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HIV Prevention

Medically reviewed on Nov 19, 2016 by L. Anderson, PharmD

How Can HIV/AIDS Be Prevented?

If you are sexually active, there are many things you can do to lower your risk of HIV infection, including:

  • Know your partner’s HIV status and avoid multiple sexual partners.
  • Use condoms correctly and each time you have vaginal, oral, or anal sex.
  • Do not have sex with people whose HIV status you do not know.
  • Do not have sex with people who use intravenous (IV) drugs.
  • Do not engage in unprotected sex unless you know your partner is not infected with HIV.

Not having sex is the only 100% effective way to prevent HIV and other sexually transmitted diseases (STDs). There is no vaccine to prevent human immunodeficiency virus (HIV) and there is no cure; however, HIV/AIDS can be prevented. You can remain HIV negative by educating yourself, learning how the virus is transmitted, and understanding ways to lower your risk using preventive measures.

How Do I Know If I Have HIV?

The only way to know if you have HIV is to get tested. HIV screening is recommended by the CDC for patients aged 13–64 years in all healthcare settings at least once in their lifetime. Get tested immediately if you know or think that you have had contact with someone who has HIV. Seek medical treatment quickly if the result is positive because early treatment is best to prevent complications and lengthen your life. Many effective HIV treatments, known as antiretroviral therapy or ART, are available today. ART can help you maintain a low viral load and live a near normal lifespan.

Can IV Drug Use Cause HIV?

Your risk for acquiring HIV may be greater if you inject drugs. Do not use intravenous (IV) drugs and share needles or syringes. The HIV virus can live in a used needle up to 42 days depending on the temperature and other factors, according to the CDC. If you do inject drugs, take advantage of needle exchange programs in your community and consider seeking help for your drug use.

Does HIV Live Outside the Body?

The HIV virus does not live for very long outside of the human body. It cannot reproduce outside a human host. HIV is not transmitted by:

  • Air or water
  • Saliva, sweat, tears or closed-mouth kissing
  • Insects or pets
  • Sharing toilets
  • Sharing food or drinks
  • Sexual activities that do not involve the exchange of body fluids

Contact with the following body fluids from an HIV-positive person can lead to HIV in another person:

  • Blood
  • Semen or pre-seminal fluid
  • Rectal fluids
  • Vaginal fluids
  • Breast milk

HIV in these fluids must enter the body to cause an infection. Body fluids containing HIV can enter through a mucous membrane (such as the vagina, rectum, penis, mouth), damaged tissue like a cut or scrape, or can be injected into your bloodstream (such as with IV drug use).

Avoid exposure to blood from injuries or nosebleeds where the HIV status of the bleeding person is unknown. Protective clothing, such as gloves, gowns, masks or goggles may be appropriate when caring for people who are injured.

The risk of HIV infection through blood transfusions or blood products is extremely low in the United States. The blood supply is well screened and is considered safe. Unfortunately, this is not always the case in other countries. If an emergency requires that you receive blood or blood products in another country, get tested for HIV as soon as you return home.

How to Prevent Mother to Child HIV Transmission?

Women considering pregnancy or pregnant women with HIV should learn about medical advances that may help prevent their baby from becoming infected. Most importantly, pregnant women can safely use many HIV medicines during pregnancy. If you have HIV, taking antiretroviral medications every day to treat HIV starting early in your pregnancy can lower your risk of transmitting the virus to your baby to 1% or less.

Can I Breastfeed If I'm HIV Positive?

Because HIV can spread in breast milk, women with HIV who live in the U.S. should not breastfeed their babies according to the Centers for Disease Control and Prevention (CDC). Infant formula is a safe and healthy alternative to breast milk.

If a single bottle of breast milk is given to a baby from a HIV positive mother, the risk is extremely that the baby will become infected. 

Do Condoms Prevent HIV?

Latex condoms are highly effective in lowering the risk of HIV transmission if used correctly. Use a new latex condom each time you have sex. If you are allergic to latex, use a polyurethane condom. Do not lambskin condoms. Use only water-based lubricants and never petroleum jelly, cold cream or oils. Oil-based lubricants can weaken condoms and cause them to break. Female condoms are also effective for HIV prevention when used correctly. Do not use a male and female condoms at the same time.

Are There HIV PrEP Treatment Guidelines?

The use of an antiretroviral medication to help to prevent HIV infection is known as Pre-exposure Prophylaxis (PrEP). HIV treatment guidelines recommend that PrEP be used for people who are HIV-negative and at substantial risk for HIV infection, including high risk men who have sex with men; high risk heterosexual men and women; and high risk injection drug users. Talk with your healthcare provider about other uses, benefits and risks of PrEP - otherwise known as HIV prevention drugs.

