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Can I get or transmit HIV from...?

You can get or transmit HIV only through specific activities. Most commonly, people get or transmit HIV through anal or vaginal sex, or sharing needles, syringes, or other drug injection equipment (for example, cookers).   Babies can also get HIV during pregnancy, birth, or breastfeeding if their mother has HIV. However, not every exposure  to HIV carries the same risk, and some sexual activities are riskier than others. Many factors can increase or decrease HIV risk. Also, there are many effective ways a person can reduce their risk of HIV getting or transmitting HIV.

Some sexual activities are riskier than others for getting or transmitting HIV. Anal sex is the riskiest type of sex for HIV transmission. If you don’t have HIV, being a receptive partner (or bottom ) for anal sex is the riskiest sexual activity for getting HIV. If you do have HIV, being the insertive partner (or top ) for anal sex is the riskiest sexual activity for transmitting HIV. There is extremely low to no risk of getting or transmitting HIV through activities like oral sex, touching, and kissing.

If the partner with HIV takes HIV medicine as prescribed and gets and keeps an undetectable viral load, they have effectively no risk of transmitting HIV through sex.

Sexual Activities

What is anal sex? Anal sex is when a penis is inserted into an anus. The partner inserting the penis is called the insertive partner. The partner receiving the penis is called the receptive partner.

Anal sex is the riskiest type of sex for getting or transmitting HIV. Although receptive anal sex is much riskier for getting HIV than insertive anal sex, it’s possible for either partner—the insertive or receptive—to get HIV.

An HIV-negative receptive partner’s risk of getting HIV is very high because the lining of the rectum is thin. HIV can enter the body through this lining during anal sex from body fluids that carry HIV, including semen (cum) or pre-seminal fluid (pre-cum). 

More information 

On average, an HIV-negative receptive partner has about a 1 in 70 chance of getting HIV every time they have receptive anal sex with a partner who has HIV.

Being the receptive partner for anal sex is about 13 times more risky for getting HIV from a partner with HIV than being the insertive partner.

For women, anal sex is about 17 times more risky for getting HIV from a man with HIV than vaginal sex.

If the partner with HIV takes HIV medicine as prescribed, and gets and keeps an undetectable viral load , you have effectively no risk of getting HIV through sex with that partner.

See how receptive anal sex compares to other sexual activities here.

An HIV-negative insertive partner is also at risk because HIV can enter the body through the opening at the tip of the penis (or urethra); the foreskin if the penis isn’t circumcised; or small cuts, scratches, or open sores anywhere on the penis. There is some evidence that circumcision decreases a man’s risk of getting HIV during sex.

More information

On average, an HIV-negative insertive partner has about a 1 in 900 chance of getting HIV every time they have insertive anal sex with a partner who has HIV.

Being the receptive partner for anal sex is about 13 times more risky for getting HIV from a partner with HIV than being the insertive partner.

For men, anal sex with a women with HIV is about 3 times more risky for getting HIV than vaginal sex.

If the partner with HIV takes HIV medicine as prescribed, and gets and keeps anundetectable viral load , you have effectively no risk of getting HIV through sex with that partner.

See how insertive anal sex compares to other sexual activities here.

More information 

An uncircumcised penis still has foreskin. The inner lining of the foreskin is different than other types of skin and has more of the cells that HIV infects. The foreskin may also be easier to tear during sex, providing another way for HIV to infect the body. Also, HIV may be able to survive for a longer time in the space between the foreskin and the penis. There is some evidence that circumcision may decrease the insertive partner’s risk of getting HIV during anal sex. And, being circumcised greatly reduces the risk of a man from getting HIV when having sex with a women who has HIV. Finally, a person with an uncircumcised penis may also have a higher risk of getting other sexually transmitted diseases (STDs), such as syphilis or herpes, which can increase the risk of getting HIV.

Keep in mind that HIV can be found in pre-seminal fluid (pre-cum), which means there’s a risk for either partner to get HIV even if the insertive partner withdraws before ejaculating. Withdrawal before ejaculating may, in theory, reduce the receptive partner’s risk of getting HIV. But it does not change the insertive partner’s risk of getting HIV.

Many things can increase someone’s risk of getting HIV from anal sex besides sexual position (insertive vs. receptive). For example, the HIV-negative partner is more likely to get HIV if either partner has another sexually transmitted disease (STD). Also, if you are HIV-negative and have anal sex with a partner who has HIV, your chance of getting HIV is very high if that partner is not on HIV treatment and does not have an undetectable or suppressed viral load. If your partner with HIV takes HIV medicine as prescribed and keeps an undetectable viral load , they have effectively no risk of transmitting HIV through sex.

More information 

You can get other STDs from anal sex even if you use a condom because some STDs are transmitted through skin-to-skin contact. And you can get hepatitis A and B, parasites like Giardia, and other bacteria like Shigella, Salmonella, Campylobacter, and E. coli from anal sex because they’re transmitted through feces.

If you’ve never had hepatitis A or B, there are vaccines to prevent these infections. Talk to a health care provider about your chances of getting hepatitis A or B and whether vaccination is right for you.

