HIV

Prevention Prevention HIV and Its Transmission 

Research has revealed a great deal of valuable medical, scientific, and public health 

information about the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The ways in which HIV can be transmitted have 

been clearly identified. Unfortunately, false information or statements that are not 

supported by scientific findings continue to be shared widely through the Internet or 

popular press. Therefore, the Centers for Disease Control and Prevention (CDC) 

has prepared this fact sheet to correct a few misperceptions about HIV. 

HIV is spread by sexual contact with an infected person, by sharing needles and/or 

syringes (primarily for drug injection) with someone who is infected, or, less commonly (and now very rarely in countries where blood is screened for HIV antibodies), through transfusions of infected blood or blood clotting factors. Babies born to 

HIV-infected women may become infected before or during birth or through 

breast-feeding after birth. 

In the health care setting, workers have been infected with HIV after being stuck 

with needles containing HIV-infected blood or, less frequently, after infected blood 

gets into a worker’s open cut or a mucous membrane (for example, the eyes or 

inside of the nose). There has been only one instance of patients being infected by a 

health care worker in the United States; this involved HIV transmission from one 

infected dentist to six patients. Investigations have been completed involving more 

than 22,000 patients of 63 HIV-infected physicians, surgeons, and dentists, and no 

other cases of this type of transmission have been identified in the United States. 

Some people fear that HIV might be transmitted in other ways; however, no 

scientific evidence to support any of these fears has been found. If HIV were being 

transmitted through other routes (such as through air, water, or insects), the pattern 

of reported AIDS cases would be much different from what has been observed. 

For example, if mosquitoes could transmit HIV infection, many more young children and preadolescents would have been diagnosed with AIDS. 

All reported cases suggesting new or potentially unknown routes of transmission 

are thoroughly investigated by state and local health departments with the assistance, guidance, and laboratory support from CDC. No additional routes of 

transmission have been recorded, despite a national sentinel system designed to 

detect just such an occurrence. 

The following paragraphs specifically address some of the common misperceptions 

about HIV transmission. 

HIV in the Environment 

Scientists and medical authorities agree that HIV does not survive well in the 

environment, making the possibility of environmental transmission remote. HIV is 

found in varying concentrations or amounts in blood, semen, vaginal fluid, breast 

How HIV is Transmitted 

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HIV and it’s Transmission, July 1999 
milk, saliva, and tears. (See page 3, Saliva, Tears, and Sweat.) To obtain data on the survival of HIV, laboratory studies have required the use of artificially high concentrations of laboratory-grown virus. Although these 

unnatural concentrations of HIV can be kept alive for days or even weeks under precisely controlled and limited 

laboratory conditions, CDC studies have shown that drying of even these high concentrations of HIV reduces 

the amount of infectious virus by 90 to 99 percent within several hours. Since the HIV concentrations used in 

laboratory studies are much higher than those actually found in blood or other specimens, drying of HIVinfected human blood or other body fluids reduces the theoretical risk of environmental transmission to that 

which has been observed—essentially zero. Incorrect interpretation of conclusions drawn from laboratory 

studies have unnecessarily alarmed some people. 

Results from laboratory studies should not be used to assess specific personal risk of infection because (1) the 

amount of virus studied is not found in human specimens or elsewhere in nature, and (2) no one has been 

identified as infected with HIV due to contact with an environmental surface. Additionally, HIV is unable to 

reproduce outside its living host (unlike many bacteria or fungi, which may do so under suitable conditions), 

except under laboratory conditions, therefore, it does not spread or maintain infectiousness outside its host. 

Households 

Although HIV has been transmitted between family members in a household setting, this type of transmission is 

very rare. These transmissions are believed to have resulted from contact between skin or mucous membranes 

and infected blood. To prevent even such rare occurrences, precautions, as described in previously published 

guidelines, should be taken in all settings—including the home—to prevent exposures to the blood of persons 

who are HIV infected, at risk for HIV infection, or whose infection and risk status are unknown. For example, 

❖ Gloves should be worn during contact with blood or other body fluids that could possibly contain visible 

blood, such as urine, feces, or vomit. 

