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Positively Negative Workshop Outline
Transmission of HIV

There are many myths about how HIV is or is not spread. The fact is,

1. One of the 4 body fluids that can transmit HIV must be present.

Ask the class to name all the body fluids they can and write them on the board under either ‘Yes’ or ‘No’.

If one of these 4 body fluids is not present, there is NO RISK. But just the presence of fluid alone isn’t enough…

2. The fluid needs a way inside another person’s body.

The fluid needs a way to get into the bloodstream of a second person. If you’re alone, there is NO RISK. Also, skin provides a layer of protection against all sorts of germs that you come across everyday, so you can’t transmit the virus through healthy skin.

A HIGH RISK activity provides one of the 4 fluids with a way inside the body (either directly or through a fragile membrane like the vagina, anus, or penis). The following activities are how the vast majority of people catch HIV.

• Shared needles bring one person’s blood into the bloodstream of a second. This is true whether the needles are used for intravenous drugs (ie. heroin, coke), body art (i.e. tattoos), or insulin.

• The lining of the vagina, penis, and anus are all very fragile, and can be easily irritated by friction, causing tiny tears. Unprotected vaginal or anal sex and sharing unclean penetrative sex toys are all high risk activities for HIV transmission.

• An open wound (for example, from a car accident or a fight) can allow one of the fluids to enter the body, although this is uncommon. The wound protects itself by bleeding out of the body and washing away germs, and doesn’t let new ones in when it’s scabbed over (unless the scab comes off with friction).

• Two other modes of HIV transmission are blood transfusions and mother to child transfer during birth. A nursing baby could also receive HIV while being breast-fed. Another interesting fact is that uncircumcised men transmit HIV more frequently that circumcised men do.

• A LOW RISK activity provides one of the fluids with a potential way inside a second person’s body (in case the condom breaks or through a stronger membrane like the mouth, nose, eyes, or ears –“head membranes”). It is possible to catch HIV, but it doesn’t happen very often.

• Any part of the body not covered by skin, like your mouth (especially if there are cuts or sores), eyes, nose, etc. can potentially allow an entry for the virus. Unprotected oral sex on either a man (semen) or a woman (vaginal fluid) allows one of the 4 body fluids into the mouth, and is low risk (BUT STILL A RISK!!!)

• Protected vaginal or anal sex posses a risk, but ONLY if the condom breaks or slips off. An intact latex or polyurethane condom will not let HIV pass through it. You can prevent condom breakage by checking the expiration date, pinching the tip to leave space for ejaculation, and adding water or silicone based lubrication to the outside.

• Also, razors or toothbrushes can transmit HIV since these items can contain blood but, they are low risk and must be used immediately after someone with HIV has cut themselves using them in order to transmit.

• There are many activities that have NO REAL RISK. This means only one person involved, none of the fluids are present, or the fluid only comes in contact with healthy skin or an unbroken barrier. HIV transmission is either impossible or has never been shown to happen!

• This includes using a barrier (condom or dental dam) for oral sex because the activity was already low risk and there is less chance of breakage.

• **These risk levels only work for HIV –there are other STIs that can be transmitted through LOW or NO REAL RISK activities. For example, kissing can pass on cold sores, oral sex can transmit Chlamydia, rimming can pass on Hep A, fingering could transmit HPV…..

• The virus CANNOT be transmitted through everyday activities. These include kissing, hugging, shaking hands, using public toilets, eating food someone else has prepared, changing a diaper, playing sports together, wiping tears…..

• The newest development in preventing the transmission of HIV is called microbicides. This is a cream or gel, much like a lube, that contains anti-HIV drugs and is proving to be effective in several studies.