Not having sex is a 100% effective way to make sure you don’t get or transmit HIV through sex. If you’re sexually active, you can lower your risk by choosing sexual activities that carry a lower risk for HIV than anal sex. You can also do other things to reduce your risk, including taking medicine to prevent or treat HIV and using condoms the right way, every time. Condoms and medicine to prevent or treat HIV are highly effective at preventing HIV if used correctly. But the medicines are much less effective if you don’t take them daily as prescribed, and condoms can sometimes break or come off during anal sex. Using a water-based or silicone lubricant can help prevent condoms from breaking or slipping.

Talking openly and frequently with your partner about sex can help you make decisions that decrease your risk of getting or transmitting HIV. Learn more about how to get the conversation started.

Conversation Starters

  • When was the last time you had an HIV test, and what was the result of that test?

    The only way to know for sure if you have HIV is to get tested. Before having sex for the first time, you and your partner may want to get tested for HIV and learn the results. Be aware that there’s a window period, which is the time between when a person gets HIV and when most HIV tests will show that a person has it. If you have sex before you learn your test results, using a condom the right way every time you have sex can lower your risk for getting or transmitting HIV.

    If you learn that you have HIV, the most important thing you can do is to take antiretroviral therapy (ART) as prescribed. ART is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are. ART can reduce the amount of HIV (viral load) in your body. Taking ART as prescribed can make your viral load so low that a test can’t detect it. This is called an undetectable viral load. If you keep an undetectable viral load , you can stay healthy for many years and have effectively no risk of transmitting HIV through sex.

  • Are you living with HIV and on treatment?

    If you have HIV, the most important thing you can do is be on HIV treatment. If you take ART as prescribed and keep an undetectable viral load, you can stay healthy and have effectively no risk of transmitting HIV through sex. If you’re taking ART, follow your health care provider’s advice. Visit your health care provider regularly and take your medicine as prescribed. This will give you the greatest chance of having an undetectable viral load .

    Even if you have undetectable viral load, you or your sex partner may want to use additional prevention options. Using a condom the right way you have sex can protect you from other STDs. Using condoms or having your partner take daily medicine to prevent HIV (called pre-exposure prophylaxis or PrEP) can provide added peace of mind.  Also consider using additional prevention methods if you

    • Are unsure, for any reason, that you have an undetectable viral load
    • Have a higher viral load (200 copies/ml of blood or greater)
    • Have trouble taking HIV medicine regularly
    • Missed some doses since your last viral load test
    • Have stopped taking HIV medicine or may do so in the future

    If your partner has HIV, encourage your partner to take ART as prescribed too, for their own health.

    If you’re HIV-negative and have a partner with HIV who is taking ART as prescribed, they have effectively no risk of transmitting HIV to you through sex as long as they keep an undetectable viral load. Even if your partner has an undetectable viral load, you or your sex partner may want to use additional prevention options. Using a condom the right way every time you have sex can protect you from other STDs. Using condoms or taking daily medicine to prevent HIV (called pre-exposure prophylaxis or PrEP) can provide added peace of mind. Also consider using additional prevention methods if you are unsure, for any reason, that your partner has an undetectable viral load.

    You and your partner should learn about all the available prevention options and make the decisions that are right for both of you.

    If you are HIV-negative and have a recent possible exposure to HIV and you’re not taking PrEP, you can take post-exposure prophylaxis (PEP). For PEP to work, you must start it as soon as possible, and always within 72 hours of a recent possible exposure.

  • How many other sex partners do you currently have?

    Having multiple partners increases your risk for HIV. The more sexual partners you have in your lifetime, the more likely you are to have a sex partner with HIV who does not know their status, is not taking medicine to treat HIV or does not have an undetectable viral load. It also increases the chances that you have a partner who has another STD.

  • Do you have any other sexually transmitted diseases (STDs)?

    Having other STDs increases your risk for getting or transmitting HIV.

  • Do you use needles to inject drugs?

    Sharing needles, syringes, or other drug injection equipment (for example, cookers) increases your risk for getting or transmitting HIV.

What is vaginal sex? Vaginal sex is when a penis is inserted into a vagina.

When a woman has vaginal sex with a partner who has HIV, HIV can enter her body through the mucous membranes that line the vagina and cervix. Most women who get HIV get it from vaginal sex.  Even if a woman’s male partner withdraws or pulls out before ejaculating, she can still get infected because pre-seminal fluid (pre-cum) can carry HIV.

More information

On average, an HIV-negative woman has about a 1 in 1,250 chance of getting HIV every time she has vaginal sex with a man who has HIV.

On average, a woman with HIV has about a 1 in 2,500 chance of transmitting HIV every time she has vaginal sex with an HIV-negative man.

For an HIV-negative woman, anal sex is about 17 times more risky than vaginal sex for getting HIV from a partner with HIV.

For a woman with HIV, anal sex is about 3 times more risky than vaginal sex for transmitting HIV to an HIV-negative partner.

If the partner with HIV takes HIV medicine as prescribed, and gets and keeps an undetectable viral load , their partner has effectively no risk of getting HIV through sex. See how receptive vaginal sex compares to other sexual activities here.

Men can also get HIV from having vaginal sex with a woman who has HIV. This is because vaginal fluid and blood can carry HIV. Men get HIV through the opening at the tip of the penis (or urethra); the foreskin if they’re not circumcised; or small cuts, scratches, or open sores anywhere on the penis. There is strong evidence that circumcision greatly reduces the man’s risk of getting HIV during vaginal sex. There is no evidence that circumcision benefits the woman, though more studies are underway.

