HIV Harm Reduction

Since HIV infection is not cured radically, the main tool in the fight against its spread is harm reduction – the prevention of new infections. Prevention of HIV infection has several directions. One of the most important and most effective is the prevention of vertical transmission of HIV from mother to child, which helps many times to reduce the likelihood of infection of a newborn from an HIV-positive mother.

Vaccines have saved humanity from many dangerous infectious diseases. There is an active search for “HIV vaccinations” in the world. Despite some encouraging results, it’s too early to talk about the massive introduction of such a vaccine.

Since the largest number of HIV infections in the world occurs sexually and with injections of drugs (in the process of behavior, which a person can change and control in his own will), in most cases, the main part of the harm reduction consists of education, training and support aimed at reducing the individual risk of infection.

Attempts to change people’s behavior, especially when it comes to areas such as sex and drug use, face many obstacles at the level of government policy, traditional culture and religion, society and a particular community, and, of course, at the level of an individual.

Often, actions dictated by the AIDS epidemic — for example, harm reduction for drug users and the sexual education of young people — are in conflict with existing ideas about the protection of public health and morality.

In such cases, society sooner or later has to abandon outdated stereotypes of thinking and change prohibitive legislation and discriminatory policies that prevent the fight against the epidemic to save the lives of their citizens. Unfortunately, in many cases, such changes are undertaken only in a critical situation when the epidemic has already done a lot of damage.

Risk or vulnerability?

The risk of acquiring HIV infection depends on the type of contact (sexual – anal, vaginal, “receiving”, “introducing”; “blood into the blood”); the amount of virus that entered the body; associated diseases and other biomedical factors.

In general, the virus is “indifferent” to which social group a person belongs and how much his/her behavior is approved by society. The concept of “risk groups” has long been rejected by the anti-AIDS community since it contributes to social discrimination and creates a sense of false security among those who do not consider themselves to be “at risk”.

• Risk is a universal concept: any person who has fallen into certain conditions of contact with a virus can become infected;
• Vulnerability is the concept of a different plan. It concerns not the whole society but only those who, due to various circumstances, are deprived of the opportunity to protect themselves from HIV/AIDS and their consequences. Vulnerability depends on how much a person is able to control the circumstances of his life. Vulnerability to HIV/AIDS means an increased likelihood of entering into dangerous contact with HIV infection and/or an increased likelihood of particularly suffering from the serious consequences of HIV infection and AIDS.

Ways of transmission and prevention

You can become infected with HIV only from an infected person. No infections from animals and insects have been reported.

In order for an infection to occur, a sufficient amount of viral particles from the body of the infected person must enter the bloodstream of another (healthy) person.

In the body, HIV is present in various fluids. But only four of them contain enough virus to infect. It:blood;sperm;vaginal secretions;breast milk.

Therefore, HIV can enter the human body in only three ways:

1. when infected blood is ingested: with blood transfusion, transplantation of tissues and organs from an infected donor, when using non-sterile instruments, when using shared syringes, needles, filters, solution for intravenous drug use, for cosmetic procedures (tattoos, piercings, etc.) with non-sterile instruments;
2. with unprotected sexual contact, both with homo – and heterosexual relationships, with anal, vaginal and oral sex;
3. from an infected mother to a child – HIV can penetrate during pregnancy, during delivery (if the tender skin of a newborn is damaged), when breastfeeding (with mother’s milk), and, conversely, from an HIV-infected child to a healthy mother when breastfeeding.

HIV is not transmitted:

• through door handles, handrails and railings in public transport;
• with bites of animals and insects;
• with handshakes, hugs and kisses, coughing, sneezing (saliva, sweat, urine are not dangerous for infection if there is no visible blood in them);
• through sweat or tears;
• through food and money;
• when using common personal belongings, household items, toys, bedding, toilet, bathroom, shower, swimming pool, cutlery and crockery, drinking fountains, sports equipment;
• if you are living with HIV in the same room.

About condoms

Condoms, if used consistently and correctly, create a sufficient barrier to HIV and other pathogens of venereal diseases. Latex, the material from which condoms are produced, has no natural pores and holes through which pathogens could penetrate. Leaky condoms may only be produced by poor-quality manufacturers.

Do not save on your health – purchase condoms of well-known companies that carefully check their products (Durex, Innotex, etc.)

