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Routes of HIV transmission

Question: 

I have heard that risks for HIV are only:
1) Having unprotected penetrative anal or vaginal sex
2) Sharing IV drug equipment with other IV drug users.

Does it mean that such situations as anal fingering with bleeding finger or accidentally getting someones drop of blood into the wound risk free?

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about acquiring HIV through unprotected sex, sharing IV drug equipment, manual insertion of the anal cavity with a bleeding finger, and blood dropping onto a wound. From the information given, this scenario is determined to be High Risk (There is evidence of transmission through these activities and are the majority of cases of transmission).

HIV transmission occurs when bodily fluid containing HIV has direct access to the bloodstream of an individual through a high risk activity.

The question mentions that unprotected anal or vaginal sex and sharing IV drug equipment are the only risks for HIV. This is untrue. These two scenarios are prime examples of High Risk activities that DO result in HIV transmission when all components of the HIV transmission equation are satisfied. Other situations you mention are NOT risk free, they are just considered to be different levels of risk.

HIV risk levels are categorized as High, Low, Negligible, and No Risk. This is evaluated based on research and the transmission equation.

In the scenario of fingering an anal cavity with a bleeding finger satisfies the transmission equation. There is an exchange of bodily fluid with direct access to the bloodstream. The anal cavity is especially sensitive to tearing and bleeding (1). It is also important to note that HIV transmission only occurs when the bodily fluid that has direct access to the bloodstream contains HIV.

In the scenario of dropping blood into a wound presents with a low risk. The wound would need to be actively bleeding in order for the bodily fluid to be transferred to an individual. It is also important to know that when bodily fluid containing HIV is exposed to the environment it is quickly rendered inactive due to the oxygen in the air (2).

Recommendation: Refer to a health care provider for HIV testing.

Regards,

AIDS Vancouver Helpline/Online, Danielle