Page 290 - AIDSBK23C

Page 290

Table 2 - Behavioral Risks for HIV Infection

Sexual Intercourse: The following are associated with greater risk for HIV infection for both
men and women, if one or both partners, either male or female, are infected:

Practices that result in lacerations, tears, or denudation of penile, vaginal, rectal, or oral epithelia
Increasing the number of sexual partners
Presence of genital, rectal, or oral ulcers from other sexually transmitted diseases
Not wearing a condom
Being under the influence of alcohol or drugs which impair judgment and decision-making
Engaging in sexual intercourse with a person whose stage of HIV infection is primary or advanced
More specific risks for a particular style of intercourse include:

Vaginal Intercourse:

Lack of circumcision in the male
Cervical ectopy
Oral contraceptive use
Pregnancy
Menstrual bleeding

Anal Intercourse:

Receptive anal intercourse > insertive anal intercourse, though either style is a risk
Use of douches or lubricants

Oral Intercourse

Presence of oral mucosal lesions
Use of cocaine (e.g., "crack pipes")

Lesbian Intercourse

Inclusion of male partners in sexual activities
Practices (e.g., mutual use of dildos) that allow exchange of blood or vaginal fluid

Blood Exposure: Any practice that allows for exchange of HIV-infected blood from one person
to another, regardless of age, sex, race, or state of health, represents a risk for HIV exposure:

Injection drug use with sharing of needles or other "works"
Use of needles "cleaned" with a disinfectant other than bleach
Tattooing with sharing of devices (e.g., needles) used
Blood rituals (e.g., "blood brothers") with commingling of blood
Transfusion with inadequately screened or tested blood or blood products

Congenital Exposure: The fetus or infant of a mother who is infected with HIV is at risk for
acquiring HIV infection, but this risk is increased with:

Maternal elevated CD8+ lymphocyte count
Maternal decreased CD4+ lymphocyte percentage
Maternal chorioamnionitis or funisitis
Persistent maternal fever
Breast feeding of the infant