More information

On average, an HIV-negative man has about a 1 in 2,500 chance of getting HIV every time he has vaginal sex with a woman who has HIV.

On average, a man with HIV has about a 1 in 1,250 chance of transmitting HIV every time he has vaginal sex with an HIV-negative woman.

For an HIV-negative man, anal sex with a woman with HIV is about 3 times more risky for getting HIV than vaginal sex.

For a man with HIV, anal sex with a woman with HIV is about 17 times more risky for transmitting HIV than vaginal sex.

If the partner with HIV takes HIV medicine as prescribed, and gets and keeps an undetectable viral load , they have effectively no risk of transmitting HIV through sex.

See how insertive vaginal sex compares to other sexual activities here.

More Information

Men who aren’t circumcised are more likely to get HIV through vaginal sex than men who are circumcised. When a man isn’t circumcised, he still has the foreskin on his penis. The inner lining of the foreskin is different than other types of skin on the body and has more of the cells that HIV infects. The foreskin may also be easier to tear during intercourse, providing another way for HIV to infect the body. In addition, HIV may be able to survive for a longer time in the space between the foreskin and the penis. Finally, uncircumcised men also have a higher risk of getting sexually transmitted diseases, such as syphilis or herpes, which can increase the risk of getting HIV.

Keep in mind that HIV can be found in pre-seminal fluid (pre-cum), which means there’s a risk for either the man or the woman to get HIV even if the man withdraws before ejaculating. Withdrawal before ejaculating may, in theory, reduce the woman’s risk of getting HIV. But it does not change the man’s risk of getting HIV.

Many things can increase someone’s risk of getting HIV from vaginal sex. For example, the HIV-negative partner is more likely to get HIV if either partner has another sexually transmitted disease (STD). Also, if you are HIV-negative and have vaginal sex with a partner who has HIV, your chance of getting HIV is very high if that partner is not on HIV treatment and does not have an undetectable or suppressed viral load. If your partner with HIV takes HIV medicine as prescribed and keeps an undetectable viral load , they have effectively no risk of transmitting HIV through sex. 

Taking daily medicine to prevent HIV (called pre-exposure prophylaxis or PrEP) can reduce your risk of getting HIV, and using condoms  the right way every time you have sex can reduce your risk of getting both HIV and other STDs like gonorrhea and chlamydia that are transmitted through body fluids. 

More Information

Condoms provide less protection against STDs that spread through skin-to-skin contact like human papillomavirus or HPV (genital warts), genital herpes, and syphilis.

Not having sex is a 100% effective way to make sure you don’t get or transmit HIV through sex. If you’re sexually active, you can lower your risk for HIV by choosing sexual activities that carry a lower risk for HIV than vaginal sex. You can also do other things to reduce your risk, including taking medicine to prevent or treat HIV and using condoms the right way, every time. Condoms and medicine to prevent or treat HIV are highly effective at preventing HIV if used correctly. But the medicines are much less effective if you don’t take them daily as prescribed, and condoms can sometimes break or come off during vaginal sex. Using a water-based lubricant can help prevent condoms from breaking or slipping.

Talking openly and frequently with your partner about sex can help you make decisions that may decrease your risk of getting or transmitting HIV. Learn more about how to get the conversation started. 

Conversation Starters:

  • When was the last time you had an HIV test and what was the result of that test?

The only way to know for sure if you have HIV is to get tested. Before having sex for the first time, you and your partner may want to get tested for HIV and learn the results. Be aware that there’s a window period, which is the time between when a person gets HIV and when most HIV tests will show that a person has it. If you have sex before you learn your test results, using a condom the right way every time you have sex can lower your risk for getting or transmitting HIV.

If you learn that you have HIV, the most important thing you can do is to take antiretroviral therapy (ART) as prescribed. ART is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are. ART can reduce the amount of HIV (viral load) in your body. Taking ART as prescribed can make your viral load so low that a test can’t detect it. This is called an undetectable viral load. If you keep an undetectable viral load , you can stay healthy for many years and have effectively no risk of transmitting HIV through sex.

  • Are you living with HIV and on treatment?

If you have HIV, the most important thing you can do is be on treatment. If you take ART as prescribed and keep an undetectable viral load, you can stay healthy and have effectively no risk of transmitting HIV through sex. If you’re taking ART, follow your health care provider’s advice. Visit your health care provider regularly and take your medicine as prescribed. This will give you the greatest chance of having an undetectable viral load. Even if you have undetectable viral load, you or your sex partner may want to use additional prevention options. Using a condom the right way every time you have sex can protect you from other STDs. Using condoms or having your partner take daily medicine to prevent HIV (called pre-exposure prophylaxis or PrEP) can provide added peace of mind. Also consider using additional prevention methods if you

• Are unsure, for any reason, that you have an undetectable viral load
• Have a higher viral load (200 copies/ml of blood or greater)
• Have trouble taking HIV medicine regularly
• Missed some doses since your last viral load test
• Have stopped taking HIV medicine or may do so in the future


If your partner has HIV, encourage your partner to take ART too.

