HIV

What is HIV?

HIV (human immunodeficiency virus) is the virus that causes AIDS. This virus may be passed from one person to another when infected blood, semen, or vaginal secretions come in contact with an uninfected person’s broken skin or mucous membranes*. In addition, infected pregnant women can pass HIV to their baby during pregnancy or delivery, as well as through breast-feeding. People with HIV have what is called HIV infection. Some of these people will develop AIDS as a result of their HIV infection.

Where did HIV come from?

The earliest known case of HIV-1 in a human was from a blood sample collected in 1959 from a man in Kinshasa, Democratic Republic of Congo. (How he became infected is not known.) Genetic analysis of this blood sample suggested that HIV-1 may have stemmed from a single virus in the late 1940s or early 1950s.

We know that the virus has existed in the United States since at least the mid- to late 1970s. From 1979-1981 rare types of pneumonia, cancer, and other illnesses were being reported by doctors in Los Angeles and New York among a number of male patients who had sex with other men. These were conditions not usually found in people with healthy immune systems.

In 1982 public health officials began to use the term "acquired immunodeficiency syndrome," or AIDS, to describe the occurrences of opportunistic infections, Kaposi's sarcoma (a kind of cancer), and Pneumocystis carinii pneumonia in previously healthy people. Formal tracking (surveillance) of AIDS cases began that year in the United States.

In 1983, scientists discovered the virus that causes AIDS. The virus was at first named HTLV-III/LAV (human T-cell lymphotropic virus-type III/lymphadenopathy- associated virus) by an international scientific committee. This name was later changed to HIV (human immunodeficiency virus).

For many years scientists theorized as to the origins of HIV and how it appeared in the human population, most believing that HIV originated in other primates. Then in 1999, an international team of researchers reported that they had discovered the origins of HIV-1, the predominant strain of HIV in the developed world. A subspecies of chimpanzees native to west equatorial Africa had been identified as the original source of the virus. The researchers believe that HIV-1 was introduced into the human population when hunters became exposed to infected blood.

What is AIDS?

AIDS stands for Acquired Immunodeficiency Syndrome.

Acquired – means that the disease is not hereditary but develops after birth from contact with a disease causing agent (in this case, HIV).

Immunodeficiency – means that the disease is characterized by a weakening of the immune system.

Syndrome – refers to a group of symptoms that collectively indicate or characterize a disease. In the case of AIDS this can include the development of certain infections and/or cancers, as well as a decrease in the number of certain cells in a person’s immune system.

A diagnosis of AIDS is made by a physician using specific clinical or laboratory standards

What causes AIDS?

AIDS is caused by infection with a virus called human immunodeficiency virus (HIV). This virus is passed from one person to another through blood-to-blood and sexual contact. In addition, infected pregnant women can pass HIV to their babies during pregnancy or delivery, as well as through breast feeding. People with HIV have what is called HIV infection. Some of these people will develop AIDS as a result of their HIV infection.

How does HIV cause AIDS?

HIV destroys a certain kind of blood cell (CD4+ T cells) which is crucial to the normal function of the human immune system. In fact, loss of these cells in people with HIV is an extremely powerful predictor of the development of AIDS. Studies of thousands of people have revealed that most people infected with HIV carry the virus for years before enough damage is done to the immune system for AIDS to develop. However, sensitive tests have shown a strong connection between the amount of HIV in the blood and the decline in CD4+ T cells and the development of AIDS. Reducing the amount of virus in the body with anti-retroviral therapies can dramatically slow the destruction of a person’s immune system.

How long does it take for HIV to cause AIDS?

Prior to 1996, scientists estimated that about half the people with HIV would develop AIDS within 10 years after becoming infected. This time varied greatly from person to person and depended on many factors, including a person's health status and their health-related behaviors.

Since 1996, the introduction of powerful anti-retroviral therapies has dramatically changed the progression time between HIV infection and the development of AIDS. There are also other medical treatments that can prevent or cure some of the illnesses associated with AIDS, though the treatments do not cure AIDS itself. Because of these advances in drug therapies and other medical treatments, estimates of how many people will develop AIDS and how soon are being recalculated, revised, or are currently under study.

