There are a lot of misconceptions about how HIV is transmitted, so let’s set the record straight.
Human immunodeficiency virus (HIV) is a virus that attacks the immune system. HIV is contagious, but the vast majority of your daily activities pose no risk of HIV transmission.
Only certain body fluids — blood, semen, vaginal fluid, anal fluid, and breast milk — can spread HIV. It can’t be transmitted via saliva, sweat, skin, feces, or urine.
So, there’s no risk of getting HIV from regular social contact, such as closed-mouth kissing, shaking hands, sharing drinks, or hugging because those bodily fluids aren’t exchanged during these activities.
The most common way that HIV Is spread is through sex, including oral and anal sex, that’s not protected by condoms.
HIV can also be transmitted by sharing needles and using blood containing HIV.
Pregnant people with HIV can transmit the virus to their child during pregnancy, delivery, and breastfeeding. But many people living with HIV are able to have healthy, HIV-negative babies by getting good prenatal care.
HIV isn’t like a cold or flu virus. It can only be transmitted when certain fluids from an HIV-positive person move directly into the bloodstream or through mucous membranes of an HIV-negative person.
Tears, saliva, sweat, and casual skin-to-skin contact can’t transmit HIV.
There’s also no need to be afraid of getting HIV from any of the following.
Saliva carries minuscule traces of the virus, but this isn’t considered harmful. Saliva contains enzymes that break down the virus before it has a chance to spread. Kissing, even “French” or open-mouth kissing, won’t transmit HIV.
Blood, however, does carry HIV. In the rare case that an HIV-positive person has blood in their mouth — and the person receiving an open-mouth kiss has an actively bleeding wound in the mouth too (such as bleeding gums, cuts, or open sores) — an open-mouth kiss could result in transmission of the virus. However, there’s only one documented case of this occurring, reported in the 1990s.
Through the air
HIV doesn’t spread through the air like a cold or flu virus. So, HIV can’t be transmitted if an HIV-positive person sneezes, coughs, laughs, or breathes nearby.
The HIV virus doesn’t live on the skin of an HIV-positive person and can’t live very long outside the body. Shaking the hand of a person with HIV won’t spread the virus.
Sharing toilets or baths
HIV isn’t spread through urine or feces, sweat, or skin. Sharing a toilet or bath with an HIV-positive person carries no risk of transmission. Sharing swimming pools, saunas, or hot tubs with an HIV-positive person is also safe.
Sharing food or drinks
Since HIV isn’t spread by saliva, sharing food or drinks, including water fountains, won’t spread the virus. Even if the food has blood containing HIV on it, exposure to air, saliva, and stomach acid would destroy the virus before it could be transmitted.
Sweat doesn’t transmit HIV. HIV can’t be transmitted via touching the skin or sweat of an HIV-positive person or from sharing exercise equipment.
From insects or pets
The “H” in HIV stands for “human.” Mosquitoes and other biting insects can’t spread HIV. Bites from other animals, like a dog, cat, or snake, also can’t transmit the virus.
If an HIV-positive person spits in food or drink, there’s no risk of getting HIV because saliva doesn’t transmit the virus.
HIV can’t be transmitted via urine. Sharing a toilet or coming into contact with the urine of an HIV-positive person doesn’t pose a risk of transmission.
Dried blood or semen
HIV can’t survive for very long outside the body. If there is contact with blood (or other bodily fluids) that has dried or has been outside the body for a while, there isn’t a risk for transmission.
A person living with HIV can only transmit the virus through certain bodily fluids if they have a detectable viral load. These fluids include:
- vaginal fluid
- anal fluid
- breast milk
For transmission of the virus to occur, these fluids then must make contact with a mucous membrane (like the vagina, penis, rectum, or mouth), a cut or injury, or be injected straight into the bloodstream.
The vast majority of the time, HIV is spread through the following activities:
- having anal or vaginal sex with someone who has HIV without using a condom or taking medications to prevent HIV transmission
- sharing needles or sharing equipment used to prepare drugs for injection with someone who has HIV
HIV may also be spread in these ways, but it’s not common:
- via an HIV-positive person who transmits the virus to their child during pregnancy, delivery, and breastfeeding (however, many people living with HIV are able to have healthy, HIV-negative babies by getting good prenatal care; that care includes being tested for HIV and beginning HIV treatment, if needed)
- accidentally being stuck with an HIV-contaminated needle
In extremely rare cases, HIV can be transmitted in the following ways:
- oral sex, if an HIV-positive person ejaculates into their partner’s mouth and the partner has an open cut or lesion
- a blood transfusion or organ transplant that contains HIV (the chance of this happening now is very rare — less than 1 in 1.5 million — because blood and organ/tissue is meticulously tested for diseases)
- food that has been prechewed (premasticated) by a person living with HIV, but only if blood from the person’s mouth mixes with food while being chewed and the person who receives the chewed food has an open wound in their mouth (the only reports of this have been between caregivers and infants; there are no reports of this kind of transmission between adults)
- a bite, if an HIV-positive person bites and breaks the skin, causing extensive tissue damage (only a few cases of this have been documented)
- blood containing HIV coming in contact with a wound or an area of broken skin
- in one case, open-mouth kissing, if both partners have bleeding gums or sores (in this case, the virus is transmitted through the blood, not the saliva)
- sharing tattoo equipment without sterilizing it between uses (there are no known cases in the United States of anyone contracting HIV this way)
Having a better understanding about HIV transmission not only prevents the spread of HIV, but also prevents the spread of misinformation. HIV can’t be spread through casual contact such as kissing, shaking hands, hugging, or sharing food or drink (as long as both people don’t have open wounds).
Even during anal or vaginal sex, using a condom correctly will prevent HIV from spreading since the virus can’t move through the latex of a condom.
While there isn’t a cure for HIV, advancements in medications for HIV have greatly reduced the chances of a person living with HIV passing the virus on to another person.
If you’re concerned that you may have shared bodily fluids with a person living with HIV, ask a healthcare provider about post-exposure prophylaxis (PEP). PEP can stop the virus from becoming an infection. It must be taken within 72 hours of the contact to be effective.