Chapter 6
Strategies for Prevention of Transmission of HIV

With over 1 million Americans infected with HIV, and an estimated 12 million cases of other sexually transmitted diseases each year in the U.S., effective strategies for preventing these diseases are critical. Practicing sexual abstinence or refraining from sexual intercourse with an infected partner are the best ways to prevent transmission of HIV and other STDs.

Practice Safe Sex

For those who choose to have sexual contact (vaginal, anal, or oral), latex condoms are highly effective when used consistently and correctly.

·         from start to finish each time

·         made only of latex or polyurethane

·         latex used only with a water-based lubricant

·         attention paid to package labeling (for documented effectiveness in preventing disease) and expiration dates

·         stored properly (away from heat, light, fluorescent light at room temperature)

·         caution with spermicides (sensitivity to these compounds may facilitate transmission)       

Seek Treatment Early If Infected with an STD

There is substantial biological evidence that the presence of other STDs increases the likelihood of both transmitting and acquiring HIV (especially if symptomatology includes genital ulcers or inflammation).

Do Not Share Injection Drug Use (IDU) Equipment

It is strongly urged that all individuals who use drugs seek treatment to help them stop. Individuals who continue to inject drugs should avoid sharing or reusing needles or syringes. If reuse is unavoidable, syringes should be decontaminated with pure bleach three times, then rinsed with water three times (by drawing up and flushing out).

Incorporating HIV Prevention in the Medical Care of Persons Living with HIV

Strategies targeted to persons who are aware of their HIV status by incorporating risk assessment and counseling in their clinical care encounters have been published (MMWR 2003 ;52 (No. RR-12).

·         Ask about continued risk behaviors such as unprotected sex or sharing of injection equipment in an open-ended and non-judgmental manner. 

·         Provide prevention education tailored to the patient’s risk and correct any misconceptions about transmission of HIV. 

·         Encourage measures such as abstinence, correct condom use, and disclosure of status to sexual partner. 

·         Injection drug users should be offered referral for substance abuse treatment or, if not willing to undergo treatment, educate on safe needle use and disposal.

·         Ask about the presence of symptoms or contact with partners with symptoms of STD’s.  Perform laboratory testing as appropriate.  Screen for syphilis at least annually, more often for patients with higher risk behaviors. 

·         Screen for pregnancy, ask about future plans for reproduction, and refer as appropriate for reproductive health services all women of child-bearing age.

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