As with other diseases, early detection of infection allows for more options for treatment and preventative health care.

How can I tell if I'm infected with HIV?
What are the symptoms?

The only way to know if you are infected is to be tested for HIV infection. You cannot rely on symptoms to know whether or not you are infected. Many people who are infected with HIV do not have any symptoms at all for many years.

The following may be warning signs of HIV infection:

  • rapid weight loss
  • dry cough
  • recurring fever or profuse night sweats
  • profound and unexplained fatigue
  • swollen lymph glands in the armpits, groin, or neck
  • diarrhea that lasts for more than a week
  • white spots or unusual blemishes on the tongue, in the mouth, or in the throat
  • pneumonia
  • red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
  • memory loss, depression, and other neurological disorders

However, no one should assume they are infected if they have any of these symptoms. Each of these symptoms can be related to other illnesses. Again, the only way to determine whether you are infected is to be tested for HIV infection.

What are the different HIV screening tests available in the U.S.?

In most cases the EIA (enzyme immunoassay), performed on blood drawn from a vein, is the standard screening test used to detect the presence of antibodies to HIV. A reactive EIA must be used with a follow-up confirmatory test such as the Western blot to make a positive diagnosis. There are EIA tests that use other body fluids to screen for antibodies to HIV. These include:

  • Oral Fluid Tests – use oral fluid (not saliva) that is collected from the mouth using a special collection device. This is an EIA antibody test similar to the standard blood EIA test and requires a follow-up confirmatory Western Blot using the same oral fluid sample.
  • Urine Tests – use urine instead of blood. The sensitivity and specificity (accuracy) are somewhat less than that of the blood and oral fluid tests. This is also an EIA antibody test similar to blood EIA tests and requires a follow-up confirmatory Western Blot using the same urine sample.

Rapid Tests:

A rapid test is a screening test that produces very quick results, in approximately 20-60 minutes. Rapid tests use blood or oral fluid to look for the presence of antibodies to HIV. As is true for all screening tests, a reactive rapid HIV test result must be confirmed with a follow-up confirmatory test before a final diagnosis of infection can be made. These tests have similar accuracy rates as traditional EIA screening tests.

In our office we offer the Oraquick rapid HIV test in Miami and results are obtained within 20 minutes. Please call 305 4488134 to arrange an appointment.

 

 

 

How long after a possible exposure should I wait to get tested for HIV?

 

It can take some time for the immune system to produce enough antibodies for the antibody test to detect and this time period can vary from person to person. This time period is commonly referred to as the “window period”. Most people will develop detectable antibodies within 2 to 8 weeks (the average is 25 days). Even so, there is a chance that some individuals will take longer to develop detectable antibodies. Therefore, if the initial negative HIV test was conducted within the first 3 months after possible exposure, repeat testing should be considered >3 months after the exposure occurred to account for the possibility of a false-negative result. Ninety seven percent will develop antibodies in the first 3 months following the time of their infection. In very rare cases, it can take up to 6 months to develop antibodies to HIV.

Where can I get tested for HIV infection?

You can call our office at 305 4488134 to arrange an appointment. Same day visits are available.

Between the time of a possible exposure and the receipt of test results, individuals should consider abstaining from sexual contact with others or use condoms and/or dental dams during all sexual encounters.

What if I test positive for HIV?

If you test positive for HIV, the sooner you take steps to protect your health, the better. Early medical treatment and a healthy lifestyle can help you stay well. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. There are a number of important steps you can take immediately to protect your health:

  • See a licensed health care provider, even if you do not feel sick. Try to find a health care provider who has experience treating HIV. There are now many medications to treat HIV infection and help you maintain your health. It is never too early to start thinking about treatment possibilities.
  • Have a TB (tuberculosis) test. You may be infected with TB and not know it. Undetected TB can cause serious illness, but it can be successfully treated if caught early.
  • Smoking cigarettes, drinking too much alcohol, or using illegal drugs (such as methamphetamines) can weaken your immune system. There are programs available that can help you stop or reduce your use of these substances.
  • Have a screening test for other sexually transmitted diseases (STDs). Undetected STDs can cause serious health problems. It is also important to practice safe-sex behaviors so you can avoid getting STDs.

