Modes of transmission of HIV aids are common and often go unnoticed

Public awareness about HIV and AIDS (HIV / AIDS) has increased in recent decades. However, that does not mean that our efforts to find ways to eradicate HIV transmission stop there. This is because in fact HIV cases and the death rate from AIDS globally are still quite high.

Understanding how HIV is transmitted is at the heart of preventing the spread of the disease and its harmful complications of HIV. Moreover, there are still many myths about the spread of HIV and AIDS out there that must be straightened out so that misunderstandings will no longer take their toll.

The most common mode of transmission of HIV

Summarizing the media release from the Indonesian Ministry of Health, the number of new HIV cases in Indonesia has continued to increase since 2005-2019.

The percentage of HIV cases until June 2019 increased by around 60.7% from the number of people living with HIV / AIDS (PLWHA) in 2016 which reached 640,443 people.

This situation description shows that more awareness is needed in order to successfully prevent the spread of HIV from becoming more widespread.

According to the Center for Disease Control and Prevention (CDC), HIV transmission can only occur through intermediaries certain body fluids.

These body fluids include blood, semen, pre-ejaculation fluids, anal fluids, vaginal fluids, and breast milk.

However, for the virus that causes HIV to pass from an infected person, this fluid must enter the body of a healthy person through:

• Open sores on the skin, such as sores around the sex organs, open mouth sores on the lips, sores on the gums or tongue.
• Mucous membrane on the vaginal wall.
• Damaged body tissue such as abrasions on the anus.
• Blood flow from needle injection.

The following are some of the main ways HIV / AIDS is transmitted:

1. Sex without a condom

Sex that involves vaginal penetration (penis to vagina) or anal penetration (penis to rectum) without using a condom is the most common mode of transmission of HIV / AIDS.

Transmission of the HIV virus through sexual contact is prone to occur from contact with blood, semen, vaginal fluids, or pre-ejaculatory fluids belonging to HIV-infected people.

This fluid can easily infect another person's body when there are open sores or abrasions on the genitals.

Transmission from vaginal sex is most common among heterosexual couples, whereas anal sex is more likely to transmit HIV to the group of homosexual partners.

Therefore, it is important to always protect yourself by using a condom when engaging in any sexual activity.

Condoms can prevent HIV transmission because they block the entry of the virus in sperm or vaginal fluids.

2. Using used syringes or alternately

Using used syringes alternately is also a common mode of transmission of HIV / AIDS. This risk is particularly high among injecting drug users.

Needles that have been used by other people will leave traces of blood. If the person is infected with HIV, the blood containing the virus that is left on the needle can transfer to the body of the needle user further through the injection wound.

The HIV virus can actually live in a syringe for 42 days after first contact depending on temperature and other factors.

It is possible that a single used needle could be an intermediary for transmitting HIV to many different people.

Therefore, make sure to always ask for equipment such as needles or other medical devices that are still in new sealed packages and have never been used before.

3. Mother-to-child transmission of HIV

Pregnant women who contract HIV before or during pregnancy can pass the infection to their babies through the placental cord in the womb.

The risk of transmitting the HIV virus from mother to baby can also occur during the delivery process, both normal delivery and cesarean section.

On the other hand, mothers with HIV who are breastfeeding can also transmit the virus to their babies through breast milk.

On this basis, the challenge for breastfeeding mothers who have HIV is that they are prohibited from giving breast milk to their babies.

In addition, transmission can also occur in infants through chewed food by an HIV-infected mother or nurse, although the risk is very low.

In an effort to avoid spreading HIV from mother to baby, it is important to always consult a doctor when planning a pregnancy.

If HIV in the mother can be detected early, transmission to the baby can be prevented by taking medication regularly.

Various uncommon ways of transmitting HIV

The following are unexpected or less common modes of transmission that can cause you to contract the HIV virus and later AIDS:

1. Oral sex

All forms of oral sex are considered to have a low risk of transmitting the HIV virus, but that is not impossible. The risk of transmission from oral sex still exists.

