RISK ASSESSMENT

Transmission questions can often not be answered in a black-or-white fashion, i.e. "this is always risky, that is never risky." The answer will usually involve two questions, going back to our conditions necessary for HIV transmission to occur:

What is the body fluid?
Is there enough HIV to cause infection?
Where is it going in the body?
The following are some examples of common situations and how the information about transmission can help you assess your risk.

Case 1

A man performed oral sex without a condom on another man. His partner did not ejaculate in his mouth. He doesn't know his partner's HIV status.

Was the virus present? We don't know, because we don't know if the partner was infected.

Was there enough concentration? There was no semen involved. It is possible that there was pre-ejaculate fluid present, which may involve some risk.

Could HIV make it into the bloodstream? If HIV were present, it could enter the body by infecting mucous membranes in the mouth or through open cuts or sores.

What was the level of risk? If the partner ,was not HIV positive, there is no risk. On the other hand, if the partner were HIV positive, there would be a low level of risk due to the possibility of contact with pre-ejaculate fluid. Considering that there are very few cases of transmission through oral sex reported, the risk in this situation is not very high. If the man is very worried about the incident, it is important for him to remember that there was some risk involved, but that the risk is not very high. If he feels that there was no risk at all and that he can continue practicing unprotected oral sex, it is important for him to know that although the risk was low, it is still there.

Case 2

A woman has found out that her previous drug partner is HIV-positive. They only shared needles once. She thinks that he got infected after they stopped seeing each other.

 

Was the virus present? We don't know because we don't know when he became infected.

Was there enough concentration? Yes. HIV in blood may be transmitted if two people share needles.

Was there a path of infection? Yes. Sharing needles provides a direct path for HIV to reach the bloodstream.

What was the level of risk? High, if her partner was already infected when they shared a needle.
It is important for her to be aware that there is a possibility for high risk.

Case 3

A woman is concerned about getting HIV from a co-worker. She accidentally drank from his cup. She thinks that he may be gay.

Was the virus present? We don't know. We cannot judge whether a person is infected or not based on his or her sexual orientation.
Was there enough concentration? No. Even if he's infected, she would have been in contact with his saliva. Saliva does not transmit HIV.
Was there a path of infection? In this case, this question is irrelevant because of the answer to the previous two questions. Speculating about open cuts in the mouth would just cloud the issue.
What was the level of risk? There was NO risk. She cannot get HIV from drinking from the same cup, even if the person is infected.

-- Copyright AIDS Committee of Newfoundland and Labrador