There is much you can do to stay healthy. Learn all that you can about maintaining good health.

Not having (abstaining from) sex is the most effective way to avoid transmitting HIV to others. If you choose to have sex, use a latex condom to help protect your partner from HIV and other STDs. Studies have shown that latex condoms are very effective, though not 100%, in preventing HIV transmission when used correctly and consistently. If either partner is allergic to latex, plastic (polyurethane) condoms for either the male or female can be used.

How is HIV passed from one person to another?

HIV transmission can occur when blood, semen (cum), pre-seminal fluid (pre-cum), vaginal fluid, or breast milk from an infected person enters the body of an uninfected person.
HIV can enter the body through a vein (e.g., injection drug use), the lining of the anus or rectum, the lining of the vagina and/or cervix, the opening to the penis, the mouth, other mucous membranes (e.g., eyes or inside of the nose), or cuts and sores. Intact, healthy skin is an excellent barrier against HIV and other viruses and bacteria.

These are the most common ways that HIV is transmitted from one person to another:

  • by having sex (anal, vaginal, or oral) with an HIV-infected person;
  • by sharing needles or injection equipment with an injection drug user who is infected with HIV; or
  • from HIV-infected women to their babies before or during birth, or through breast-feeding after birth.

HIV also can be transmitted through receipt of infected blood or blood clotting factors. However, since 1985, all donated blood in the United States has been tested for HIV. Therefore, the risk of infection through transfusion of blood or blood products is extremely low. The U.S. blood supply is considered to be among the safest in the world.

Which body fluids transmit HIV?

These body fluids have been shown to contain high concentrations of HIV:

  • blood
  • semen
  • vaginal fluid
  • breast milk
  • other body fluids containing blood

The following are additional body fluids that may transmit the virus that health care workers may come into contact with:

  • fluid surrounding the brain and the spinal cord
  • fluid surrounding bone joints
  • fluid surrounding an unborn baby

HIV has been found in the saliva and tears of some persons living with HIV, but in very low quantities. It is important to understand that finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid. HIV has not been recovered from the sweat of HIV-infected persons. Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV.

Can I get HIV from kissing?

On the Cheek:

HIV is not transmitted casually, so kissing on the cheek is very safe. Even if the other person has the virus, your unbroken skin is a good barrier. No one has become infected from such ordinary social contact as dry kisses, hugs, and handshakes.

Open-Mouth Kissing:

Open-mouth kissing is considered a very low-risk activity for the transmission of HIV. However, prolonged open-mouth kissing could damage the mouth or lips and allow HIV to pass from an infected person to a partner and then enter the body through cuts or sores in the mouth. Because of this possible risk, the CDC recommends against open-mouth kissing with an infected partner.

One case suggests that a woman became infected with HIV from her sex partner through exposure to contaminated blood during open-mouth kissing.

Can I get HIV from oral sex?

Yes, it is possible for either partner to become infected with HIV through performing or receiving oral sex. There have been a few cases of HIV transmission from performing oral sex on a person infected with HIV. While no one knows exactly what the degree of risk is, evidence suggests that the risk is less than that of unprotected anal or vaginal sex.

If the person performing oral sex has HIV, blood from their mouth may enter the body of the person receiving oral sex through

  • the lining of the urethra (the opening at the tip of the penis);
  • the lining of the vagina or cervix;
  • the lining of the anus; or
  • directly into the body through small cuts or open sores.

If the person receiving oral sex has HIV, their blood, semen (cum), pre-seminal fluid (pre-cum), or vaginal fluid may contain the virus. Cells lining the mouth of the person performing oral sex may allow HIV to enter their body.

The risk of HIV transmission increases

  • if the person performing oral sex has cuts or sores around or in their mouth or throat;
  • if the person receiving oral sex ejaculates in the mouth of the person performing oral sex; or
  • if the person receiving oral sex has another sexually transmitted disease (STD).

Not having (abstaining from) sex is the most effective way to avoid HIV.

If you choose to perform oral sex, and your partner is male,

  • use a latex condom on the penis; or
  • if you or your partner is allergic to latex, plastic (polyurethane) condoms can be used.

