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What are the risk factors for HIV infection?

There are many ways in which you can be at risk of contracting HIV. And while all it takes is transmission from a single contact, the more often you have contact with fluids which contain the HI-virus, the higher your risk of infection.

The most common risky practices include:

• Anal sex without a condom: men who have sex with men are at the greatest risk of HIV infection.
• Vaginal or anal sex between men and women without protection.
• Sex with many partners, thereby increasing the chance of encountering a partner who is HIV infected.
• Sharing needles (for example for intravenous drug use, tattooing or body piercing).
• Those with another STI, especially STIs that cause open sores or ulcers such as herpes, chancroid or syphilis.
• Haemophiliacs and those who frequently receive blood products in countries that do not screen for HIV (Australia does screen all blood donations).

Other ways in which HIV can be spread include:

• Mother-to-child-transmission if the mother has HIV – this can affect the child during pregnancy, birth, or via breastfeeding.
• Oral sex without protection with an HIV+ person.
• Exposure to HIV positive blood.

HIV in Australia is most commonly spread by sexual intercourse without a condom and through sharing of needles, syringes and other injecting equipment.

When to call a health professional
If you suspect you have been exposed to HIV contact your doctor or local clinic as soon as possible. They will likely suggest you take a treatment called post-exposure prophylaxis (PEP) for HIV. This is a course of drugs generally taken for a month which may prevent you becoming infected with HIV - if you begin treatment within three days of exposure to HIV.

A health care professional should be seen if:

• You have been at risk of HIV infection (for example through unprotected sex, rape or sharing of needles). Anti-HIV drugs taken within hours of exposure to HIV can decrease the risk of contracting the virus.
• Your sexual partners engage in high-risk behaviour or are known to be HIV positive.
• You are pregnant or plan to have a child.
• Any of the symptoms listed above are present.
• An HIV-positive person develops shortness of breath, convulsions, weakness in a limb or one side of the body, or loses consciousness (they should receive emergency care).

Visit preparation
Making the decision to go for an HIV test should be an individual choice and should be done with informed consent. Be prepared for the test with enough information and counselling as necessary on what the test involves and the implications of the results.

A result which shows you are indeed HIV+ can have a huge psychological impact and, while early detection and treatment is key to living as long and as healthy a life as possible with the virus, if you are overwhelmed by the results you should seek immediate psychological assistance.

In most parts of Australia anyone who requests an HIV test must, by law, receive pre- and post-test counselling which is given by a doctor, or someone who has completed an approved training course.

• Testing should be voluntary.
• Information should be provided about what is involved in the test.
• Information must include what it means to be tested.
• Test results are only given to people in a face-to-face setting during post-test counselling.

If the test is positive, you have the following options available:

• Have further tests to discover how far the HIV infection has progressed.
• Begin treatments that can slow the progress of HIV infection and reduce the chances of developing Aids.
• Make lifestyle changes (diet, exercise, stress, smoking, drug use) to improve overall health. • Make informed decisions about relationships, pregnancy, career etc.
• Ensure decisions do not put others at risk of HIV infection. For those who are not infected, pre- and post-HIV test counselling is important to help people make changes to their sexual or drug-use practices to ensure they stay uninfected.
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