❖ Cuts, sores, or breaks on both the care giver’s and patient’s exposed skin should be covered with bandages. 

❖ Hands and other parts of the body should be washed immediately after contact with blood or other body 

fluids, and surfaces soiled with blood should be disinfected appropriately. 

❖ Practices that increase the likelihood of blood contact, such as sharing of razors and toothbrushes, should 

be avoided. 

❖ Needles and other sharp instruments should be used only when medically necessary and handled according 

to recommendations for health-care settings. (Do not put caps back on needles by hand or remove needles 

from syringes. Dispose of needles in puncture-proof containers out of the reach of children and visitors.) 

Businesses and Other Settings 

There is no known risk of HIV transmission to co-workers, clients, or consumers from contact in industries such 

as food-service establishments (see information on survival of HIV in the environment). Food-service workers 

known to be infected with HIV need not be restricted from work unless they have other infections or illnesses 

(such as diarrhea or hepatitis A) for which any food-service worker, regardless of HIV infection status, should 

be restricted. CDC recommends that all food-service workers follow recommended standards and practices of 

good personal hygiene and food sanitation. 

In 1985, CDC issued routine precautions that all personal-service workers (such as hairdressers, barbers, 

cosmetologists, and massage therapists) should follow, even though there is no evidence of transmission from a 

personal-service worker to a client or vice versa. Instruments that are intended to penetrate the skin (such as 

tattooing and acupuncture needles, ear piercing devices) should be used once and disposed of or thoroughly 

cleaned and sterilized. Instruments not intended to penetrate the skin but which may become contaminated with 

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2 HIV and it’s Transmission, July 1999 
blood (for example, razors) should be used for only one client and disposed of or thoroughly cleaned and 

disinfected after each use. Personal-service workers can use the same cleaning procedures that are recommended for health care institutions. 

CDC knows of no instances of HIV transmission through tattooing or body piercing, although hepatitis B virus 

has been transmitted during some of these practices. One case of HIV transmission from acupuncture has been 

documented. Body piercing (other than ear piercing) is relatively new in the United States, and the medical 

complications for body piercing appear to be greater than for tattoos. Healing of piercings generally will take 

weeks, and sometimes even months, and the pierced tissue could conceivably be abraded (torn or cut) or 

inflamed even after healing. Therefore, a theoretical HIV transmission risk does exist if the unhealed or abraded 

tissues come into contact with an infected person’s blood or other infectious body fluid. Additionally, HIV could 

be transmitted if instruments contaminated with blood are not sterilized or disinfected between clients. 

Kissing 

Casual contact through closed-mouth or “social” kissing is not a risk for transmission of HIV. Because of the 

potential for contact with blood during “French” or open-mouth kissing, CDC recommends against engaging in 

this activity with a person known to be infected. However, the risk of acquiring HIV during open-mouth kissing 

is believed to be very low. CDC has investigated only one case of HIV infection that may be attributed to 

contact with blood during open-mouth kissing. 

Biting 

In 1997, CDC published findings from a state health department investigation of an incident that suggested 

blood-to-blood transmission of HIV by a human bite. There have been other reports in the medical literature in 

which HIV appeared to have been transmitted by a bite. Severe trauma with extensive tissue tearing and 

damage and presence of blood were reported in each of these instances. Biting is not a common way of transmitting HIV. In fact, there are numerous reports of bites that did not result in HIV infection. 

Saliva, Tears, and Sweat 

HIV has been found in saliva and tears in very low quantities from some AIDS patients. It is important to 

understand that finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be 

transmitted by that body fluid. HIV has not been recovered from the sweat of HIV-infected persons. Contact 

with saliva, tears, or sweat has never been shown to result in transmission of HIV. 

Insects 

From the onset of the HIV epidemic, there has been concern about transmission of the virus by biting and 

bloodsucking insects. However, studies conducted by researchers at CDC and elsewhere have shown no 

evidence of HIV transmission through insects—even in areas where there are many cases of AIDS and large 

populations of insects such as mosquitoes. Lack of such outbreaks, despite intense efforts to detect them, 

supports the conclusion that HIV is not transmitted by insects. 