Studies have shown that latex condoms are very effective, though not perfect, in preventing HIV transmission when used correctly and consistently. If either partner is allergic to latex, plastic (polyurethane) condoms for either the male or female can be used.

If you choose to have oral sex, and your partner is female,

  • use a latex barrier (such as a natural rubber latex sheet, a dental dam or a cut-open condom that makes a square) between your mouth and the vagina. A latex barrier such as a dental dam reduces the risk of blood or vaginal fluids entering your mouth. Plastic food wrap also can be used as a barrier.

If you choose to perform oral sex with either a male or female partner and this sex includes oral contact with your partners anus (analingus or rimming),

  • use a latex barrier (such as a natural rubber latex sheet, a dental dam or a cut-open condom that makes a square) between your mouth and the anus. Plastic food wrap also can be used as a barrier.

If you choose to share sex toys with your partner, such as dildos or vibrators,

  • each partner should use a new condom on the sex toy; and
  • be sure to clean sex toys between each use.

Can I get HIV from anal sex?

Yes. In fact, unprotected (without a condom) anal sex (intercourse) is considered to be very risky behavior. It is possible for either sex partner to become infected with HIV during anal sex. HIV can be found in the blood, semen, pre-seminal fluid, or vaginal fluid of a person infected with the virus. In general, the person receiving the semen is at greater risk of getting HIV because the lining of the rectum is thin and may allow the virus to enter the body during anal sex. However, a person who inserts his penis into an infected partner also is at risk because HIV can enter through the urethra (the opening at the tip of the penis) or through small cuts, abrasions, or open sores on the penis.

Not having (abstaining from) sex is the most effective way to avoid HIV. If people choose to have anal sex, they should use a latex condom. Most of the time, condoms work well. However, condoms are more likely to break during anal sex than during vaginal sex. Thus, even with a condom, anal sex can be risky. A person should use generous amounts of water-based lubricant in addition to the condom to reduce the chances of the condom breaking.

Can I get HIV from vaginal sex*?

Yes, it is possible for either partner to become infected with HIV through vaginal sex* (intercourse). In fact, it is the most common way the virus is transmitted in much of the world. HIV can be found in the blood, semen (cum), pre-seminal fluid (pre-cum) or vaginal fluid of a person infected with the virus.

In women, the lining of the vagina can sometimes tear and possibly allow HIV to enter the body. HIV can also be directly absorbed through the mucous membranes that line the vagina and cervix.

In men, HIV can enter the body through the urethra (the opening at the tip of the penis) or through small cuts or open sores on the penis.

Not having (abstaining from) sex is the most effective way to avoid HIV. If you choose to have vaginal sex, use a latex condom to help protect both you and your partner from HIV and other STDs. Studies have shown that latex condoms are very effective, though not perfect, in preventing HIV transmission when used correctly and consistently. If either partner is allergic to latex, plastic (polyurethane) condoms for either the male or female can be used.

Is there a connection between HIV and other sexually transmitted diseases?

Yes. Having a sexually transmitted disease (STD) can increase a person's risk of becoming infected with HIV, whether the STD causes open sores or breaks in the skin (e.g., syphilis, herpes, chancroid) or does not cause breaks in the skin (e.g., chlamydia, gonorrhea).

If the STD infection causes irritation of the skin, breaks or sores may make it easier for HIV to enter the body during sexual contact. Even when the STD causes no breaks or open sores, the infection can stimulate an immune response in the genital area that can make HIV transmission more likely.

In addition, if an HIV-infected person is also infected with another STD, that person is three to five times more likely than other HIV-infected persons to transmit HIV through sexual contact.

Not having (abstaining from) sexual intercourse is the most effective way to avoid all STDs, including HIV. For those who choose to be sexually active, the following HIV prevention activities are highly effective:

  • Engaging in behaviors that do not involve vaginal or anal intercourse or oral sex
  • Having sex with only one uninfected partner
  • Using latex condoms every time you have sex

Why is injecting drugs a risk for HIV?

