HIV/AIDS

HIV Infection and AIDS

The human immunodeficiency virus (HIV) does not kill a person directly. Instead, it destroys the immune system and makes people infected with HIV vulnerable to infections that are rarely seen in people with normal immune systems. After a person becomes infected with HIV, it may take years for symptoms to develop. During this latency period, many people are unaware they are infected but can still transmit the virus to others. Acquired immunodeficiency syndrome (AIDS) is diagnosed by a physician using certain clinical criteria (e.g., blood test results, AIDS indicator illnesses).

How HIV is and is not Transmitted

HIV can be spread by oral, vaginal, and anal sex with an infected person. The risk of HIV transmission through oral sex is much smaller than that associated with vaginal and anal sex. HIV is also transmitted by sharing needles or syringes with someone who is infected. Babies born to women infected with HIV may become infected before or during birth, or after birth through breast-feeding. Health care workers may be infected with HIV after being stuck with needles containing HIV-infected blood, or after infected blood gets into a worker's open cut or a mucous membrane (e.g., the eyes or inside of the nose). There has been one case of HIV transmission from acupuncture.

Most HIV-positive inmates became infected prior to their incarceration. HIV transmission through sharing injection equipment and unprotected sex does occur within correctional facilities, although not very frequently. A 1997/1998 article published in The Canadian HIV/AIDS Policy & Law Newsletter, for example, described a 1993 study of an HIV outbreak in a Scottish prison, which revealed that 13 inmates who engaged in extensive syringe sharing had become infected in prison. A study of an Australian prison found that at least four injection drug-using inmates had become infected in prison.

Correctional officers and inmates are often afraid of HIV being transmitted through a bite or a sneeze. Neither a small amount of blood being exposed to intact skin nor exposure to sweat, tears, saliva, or airborne droplets has ever been shown to result in HIV transmission. Biting or needlestick injuries pose a low threat of HIV transmission. According to the Centers for Disease Control and Prevention (CDC), 99.7% of needlestick/cut exposures do not lead to infection. Biting presents even less of a risk of HIV transmission than does a needlestick. Typically, a biter is more likely to come into contact with the victim's blood than vice versa. The medical literature has reported cases in which HIV appeared to have been transmitted by a bite but all of these cases involved severe trauma with extensive tissue tearing and damage, and the presence of blood. The CDC knows of cases where the hepatitis B virus has been transmitted through tattooing or body piercing, but no instances of HIV transmission through these practices. In the United States, blood is routinely screened for HIV antibodies. Consequently, HIV is very rarely transmitted through transfusions of infected blood or blood clotting factors. HIV is not spread by insects nor through casual contact such as sharing food utensils, towels and bedding, telephones, or toilet seats.

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