HIV Myths and Misconceptions
Although our knowledge on HIV, including its transmission and treatment, has come a long way since the virus was first found in the population, there are still some common myths and misconceptions about HIV.
Myth: HIV lives on surfaces for a long time.
Fact: Some viruses, especially viruses that cause colds and flus, can live on surfaces for days and still be infectious. This is not the case for HIV. Even in very precisely controlled laboratory conditions with large amounts of infectious HIV particles, the virus does not live for more than a few hours outside of the body. In realistic conditions outside the laboratory, HIV is not expected to live for long at all, making environmental transmission outside the body virtually non-existent.1,2 This means HIV cannot be transmitted through contact with everyday surfaces, like toilet seats.3
Myth: HIV can be transmitted through food and drink.
Fact: HIV cannot be transmitted through water, other drinks, or food. Individuals with HIV can prepare and serve food without transmitting the virus. As mentioned, HIV cannot live for long at all outside the body. Any virus particles that may make it outside the body and into food or drinks would be killed by the heat from cooking, stomach acid, and exposure to the environment in general.3 Several false Internet claims have arisen in recent years regarding HIV transmission through food or drinks. HIV has never been transmitted through any food or drinks, including, but not limited to, candy eggs, bananas, Pepsi, or bottled sangria, which have been the center of some of these hoaxes.
Myth: You won’t get HIV if you use a needle that hasn’t been used by someone else in a while.
Fact: Although HIV cannot live outside the body on its own, it can live inside a needle for several weeks. Some estimates have suggested that under the right conditions, and when not exposed to air, HIV can live inside a needle for up to six weeks.4 This is why sharing needles at any time is risky, regardless of when the needle was last used. Just because no blood is visible on a needle, doesn’t mean that HIV particles are not inside.
Myth: You can get HIV from touching, hugging, or kissing someone with the virus.
Fact: HIV is transmitted through contact with bodily fluids that could contain the virus. These include blood, semen, preseminal fluid (precum), vaginal fluid, rectal fluid, and breastmilk. These fluids must contain the virus, and come in contact with an HIV-negative individual’s mucus membranes (mouth, rectum, vagina, and other body cavity linings), or a break in the skin, for the virus to be transmitted. HIV is not found in saliva, tears, or sweat, meaning casual contact such as shaking hands, hugging, sharing drinks and food, cuddling, or closed-mouth kissing will not transmit the virus.3,4
Myth: Mosquitos carry HIV.
Fact: Insects, including ticks and mosquitos, do not carry or transmit HIV. HIV needs human cells to replicate, which mosquitos and other insects do not have. This means HIV will die in a mosquito and be broken down in its digestive system before it can be passed on. There are other illnesses that can be passed through insects, including malaria, dengue fever, Zika virus, Lyme disease, West Nile virus, and Rocky Mountain spotted fever, among others. HIV is not among the conditions transmitted by insects.3,5,6
Myth: HIV only affects men who have sex with men.
Fact:HIV does not discriminate, and can affect anyone, regardless of age, race, ethnicity, sexual practices, and location. While anal sex does carry the highest risk of transmitting the virus, other behaviors, such as vaginal sex or sharing needles, can also lead to the transmission of HIV.4 Although gay and bisexual men, and other men who have sex with men, are the most commonly affected by HIV, the next most commonly affected groups are African American heterosexual women, people who inject drugs, African American heterosexual men, white heterosexual women, and Hispanic or Latina heterosexual women.7
Myth: There is no way for an HIV-positive person to be with an HIV-negative person without transmitting HIV.
Fact: Any individual can decrease their risk of transmitting the virus, including between their sexual partners. The current standard of care for HIV in the United States is treatment with antiretroviral therapy (ART). ART involves using different medications that can prevent the multiplication of HIV within the body. These medications are intended to be used daily, and if used as directed, can help reduce an individual’s viral load. A viral load is a measure of how much HIV is in the body.8
Eventually, a person’s viral load can become “undetectable” meaning that the amount of HIV in the blood is so low, that the virus is not detected when tested. Recent research has suggested that those who achieve and maintain an undetectable viral load have virtually no risk of transmitting the virus to an HIV-negative partner. This idea has been referred to as “undetectable = untransmittable” or “U=U”. Therefore, the risk of HIV transmission to an HIV-negative partner can be reduced when an HIV-positive partner is on ART and taking their medications as prescribed.8,10
Regardless of whether or not an individual is “undetectable”, the risk of transmitting the virus can still be greatly reduced by using condoms and lubrication during sex to provide a barrier for bodily fluids and prevent tears, as well as using pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP). PrEP is a medication taken daily by an HIV-negative individual who is considered to regularly be at a higher risk of getting HIV (such as having an HIV-positive partner). Taking these medications daily can greatly reduce the risk of HIV transmission. PEP is similar to PrEP, in that it helps reduce the chances of HIV being spread, however, it is used after a potential exposure to the virus. PEP cannot be used long-term, and instead, should be used in emergencies only, such as after unprotected sex with an HIV-positive partner or when a condom breaks. If an individual is constantly at a higher risk of getting HIV, PrEP may be beneficial.11,12
Myth: Used needles can be hiding in public places and infect unsuspecting individuals.
Fact: As the opioid epidemic and injection drug use increasing in America, many have become concerned with potentially HIV-exposed needles hiding in everyday places, including parks, playgrounds, gas pumps, movie theater seats, bathrooms, and more. Some worry that they, or their children, will accidentally be stuck by a needle and get the virus. While needles may be in public places, the risk of getting HIV from an accidental needle stick is very low. Some estimates suggest that the risk is as low as 0.23 percent or less, and depends on how long ago the needle was used, the viral load of the person using the needle, how much blood is in the needle, and more. As of now, there have been no known cases of HIV transmission through an accidental needle stick in the community.13,14
Needle exchange programs are arising in many areas of the country to encourage those injecting drugs to used sterilized equipment, and dispose of used materials safely. These programs can help keep others in the community safe as well. Aside from these, the best practice in this situation is to be aware and safe. It’s important to teach children about the dangers of needles and to alert an adult if they see or get stuck with one. Immediate medical attention is needed if a needle stick occurs, and steps can be taken to greatly reduce the risk this transmission event. When needles are found in the community, it’s important to contact the police or other professional authorities to help with proper, safe disposal. It is not safe to try to discard a needle on your own, or throw away a needle in a nearby trashcan.
Myth: You can’t get HIV from oral sex.
Fact: Oral sex, also called fellatio, blowjob, giving head (when involving the penis), cunnilingus, eating out (when involving the vagina), anilingus, or rimming (when involving the anus), involves using the mouth to stimulate a partner’s genitals. Although low, there is a small risk of transmitting HIV during this act. The risk increases when sores are present in the mouth or on the genitals of one of the partners, blood (including menstrual blood) is present, when a male partner ejaculates into their partner’s mouth, or when another STI is present. Brushing your teeth before oral sex does not prevent the spread of HIV. Brushing or flossing before oral sex may actually cause bleeding or irritation, which could increase the risk of virus transmission. Chewing gum or using mouthwash before oral sex may be better options if desired.4,15,16