At the start of every intravenous injection, blood is introduced into the needle and syringe. HIV can be found in the blood of a person infected with the virus. The reuse of a blood-contaminated needle or syringe by another drug injector (sometimes called "direct syringe sharing") carries a high risk of HIV transmission because infected blood can be injected directly into the bloodstream.

Sharing drug equipment (or "works") can be a risk for spreading HIV. Infected blood can be introduced into drug solutions by

  • using blood-contaminated syringes to prepare drugs;
  • reusing water;
  • reusing bottle caps, spoons, or other containers ("spoons" and "cookers") used to dissolve drugs in water and to heat drug solutions; or
  • reusing small pieces of cotton or cigarette filters ("cottons") used to filter out particles that could block the needle.

" Street sellers" of syringes may repackage used syringes and sell them as sterile syringes. For this reason, people who continue to inject drugs should obtain syringes from reliable sources of sterile syringes, such as pharmacies.

It is important to know that sharing a needle or syringe for any use, including skin popping and injecting steroids, can put one at risk for HIV and other blood-borne infections.

Are patients in a health care setting at risk of getting HIV?

Although HIV transmission is possible in health care settings, it is extremely rare. Medical experts emphasize that the careful practice of infection control procedures, including universal precautions (i.e., using protective practices and personal protective equipment to prevent HIV and other blood-borne infections), protects patients as well as health care providers from possible HIV transmission in medical and dental offices and hospitals.

In 1990, the CDC reported on an HIV-infected dentist in Florida who apparently infected some of his patients while doing dental work. Studies of viral DNA sequences linked the dentist to six of his patients who were also HIV-infected. The CDC has not yet been able to establish how the transmission took place. No additional studies have found any evidence of transmission from provider to patient in health care settings.

CDC has documented rare cases of patients contracting HIV in health care settings from infected donor tissue. Most of these cases occurred due to failures in following universal precautions and infection control guidelines. Most also occurred early in the HIV epidemic, before established screening procedures were in place.

Are “lesbians” or other women who have sex with women at risk for HIV?

Female-to-female transmission of HIV appears to be a rare occurrence. However, there are case reports of female-to-female transmission of HIV. The well documented risk of female-to-male transmission of HIV shows that vaginal secretions and menstrual blood may contain the virus and that mucous membrane (e.g., oral, vaginal) exposure to these secretions has the potential to lead to HIV infection.

In order to reduce the risk of HIV transmission, women who have sex with women should do the following:

  • Avoid exposure of a mucous membrane, such as the mouth, (especially non-intact tissue) to vaginal secretions and menstrual blood.
  • Use condoms consistently and correctly each and every time for sexual contact with men or when using sex toys. Sex toys should not be shared. No barrier methods for use during oral sex have been evaluated as effective by the FDA. However, natural rubber latex sheets, dental dams, cut open condoms, or plastic wrap may offer some protection from contact with body fluids during oral sex and possibly reduce the risk of HIV transmission.
  • Know your own and your partner’s HIV status. This knowledge can help uninfected women begin and maintain behavioral changes that reduce the risk of becoming infected. For women who are found to be infected, it can assist in getting early treatment and avoiding infecting others.

Can I get HIV from getting a tattoo or through body piercing?

A risk of HIV transmission does exist if instruments contaminated with blood are either not sterilized or disinfected or are used inappropriately between clients. CDC recommends that instruments that are intended to penetrate the skin be used once, then disposed of or thoroughly cleaned and sterilized between clients.

Personal service workers who do tattooing or body piercing should be educated about how HIV is transmitted and take precautions to prevent transmission of HIV and other blood-borne infections in their settings.

If you are considering getting a tattoo or having your body pierced, ask staff at the establishment what procedures they use to prevent the spread of HIV and other blood-borne infections, such as the hepatitis B virus. You also may call the local health department to find out what sterilization procedures are in place in the local area for these types of establishments.

Can I get HIV from a bite?

Human Bite:

In 1997, CDC published findings from a state health department investigation of an incident that suggested blood-to-blood transmission of HIV by a human bite. There have been other rare reports in the medical literature in which HIV appeared to have been transmitted by a bite. Severe trauma with extensive tissue tearing and damage and presence of blood were reported in each of these instances. Biting is not a common way of transmitting HIV. In fact, there are numerous reports of bites that did not result in HIV infection.

