HIV transmission risk is often misunderstood. The risk of HIV transmission is only present in certain conditions. HIV transmission may occur if you have sexual contact (usually penetrative sex) with an HIV positive person or if you share injecting equipment such as needles or syringes with someone who is infected with HIV.
HIV is most commonly spread by unprotected (without a condom) penetrative sex which may be vaginal or anal and which occurs between an HIV positive and an HIV negative person.
The two most effective things people can do to reduce HIV transmission risk as much as possible are to always use good quality condoms with lubrication for penetrative sex and to know their HIV status by having regular HIV tests.
Unprotected anal sex carries the greatest risk for the receptive (the person being penetrated) partner. This is because the anal and rectal canals are more delicate than vaginal tissue and the membranes are likely to bleed. Other STDs which might be present like gonorrhoea, syphilis, Chlamydia and especially herpes will help boost the infection with HIV.
The HIV transmission risk is increased if the HIV positive person has acquired their infection in the fairly recent past. This is because people who have been recently infected with HIV will have very high levels of HIV in their blood and semen and other body fluids.
HIV transmission will reduce very markedly if an HIV positive person is taking optimal treatment with anti-retroviral medications. These will ideally suppress the viral load to undetectable levels. There is good evidence to suggest that the infectivity of people who have undetectable viral loads is negligible.
HIV transmission risk through oral sex is very, very low. Several well constructed studies have tried to define the risk but in these studies, despite many thousands of oral episodes between an HIV positive and an HIV negative partner, there have not been any new infections in the study groups.
Having regular STD screening tests and also visiting the dentist and maintaining good oral health is likely to further protect you against HIV.
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