The topic of HIV/AIDS in a multifaceted issue which cannot, and should not, be reduced to medical terminology and factual information alone. HIV/AIDS is very much a human and social problem that cannot be addressed merely as a public health and medical issue. However, a basic understanding and knowledge base of factual information is a necessary prerequisite to our grasp of the scope and complexity of this human, social, medical, and public health problem. In addition to possessing a factual knowledge base, a more thorough understanding of HIV/AIDS also requires that we focus upon our attitudes and beliefs, as well as the emotional components concerning the virus and syndrome, and the behaviors that place others and ourselves at-risk of contracting the virus. As with most human conditions and behavior, there is often a gap between what we know and what we do. That is, regardless of how much knowledge we possess, people still make poor decisions, people still engage in risk-taking behaviours that disregard possible out-comes or known consequences, and people still make mistakes. Based on our current knowledge, the transmission of HIV has been associated only with the following sources: blood and direct derivatives of blood, semen, vaginal and cervical secretions in the female genital tract, and possible breast milk. That is, HIV is transmitted only by direct exposure to blood or blood derivatives, sexual intercourse of certain types, from women to fetus during gestation and birth, or possible from mother to infant during breast feeding.
In general, there are three ways HIV can be transmitted via blood or blood derivatives: needle sharing (IDUs), accidental injuries resulting in direct exposure to HIV-injected blood (the intact skin provides an effective barrier to HIV), and transfusion of blood or blood derivatives, or the transplantation of tissues or organs from an infected donor.
The majority of blood transmitted cases of HIV are due to the transfer of infected blood in shared needles, most frequently in the use of illicitly injected drugs. Accidental exposures of HIV-infected blood are about 3 chances out of 1000 for a health car worker to be infected by an HIV patient (e.g. a needle stick injury) and the transmission of HIV from an infected surgeon to a patient occurs about once in every 42,000 to 42,000 medical procedures. Before 1985, HIV infection through transfusion was a significant form of transmitting HIV/AIDS, especially for hemophiliacs. And currently, the risk of transmitting HIV cannot be entirely eradicated, since some individuals may have donated blood, tissue, or organs after being HIV-infected but prior to being assessed as HIV positive through HIV antibody testing.
The transmission of HIV sexually is solely associated with intercourse, with insertive and receptive anal intercourse, and insertive and receptive vaginal intercourse resulting in HIV. The probability of transmitting HIV during unprotected anal intercourse is greater for the receptive partner than the insertive partner among men, and the risk of transmitting HIV from man to woman is greater during anal intercourse than vaginal intercourse. The chance of transmitting HIV from male to female during vaginal intercourse also is higher than of female to male transmission; however, the probability of transmitting HIV from female to male is increased if menstrual blood is present during intercourse. Although it may require several acts of sexual intercourse to become infected by an HIV-infected sexual partner, an individual may become infected with HIV with a single event of intercourse.
The probability to transmitting HIV through fellation appears to be much lower than through anal and vaginal intercourse; however, some HIV cases have been reported to have been transmitted from an infected man to this sexual partner via the semen or pre-ejaculatory fluid during oral sex. There is also some evidence that seroconversion to HIV may be associated with cunnilingus, but the chance of transmitting HIV from an infected woman to her sexual partner through vaginal or cervical secretions during oral sex is uncertain.