• Routes of transmission

    • Sexual: Unprotected intercourse is the most common route of transmission, irrespective of gender or sexual orientation.

    • Injection drug use: Sharing unsterilized injection equipment is a very efficient means of transmitting HIV.

    • Perinatal: Infection from mother to infant can occur during gestation, delivery, or breast-feeding.

    • Blood transfusion: In the U.S., screening blood for HIV has reduced the risk by transfusion to almost zero.

  • Cofactors that enhance transmission

    • Physical: The presence of sexually transmitted diseases may cause genital lesions or genital/mucous membrane bleeding during sexual activity.

    • Behavioral: Substance use lowers sexual inhibitions, impairs judgment, and increases impulsivity.


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