women with HIV/AIDS are at greater risk of having preterm births, stillbirths, and low birthweight babies.
The best evidence is reassuring. Recent studies among family planning clients in Uganda and Zimbabwe and women in a study in South Africa found that users of DMPA, NET-EN, or combined oral contraceptives were no more likely to become infected with HIV than women using nonhormonal methods. Use of hormonal methods is not restricted for women at high risk for HIV or other STIs.
On average, condoms are 80% to 95% effective in protecting people from HIV infection when used correctly with every act of sex. This means that condom use prevents 80% to 95% of HIV transmissions that would have occurred without condoms. (It does not mean that 5% to 20% of condom users will become infected with HIV.) For example, among 10,000 uninfected women whose partners have HIV, if each couple has vaginal sex just once and has no additional risk factors for infection, on average:
- If all 10,000 did not use condoms, about 10 women would likely become infected with HIV.
- If all 10,000 used condoms correctly, 1 or 2 women would likely become infected with HIV.
The chances that a person who is exposed to HIV will become infected can vary greatly. These chances depend on the partner's stage of HIV infection (early and late stages are more infectious), whether the person exposed has other STIs (increases susceptibility), male circumcision status (uncircumcised men are more likely to become infected with HIV), and pregnancy (women who are pregnant may be at higher risk of infection), among other factors. On average, women face twice the risk of infection, if exposed, that men do.