Modes of Transmission - HIV / AIDS

Ryan gallantly fought the often cruel and violent AIDS related discrimination with education and actions until his death at age 18.

Transmission of HIV

To combat further infection of patients in need of life saving blood transfusions protocols and procedures were developed to protect the public, ELISA testing was mandated, (ELISA is the enzyme-link immunosorbent assay that is a common lab technique used to measure the concentration of antibodies and/or antigens in a solution.). Due to the many uncertainties about HIV/AIDS in the 1980’s there was mass hysteria surrounding the virus; and though we have come a long way on understanding and tolerating HIV/AIDS there are still myths that haunts it’s transmission.

Ryan White (December 6, 1971 – April 8, 1990) was 13 when he was diagnosed with AIDS. Ryan gallantly fought the often cruel and violent AIDS related discrimination with education and actions until his death at age 18. As a hemophiliac Ryan was subject to blood transfusions and unfortunately was inadvertently infected with HIV/AIDS.

Predominant modes of HIV transmission vary around the world. In the US HIV is mainly transmitted through unprotected sex between men and unsafe practices of intravenous drug users. According to the CDC certain body fluids which include blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, and breast milk from an infected person are the vehicles for transmission. These body fluids must come into contact with a mucus membrane (found inside the rectum, vagina, mouth or opening of the penis) or compromised tissue or injected into the bloodstream.

Unprotected sex: penile -vaginal or penile - anal, heterosexual, or gay person are the primary modes of transmission, with anal sex posing the highest and vaginal sex being the second highest. Participating in anal sex is the riskiest of sexual behaviors due to the thin rectal lining where HIV has an easier route to enter the body. Vaginal sex can still be high risk behavior and either partner can become infected. Much like the rectal lining, the lining of the vagina may experience tears allowing the HIV to be absorbed in the mucous membrane of the vagina and cervix. When engaging in vaginal sex men may experience tiny cuts, abrasions or open sores that will offer a pathway for infection. Infection may also enter through the urethra.

Having multiple sex partners can increase one’s risk of infection simply due to the law of averages even when protection is used. Having other sexually transmitted infections heightens the risk due to the symptoms these infections can produce e.g., skin irritations, broken skin and or sores making it easier for the HIV to enter the body. Even if the infection does not create breaks or open sores, this risk is increased due to inflammation which increases the number of cells to be targeted.

Drug use is a contributing factor to HIV infection. Each type of drug has the capacity to possess individual risk factors and behaviors. Methamphetamine or “meth” users tend to be white males. Gay and bisexual men use meth and other stimulants more than the general population. Meth is highly addictive, very drying to the skin of the penis and mucosal tissues in the anus and vagina, which may lead to microscopic tears and cuts during sexual activity. It is often combined with erectile dysfunction drugs, and this is associated with unprotected anal sex.

Crack cocaine is also a highly addictive drug with a short-lived euphoric span, sending users in a constant chase for the next “high,” which causes an exhaustive depletion of resources, creating higher incidents of trading sex for drugs or money. Further, crack cocaine enhances sexual pleasure and lowers the use of condoms. Primarily, crack cocaine users are Black Americans. Even inhalants pose a risk; sadly, due to their availability (inhalants are found in most household products) pre-teens and teenager are affected. Like meth, amyl nitrite is linked to increased HIV risk. Inhalants also enhance sexual pleasure and in addition, it relaxes the sphincter muscle leading to more unprotected sex.

Intravenous drug addiction is never a good thing and when the sharing of needles, syringes, other equipment, and rinse water is added to the equation the risk of becoming infected with HIV is daunting. The use of other drugs or alcohol may increase the risk of infection as intoxication can diminish ones, better judgement, and lower one’s inhibitions, leading to risky behavior.

Oral sex is a sexual activity that involves the stimulation of the genitals of one partner by the mouth of the other partner, fellatio (oral stimulation of the penis), cunnilingus (oral stimulation of female genitals), or anilingus (oral stimulation of the anus). According to the CDC oral sex poses little to no risk of HIV transmission, the riskiest is fellatio when ejaculation results in the mouth; and still poses less risk than anal or vaginal sex. There are factors that heighten the risk, such as oral ulcers, bleeding gums, genital sores, and the presence of other STD’s.

There are other ways that HIV can be transmitted that are not as common as the ones we have already discussed but, care and caution should be taken. Other forms of transmissions are listed below:

  • Mothers with HIV can infect their children through pregnancy, childbirth, and breastfeeding.

  • Health care professional or lay persons being stuck with contaminated utensils.

  • Though, the number of documented cases is small, being severely bitten with trauma to the skin by an infected person.

  • Incidents are rare but, contact between broken skin and mucous membranes with HIV infected body fluids.

  • HIV cannot be spread through saliva; however, deep open mouth kissing with a HIV infected person who has bleeding gums or mouth sores is a source for infection.

Uncommon means of transmission:

Myths About the Transmission of HIV / AIDS



HIV cannot be spread by holding hands, shaking hands, sharing dishes, social kissing, closed mouth kissing, salvia, tears, sweat, or spitting. It is not spread through water or air and neither on toilet seats. There is no evidence that insects (mosquitoes or ticks) can spread it. Truth told, outside of the body HIV is a very fragile virus as it cannot survive on surfaces, and it cannot reproduce.

Modes of Transmission
HIV / AIDS

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