How can the spread of Human Immunodeficiency Virus (HIV) be prevented?

Preventing HIV Transmission

The most effective methods for preventing HIV transmission are sexual abstinence, limiting sexual activity to partners with known HIV status, consistent and correct use of condoms, and avoiding sharing injection equipment among drug users. 1

Sexual Transmission Prevention

• HIV-infected persons can prevent sexual transmission to non-infected persons through sexual abstinence or by limiting sexual activity to partners already known to be HIV-infected 1
• For consensual sex with a person of unknown or discordant HIV status, consistent and correct use of condoms made of latex, polyurethane, or other synthetic materials can reduce the risk of HIV transmission by approximately 90-95% 1, 2
• Condoms provide substantial protection against HIV when used consistently, making users 10-20 times less likely to become infected when exposed to the virus compared to inconsistent or non-users 2
• Both male and female condoms are effective multipurpose prevention technologies that can prevent both unintended pregnancy and sexually transmitted infections including HIV 3

Injection Drug Use Prevention

• For injection-related transmission prevention, the only certain methods are:
  • Abstaining from injection drug use completely 1
  • For those unable or unwilling to stop injecting drugs, refraining from sharing injection equipment (syringes, needles, cookers, cottons, water) with other persons 1
• HIV-infected injection drug users should be counseled not to share drug-injection equipment, even with other HIV-infected users, due to risk of acquiring other bloodborne pathogens 1

Additional Prevention Strategies

• Regular screening for sexually transmitted diseases (STDs) and prompt treatment when detected 1

  • STDs have a synergistic effect on HIV infectivity and susceptibility 1
  • Rising STD rates indicate increased potential for HIV transmission 1

• Pre-exposure prophylaxis (PrEP) for high-risk HIV-negative individuals can be an effective additional prevention strategy 4

  • However, PrEP should not replace other prevention methods like condom use 4

• Antiretroviral therapy for HIV-infected individuals:

  • Reduces viral load and may decrease transmission risk 1
  • However, HIV can still be detected in bodily fluids even with undetectable plasma viral loads, so all prevention measures should still be used 1

Common Misconceptions and Pitfalls

• Antiretroviral therapy is not a substitute for safer sex practices: Even with undetectable viral loads, HIV can still be detected in semen, rectal secretions, and genital secretions 1

• Post-exposure prophylaxis has limitations: While it may reduce infection risk after exposure, it is not 100% effective and should not be used as justification for engaging in risky behavior 1

• Condom effectiveness varies: While highly effective when used correctly and consistently, inconsistent or incorrect use significantly reduces protection 2, 5

• HIV disclosure responsibility: HIV-infected individuals have a responsibility to disclose their HIV status to prospective sexual partners 1

• Superinfection risk: Even between HIV-positive partners, condom use is recommended to prevent transmission of other STDs and potential HIV superinfection with different strains 1

Prevention Education and Resources

• Healthcare providers should incorporate HIV prevention messages into routine care of HIV-infected patients 1
• Prevention materials should be readily available in clinical settings, including printed information about transmission risks and prevention methods 1
• Condoms should be readily accessible at clinics 1
• Repeated prevention messages throughout clinical encounters reinforce their importance 1