If you’re HIV-negative and have a partner with HIV who is taking ART as prescribed, they have effectively no risk of transmitting HIV to you through sex as long as they keep an undetectable viral load. Even if your partner has an undetectable viral load, you or your sex partner may want to use additional prevention options. Using a condom the right way every time you have sex can protect you from other STDs. Using condoms or taking daily medicine to prevent HIV (called pre-exposure prophylaxis or PrEP) can provide added peace of mind. Also consider using additional prevention methods if you are unsure, for any reason, that your partner has an undetectable viral load.

You and your partner should learn about all the available prevention options and make the decisions that are right for both of you.

If you’re not taking PrEP, you can take post-exposure prophylaxis (PEP) if you have a recent possible exposure to HIV. For PEP to work, you must start it as soon as possible, and always within 72 hours of a recent possible exposure.

  • How many other sex partners do you currently have?

Having multiple sexual partners increases your risk for HIV. The more sexual partners you have in your lifetime, the more likely you are to have a sex partner with HIV who does not know their status, is not taking medicine to treat HIV, and/or does not have an undetectable viral load. It also increases the chances that you have a partner who has another STD. 

  • Do you have any other sexually transmitted diseases (STDs)?

Having other STDs increases your risk for getting or transmitting HIV.

  • Do you use needles to inject drugs?

Sharing needles, syringes, or other drug injection equipment (for example, cookers) increases your risk for getting or transmitting HIV.

What is oral sex? Oral sex involves putting the mouth on the penis (fellatio), vagina (cunnilingus), or anus (anilingus).

The chance an HIV-negative person will get HIV from oral sex with an HIV-positive partner is extremely low. However, it’s hard to know the exact risk because a lot of people who have oral sex also have anal or vaginal sex. The risk is even lower if the HIV-negative partner is taking medicine to prevent HIV (pre-exposure prophylaxis or PrEP). If the partner with HIV is taking HIV medicine as prescribed and keeps an undetectable viral load , they have effectively no risk of transmitting HIV through sex, including oral sex.

But you can get other sexually transmitted diseases (STDs) from oral sex. And, if you get feces in your mouth during anilingus, you can get hepatitis A and B, parasites like Giardia, and other bacteria like Shigella, Salmonella, Campylobacter, and E. coli.

Choosing activities with extremely low to no risk like oral sex instead of higher-risk activities like anal or vaginal sex can lower your chances getting or transmitting HIV. If you have oral sex. If you have oral sex, using a barrier (e.g., a condom, dental dam, or cut-open nonlubricated condom) can make your risk of getting or transmitting HIV even lower and protect you and your partner from some other STDs, including gonorrhea of the throat, and hepatitis.

More Information A dental dam is a thin, square piece of rubber that is placed over the vagina or anus during oral sex. Dental dams are usually made from latex or silicone, and they work by preventing the mouth from coming into direct contact with the vagina and anus.

Because your mouth may come into contact with feces or other  body fluids during oral sex, it is important that you talk to a  health care provider about your chances of getting hepatitis A and B. If you’ve never had hepatitis A or B, there are vaccines to prevent it. Your provider can help you decide if vaccination is right for you.

What is Touching? Touching involves one partner putting their hands or other body parts on their sex partner's vagina, penis, or anus (with or without clothes on). Touching can also include the use of sex toys.  

 

There’s extremely low to no risk for getting or transmitting HIV from touching. The only possible risk would be if body fluids from a partner with HIV touch the mucous membranes or damaged tissue of someone who’s HIV-negative. Mucous membranes can be found inside the rectum , the vagina, the opening of the penis, and the mouth. Damaged tissue could include a cut, sore, or open wound.

There’s a chance of getting or transmitting other sexually transmitted diseases (STDs) through touching because some STDs (like human papillomavirus or HPV, genital herpes, and syphilis) can be transmitted through skin-to-skin contact.

You could also get or transmit other kinds of infections, like hepatitis A and hepatitis B virus; parasites like Giardia; and bacteria such as Shigella, Salmonella, Campylobacter, or E. coli if you touch someone’s anus because you may get feces on your hands or fingers.

What you can do: Touching

Choosing activities with little to no risk like touching instead of higher-risk activities like anal or vaginal sex can lower your chances of getting or transmitting HIV. To make this risk even lower, make sure you and your partner don’t have open cuts, wounds, or sores on the hands or fingers. To prevent transmission of STDs that can be transmitted through skin-to-skin contact, you can wear medical gloves for touching.

If your genitalia is touching your partner’s genitalia, keeping your clothes on will reduce the chances of exposure to body fluids and open sores that can spread HIV or other STDs.

If you use sex toys, do not share them with your partner. If you do share them, cover sex toys with a new condom if possible, and wash them carefully after each use.

If a person with HIV takes HIV medicine as prescribed and keeps an undetectable viral load they have effectively no risk of transmitting HIV through sex, including touching.

Certain things about your sex and injection partners can put you at increased risk for getting or transmitting HIV. Explore Estimate the HIV Risk to learn more.

Learn about the Centers for Disease Control and Prevention’s HIV prevention campaigns:

What is kissing? Kissing involves partners touching their lips and/or tongues together.