Non-Human Bite:

HIV is a virus that infects humans and thus cannot be transmitted to or carried by non-human animals. The only exception to this is a few chimpanzees in laboratories that have been artificially infected with HIV. Because HIV is not found in non-human animals it is not possible for HIV to be transmitted from an animal bite, such as from a dog or cat.

Some animals can carry viruses that are similar to HIV, such as FIV (Feline Immunodeficiency Virus) found in cats or SIV (Simian Immunodeficiency Virus) found in apes. These viruses can only exist in their specific animal host and are not transmissible to humans.

Can I get HIV from casual contact (shaking hands, hugging, using a toilet, drinking from the same glass, or the sneezing and coughing of an infected person)?

No. HIV is not transmitted by day-to-day contact in the workplace, schools, or social settings. HIV is not transmitted through shaking hands, hugging, or a casual kiss. You cannot become infected from a toilet seat, a drinking fountain, a door knob, dishes, drinking glasses, food, or pets.

HIV is not an airborne or food-borne virus, and it does not live long outside the body. HIV can be found in the blood, semen, or vaginal fluid of an infected person. The three main ways HIV is transmitted are

  • through having sex (anal, vaginal, or oral) with someone infected with HIV.
  • through sharing needles and syringes with someone who has HIV.
  • through exposure (in the case of infants) to HIV before or during birth, or through breast feeding.

Although contact with blood and other body substances can occur in households, transmission of HIV is rare in this setting. A small number of transmission cases have been reported in which a person became infected with HIV as a result of contact with blood or other body secretions from an HIV-infected person in the household.

Persons living with HIV and persons providing home care for those living with HIV should be fully educated and trained regarding appropriate infection-control procedures.

Can I get HIV from mosquitoes?

No. From the start of the HIV epidemic there has been concern about HIV transmission from biting and bloodsucking insects, such as mosquitoes. However, studies conducted by the CDC and elsewhere have shown no evidence of HIV transmission from mosquitoes or any other insects - even in areas where there are many cases of AIDS and large populations of mosquitoes. Lack of such outbreaks, despite intense efforts to detect them, supports the conclusion that HIV is not transmitted by insects.

The results of experiments and observations of insect biting behavior indicate that when an insect bites a person, it does not inject its own or a previously bitten person's or animal's blood into the next person bitten. Rather, it injects saliva, which acts as a lubricant so the insect can feed efficiently. Diseases such as yellow fever and malaria are transmitted through the saliva of specific species of mosquitoes. However, HIV lives for only a short time inside an insect and, unlike organisms that are transmitted via insect bites, HIV does not reproduce (and does not survive) in insects. Thus, even if the virus enters a mosquito or another insect, the insect does not become infected and cannot transmit HIV to the next human it bites.

There also is no reason to fear that a mosquito or other insect could transmit HIV from one person to another through HIV-infected blood left on its mouth parts. Several reasons help explain why this is so. First, infected people do not have constantly high levels of HIV in their blood streams. Second, insect mouth parts retain only very small amounts of blood on their surfaces. Finally, scientists who study insects have determined that biting insects normally do not travel from one person to the next immediately after ingesting blood. Rather, they fly to a resting place to digest the blood meal.

Frequently Repeated Rumors about HIV Transmission:

I got an e-mail warning that a man, who was believed to be HIV-positive, was recently caught placing blood in the ketchup dispenser at a fast food restaurant. Because of the risk of HIV transmission, the e–mail recommended that only individually wrapped packets of ketchup be used. Is there a risk of contracting HIV from ketchup?

No incidents of ketchup dispensers being contaminated with HIV-infected blood have been reported to CDC. Furthermore, CDC has no reports of HIV infection resulting from eating food, including condiments.

HIV is not an airborne or food-borne virus, and it does not live long outside the body. Even if small amounts of HIV-infected blood were consumed, stomach acid would destroy the virus. Therefore, there is no risk of contracting HIV from eating ketchup.

