Human immunodeficiency virus (HIV) is a virus that attacks and weakens your immune system, making you more vulnerable to illness. Untreated HIV can lead to acquired immune deficiency syndrome (AIDS), a disease that occurs when your immune system is so weak it can’t fight off illness.
There’s an epidemic of HIV in the United States and around the world. According to the Centers for Disease Control and Prevention (CDC), more than 1.2 million people in the U.S. have HIV. An estimated 44,073 people in the country were diagnosed with HIV in 2014 alone.
You can contract HIV in many different ways, including through unprotected sex and by sharing needles. Your chances of getting HIV vary. A lot depends on several factors, including your:
- sexual practices
- history of intravenous drug use
- age, gender, sexuality, ethnicity, and race
Learn how to recognize and manage your risk factors to help stop the spread of HIV.
Unprotected sex is one of the foremost ways that HIV is spread. Unprotected sex also raises your risk of contracting and spreading other sexually transmitted infections (STIs), such as genital herpes, chlamydia, and gonorrhea.
HIV can spread through semen, vaginal secretions, blood, and other bodily fluids. Having sexual contact with someone who has HIV greatly increases your chances of contracting the virus. Unprotected sex is particularly risky. When you don’t use a condom during sex, it’s easier for semen, vaginal fluids, blood, or other bodily fluids to enter your system. If your partner has HIV or another infection, it can pass into your body through these fluids. If you use a condom during sex, your chances of contracting HIV and infections will be lower.
All forms of unprotected sex, including oral, vaginal, and anal sex, put you at risk of HIV and other STIs. Unprotected anal sex is particularly risky. Other risk factors can also raise your chances of contracting HIV from unprotected sex, including:
- the sex of your partner
- bottoming during anal sex
- having another sexually STI
Male vs. female partners
It’s easier to contract HIV from sex with a male partner than a female partner.
If you have unprotected vaginal sex with a male partner, your vaginal membranes are more likely to tear than your partner’s penis. If you have unprotected anal sex with a male partner, your rectal membranes are also more likely to tear than their penis. Tears create an easier path for HIV and other pathogens to enter your body.
That doesn’t mean that you can’t get HIV from sex with a female partner. You can. If your partner has HIV, it can be carried in their vaginal secretions. If you have open sores on your mouth or penis, they can create a gateway for vaginal secretions or other bodily fluids with HIV to enter your body. If you’re male and uncircumcised, you’re also at higher risk of contracting HIV from unprotected sex than circumcised men. The delicate membranes of your foreskin can tear during sex. This creates a pathway for HIV to enter your system.
Bottoming vs. topping
“Topping” and “bottoming” are common names for positions in anal sex. The person topping is the one in the insertive position. The person bottoming is in the receptive position.
You can get HIV while topping or bottoming, especially during unprotected anal sex. But bottoming is riskier than topping. That’s because the lining of your rectum is fragile and can tear easily during anal sex. These tears can create a route for HIV-infected fluids, such as semen, to enter your body.
Having another STI
If you have another untreated STI, you’re more likely to contract HIV too. Why?
First, some STIs cause ulcers, or sores, to develop in your genital area. These sores create an opening in your skin, making it easier for HIV to enter your system.
Second, when you have an infection, your immune system sends out certain cells to help fight it. These cells are called CD4+ cells. They’re the same cells that HIV targets. When your immune system is fighting off another infection, you may be more susceptible to HIV.
If your partner has another STI, in addition to HIV, it’s more likely they’ll pass it on to you. People with both HIV and other STIs tend to have higher concentrations of the virus in their genital fluids. As a result, they’re more likely to pass it to you.
Not all HIV infections are passed through sexual contact. Sharing needles also puts you at higher risk of contracting HIV. If you use intravenous drugs, you’re more likely to contract the disease from an infected needle.
When you inject a needle into your body, you break the skin barrier. If the needle has already been injected into another person, it can carry traces of their blood, along with any infections they have. The contaminated needle can introduce these infections into your body.
HIV can affect anyone. Whatever your age, gender, sexuality, ethnicity, or race, it’s important to take steps to protect yourself. But due to physiological and historical factors, some demographic traits can affect your chances of contracting HIV.
According to the CDC, demographic risk factors for HIV include:
- Age: You’re more likely to contract HIV if you’re younger. In 2014, 36 percent of people diagnosed with HIV in the U.S. were between the ages of 20 and 29, while another 24 percent were aged 30 to 39.
- Sexuality: If you’re a man who has sex with men you’re at a higher risk of getting HIV. In 2014, gay and bisexual men accounted for more than 83 percent of new HIV diagnoses among men aged 13 and older.
- Ethnicity and race: Your risk of contracting HIV is higher if you’re African-American, Hispanic, or Latino. African-Americans comprised only 12 percent of the American population in 2014, but they accounted for roughly 44 percent of new HIV diagnosis.
Transgender women are also more likely to get the virus, reports the CDC.
To lower your risk of getting HIV and other infections:
- Limit your number of sexual partners.
- Use condoms during oral, vaginal, and anal sex.
- Get tested for STIs and follow your doctor’s recommended screening schedule.
- Ask your sexual partner to get tested for STIs before you have sex with them.
- Avoid using intravenous drugs.
- Avoid sharing needles.
If your sexual partner has HIV, or you’re at high risk of contracting the virus for other reasons, talk to your doctor about pre-exposure prophylaxis (PrEP). This is a HIV prevention pill that you take daily. It’s known to reduce your chances of contracting the virus. If your doctor thinks you’re a good candidate for PrEP, they’ll prescribe it to help lower your risk of getting HIV.
If you think you might have HIV, get tested immediately. There’s no known cure. But early testing and treatment can help you manage your symptoms, lower your risk of complications, and live a longer and healthier life. Your doctor can also help you learn how to avoid spreading the virus to other people.