In fact, this risk can be even greater if you ejaculate in your mouth and don't use condoms or other mouth protectors (such as dental and / female condoms).

HIV transmission can occur when you stimulate or suck on the genitals of an HIV-infected partner with your tongue and you have an open sore or canker sores in your mouth.

How about a kiss? If kissing occurs only in the exchange of saliva, the HIV virus will not spread.

It's different if when you kiss there is a wound, canker sores, or blood contact between you and a partner who has the HIV virus, transmission can occur.

The same is true if your partner accidentally bites your lips or tongue during kissing, the new wound can become a gateway for the HIV virus through the partner's saliva.

2. Blood donation and organ transplants

Direct blood transfusions from infected blood donors have a high risk of transmitting the HIV virus.

However, transmission of the HIV virus through blood donors and organ transplants is less common. The reason is, there is a fairly strict selection for potential donors before donating blood.

Blood or organ donors usually undergo screening first, including an HIV blood test.

This aims to minimize HIV transmission by means of organ and blood donors.

The risk of HIV-infected blood passing through to use for transfusion is actually small. This is because blood donors and transplanted organs must go through a rigorous selection process.

So, blood transfusions that are received and later given to people who need blood are actually safe.

If it turns out that one donation is found to be positive too late, the blood will be immediately discarded while the organ of the transplant candidate will also not be used.

Unfortunately, some developing countries may not have the technology or related equipment to test all blood and prevent the transmission of HIV / AIDS.

There may be some samples of donated blood products that have been received that contain HIV. Fortunately, this incident is considered rare.

3. Being bitten by a person with HIV

According to a 2011 study from the journal AIDS Research and TherapyThere is a biological possibility that human bites may be an unpredictable mode of transmission of HIV.

So far, saliva has been researched to be less effective as an intermediary for the carrier of the HIV virus because it has viral inhibitor properties. However, the cases examined in the journal are unique.

In the journal, it was told that the fingers of a healthy non-HIV man who had diabetes were bitten by his HIV-positive adopted son. The man's finger was bitten down hard and deep enough that the insides of his nails were bleeding.

Some time after being bitten, the man tested positive for HIV and was detected as having viral load high after experiencing high HIV fever and various infections.

Doctors and researchers have finally concluded for a while that saliva can be a medium for the spread of HIV, although they are not quite sure what the exact mechanism is.

Further research and examination is needed to confirm this mode of transmission of HIV.

4.Use sex toys (sex toys)

Penetration of sex, whether it's vaginal (penis to vagina), oral (genitals and mouth), or anal (penis to rectum), with a partner who has HIV and AIDS can catch you.

Not only through direct genitalia, the use of objects or toys such as sex dolls has the risk of transmitting diseases, including HIV. This condition is even more risky if the sex toy you are using is not coated with protection.

Transmission of the HIV and AIDS virus from one person to another often occurs when sex toys are used interchangeably. If you or your partner has HIV, do not use sex toys alternately in one sex session.

In general, the HIV virus cannot live long on the surface of inanimate objects. However, sex toys that are still wet with sperm, blood, or vaginal fluids can be an intermediary for the virus to pass to other people.

5. Doing piercing, eyebrow embroidery, eyebrow tattoo, lip embroidery

Piercing body parts or getting tattoos can also increase the risk of HIV transmission. The mode of transmission of HIV in this process occurs when during the process of piercing and making tattoos, the skin is pierced and then injured until it bleeds.

If the tools are used interchangeably, people who are infected with HIV may leave blood marks that contain the virus.

Actually doing eyebrow embroidery, eyebrow tattoo, and lip embroidery is quite safe for health. However, this rising beauty trend can also be a way of transmitting HIV and AIDS.

This can happen if the process is carried out by inexperienced staff and does not use sterile equipment. The reason is, this facial embroidery or tattoo procedure involves cutting open skin.

To prevent the spread of HIV, before you sit down and sew your eyebrows or lips, make sure that all the equipment used is still sterile.

