What is my HIV transmission risk
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Compared to other viruses, HIV is relatively difficult to transmit. The risk of transmission depends on the number of viruses in the blood and genital secretions. The more viruses, the higher the risk of infection.
Only blood, semen and vaginal fluid are contagious. In Germany, HIV is most frequently transmitted through sexual intercourse and - due to improved prevention - only in individual cases through intravenous drug use or occupational exposure.
Sweat, tear fluid, saliva, urine and feces are not infectious. HIV cannot be transmitted in everyday interpersonal dealings (using the same cutlery, kissing, shaking hands, using the same toilet, etc.). Even blood, semen and vaginal secretions are not contagious on uninjured skin.
The retrovirus HIV
HIV (human immunodeficiency virus) is a retrovirus and belongs to the lentivirus family. "Retro" (lat. Back, backwards) because these viruses have their genetic information stored in RNA (ribonucleic acid) and not - like other viruses or organisms - in DNA (deoxyribonucleic acid). Before the RNA-based viral genetic information can be integrated into the cells of a host organism, it has to be "written back" to DNA with the help of a specialized enzyme, reverse transcriptase.
Vaginal intercourse is infectious for both partners. There is a higher risk for women than for men, since the HIV concentration in the semen of untreated men is considerably higher than in the vaginal secretion of untreated women. Anal intercourse is also infectious for both partners. On average, less than 1% of sexual contacts with (untreated) HIV-infected people lead to infection. However, unfavorable factors can turn this statistically low risk into a high risk, for example with a high viral load in the acute phase of the infection or with syphilis in one of the partners.
Oral sex can be infectious in certain cases, especially if semen gets into your mouth. The prostate secretion (also pre-dripping or pleasure drops) contains viruses in low concentrations, but the infectious dose is not sufficient. If ejaculation occurs in the mouth, the semen should not be swallowed, but spit out immediately. Then rinse the mouth and throat repeatedly with plenty of toothpaste. Toothpaste contains substances that effectively destroy the fatty virus envelope - without it, HIV is no longer infectious. With vaginal oral sex, the risk of infection depends on the amount of secretion; it is low to very low.
Likelihood of infection
The risk of contracting HIV through sexual contact depends on many factors. Unprotected anal intercourse is the riskiest. This is followed by vaginal intercourse - higher for women than for men - and oral intercourse with ejaculation. The statistically highest risk is involved in sharing hypodermic needles, as infectious blood is injected directly into the bloodstream.
Successfully treated HIV-infected people are not infectious if the virus concentration in the blood ("viral load") has been below the detection limit (<50 virus copies / ml blood plasma) for more than six months, regular intake of antiretroviral medication is ensured and there are no sexually transmitted diseases are present.
In general, the following applies: The likelihood of infection depends crucially on the virus concentration in the patient. The probability of transmission can only be assessed more precisely if a doctor who is familiar with the HIV infection is aware of the individual case. For information on post-exposure prophylaxis, see HIV-PEP.
The most important basic rule for safe sex: Potentially infectious body fluids such as semen and blood should not get on the mucous membranes or directly into the bloodstream.
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