In the 1980s, human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) became an epidemic. Now 40 years later, HIV is still an issue. With sexual trends continuing to change in the United States, younger generations are more at risk. Two Roche Diagnostic HIV experts, Tamar Tchelidze, M.D., MPH, disease area partner, and Benjamin LaBrot, M.D., global medical affairs manager, debunk 13 myths around HIV.
There are over 36,000 new HIV infections in the U.S. every year and over 18,000 deaths. In 2020, almost 60% of all new diagnoses occurred in people ages 13 to 34 – and nearly 40% of new diagnoses were in people ages 25 to 34. As young people increasingly engage in less protected sexual activity and more risky sexual practices, HIV heavily impacts them. HIV is still very much with us – it has become a forgotten disease, but the disease has not forgotten us.
Absolutely not. With the current antiretroviral treatment, most people do not get AIDS. They live long, healthy lives.
There are many ways to prevent HIV. Not engaging in vaginal or anal sex, not sharing needles when injecting drugs, practicing safer sex with condoms, finger cots and dental dams, and using Pre-Exposure Prophylaxis, known as PrEP all help in preventing the spread of HIV. If taken when HIV-free, Pre-Exposure Prophylaxis – a medication in the form of pills or injections – significantly reduces the chance of getting HIV from sex or injection drug use.
Anyone can get HIV. In 2020, almost a quarter of all new HIV infections occurred through heterosexual encounters. While the disease is currently more prevalent among men who have sex with men, anyone who has sex is at risk of HIV. Newer sexual trends may place straight people more at risk as anal sex – a riskier form of sex for HIV transmission – has gained popularity.
Heterosexual anal intercourse (HAI) has become more typical, with more than 3 in 10 people reporting having HAI. A survey question from the Centers for Disease Control's National Survey of Family Growth showed that about 38% of women said they had anal sex with a different sexual partner in 2017 to 2019, compared to 33% in 2015 to 2017. Men stayed consistent at about 38%.
Women ages 25 to 29 reported in 2015 to be the population most actively engaging in anal receptive sex in the past month, according to the most recent data available from the 2015 Sexual Exploration in America Study survey.
Although the risk of getting HIV from oral sex is extremely low, you absolutely can get HIV from vaginal sex. About 7,000 women in the U.S. get infected with HIV annually, many from unprotected vaginal intercourse.
With the exception of condoms, most birth control methods such as oral contraceptives and IUDs prevent only pregnancy, not HIV or other sexually transmitted infections. Pre-Exposure Prophylaxis, known as PrEP, is the best HIV prevention option currently available, offering over 95% protection. Condoms, and to a lesser extent finger cots and dental dams, also help prevent the spread of HIV but aren't as effective as PrEP.
However someone identifies, anyone who has unprotected vaginal or anal sex absolutely can contract HIV and a slew of other diseases as well, including hepatitis, gonorrhea, syphilis and even Zika. Injecting drugs and sharing needles add even more risk.
Those who have unprotected sex are at high risk – similar to risks for other sexually transmitted diseases – and having receptive anal sex is the riskiest type of sex for getting or transmitting HIV.
Even when you trust your partner, getting routine HIV testing can assure you are both disease free.
Current studies of American couples indicate that 20% to 40% of straight married men and 20% to 25% of straight married women will also have an extramarital affair during their lifetime, and polyamorous individuals have amplified risk. It is important to be able to trust your partner or partners, but also important not to forget about human nature.
There are many ways to prevent HIV. Some include taking a daily oral medication, but many others include long-acting injections and avoiding high-risk activities such as unprotected vaginal or anal sex or sharing needles. New protection options are constantly developing, including twice-yearly injections, patches and other ideas to make it easier and more convenient.
This is a common misconception. There are many different strains of HIV, and some respond better to treatment than others. In fact, many strains now are showing more resistance to the drugs we rely on to treat HIV. A person with HIV can contract additional, more severe strains of HIV from another infected person.
No, this is an urban legend. There are many diseases that mosquitoes can transmit, but thankfully HIV is not one of them.
No, this is a common myth about HIV, but HIV transmission requires direct contact between two peoples' bodily fluids. You simply cannot contract it from a toilet seat or swimming pool, and to date, there are no known cases where sharing utensils (or even spitting in someone's mouth) resulted in contracting HIV, as HIV does not live well in saliva. HIV in the U.S. is transmitted almost exclusively through unprotected anal and vaginal sex and sharing needles when injecting drugs.
Disclaimer: This content is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or another qualified health provider regarding a medical condition.
Tamar Tchelidze, M.D., MPH, is a disease area partner at Roche Diagnostics. She has over 20 years of experience in global health, managing change and transformation with demonstrated agility in academic, private and government environments. Before joining Roche, Tchelidze was the lead liaison for a PrEP Project, designed to review, discuss and recommend strategies that would allow less resource-intensive clinical trial options to approve new PrEP interventions while maintaining scientific rigor.
Benjamin LaBrot, M.D., is a global medical affairs manager for infection and immunity (HIV and HXV) at Roche Molecular Diagnostic. He is a primary care physician who attended the Royal College of Surgeons, Ireland and worked as a hospitalist until founding the Floating Doctors humanitarian medical aid organization in 2009, subsequently practicing for over 10 years in remote, rural underserved settings in Haiti, Honduras and Panama. LaBrot is also a clinical professor teaching Palliative Care, Malaria and International Aid Work at USC Keck School of Medicine.