6. Work in the hospital

Maybe at first glance you think that medical personnel are the healthiest people because they have access and qualified knowledge about health.

However, apart from drug users who deliberately share needles, the risk of HIV transmission is also high for medical personnel.

These medical personnel include doctors, nurses, laboratory workers, and cleaners of health facility waste through medical equipment intermediaries.

Syringes can mediate the HIV virus when the blood of HIV positive patients can be transferred to health workers if they have open wounds that are not protected by clothing.

HIV can also be transmitted to health workers in the following ways:

• If a syringe that has been used by an HIV positive patient is accidentally stuck into a health worker (also calledneedle-stick injury).
• If blood contaminated with HIV on mucous membranes, such as eyes, nose, and mouth.
• Through other health equipment that is used without being sterilized.

Even so, the chances of spreading the HIV virus among medical workers in health facilities through used needles are relatively small.

This is because all health facilities, from the smallest to the international scale, have standardized safety protocols.

The risk of HIV transmission is high if viral load high

Apart from considering the risk of transmission from the type of intermediate fluid, you also need to know the amount viral load HIV in the body.

Viral load is the number of virus particles in 1 ml or 1 cc of blood. The greater the amount of virus in the blood, the higher your risk of transmitting HIV to other people.

So when viral load of HIV-positive people who are successfully transmitted through HIV treatment, the chance of HIV transmission is also reduced.

However, the spread of HIV from a person who is infected with the virus to their partner is still possible despite the test results viral load indicates that the virus is no longer detected.

The risk of transmitting HIV from PLWHA to their sex partners will still exist because:

• Test viral load just measure the amount of virus in the blood. So, the HIV virus can still be found in genital fluids (sperm, vaginal fluids).
• Viral load can increase between routine test schedules. If this happens, people with HIV are more likely to transmit HIV to their partners.
• Having other sexually transmitted diseases can improve viral load in genital fluids.

If you are sexually active, you and your partner should consider having an HIV test as a measure to prevent transmission of the disease.

Impossible mode of transmission of HIV

HIV cannot reproduce in a host other than humans, and it is unable to survive outside the human body for very long.

Then, HIV transmission will not be possible through any means following:

• Animal bites, such as mosquito bites, fleas, or other insects.
• Physical interactions between people that do not involve the exchange of bodily fluids, for example:
  • Touch and hug
  • Shaking or holding hands
  • Sleeping together in one bed without sexual activity
  • Cipika-cipiki
• Sharing utensils and borrowing clothes or towels with people living with HIV.
• Use the same bathroom / toilet.
• Swim in public pools with people living with HIV.
• Saliva, tears, or sweat that does not mix with the blood of an HIV positive person.
• Other sexual activities that do not involve the exchange of bodily fluids, for example kissing on the lips and petting (rubbing genitals) while still fully clothed.

Saliva, tears, and sweat are not ideal intermediaries for HIV transmission. This is because these fluids do not contain sufficient amounts of the active virus to transmit the infection to other people.

In addition, the HIV virus can only survive for a few days or weeks in the laboratory under suitable conditions such as in the human body.

Here are the principles that need to be understood about the chances of the HIV virus surviving:

• HIV is sensitive to high temperatures, that is, it will die in hot temperatures, which is above 60 degrees Celsius.
• HIV is better able to survive in the laboratory in cold temperatures, which are around 4 to -70 degrees Celsius.
• HIV is very sensitive to changes in pH or acid-base levels. A pH level below 7 (acidic) or above 8 (alkaline) does not support HIV survival.
• HIV can survive in dry blood in the laboratory at room temperature for 5-6 days, but must be at a supportive pH level.

HIV is a rapidly growing virus, but fortunately the spread of this virus is preventable and controllable.

Therefore, it is better if you and your partner be aware of the risk of transmission by routinely undergoing annual venereal disease tests.

Many people do not know or even realize that they have been infected because HIV symptoms do not appear immediately at the beginning.

x