When AIDS first appeared, it was an exceedingly mysterious disease. But over the past 30 years, researchers have learned a great deal about how it is transmitted — and how it can be prevented.
Knowledge, though, does not necessarily translate into action. Each year, more than 56,000 people in the United States still become infected with HIV — the virus that causes AIDS — and nearly 18,000 Americans die of AIDS annually.
What seems to be driving this pandemic, especially in the United States, is the fact that many people don’t take steps to prevent themselves from becoming infected, says Steven Santiago, MD, medical director of Care Resource, South Florida’s oldest and largest nonprofit HIV/AIDS organization. “A lot of people who think they are not at risk actually are,” he says.
How HIV Is Transmitted
The most common ways that HIV spreads is when someone does not use a condom when having sex with an infected person; has multiple sexual partners; or shares needles, syringes, rinse water, or other equipment used to prepare illegal drugs. It is also easier to contract if you have another sexually transmitted disease. “We think that STDs act as a portal because they cause inflammation, which stimulates the immune system, and they also cause ulcers, which can make infection easier,” says Dr. Santiago.
In the past, AIDS was transmitted mostly through blood infusions, but that type of transmission is unlikely now because the blood supply has been checked for HIV for decades. There have also been scares about AIDS transmission from sharing a razor or toothbrush with an infected person, but this actual risk is very low. Still, Santiago notes, “It’s common sense that there might be a bit of microscopic blood if you share razors or toothbrushes, so why take the risk?”
How to Prevent the Spread of HIV
It's important to be aware of how prevalent the risk factors for HIV and AIDS are in your community because this offers you information on how to protect yourself, says Santiago. “HIV is more prevalent in large cities, where people are transient, as opposed to small towns, where everyone knows each other," he notes. "There [is] also more likely to be drug abuse in larger areas." But living in a small town doesn’t guarantee you protection from HIV; you need to practice safe sex no matter where you live.
The advent of drug treatment known as antiretroviral therapy also has helped stem the tide of the epidemic. These drugs not only help prevent HIV from turning into AIDS but also reduce the viral load to such an extent that infected people are less likely to pass on the virus. Nonetheless, they don’t offer 100 percent protection, so the best practice is still to use a condom.
This applies to you even if you consider yourself part of a monogamous couple; too often, people often don't know their partner’s HIV status. People can have HIV even if they have appeared perfectly healthy for years. The only way to know is for both of you to be tested. And even if both people in a couple test negative, things can change later — one person in the couple may think the other is still monogamous when he or she is not.
Choose the Right Condom
Many people with AIDS contracted HIV during unprotected sex, which is why condoms are always important. When it comes to choosing a condom, remember that latex condoms are your best protection against HIV and other sexually transmitted diseases. Experts also recommend that you not use a condom treated with a spermicide. It used to be thought that this conferred some extra protection, but it’s been found that Nonoxynol 9, the most common spermicide, does not protect against HIV, as previously thought.
If you are having protected sex, make sure lubricants are water-based (oil-based lubricants can damage the condom). Don’t use lubricants if you are having unprotected anal sex, however: Recent research suggests that lubricants can irritate anal tissue and actually increase HIV risk.
Practicing safe sex is especially important when you know or suspect your partner is HIV-positive. Besides wearing a condom during anal or vaginal sex, use a flavored condom when having oral sex. For oral sex, some experts also recommend using dental dams, which are thin rectangular sheets of latex.
Other Factors to Keep in Mind
One of the greatest successes in the fight against HIV/AIDS has been the dramatic reduction in the number of HIV-infected babies born in the United States. This has been attributed to testing guidelines that help identify and treat infected mothers, which helps them avoid giving HIV to their unborn children. However, women who are infected with HIV are still warned not to breastfeed because of the possibility that the infection may be transmitted.
Avoiding illegal IV drug use is also crucial in preventing HIV/AIDS. If you do use IV street drugs, however, using only clean needles may prevent you from contracting HIV/AIDS. Check with your local health organization or a narcotics treatment center for more information, or visit FriendtoFriend.org.
It’s well-known that sharing needles and syringes is dangerous, but don't overlook the threat posed by other drugs, such as marijuana and alcohol. “People too often forget that HIV is primarily spread through risky behavior, so anything that lowers your inhibitions will make it more likely that you’ll engage in unprotected sex,” says Santiago. “I think that’s even more of a problem than drugs because alcohol is so readily available.”
Last Updated: 11/30/2011