Transmission Route of HIV

Click here to view an explanation about how is HIV transmitted.

HIV is not only transmitted through sexual intercourse as generally perceived. HIV can be contracted through:

• Mother to child transmission (MTCT)
• Sexual intercourse
• Blood transfusion (including donor transplants)
• Contamination with infected blood or body fluids

Mother to Child Transmission

An HIV positive pregnant woman will transmit the virus to the unborn child “in utero” if there is a breakage of the placenta during pregnancy. If there was no breakage transmission can be avoided through selective Caesarian section. During normal vaginal delivery (NVD), there is likelihood of a tear or some form of breakage of the skin where blood from the mother can contaminate the baby. There is evidence that a high percentage of babies that were on the prevention of MTCT programme did not get infected by their mother’s virus, provided the programme was properly followed, e.g. no beast feeding at all or breastfeeding only.

Sexual Intercourse

In sexual intercourse, there is an exchange of body fluids where the woman secretes a lubricant and the man secretes semen. These fluids are secreted even before penetration but at arousal. When this fluid gets through broken skin, the HI Virus will be transmitted even if there was no penetration. This includes oral and anal sex.

Blood Transfusion

Blood transfused in South Africa goes through rigorous testing before it can be declared fit for human transfusion. It goes through a battery of tests including syphilis, gonorrhoea, herpes, malaria and HIV, amongst others. However, there are times when the HI Virus is at very low levels during the “window period” that it is not yet detectable.

If this blood is transfused to another person this receiver will at a later stage sero-convert and HIV will be detected in his/her system. At this stage the donor would also have sero-converted and the Blood Transfusion Services will be able to track the donor down and inform them, after counselling, that they have sero-converted. The same process happens in cases of organ transplantation.

Contamination with Blood or Body Fluids

Contamination with blood and body fluids happens mostly to health workers like nurses, doctors, laboratory personnel and cleaners and in health facilities and in Home Based Care (HBC) of the infected. When blood or body fluids get through cuts on the skin or membrane, transmission of the virus occurs. It is imperative that health centres have emergency prophylaxis programmes that are known and are easily accessible to all. Gloves and protective clothing should always be worn when handling blood or body fluid from everyone, irrespective of whether their HIV / Aids status is known or not. The other at-risk group is the intravenous drug users because they share needles when injecting drugs into themselves. If one of the people sharing the syringe is infected, everyone using that syringe will be infected.

Note that HIV cannot be transmitted as follows:

• Kissing, embracing or social contact
• Sharing of bedding, cutlery or clothes
• Sharing of bathrooms or toilets
• Eating food prepared or served by a HIV-Positive person
• Living or working with a HIV-Positive person
• Mosquitoes and/or other insects/animals
• Sharing public transport or facilities
• Controlled and professional blood transfusions – South Africa has an excellent reputation and only sterilised needles are used.