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Health

How is HIV transmitted from a man, a woman at home, sexually, through a kiss, through blood

, medical expert
Last reviewed: 20.10.2021
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The human immunodeficiency virus has a name for this, it's a purely human pathology, not dangerous for other mammals. There are, however, a couple of variations of this virus, which, according to special studies, affect African monkeys (HIV-2) and possibly chimpanzees (HIV-1), but to humans they have nothing to do, being transmitted only within the species. For the human race, the danger is precisely HIV infection, which opens the way to the body for many dangerous viruses and bacteria. Therefore, it is not worth blithely treating it. But to protect yourself from this terrible disease you can only know how HIV is transmitted from person to person.

A little bit about HIV itself

The human immunodeficiency virus was recognized at the end of the 20th century (1983), when at the same time the virus was discovered in two scientific laboratories. One of them was located in France (the Louis Pasteur Institute), the other - in the USA (National Cancer Institute). A year earlier, his current name was acquired immunodeficiency syndrome (AIDS), which, as it turned out, is the final phase of HIV infection.

When a new unknown retrovirus was isolated and given the name HTLV-III, it was also suggested that this particular virus could be the cause of such a terrible disease as AIDS. Further studies have confirmed this hypothesis, and humanity has learned of a new danger that can be killed without weapons.

HIV is one of the varieties of viral pathologies, characterized by a sluggish course. The incubation period, lasting from 3 weeks to 3 months, and the latent stage, the duration of which can be 11-12, and sometimes more than years, proceed without any obvious symptoms. However, during this period, almost complete destruction of immunity occurs.

Disorder in the immune system and its inability to protect the body from an alien invasion make it possible to penetrate into its bowels and actively multiply even to such infections that are actually unable to manifest activity in a healthy body. For example, the causative agents of pneumocystis pneumonia can manifest themselves only against a background of significantly weakened immunity, which is extremely rare (mainly because of HIV). The same can be said about the oncological pathology called Kaposi's sarcoma, for the development of which almost complete absence of immunity is required.

The human immunodeficiency virus itself is considered unstable. It can not exist outside the carrier's body (in this case, both the carrier and the source of infection is considered to be an infected person), however, in each specific case the virus is somewhat modified, which allows it to survive and excludes the possibility of the invention of an effective antiviral vaccine.

Where in the body are the viral elements concentrated? Well, of course, first of all it is blood, therefore the probability of infection through this important physiological fluid is so great (more than 90%). In 1 ml of blood, up to 10 doses of a viral component capable of causing infection can be detected. A similar concentration of viral particles can boast of semen (sperm) in men. Slightly less virus cells are characterized by breast milk and vaginal discharge in women.

The virus is able to nest in any physiological fluids, including saliva and cerebrospinal fluid, but its concentration there is negligible, as, however, and the risk of infection with their participation.

By isolating the virus and studying it, scientists came to the conclusion that it is possible to destroy viral cells by exposing them to high temperatures and certain chemicals. If the reservoir with the virus is heated above 57 degrees, the virus will die within half an hour. When the liquid in which the cells of the virus are placed is boiled, it takes no more than 1 minute to completely destroy them. Chemicals such as alcohol, ether and acetone are also enemies of HIV, which makes it possible to use these substances and high temperatures for disinfection.

Alas, none of these ways of fighting HIV infection is applicable to humans. It is impossible to boil blood to kill all the viruses in it, without changing the structure of the liquid itself. Yes, and the amount of alcohol that would cope with the infection, a person can not drink without consequences. All that people can still do is to protect themselves from getting the infection into the body or stop the virus from progressing until it passes into the stage of AIDS.

But to effectively protect yourself, you need to know how HIV is transmitted. After all, who is forewarned, he, as they say, is armed.

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What are the ways HIV is transmitted?

The human immunodeficiency virus is a terrible and insidious disease, whose effective treatment does not yet exist. But around the HIV there are many different rumors. Some say that the virus itself is not so terrible, if you can safely live with it for more than 10 years. The real danger, in their opinion, is only the last stage of the disease - AIDS, when the body develops various pathologies, most of them having a complicated course.

Others panic fear of contracting HIV, believing that any contact with an infected person is a great danger. This leads to neurotic disorders and depression, because an infected person may not even know about his carrier, not to mention other people who do not notice any changes in the virus carrier. Determine the presence of the virus in the body can only be diagnosed by conducting a special blood test for antibodies to HIV.