The results of experiments and observations of insect biting behavior indicate that when an insect bites a 

person, it does not inject its own or a previously bitten person’s or animal’s blood into the next person bitten. 

Rather, it injects saliva, which acts as a lubricant or anticoagulant so the insect can feed efficiently. Such diseases 

as yellow fever and malaria are transmitted through the saliva of specific species of mosquitoes. However, HIV 

lives for only a short time inside an insect and, unlike organisms that are transmitted via insect bites, HIV does 

not reproduce (and does not survive) in insects. Thus, even if the virus enters a mosquito or another sucking or 

biting insect, the insect does not become infected and cannot transmit HIV to the next human it feeds on or 

bites. HIV is not found in insect feces. 

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3 HIV and it’s Transmission, July 1999 
There is also no reason to fear that a biting or bloodsucking insect, such as a mosquito, could transmit HIV from 

one person to another through HIV-infected blood left on its mouth parts. Two factors serve to explain why this 

is so—first, infected people do not have constant, high levels of HIV in their bloodstreams and, second, insect 

mouth parts do not retain large amounts of blood on their surfaces. Further, scientists who study insects have 

determined that biting insects normally do not travel from one person to the next immediately after ingesting 

blood. Rather, they fly to a resting place to digest this blood meal. 

Effectiveness of Condoms 

Condoms are classified as medical devices and are regulated by the Food and Drug Administration (FDA). 

Condom manufacturers in the United States test each latex condom for defects, including holes, before it is 

packaged. The proper and consistent use of latex or polyurethane (a type of plastic) condoms when engaging in 

sexual intercourse—vaginal, anal, or oral—can greatly reduce a person’s risk of acquiring or transmitting 

sexually transmitted diseases, including HIV infection. 

There are many different types and brands of condoms available—however, only latex or polyurethane 

condoms provide a highly effective mechanical barrier to HIV. In laboratories, viruses occasionally have been 

shown to pass through natural membrane (“skin” or lambskin) condoms, which may contain natural pores and 

are therefore not recommended for disease prevention (they are documented to be effective for contraception). 

Women may wish to consider using the female condom when a male condom cannot be used. 

For condoms to provide maximum protection, they must be used consistently (every time) and correctly. 

Several studies of correct and consistent condom use clearly show that latex condom breakage rates in this 

country are less than 2 percent. Even when condoms do break, one study showed that more than half of such 

breaks occurred prior to ejaculation. 

When condoms are used reliably, they have been shown to prevent pregnancy up to 98 percent of the time 

among couples using them as their only method of contraception. Similarly, numerous studies among sexually 

active people have demonstrated that a properly used latex condom provides a high degree of protection 

against a variety of sexually transmitted diseases, including HIV infection. 

For more detailed information about condoms, see the CDC publication “Male Latex Condoms and Sexually 

Transmitted Diseases.” 

CDC’s Response 

CDC is committed to providing the scientific community and the public with accurate and objective 

information about HIV infection and AIDS. It is vital that clear information on HIV infection and AIDS be 

readily available to help prevent further transmission of the virus and to allay fears and prejudices caused by 

misinformation. For a complete description of CDC’s HIV/AIDS prevention programs, see “Facts about 

CDC’s Role in HIV and AIDS Prevention.” 

For more information... 

CDC National AIDS Hotline: 

1-800-342-AIDS (2437)

Spanish: 1-800-344-SIDA (7432) (HIV and STDs)

Deaf: 1-800-243-7889

CDC National Prevention Information Network: Internet Resources: 

P.O. Box 6003 DHAP: http://www.cdc.gov/hiv 

Rockville, Maryland 20849-6003 NCHSTP: http://www.cdc.gov/nchstp/od/nchstp.html 

1-800-458-5231 NPIN: http://www.cdcnpin.org 

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4 HIV and it’s Transmission, July 1999