There’s no chance of getting HIV from closed-mouth or “social” kissing, and you can’t get HIV through saliva. In some very rare cases, people have gotten HIV from deep, open-mouth “French” kissing because they and their partners had blood in their mouths from bleeding gums or sores (like canker sores). But the chance of getting HIV from deep, open-mouth kissing is much lower than from most other sexual activities.

 

Choosing activities with little to no risk like kissing instead of higher-risk activities like anal or vaginal sex can lower your chances of getting or transmitting HIV. To make this risk even lower, make sure you and your partner don’t have bleeding gums or mouth sores when kissing.

If a person with HIV takes HIV medicine as prescribed and keeps an undetectable viral load , they have effectively no risk of transmitting HIV to through sex, including kissing.

People who inject drugs, hormones or steroids, or silicone can get or transmit HIV by sharing needles, syringes or other drug injection equipment , (for example, cookers) because these items may have someone else’s blood in them.

HIV could also be transmitted when needles or syringes are shared for piercings and tattoos.

Needle/Syringe Use

What is injecting?

Injection drug use is using syringes (includes needles) to inject drugs into a vein or under the skin (i.e., skin popping, muscling).

The risk for getting or transmitting HIV is very high if an HIV-negative person uses needles, syringes, or other drug injection equipment (for example, cookers) after someone with HIV has used them. This is because the needles, syringes, or other injection equipment may have blood in them, and blood can carry HIV. Likewise, you’re at risk for getting or transmitting hepatitis B and C if you share needles, syringes, or other injection equipment because these infections are also transmitted through blood.

More Information

In 2017, 6% of new HIV diagnoses in the United States were attributed to injection drug use and 3% were attributed to injection drug use and male-to-male sexual contact (men who reported both risk factors). On average, an HIV-negative person has about a 1 in 160 chance of getting HIV every time they share needles, syringes, or other injection equipment with a person who has HIV.

More Information There may be extremely tiny amounts of blood in syringes or works that you may not be able to see, but could still carry HIV. Be aware that HIV can survive in a used syringe for up to 42 days depending on temperature and other factors.

More Information Hepatitis B and C are viruses that infect the liver. Many people with hepatitis B or C don’t know they have it because they don’t feel sick. Even if you don’t feel sick, you can transmit the virus to others. The only way to know for sure if you have hepatitis B or C is to get tested. Your health care provider will recommend a hepatitis B or C test if you have risk factors for these infections, such as injection drug use. If you don’t have a health care provider, click here to find contact information for your local health department.

There are medicines to treat hepatitis B. If you’ve never had hepatitis B, there’s a vaccine to prevent it. There are medicines to treat hepatitis C, but they aren’t right for everyone. There’s no vaccine to prevent hepatitis C. Talk to your health care provider to learn more about hepatitis B and C.

If a person with HIV takes their HIV medicine as prescribed and gets and keeps an undetectable viral load , their chance of transmitting HIV through sharing needles, syringes, or other drug injection equipment is reduced.

Another reason people who inject drugs can get or transmit HIV (and other sexually transmitted diseases or STDs) is that when people are high, they’re more likely to engage in risky sexual behaviors, such as having anal or vaginal sex without protection (like a condom or medicine to prevent or treat HIV), having sex with multiple partners, or trading sex for money or drugs.

In addition to being at risk for HIV and other STDs, people who inject drugs can get other serious health problems, like skin infections and heart infections. And sometimes people can overdose and get very sick or even die from having too many drugs or too much of one drug in their body or from products that may be mixed with the drugs without their knowledge (for example, fentanyl).

The best way to reduce the risk of getting or transmitting HIV through injection drug use is to stop injecting drugs. You may need help to stop or cut down injecting drugs, but many resources are available. Therapy, medication-assisted treatment, and other methods can help you. Talk with a counselor, doctor, or other health care provider  about substance use disorder treatment. 

More Information Some treatment programs provide medicines such as methadone or buprenorphine to people on an outpatient basis to help them quit using drugs like heroin, OxyContin, Opana, or Vicodin.

People who continue injecting drugs should never share needles, syringes, or other injection equipment such as cookers. Many communities have syringe services programs (SSPs) where people can get free sterile needles and syringes and safely dispose of used ones. SSPs can also refer people to treatment for substance use disorder and help them get tested for HIV and hepatitis. People can contact their local health department or the North American Syringe Exchange Network (NASEN) to find an SSP. Also, some pharmacies may sell needles and syringes without a prescription.

If you keep injecting drugs, here are some things you can do to lower your risk for getting or transmitting HIV and other infections:

  • Use only your own new, sterile syringes and injection equipment each time you inject.
  • Use bleach to clean used needles, syringes, cookers and surfaces where drugs are prepared when you can’t get new ones. Bleaching a used syringe may reduce the risk of HIV and hepatitis C but doesn’t eliminate it. Here are instructions on using bleach to clean your syringes.
  • Use sterile water to fix drugs. You can buy sterile water from a store. If you can’t get sterile water, use water that has been boiled for 10 minutes or clean tap or bottled water.
  • If you inject around other people, be careful not to get someone else’s blood on your hands, needles, syringes, or other injection equipment.
  • Dispose of syringes and needles safely after one use. You can use a sharps container or another container like an empty bleach or laundry detergent bottle. Make sure to keep used syringes away from other people. Some communities have drop boxes where you can dispose of your used syringes safely.