In principle, there is some truth in both opinions. But as careless attitude to the problem of HIV, and excessive care for one's health at the expense of human relationships and mental health are extremes that will not benefit either one or the other.

HIV has three main modes of transmission, which should be closely monitored, because it is in these cases that the risk of infection is particularly high:

  • With sexual intercourse (sexual or contact transmission),
  • When manipulating blood (parenteral route),
  • At pregnancy, patrimonial activity and thoracal feeding (a vertical way of transmission of an infection).

In other cases, the possibility of getting HIV is so small that even doctors do not consider these ways as dangerous.

When you learn how HIV is transmitted, you can take all measures to block out any ways to get the infection into the body. It is not necessary to think that only those people who by virtue of their professional duties are forced to come into contact with the infected or who are with the virus carriers in a certain relationship are at risk. To infect the human immunodeficiency virus can even have a virus-negative partner.

And on the other hand, some couples, one of the partners in which is a virus carrier, live quite happily, as they are careful in sexual intercourse. Thus, attention to others and caution are important conditions that help stop the spread of a terrible disease.

How is HIV transmitted from a man?

So, the greatest chance to start HIV infection in your body is observed during sexual intercourse. This applies to both heterosexual and homosexual couples. A man in sex always acts as an introverting party. And often it is men who are the "customers" of amorous entertainment. Therefore, the risk of infection from a man is higher than that of a woman.

This is facilitated by such a moment that the content of cells of the virus in the semen is almost 3 times higher than in the vaginal secretion of women. Even the minimal amount of sperm on the penis can infect the female body, but it is very difficult to remove it because of the structure of the female genital organs, which are located deep inside. Ordinary douching after sex does not guarantee the removal of the virus from the body.

Note that sex with an HIV-positive partner does not necessarily end with infection. In order for the virus to become active, it is necessary that it enter the bloodstream. He can get into the blood only through damage to the skin and mucous membranes. Usually, during sexual intercourse, microcracks form on the vaginal mucosa, which do not carry danger for a woman until some infection, for example, the human immunodeficiency virus, enters her bowels. If there is no microdamage, and the woman after the sexual intercourse made a thorough cleaning of the vagina, infection may not occur.

The danger for a woman is infectious and inflammatory processes in the vagina, which make the mucosa more vulnerable and permeable to all kinds of bacteria and viruses. The probability of violation of the integrity of the mucosa during sexual intercourse is great in inflammation of internal genital organs and venereal diseases. In the latter case, partners can simply exchange "sores", which will only aggravate the situation of both.

But so far it was a classic sexual act between a man and a woman. However, in our time is very actively practiced and some kind of its perverted form - anal sex, when the penis is inserted not into the vagina, but into the rectum through the anus. Some such a method is considered as the possibility of preventing an unwanted pregnancy without the use of contraceptives.

I must say that such intercourse is not enough, which is unnatural, but also carries a great danger in terms of the spread of HIV infection. And all because the tender tissue of the rectum and the anal opening is prone to damage even more than the inner sheath of the vagina, which is protected by the mucous secret produced in it, which softens the friction.

The rectum in nature is intended for other purposes. It does not belong to the reproductive organs and does not produce a special lubricant, which protects the walls from friction and damage. Therefore, during anal sex, the probability of damage to the tissues of the anus and the intestine is great because of strong friction, especially if the intercourse is made in crude form.

In this case, the man, again, suffers less, because if a member has no damage, then it is unlikely to get infected from an HIV-positive partner. Moreover, hygiene of the penis is much easier than cleaning the internal reproductive organs in a woman. But if a woman had anal sex with an HIV-positive man, then the probability of infection is almost 100%.

Knowing how HIV is transmitted is very important for homosexual couples, and we have many such, because persecution of people with non-traditional orientation has long been a thing of the past. For homosexual couples, the main source of sexual satisfaction is anal sex, in which the risk of infection is incredibly great.

A certain danger for partners can also be oral sex with an HIV-positive man (the penis is injected into the mouth of a partner or homosexual partner). The fact is that in the oral cavity there may also be various microdamages provoked by rough or spicy food, inflammation in the tissues, etc. The infection of infected sperm on the wound is fraught with the transmission of the virus into the bloodstream, from which it is no longer possible to remove it.