Do not be lazy to read the instructions for the first experience with a condom. This will help you avoid embarrassment and missteps at the crucial moment.

Latex condom collapses when exposed to:

• light and heat – do not store a condom on a sunny window sill, near radiators, heating devices, etc.;
• fat – use a lubricant with a water base and don’t forget that lipstick also has a fat base;
• sharp edges of nails, rings, etc.

How to prevent sexually transmitted infections?

HIV infection, like other sexually transmitted infections, can occur with any form of sexual contact (homo- and heterosexual relationships, anal, vaginal, oral sex). During any sexual contact, the tender mucous membrane of the genital organs, the oral cavity, the rectum, etc. is injured by friction with the formation of microtraumas and cracks, through which the pathogens penetrate.

Infection with HIV/STIs is possible by contact of mucous membranes containing microbes and viruses, or through infected sperm, vaginal secretions, or pre-ejaculate or blood from microcracks. Therefore, simply interrupting sexual intercourse is not effective for preventing HIV/STIs.

The risk of acquiring HIV through sexual contact is directly proportional to the number of unprotected sexual contacts, however, sometimes even having one sexual contact with an infected partner is enough for infection.

What increases the risk of HIV infection?

• sadomasochistic games, sex during menstruation and defloration (rupture of the hymen) – blood containing the virus can penetrate through microtraumas and wounds and infect a partner;
• sex between partners with STIs, especially with ulcerations (genital herpes, syphilis), other inflammatory processes (adnexitis, cervical erosion).

The probability of a woman becoming infected during sexual intercourse is higher than men since the volume of sperm taken is 2-4 times greater than the secret of a woman. The concentration of HIV and other pathogens in sperm is higher, sperm lasts up to 3 days in the vagina, which can lead to subsequent infection.

In the world statistics of HIV/AIDS, the sexual way is the leading one (70-80%). This path is becoming increasingly important. Therefore, in order to protect your sexual partners from becoming infected with HIV, avoid sexual contact during menstruation (it is dangerous for both women and her partner), elements of sado-masochism. Always use a condom during sexual intercourse, especially when deflorating. Watch yourself and your partner – timely detect and treat any STIs.

How to prevent transmitting HIV through contaminated blood?

Infection with HIV infection through the blood occurs when HIV-infected blood enters the body directly into the bloodstream.

The risk of infection is very high (90-100%) when the virus enters the bloodstream directly. Such situations may occur during the transfusion of infected donor blood and preparations from it, as well as the transplantation of tissues and organs of an infected person (donor). Therefore, an HIV-infected person cannot participate in blood transfusion and organ transplantation to another person.

The risk of HIV infection is quite high when using common tools (syringes, needles, filters, solution) when drugs are injected intravenously. Infection can be transmitted through the remnants of infected blood on common instruments. Therefore, if you are taking drugs, it is always necessary to use only individual syringes and instruments. Preventing the spread of HIV among injecting drug users is a harm reduction strategy.

Medical manipulations and cosmetic procedures (piercing, tattooing, manicure, pedicure, shaving) with common or non-sterile instruments are dangerous if they have been used by an HIV-infected person. Non-disinfected instruments may leave traces of blood containing the virus.

Also, always use personalized or disinfected personal hygiene items and medical instruments, do not allow other people to use your razors, toothbrushes, manicure accessories and medical instruments, and also warn your health care provider or cosmetologist if you are at risk for injury and contact with by blood.

What are emergency situations?

The risk of infection also occurs in the so-called traumatic or emergency situations, in case of accidental injections or cuts, in the provision of medical care, etc., when infected blood, semen, vaginal secretions or breast milk containing HIV can get through wounds, abrasions cuts uninfected person and cause infection with HIV.

Therefore, HIV-infected biological fluids (blood, semen, vaginal secretions, breast milk) should not get on damaged skin, ulcers, and wounds of another person. In the case of bleeding, treat the blood accumulation sites on your own or offer another person to wear protective rubber gloves. Keep a first aid kit at home and use a protection algorithm to protect loved ones in emergency situations.

The home first aid kit must contain:

• ethyl alcohol 70%;
• iodine, alcohol solution;
• potassium permanganate;
• cotton wool, bandage, fingertips, rubber gloves;
• 3% or more chlorine-containing preparations.

Relatives and friends who provide you with first aid should avoid cuts and accidental pricks, stick wounds and abrasions with adhesive tape, and use rubber gloves.