Learn about other things you can do to prevent getting or transmitting HIV. 

More Information

  • Get tested for HIV. CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care. People with certain risk factors should get tested more often. People with more than one sex partner, people with other sexually transmitted diseases (STDs), and people who inject drugs are likely to be at high risk for HIV and should get tested at least once a year.
  • If you have  HIV, take HIV medicine, called antiretroviral therapy (ART) and follow your health care provider’s advice. If you learn that you have HIV, the most important thing you can do is to take ART as prescribed. ART is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are. This is the most important thing you can do to protect your health.
  • If you have HIV, take HIV medicine to get and keep an undetectable viral load. HIV medicine, called antiretroviral therapy (ART), can reduce the amount of HIV (viral load) in your body. Taking ART as prescribed can make your viral load so low that a test can’t detect it. This is called an undetectable viral load. If you keep an undetectable viral load , you can stay healthy for many years and have effectively no risk of transmitting HIV through sex. Having an undetectable viral load  also reduces your risk of transmitting HIV by sharing needles, syringes, or other injection equipment (for example, cookers).
  • If you’re HIV-negative, consider taking daily medicine to prevent HIV (called pre-exposure prophylaxis or PrEP). If taken daily, PrEP is highly effective preventing HIV from injection drug use. PrEP is much less effective when it is not taken consistently. PrEP may be right for you if you injected dru[TK((1> gs to get high in the past 6 months and also shared syringes or works during that time. Talk to your health care provider about PrEP. If you don’t have a health care provider, click here to find contact information for your local health department.
  • Don’t have sex if you’re high. If you do have sex, taking medicines to prevent or treat HIV and using a condom the right way every time you have sex can reduce your risk of getting or transmitting HIV. Condoms and medicine to prevent or treat HIV are highly effective if they are used correctly. But the medicines are much less effective if you don’t take them consistently, and condoms can sometimes break or come off during sex. Using a water-based or silicone lubricant can help prevent condoms from breaking or slipping.

Certain things about your sex and injection partners can put you at increased risk for getting or transmitting HIV. Explore Estimate the HIV Risk to learn more about the risk of getting or transmitting HIV through sex.

Explore other resources from CDC:

Find treatment centers in your area by using the locator tools on SAMHSA.gov or HIV.gov, or call 1-800-662-HELP (4357).

Learn about the Centers for Disease Control and Prevention’s HIV prevention campaigns:

What are hormone and steroid injections? Hormones and steroids can be injected into the body to make people look more feminine or masculine, to improve athletic performance, or for medical reasons. Sometimes people share needles or syringes when they inject hormones or steroids. 

Hormone and steroid injections can be done safely by a health care provider. But there’s a chance that someone can get or transmit HIV if an HIV-negative person uses needles, syringes, or other injection equipment after someone with HIV has used them. This is because the needles, syringes, or other injection equipment may have blood in them, and blood can carry HIV. Likewise, you’re at risk for getting or transmitting hepatitis B and C if you share syringes because these infections are also transmitted through blood.

More Information About 1 out of every 10 HIV diagnoses in the United States is among people who inject drugs. This includes gay and bisexual men who inject drugs. On average, an HIV-negative person has a 1 in 420 chance of getting HIV from a needlestick if the needle or syringe contains HIV-infected blood.

More Information There may be extremely tiny amounts of blood in syringes or works that you may not be able to see, but could still carry HIV. Be aware that HIV can survive in a used syringe for up to 42 days depending on temperature and other factors.

More Information Hepatitis B and C are viruses that infect the liver. Many people with hepatitis B or C don’t know they have it because they don’t feel sick. Even if you don’t feel sick, you can transmit the virus to others. The only way to know for sure if you have hepatitis B or C is to get tested. Your health care provider will recommend a hepatitis B or C test if you have risk factors for these infections, such as injection drug use. If you don’t have a health care provider, click here to find contact information for your local health department.

There are medicines to treat hepatitis B. If you’ve never had hepatitis B, there’s a vaccine to prevent it. There are medicines to treat hepatitis C, but they aren’t right for everyone. There’s no vaccine to prevent hepatitis C. Talk to your health care provider to learn more about hepatitis B and C.

If people with HIV take their HIV medicine as prescribed and get and keep an undetectable viral load, their risk of transmitting HIV transmission through sharing needles, syringes, or other drug injection equipment (for example, cookers) is reduced.

Don’t inject any substance into your body unless a health care provider prescribed it for you. If you keep injecting hormones or steroids, here are some things you can do to lower your risk for getting or transmitting HIV and other infections:

  • Use only your own new, sterile syringes and injection equipment each time you inject.
  • Use bleach to clean used syringes when you can’t get new ones. Bleaching a used syringe may reduce the risk of HIV and hepatitis C but doesn’t eliminate it. Here are instructions on using bleach to clean your syringes.  
  • If you inject around other people, be careful not to get someone else’s blood on your hands, needles, syringes, or other injection equipment.
  • Dispose of needles safely after one use. Use a sharps container or make sure to keep used needles away from other people. Some communities may have drop boxes where you can dispose of your used needles safely.