And even if there were no sores on the mucous membranes, they could end up in the esophagus and stomach. In such cases, the danger is caused by the ingestion of sperm, which many women do not disdain, having read information about the useful composition of semen and its effect on youth and beauty.

As you can see, the sexual way of HIV infection is quite common. Not without reason, almost 70% of cases of infection fall precisely on this factor. An interesting fact is also: despite the fact that a woman at sexual risk risks more, the prevalence of the virus among men and women is approximately the same. And the blame for all the promiscuous sex with a large number of partners, an increase in the number of homosexual couples, the practice of group sex.

There is something to think about. But it is not so difficult to prevent the ingress of HIV into the body during sexual intercourse, if you use high-quality condoms every time, if you know that the partner is the carrier of the virus. And even if there is no information about the health status of a partner for sex, exclude the possibility of virus carrying is not worth it. But it is necessary to protect yourself from possible infection by insisting on protected sex using a condom.

Practicing unprotected sex is possible only with a permanent partner, in which you are 100% sure. But there is no need to reject the likelihood of infection partner in other ways (for example, through the blood during surgery, if surgical instruments were not disinfected, or after visiting the dentist). It would be nice to take an HIV test after each such intervention, but practice shows that this recommendation is very, very rare.

How is HIV transmitted from a woman?

Although the likelihood of catching HIV from a fairer sex is less, but it is also not to be ruled out. After all, inflammatory pathologies of the genital organs, weakening their tissues, are not only in women, but also in men. Therefore, after sex in an HIV-positive partner, a man with inflammation or mechanical trauma to the penis, which leads to damage to his tissues, can also later discover HIV in his or her body.

Therefore, it can safely be said that sex with a condom prevents from infection not only a woman, but also a man. And if you take into account that men are polygamous by their nature, that is, can not long remain faithful to one partner, then having sex without a condom, they endanger not only themselves, but also their constant partner. After all, for a beloved woman, the source of infection is already themselves, even for the time being and not suspecting.

Especially dangerous is such carelessness for young couples who still plan to have children. After all, an unsuspecting woman (we do not forget that the disease can manifest itself even after 10 or more years), after consulting for pregnancy, can in horror learn about its virus carrier. Therefore, couples planning to replenish the family must necessarily be aware of the issue of how HIV is transmitted from a man to a woman and from a woman to a child.

One must always remember that a man can get infected from either a man or a woman, but from a woman, a virus can be transmitted to her child, who is in the womb for a certain time. The virus can enter the bloodstream of the fetus during pregnancy (through the placental barrier) or during the passage of the baby along the birth canal, because babies have such a tender skin that any exposure can cause on it microdamages that are invisible to the eye, but sufficient to penetrate the cells of the virus, which also have microscopic dimensions. And if you consider that the newborn's immune system is still in the formation stage, some babies die in the first days and months after birth.

Even if the baby was born healthy, there is a risk of HIV transmission from the mother through breast milk. For this reason, female virus carriers have to give up breastfeeding of the baby, which, of course, does not have the best effect on his natural immunity, but at the same time protects the newborn from the unwanted "gift" of a loving mother in the form of a terrible retrovirus.

Yes, we will not hide, earlier the percentage of HIV-infected children born from mothers with human immunodeficiency virus was much higher (about 40%). Today, doctors have learned with the help of chemical antiviral drugs (usually prescribed, starting from the 28th week of pregnancy) to reduce the activity of HIV in the mother's body and reduced the intra-uterine morbidity to 1-2%.

This is facilitated by the practice of caesarean section in HIV-infected mothers, which is the prevention of infection of the baby during childbirth, as well as the appointment of antiviral drugs to newborns for several months after birth. The sooner an infection in the baby's body is detected, the easier it will be to fight it and the greater the chance that the child will live a long happy life. If preventive measures are not taken, then the child maximum can predict 15 years of life.

Preparing for a new small family member is always a very exciting moment for a woman, but this is a pleasant excitement. For an HIV-infected pregnant woman, the joy of motherhood is overshadowed by concern about the fate of her baby, who may already have a terrible illness since birth. And this anxiety will not leave a woman for all 9 months, even if she will diligently follow all the doctor's instructions and undergo scheduled examinations.

