HIV is not an easily transmitted virus. The virus is reasonably fragile and skin is an effective barrier. To cause infection HIV has to pass through a break in skin, or through mucous membranes (the lining of internal organs such as the vaginal wall). It is not transmitted through casual contact such as sharing eating utensils or touching someone with HIV. The most common ways that HIV is transmitted [link to HIV article] are through sexual contact and through sharing needles or other equipment used to inject drugs. It can also be transmitted from mothers to infants. This can occur while the fetus is still in the uterus, but the greater risk is during childbirth. Cesarean section reduces the risk of transmission to an infant during birth. Giving HIV drugs to the mother before and during childbirth can reduce the risk of transmission to an infant from about 25% to less than 2%. HIV can also be transmitted through breast feeding. This risk can be reduced two ways. Bottle feeding eliminates this risk. In the developing world, this is often not practical, and can increase the risk of other infections. Recent data suggest that the risk of HIV transmission through breast feeding is greatest when infants are fed solid food or even water or animal milk before age 6 months. An alternative formula feeding in settings in which formula feeding is difficult or impossible is to exclusively breast feed infants until the age of 6 months.
Use of condoms by men has been shown to reduce the risk that men will transmit HIV to male or female sexual partners. Condoms also reduce the risk to men of acquiring HIV infection if they have sex with an infected partner. The success of male condoms has led to efforts to provide female condoms that can be used in the vagina (or in the anus). Though these appear to work, they are much less widely used than male condoms.
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