Learn about other things you can do to prevent getting or transmitting HIV. 

  • Get Tested for HIV. CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care. People with certain risk factors should get tested more often. People with more than one sex partner, people with other sexually transmitted diseases (STDs), and people who inject drugs are likely to be at high risk for HIV and should get tested at least once a year.
  • If you have HIV, take HIV medicine, called antiretroviral therapy (ART) and follow your health care provider’s advice. If you learn that you have HIV, the most important thing you can do is to take ART as prescribed. ART is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are. This is the most important thing you can do to protect your health.  
  • If you have HIV, take HIV medicine to get and keep an undetectable viral load. HIV medicine, called antiretroviral therapy (ART), can reduce the amount of HIV (viral load) in your body. Taking ART as prescribed can make your viral load so low that a test can’t detect it. This is called an undetectable viral load. If you keep an undetectable viral load , you can stay healthy for many years and have effectively no risk of transmitting HIV through sex. Having an undetectable viral load also reduces your risk of transmitting HIV by sharing needles, syringes, or other injection equipment (for example, cookers).
  • If you’re HIV-negative, consider taking daily medicine to prevent HIV (called pre-exposure prophylaxis or PrEP). If taken daily, PrEP is highly effective preventing HIV from injection drug use. PrEP is much less effective when it is not taken consistently. PrEP may be right for you if you injected drugs to get high in the past 6 months and also shared syringes or works during that time. Talk to your health care provider about PrEP. If you don’t have a health care provider, click here to find contact information for your local health department

What is injecting silicone (pumping silicone)? Silicone (or other thick liquids) can be injected into body tissue to make certain areas of the body, such as the breasts, buttocks, thighs, and face, look fuller and more feminine. This is sometimes called “pumping."

Silicone injections can be done safely by a health care provider, but sometimes people inject silicone with friends or acquaintances at parties. There’s a chance that someone can get or transmit HIV if an HIV-negative person uses needles, syringes, and other injection equipment after someone with HIV has used them. This is because the needle, syringe, or other injection equipment may have blood in them, and blood can carry HIV. Likewise, you’re at risk for getting or transmitting hepatitis B and C if you share needles, syringes, or other injection equipment because these infections are also transmitted through blood.

More information: About 1 out of every 10 HIV diagnoses in the United States is among people who inject drugs. This includes gay and bisexual men who inject drugs. On average, an HIV-negative person has about a 1 in 420 chance of getting HIV from a needlestick if the needle or syringe contains HIV-infected blood.

More information: There may be extremely tiny amounts of blood in syringes or works that you may not be able to see, but could still carry HIV.  Be aware that HIV can survive in a used syringe for up to 42 days depending on temperature and other factors.

More information: Hepatitis B and C are viruses that infect the liver. Many people with hepatitis B or C don’t know they have it because they don’t feel sick. Even if you don’t feel sick, you can transmit the virus to others. The only way to know for sure if you have hepatitis B or C is to get tested. Your health care provider will recommend a hepatitis B or C test if you have risk factors for these infections, such as injection drug use. If you don’t have a health care provider, click here to find contact information for your local health department.

 

There are medicines to treat hepatitis B. If you’ve never had hepatitis B, there’s a vaccine to prevent it. There are medicines to treat hepatitis C, but they aren’t right for everyone. There’s no vaccine to prevent hepatitis C. Talk to your health care provider to learn more about hepatitis B and C.

If a person with HIV takes their HIV medicine as prescribed and gets and keeps an undetectable viral load , their chance of transmitting HIV through sharing needles, syringes, or other drug injection equipment (for example, cookers) is reduced.

When you inject liquids like silicone, they can spread to other parts of the body through the bloodstream. This can cause serious health problems like abscesses, severe skin swelling, disfigurement, and even death. Many times, the liquids used in these injections aren’t approved for use in the body.

 

What you can do: Injecting Silicone (Pumping Silicone)

Don’t inject any substance into your body unless a health care provider prescribed it for you. If you inject silicone, here are some things you can do to lower your risk for getting or transmitting HIV and other infections:

Learn about other things you can do to prevent getting or transmitting HIV. 

More information

  • Get tested for HIV. CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care. People with certain risk factors get tested more often. People with more than one sex partner, people with other sexually transmitted diseases (STDs), and people who inject drugs are likely to be at high risk and should get tested at least once a year.
  • If you have HIV, take HIV medicine, called antiretroviral therapy (ART), and follow your health care provider’s advice. If you learn that you have HIV, the most important thing you can do is to take ART as prescribed. ART is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are. This is the most important thing you can do to protect your health.  
  • If you have HIV, take HIV medicine to get and keep an undetectable viral load. HIV medicine, called antiretroviral therapy (ART), can reduce the amount of HIV (viral load) in your body. Taking ART as prescribed can make your viral load so low that a test can’t detect it. This is called an undetectable viral load . If you keep an undetectable viral load, you can stay healthy for many years and have effectively no risk of transmitting HIV through sex. Having an undetectable viral load also reduces your risk of transmitting HIV by sharing needles, syringes, or other injection equipment (for example, cookers).
  • If you’re HIV-negative, consider taking daily medicine to prevent (called pre-exposure prophylaxis or PrEP). If taken daily, PrEP is highly effective preventing HIV from injection drug use. PrEP is much less effective when it is not taken consistently. PrEP may be right for you if you injected drugs to get high in the past 6 months and also shared syringes or works during that time. Talk to your health care provider about PrEP. If you don’t have a health care provider, click here to find contact information for your local health department.