Even greater responsibility lies with women who knew about their illness before conception of the baby. They should think about it several times and weigh it before deciding to give life to the child. After all, together with life they can reward the baby and a dangerous disease, predicting it (albeit far from always) sad fate. All future risks associated with HIV infection, the expectant mother should discuss with the doctor and, with a positive decision, strictly adhere to all medical recommendations.

It is worthwhile in advance to think about who will help the infected mother to take care of the child and educate him. Still, constant contact with a child who does not yet know how to protect himself from danger, even if small, but the risk of infection of the baby. And the life of an HIV-positive mother may not be as long as she would like. It is necessary to do everything before the birth of the child so that later he does not remain alone in this life.

As for men, for them the representatives of the most ancient profession are also very much in danger. It is necessary to understand that clients of a woman of easy behavior can have quite a lot, health certificates do not require anyone, which means that HIV-infected men may well be among the sexual partners. Such a present in the form of HIV infection Putana can present to any subsequent client with whom will have vaginal or anal sex.

Do not risk men and having sex with a woman during menstruation. Firstly, this is not an urgent necessity; secondly, it is unhygienic and, thirdly, it is quite dangerous in terms of blood contact with the penis, if there is a possibility that the woman is a carrier of HIV infection. Still, the blood is saturated with the cells of the virus is much stronger than the vaginal secret, and hence the probability of infection is significantly increased. Is the game worth the candle?

How is HIV transmitted during kissing?

This issue is especially interesting for young couples who today practice not only light superficial kisses, but also sensual deep ones. And we already wrote that some of the cells of the virus are found in many human physiological fluids, including the saliva contained in the oral cavity. It is this moment that disturbs lovers, for a kiss is the most sincere expression of love for a person.

It is not worth worrying especially if one of the partners is HIV-positive. Such a manifestation of love, as a kiss, is entirely permissible in this situation. Saliva contains such a miserable number of viral cells that the incorrect question as to how HIV is transmitted through saliva, the answer is "almost nothing".

Theoretically, the possibility of infection in this way remains due to the same mise virus cells in the saliva, but in the life of confirmed cases of infection through saliva was never. It should be understood that this is not just a way to appease lovers, but statistical information. There are special centers that deal with the study of the virus and ways of its spread. Medical scientists are concerned about the increasing number of patients with HIV, so for each specific case, complete information is collected about where and by what route the infection has occurred. All this is necessary in order to develop effective preventive measures that will help stop the course of the human immunodeficiency virus on our home planet.

During such studies in the US, a case of HIV transmission during a kiss was documented. But the carrier of the infection, as it turned out, was not saliva, but the blood that acted on the site of the bite (apparently was produced in a fit of passion).

A simple loving kiss without damage to the tissues of the oral cavity can not harm a healthy person, so lovers can safely practice such kisses. Another thing is if the mouth of both partners shows bleeding wounds, which is observed with periodontitis, stomatitis, angina and some other pathologies of the oral cavity. Any open wound in an HIV-infected person is a source of infection, while the same injuries in a healthy person carry the risk of infection.

Parenteral route of HIV transmission

If the vertical route of transmission of the virus is characteristic only of women who have decided to give birth to a child, then both women and men can become equally infected by contact and parenteral routes. All the nuances of the contact path of infection we have already considered. It's time to pay attention to getting HIV through the blood.

There are 2 risk factors associated mainly with the medical tool. First, these are surgical accessories, which must be strictly sterile. Insufficient disinfection of a tool that was previously used in manipulating an HIV-infected patient is a risk factor for infection of another patient.

And this applies not only to surgery, but also to dental offices, beauty salons, practicing manicures and pedicures, where clients are not asked at all about a lack of HIV in the body. In case of an accidental cut, the blood particles of the infected person remain on the scalpel or other device used in surgery, dentistry, cosmetology. If the tool is not sufficiently processed (washed with water and enough, but you need to treat it with alcohol or boil for at least 1-2 minutes), the cells of the virus that remain on it can safely enter the body of a healthy person through various damages on the skin.

Let the probability of infection in this case is small, but it also can not be discounted. To protect oneself from parenteral infection by medical or cosmetological manipulations, one must insist on using disposable instruments that are removed from the package in front of the patient. Fortunately, now disposable tools are not a problem. At least in private medical centers, which value their reputation and income.