According to the CDC, to be clinically eligible to receive PrEP you must have:

  1. A documented negative HIV test before PrEP is prescribed.
  2. No signs/symptoms of acute HIV infection
  3. Normal kidney function
  4. No contraindications with medications that you take.
  5. Documented hepatitis B virus infection and vaccination status.

For PrEP to be effective, you must commit to taking the medicine every day and following up with your doctor on a regular schedule for HIV tests, prescription refills, and other medical tests and counseling, as needed. PrEP should be used with counseling on other risk reduction methods, such as correct condom use and safe needle practices for optimal effect.

PrEP: HIV Prevention With Truvada

In July 2012 the U.S. Food and Drug Administration (FDA) approved the use of Truvada, an antiretroviral medication to prevent HIV infection in certain high risk individuals. Truvada is a combination of two drugs (tenofovir disoproxil fumarate plus emtricitabine) and can be used in high risk HIV-negative persons to lower their risk of infection. The medication works by preventing the virus from making copies of itself. With PrEP, you take the medication daily, and it's important not to miss any dose. It can lower your risk of contracting HIV by up to 92 percent.

PEP: HIV Post-Exposure Prophylaxis

If you have been exposed to HIV, and it is less than 72 hours since your exposure, immediately seek medical care as you may be eligible to start post-exposure prophylaxis (PEP) treatment to lower your risk of becoming HIV-positive. The sooner you get medical care, the better. You may be eligible for PEP:

  • If you were exposed to HIV during sex (for example, a condom broke)
  • If you were exposed to HIV by sharing needles, syringes or other IV drug use materials.
  • If you’ve been sexually assaulted.
  • If you're a healthcare worker exposed to HIV.

You can seek PEP treatment at your doctor's office, emergency room, urgent care clinic, or a local HIV clinic. PEP should be used only in emergency situations and is not a regular substitute for proven HIV prevention measures, such as PrEP, condom use, or safe needle practices. PEP has limited effect in preventing HIV infection if you do not start treatment within 72 hours after HIV exposure.

How Can HIV Transmission Be Reduced or Prevented?

If you have been diagnosed with HIV/AIDS, the following preventive measures can help you protect others:

  • Avoid practices that expose others to infected body fluids. Always use a new latex or polyurethane condom for any sexual activity.
  • If you are pregnant, seek medical treatment immediately. HIV infection can be passed on to your baby, but treatment during pregnancy can greatly reduce the risk.
  • Tell previous or current partners that you are HIV positive so that they can be tested. Many states have laws that require you to tell your sexual partners if you’re HIV-positive.
  • If you use intravenous drugs, never share your needles and syringes with anyone else as they may contain traces of HIV infected blood.
  • Do not donate blood or organs.
  • Do not share personal items such as razor blades or toothbrushes.

Should You Use Circumcision to Prevent HIV?

Circumcision has been shown to reduce the risk of men getting HIV from an HIV-positive woman, compared to uncircumcised men. Studies in heterosexuals have shown that male circumcision reduced the risk for HIV in the man by 50% to 60%.

However, circumcision should be used along with other methods of prevention. Additional measures, such as correct condom use with lubricants or preventive medications in high risk groups are also needed. Male circumcision has not been shown to lower the risk of HIV in women, gay or bisexual men.

What is the HIV Life Expectancy?

You can now live a near normal life span with HIV due to advanced medical treatments. In fact, over 1 million people are living with HIV in the United States. Taking a combination of medications to treat HIV, called antiretroviral therapy (ART), is recommended for all people with HIV. If you have been diagnosed with HIV, you should start medical treatment as soon as possible to maintain a low viral load.

Life expectancy of HIV without treatment, meaning people who do not receive ART and progress to AIDS, typically survive about 3 years. Without medical treatment, serious and life-threatening opportunistic infections can occur. Once you have an opportunistic illness, life-expectancy without HIV treatment falls to about 1 year. Examples of opportunistic infections common in AIDS patients are:

  • Pneumocystis carinii pneumonia
  • Mycobacterium avium complex
  • Cytomegalovirus retinitis
  • Kaposi's sarcoma
  • Histoplasmosis
  • Fungal infections of the respiratory tract (candidiasis)

Conclusion

Preventing or managing HIV infection is an achievable goal in today’s society. Advances in medical treatments, ease of testing, diagnosis, and manageable drug regimens have made HIV a chronic illness in which patients can live longer with a high quality of life. However, prevention efforts must be adhered to on a regular basis. For treatment, ART medications must be taken on a daily basis without fail, and monitoring of viral loads is needed. Early treatment is most effective, so a timely diagnosis is imperative. For HIV-negative people at a high risk for HIV infection, a PrEP regimen, if adhered to, can lower HIV risk by up to 92%.

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