HIV is most commonly transmitted through specific sexual behaviors (anal, vaginal, or oral sex) or needle sharing with an infected person. An HIV-infected woman can pass the virus to her baby before or during childbirth or after birth through breastfeeding. Although the risk is extremely low in the United Stats, it is also possible to acquire HIV through transfusions of infected blood or blood products.

Did a Texas child die of a heroin overdose after being stuck by a used needle found on a playground?

This story was investigated and found to be a hoax. To become overdosed on a drug from a used needle and syringe, a person would have to have a large amount of the drug injected directly into their body. A needle stick injury such as that mentioned in the story would not lead to a large enough injection to cause a drug overdose. In addition, drug users would leave very little drug material in a discarded syringe after they have injected. If such an incident were to happen, there would likely be concerns about possible blood borne infections, such as human immunodeficiency virus and hepatitis B or C. The risk of these infections from an improperly disposed of needle, such as that described in the story, are extremely low.

Can HIV be transmitted through contact with unused feminine (sanitary) pads?

HIV cannot be transmitted through the use of new, unused feminine pads. The human immunodeficiency virus, or HIV, is a virus that is passed from one person to another through blood-to-blood and sexual contact with someone who is infected with HIV. In addition, infected pregnant women can pass HIV to their babies during pregnancy or delivery, as well as through breast feeding. Although some people have been concerned that HIV might be transmitted in other ways, such as through air, water, insects, or common objects, no scientific evidence supports this. Even though no one has gotten HIV from touching used feminine pads, used pads should be wrapped and properly disposed of so no one comes in contact with blood.

Is a Weekly World News story that claims CDC has discovered a mutated version of HIV that is transmitted through the air true?

This story is not true. It is unfortunate that such stories, which may frighten the public, are being circulated on the Internet.

Human immunodeficiency virus (HIV), the virus that causes AIDS, is spread by sexual contact (anal, vaginal, or oral) or by sharing needles and/or syringes with someone who is infected with HIV.

Babies born to HIV-infected women may become infected before or during birth or through breast feeding.

Many scientific studies have been done to look at all the possible ways that HIV is transmitted. These studies have not shown HIV to be transmitted through air, water, insects, or casual contact.

I have read stories on the Internet about people getting stuck by needles in phone booth coin returns, movie theater seats, gas pump handles, and other places. One story said that CDC reported similar incidents about improperly discarded needles and syringes. Are these stories true?

CDC has received inquiries about a variety of reports or warnings about used needles left by HIV-infected injection drug users in coin return slots of pay phones, the underside of gas pump handles, and on movie theater seats. These reports and warnings have been circulated on the Internet and by e-mail and fax. Some reports have falsely indicated that CDC "confirmed" the presence of HIV in the needles. CDC has not tested such needles nor has CDC confirmed the presence or absence of HIV in any sample related to these rumors. The majority of these reports and warnings appear to have no foundation in fact.

CDC was informed of one incident in Virginia of a needle stick from a small-gauge needle (believed to be an insulin needle) in a coin return slot of a pay phone. The incident was investigated by the local police department. Several days later, after a report of this police action appeared in the local newspaper, a needle was found in a vending machine but did not cause a needle-stick injury.

Discarded needles are sometimes found in the community outside of health care settings. These needles are believed to have been discarded by persons who use insulin or are injection drug users. Occasionally the "public" and certain groups of workers (e.g., sanitation workers or housekeeping staff) may sustain needle-stick injuries involving inappropriately discarded needles. Needle-stick injuries can transfer blood and blood-borne pathogens (e.g., hepatitis B, hepatitis C, and HIV), but the risk of transmission from discarded needles is extremely low.

CDC does not recommend testing discarded needles to assess the presence or absence of infectious agents in the needles. Management of exposed persons should be done on a case-by-case evaluation of (1) the risk of a blood-borne pathogen infection in the source and (2) the nature of the injury. Anyone who is injured from a needle stick in a community setting should contact their physician or go to an emergency room as soon as possible. The health care professional should then report the injury to the local or state health department. CDC is not aware of any cases where HIV has been transmitted by a needle-stick injury outside a health care setting.

The above information has been obtained from the Center for Disease Control.