Another unlikely way to infect a patient with human immunodeficiency virus is to transfuse the blood of an HIV-infected person. This can happen only in an emergency situation, when there is no stock of blood, and the account goes for a second. In this case, the blood can be taken from an untested person only on the basis of the compatibility of the group and the Rh factor, while the donor himself may not be aware of his illness, which usually does not hurry to manifest himself. Blood at donor sites must undergo an HIV test, so the probability of infection from proven blood donation is almost zero.

Some people have a risk of infection with manipulation of HIV-infected patients. This risk is small, and is caused mainly by the carelessness of a doctor or a nurse who, during an operation or other actions with a patient's blood, will inadvertently damage the tissues on the arm in the place where it contacts the blood of the HIV-positive patient. Infections may not occur, but there is still danger, and you can not forget about it.

When asked how parenterally transmitted HIV infection is, there is another answer. The risk of contracting blood with human immunodeficiency virus is considered to be the use of injecting equipment by a group of people. In practice, this phenomenon is common among drug addicts who are trying to save on syringes.

Potentially dangerous in this case are considered not only the needles of syringes, which directly contact the tissues and blood of a person, but also the syringes themselves, as well as the containers from which the liquid drug is taken. These tools among drug addicts are not processed in any way, which means that they retain the blood particles of the previous user, who may have HIV-positive status. Drugs are injected into the body intravenously, and the virus is delivered directly into the bloodstream, where it begins its destructive effect.

Addiction is a disease, and recovering from pathological dependence is not so simple. But you can do anything to prevent the harmful effects of drugs from becoming infected with HIV.

Prevention in this case is the use of individual (better disposable) syringes and ampoules, as well as avoiding promiscuous sexual intercourse, which is often practiced among drug addicts against the background of the narcotic ecstasy they get, clouding the mind and logical thinking. But even in this state, a person is able to realize the danger of his actions, if, of course, drugs have not completely destroyed his ability to think. In this case, kisses need to be canceled for a while, and resume them only after the full healing of damage to the oral mucosa, gums and lips.

The probability of contracting HIV with a kiss is negligible, but it is not worth completely ignoring the fact of this possibility. If the kiss is a manifestation of true love, the partners will take all precautions so as not to harm each other. After all, in this case, infection with the human immunodeficiency virus is a tragedy for both.

But with unverified partners, passionately kissing is clearly not worth it. And it's not even in the depths of the kiss. It is worth considering whether an unfamiliar person will take care of your safety in a fit of passion or are you threatened with bites or unprotected sex, which may well follow the kisses? Are you completely sure that your casual partner is HIV negative?

Only with a trusted partner can you feel safe, while observing preventive measures, such as using a condom and caution when kissing. Do not rush to reject a loved one if he has HIV, because the human immunodeficiency virus is not an ARVI or fungus, it is not transmitted by airborne droplets, through hands, dishes, bathroom, toilet. So, with care, the probability of getting infected is not that high, as many happy couples prove, one of the partners in which is a virus carrier.

How is HIV transmitted in everyday life?

If the topic of kisses was interesting mainly to couples in love and loving parents who also gladly give kisses to their children, the issue of the risk of acquiring HIV infection in everyday life worries already many readers of different ages. After all, if it turns out that HIV can be picked up not through sexual contact, a surgical operation or during a blood transfusion, but by domestic means, the danger can threaten almost all people.

We will not deceive the reader, arguing that HIV infection in the home is impossible, if only to prevent panic. Let's face it, the danger of infection exists and it's real. Nevertheless, this is not a reason to panic in advance. In order for the infection to occur, certain conditions are required that can be successfully suppressed, it is important only to know how HIV is transmitted in everyday life, and to avoid such situations.

Most often in a domestic environment, men get infected, which once again equates them with women's chances of getting an unwanted "gift." The cause of infection in the vast majority of cases is the usual shave, which in the male environment is considered a habitual procedure.

Shave can be and twice a day, and once a week, from this the probability of HIV infection will not change. Even the type of shaving device in this case does not play a significant role, because with careless shaving it is possible to injure yourself and a safe or electric shaver. What's important is another one, whose machine or razor do you shave?

A shaving appliance, like a toothbrush, must be individual. By giving a razor to others or using someone else's, you can only bring yourself trouble in the form of HIV infection with HIV. And here it does not matter how many times she had to use. Having cut the razor on which the blood of the HIV-infected person (a friend or relative, and we know that he himself could not suspect of the disease) is preserved, there are all chances to let the virus into his blood. And these chances are great enough.

