I used to spend every Thursday evening talking fellatio and semen with complete strangers. While this sounds racy, my conversations tended to be more clinical than copulatory. I was a volunteer at the San Francisco AIDS Foundation, and spent four hours a week answering calls on the California HIV/AIDS Hotline. It’s true I heard a lot of who put what where, but it was all in the context of: am I at risk for HIV?
I was a volunteer in 2003—thirty years after it was established that HIV is the virus that causes AIDS—and was surprised by how many people still had misconceptions about transmission of the human immunodeficiency virus. Can I get it from kissing? Touching blood? Shaking hands?
Although I knew how to answer most of these questions, I never quite knew how to quell the anxiety and fear callers had while they waited for test results or recounted a night of unprotected sex. HIV is not an epidemic in the United States, like it is in Africa, India, and other developing nations, but it is still something very much on our minds. And while it used to only be associated with homosexual men and intravenous drug users, HIV is increasing among women. This probably has to do with the fact that women are much more likely to contract HIV from a night of unprotected sex than men are. This—like periods, PMS, and pregnancy—is totally unfair, but just another reason to protect ourselves.
Here are the facts:
For HIV transmission to occur, the virus must be present in sufficient quantity and it must enter the bloodstream. The virus is present in four bodily fluids: the highest concentration is in blood, then semen, then vaginal fluid, and the lowest is in breast milk. Pre-seminal fluid, or pre-cum, can contain small amounts of the virus. The virus cannot be transmitted by sweat, saliva, urine, tears, or feces.
The virus can get into our bloodstream in three ways: sexual contact, blood to blood (intravenous drug use or blood transfusions), and mother to child (before birth or after birth, through breast milk). The majority of women (about 77 percent, according to the CDC) get it from heterosexual sex, the rest from intravenous drug use. Very few cases of mother to child transmission occur in the US because of rigorous prenatal testing. We can’t get it from shaking hands, sharing plates, or even kissing—unless you’re French kissing with gaping wounds in your mouth.