Getting HIV From Needle Use: Less Common Ways

What are some of the less common ways of getting HIV from needle use? It’s possible to get HIV by sharing needles, syringes, or other injection equipment to inject medicines your doctor prescribed for medical purposes (like insulin to treat diabetes). You could also get HIV from reused tattoo or piercing syringes and needles, ink, or other equipment.

The risk for getting or transmitting HIV is very high if an HIV-negative person shares needles, syringes, other injection equipment with someone who has HIV. It’s also possible to get HIV from tattooing or body piercing if the equipment has someone else’s blood in it or if the ink is shared. The risk of getting HIV from tattooing or body piercing is higher when the person doing the procedure doesn’t have a license. That person may be more likely to use unsafe practices like sharing syringes or ink. There are no known cases in the United States of anyone getting HIV this way.

More Information On average, an HIV-negative person has a 1 in 420 chance of getting HIV from a needlestick if the needle or syringe contains HIV-infected blood.

More Information There may be extremely tiny amounts of blood in syringes or works that you may not be able to see, but could still carry HIV.  Be aware that HIV can survive in a used syringe for up to 42 days depending on temperature and other factors.

If you inject prescription drugs for medical purposes, be sure to use new, sterile needles, syringes, or other injection equipment each time you inject. Never share your needles, syringes, or other injection equipment with anyone. If you get a tattoo or a body piercing, be sure that the person doing the procedure has the right license and that they use only new, sterile syringes and needles, ink, and other supplies.

If the person with HIV takes their medicine as prescribed and gets and keeps an undetectable viral load, their chance of transmitting HIV through sharing needles, syringes, or other injection equipment is reduced.

Certain things about your sex and injection partners can put you at increased risk for getting or transmitting HIV. Explore Estimate the HIV Risk to learn more about the risk of getting or transmitting HIV through sex.

Explore other resources from CDC:

Learn about the Centers for Disease Control and Prevention’s HIV prevention campaigns:

What is HIV transmission during pregnancy, childbirth, and breastfeeding?

When HIV is transmitted from a mother to her child, it's called mother-to-child or perinatal transmission. This can happen during pregnancy, labor, delivery, or breastfeeding.

Getting HIV from Pregnancy,Childbirth, and Breastfeeding

Mother-to-child transmission of HIV is the most common ways that children get HIV. Studies show that the risk can be much lower if pregnant women with HIV and their newborns take HIV medicine called (antiretroviral therapy or ART). All pregnant women should  get tested for HIV as early as possible so that they can begin treatment if they have HIV.

More Information If a woman with HIV takes HIV medicine daily as prescribed throughout pregnancy, labor, and delivery and gives HIV medicine to her baby for 4-6 weeks after delivery, the risk of transmitting HIV to the baby can be 1% or less. If a woman doesn’t receive treatment until she’s in labor, the chance of transmitting HIV to her baby is about 13%. The chance of the baby getting HIV is much higher if the mother with HIV is not on treatment. On average, a baby has about a 1 in 4 chance of getting HIV from a mother with HIV who is not on treatment.

More Information Testing pregnant women for HIV and treating those who have HIV has led to a big decline in the number of babies who get HIV.

If you’re pregnant, talk to your health care provider as soon as possible about getting tested for HIV and other ways to protect you and your child from getting HIV. If you’re in labor and don’t know if you have HIV, request a rapid HIV test.

More Information In 2006, the Centers for Disease Control and Prevention (CDC) published recommendations that all pregnant women be routinely tested for HIV unless they say they don’t want an HIV test. The guidelines say that women in their third trimester should be tested again if they’re known to inject drugs or have sexual partners who inject drugs, if they have new or multiple sexual partners, or if they have symptoms of acute HIV infection.

If you learn that you have HIV, the most important thing you can do is to take ART as prescribed. ART is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are.  ART can reduce the amount of HIV (viral load) in your body. Taking ART as prescribed can make your viral load so low that a test can’t detect it. This is called an undetectable viral load. If you get and keep an undetectable viral load, you can stay healthy for many years and have effectively no risk of transmitting HIV through sex. The sooner you start taking ART, the more effective it will be at improving your health and preventing transmission to your baby.

More Information After delivery, you can prevent transmitting HIV to your baby by not breastfeeding since breast milk contains HIV. Taking HIV medicine as prescribed and keeping an undetectable viral load substantially reduces, but does not eliminate, the risk of transmitting HIV through breastfeeding. The current recommendation in the U.S. is that mothers with HIV should not breastfeed their babies. Also, don’t give your baby pre-chewed food because infected blood from your mouth can mix with food while you chew it.

If you or your partner has HIV and is thinking about getting pregnant, you should talk to your doctor as soon as possible about taking pre-exposure prophylaxis (PreP). If you’re not already taking it, PrEP may be an option to help protect you or your partner from getting HIV while you or your partner try to get pregnant, during pregnancy, or while breastfeeding.

Content last updated May 28, 2020

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