When asked if there were any cases of HIV infection during shaving, the answer will be positive. True information about the path of infection in all episodes was obtained from the patient himself and is based on his assumptions. Perhaps there have been other contacts that could have caused the infection, or the public razor has become the culprit of the disaster. Whatever it was, but exclude the completely logical possibility of household HIV infection is not worth it. But you can prevent this possibility if you use an individual shaving device, protecting it from the encroachments of friends and family members (among whom, incidentally, there may be women who are not spared from excessive vegetation).

Above we mentioned the toothbrush. And not for nothing, because if an HIV-positive person has problems with teeth, gums or the oral mucosa, on the brush after the procedure of cleaning the teeth particles of contaminated blood, which will become a source of infection for another user of the brush, can surely hide.

True, in order for infection to occur through a razor or toothbrush, it is necessary that the blood is sufficiently fresh, because the human immunodeficiency virus is a very unstable substance that can not exist outside the host's body, so it quickly perishes in the open air.

Theoretically, human immunodeficiency virus can be transmitted and shaking hands. This would in fact be an incredible situation, because infection is possible only if there are fresh injuries on hands stretched out for handshake (rather even hands) of both partners. Plus, the blood of an HIV-positive person should get into the wound of a healthy person. Yes, the situation is more than rare, because someone will stretch out a bloodied hand during the greeting, but it's still worth knowing about such a probability.

Even less likely to become infected with AIDS in the basin, where they are allowed only after providing information about the absence of various kinds of infections in the body of the visitor. True, the HIV test is not taken in all cases. But this has little effect on the probability of infection. To become infected in the pool, you either have to open an open wound on the infected person's blood, or you may end up with the same wound in water, markedly sprinkled with foreign blood, or provoke a bloody fight. What, in your opinion, is the probability of such an event?

Public baths and saunas practically exclude the possibility of HIV infection, although no one requests a certificate. But, firstly, the virus can not live independently without the owner, and secondly, it is afraid of exposure to high temperatures.

As for the massage rooms, the probability of HIV infection is much higher during the manicure or pedicure, which can be done in the beauty salons at home by both women and men. And all the fault will be poorly disinfected instruments. Trust your nails only to proven and accurate beauticians, and you will not have HIV problems.

With massage, infection can occur again only during the mixing of blood, i.e. It is necessary that the hands of the masseur and the client's skin, to which the massage therapist touches, are also damaged. It is clear that such a situation can be considered an exception to the rule.

It's time to talk about things that are more mundane, such as a toilet. Can I get infected with human immunodeficiency virus by using the toilet?

Neither urine nor feces are considered a serious source of HIV infection, capable of provoking the disease. In a public toilet, it is possible to pick up other infections, including those that are sexually transmitted than the immunodeficiency virus, which is transmitted mainly through blood or semen.

Yes, such allocation may happen to be on the rim of the toilet bowl, but in order for them to cause infection, it is necessary that the buttocks of the person who sits on them should be damaged, through which the virus would penetrate into the blood. This situation is simply ridiculous, because no intelligent person will sit down on the toilet in a public place (and even with so obvious traces of someone else's stay), without first having bedded at least toilet paper, but rather a one-time seat specially designed for this purpose.

If it is not a toilet, but a bowl or a drainage hole, which can often be found in public latrines, then they generally do not pose any danger of infection, since contact of physiological fluids is excluded.

The fact that HIV is not transmitted in a public toilet does not mean that you do not need to follow the rules of personal hygiene. Clean hands and caution will help to avoid infection with other, no less dangerous infections, which is quite enough in places of common use with the abbreviation MF.

As for cutlery and dishes, then there is no need to worry, even when visiting dining rooms and cafes. Through the dishes, HIV is not exactly transmitted, unlike many intestinal infections.

Based on the foregoing and information on how HIV is transmitted, we can conclude that the human immunodeficiency virus is virtually impossible to get yourself. You have to be an extremely sloppy, unscrupulous or awkward person to get on the list of exceptions, which otherwise you can not call a funny accident. But caution and understanding will serve a good service for more than one person, including those who have found their happiness in the person of an HIV-positive partner.

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