Routes of Transmission

Parenteral transmission included needlestick injuries, bites, unscreened blood transfusions, tattooing, acupuncture, and dental procedures where equipment is inadequately sterilized. Risk of transmission is increased with deep penetrating injuries with hollow bore needles that are visibly bloodstained, especially when the device has previously been in the source patient's (contact) artery or vein.

Other routes include mucous membrane exposure (eyes, mouth, and genital mucous membranes) and contamination of broken skin.

The higher the viral load in the contact, the greater the risk of transmission. This is more likely at the terminal stage of infection. HIV is transmitted mainly through blood or other body fluids that are visibly blood stained, with the exception of semen, vaginal fluid, and breast milk. Saliva alone is most unlikely to transmit infection. Therefore, people who have sustained penetrating bite injuries can be reassured that they are not at risk, providing the contact was not bleeding from the mouth at the time.

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