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Do not fill this in! === Sexual === <!--Overview --> The most frequent mode of transmission of HIV is through sexual contact with an infected person.<ref name=TransmissionM2007/> However, an HIV-positive person who has an undetectable viral load as a result of long-term treatment has effectively no risk of transmitting HIV sexually.<ref name="CDCUndetectable" /><ref name="Risk of sexual transmission of huma"/> The existence of functionally noncontagious HIV-positive people on antiretroviral therapy was controversially publicized in the 2008 [[Swiss Statement]], and has since become accepted as medically sound.<ref>{{cite journal |last1=Vernazza |first1=P |last2=Bernard |first2=EJ |title=HIV is not transmitted under fully suppressive therapy: The Swiss Statement β eight years later |journal=Swiss Medical Weekly |date=January 29, 2016 |volume=146 |pages=w14246 |doi=10.4414/smw.2016.14246|pmid=26824882 |doi-access=free }}</ref> Globally, the most common mode of HIV transmission is via [[Heterosexuality|sexual contacts between people of the opposite sex]];<ref name=TransmissionM2007/> however, the pattern of transmission varies among countries. {{As of|2017}}, most HIV transmission in the United States occurred among [[men who had sex with men]] (82% of new HIV diagnoses among males aged 13 and older and 70% of total new diagnoses).<ref>{{cite web |title=HIV and Men |url=https://www.cdc.gov/hiv/group/gender/men/index.html |website=U.S. [[Centers for Disease Control and Prevention]] (CDC) |access-date=November 3, 2019 |archive-url=https://web.archive.org/web/20191201111721/https://www.cdc.gov/hiv/group/gender/men/index.html |archive-date=December 1, 2019 |url-status=live }}</ref><ref>{{cite web |title=HIV and Gay and Bisexual Men |url=https://www.cdc.gov/hiv/group/msm/index.html |website=U.S. [[Centers for Disease Control and Prevention]] (CDC) |access-date=November 3, 2019 |archive-url=https://web.archive.org/web/20191102163544/https://www.cdc.gov/hiv/group/msm/index.html |archive-date=November 2, 2019 |url-status=live }}</ref> In the US, gay and bisexual men aged 13 to 24 accounted for an estimated 92% of new HIV diagnoses among all men in their age group and 27% of new diagnoses among all gay and bisexual men.<ref name=CDC2016Bi>{{cite web |title=HIV Among Gay and Bisexual Men |url=https://www.cdc.gov/hiv/pdf/group/msm/cdc-hiv-msm.pdf |access-date=January 1, 2017 |url-status=live |archive-url=https://web.archive.org/web/20161218225712/https://www.cdc.gov/hiv/pdf/group/msm/cdc-hiv-msm.pdf |archive-date=December 18, 2016 }}</ref> <!--Per act risk --> With regard to [[unprotected sex|unprotected]] heterosexual contacts, estimates of the risk of HIV transmission per sexual act appear to be four to ten times higher in low-income countries than in high-income countries.<ref name=Boily2009/> In low-income countries, the risk of female-to-male transmission is estimated as 0.38% per act, and of male-to-female transmission as 0.30% per act; the equivalent estimates for high-income countries are 0.04% per act for female-to-male transmission, and 0.08% per act for male-to-female transmission.<ref name=Boily2009/> The risk of transmission from anal intercourse is especially high, estimated as 1.4β1.7% per act in both heterosexual and homosexual contacts.<ref name=Boily2009/><ref>{{cite journal |vauthors=Beyrer C, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, Brookmeyer R |title=Global epidemiology of HIV infection in men who have sex with men |journal=The Lancet |volume=380 |issue=9839 |pages=367β77 |date=July 2012 |pmid=22819660 |doi=10.1016/S0140-6736(12)60821-6 |pmc=3805037}}</ref> While the risk of transmission from [[oral sex]] is relatively low, it is still present.<ref>{{cite journal |vauthors=Yu M, Vajdy M |title=Mucosal HIV transmission and vaccination strategies through oral compared with vaginal and rectal routes |journal=[[Expert Opinion on Biological Therapy]] |volume=10 |issue=8 |pages=1181β95 |date=August 2010 |pmid=20624114 |pmc=2904634 |doi=10.1517/14712598.2010.496776}}</ref> The risk from receiving oral sex has been described as "nearly nil";<ref>{{cite book |last=StΓΌrchler |first=Dieter A. |title=Exposure a guide to sources of infections |year=2006 |publisher=ASM Press |location=Washington, DC |isbn=978-1-55581-376-5 |page=544 |url=https://books.google.com/books?id=MWa5or3Xa9EC&pg=PA544 |access-date=June 27, 2015 |archive-url=https://web.archive.org/web/20151130024240/https://books.google.com/books?id=MWa5or3Xa9EC&pg=PA544 |archive-date=November 30, 2015 |url-status=live }}</ref> however, a few cases have been reported.<ref>{{cite book |veditors=Pattman R, etal |title=Oxford handbook of genitourinary medicine, HIV, and sexual health |year=2010 |publisher=[[Oxford University Press]] |location=Oxford |isbn=978-0-19-957166-6 |page=95 |edition=2nd}}</ref> The per-act risk is estimated at 0β0.04% for receptive oral intercourse.<ref name=Dosekun2010>{{cite journal |vauthors=Dosekun O, Fox J |title=An overview of the relative risks of different sexual behaviours on HIV transmission |journal=[[Current Opinion in HIV and AIDS]] |volume=5 |issue=4 |pages=291β97 |date=July 2010 |pmid=20543603 |doi=10.1097/COH.0b013e32833a88a3|s2cid=25541753 }}</ref> In settings involving [[prostitution]] in low-income countries, risk of female-to-male transmission has been estimated as 2.4% per act, and of male-to-female transmission as 0.05% per act.<ref name=Boily2009>{{cite journal |vauthors=Boily MC, Baggaley RF, Wang L, Masse B, White RG, Hayes RJ, Alary M |title=Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies |journal=The Lancet. Infectious Diseases |volume=9 |issue=2 |pages=118β29 |date=February 2009 |pmid=19179227 |pmc=4467783 |doi=10.1016/S1473-3099(09)70021-0}}</ref> <!--Factors that increase the risk --> Risk of transmission increases in the presence of many [[sexually transmitted infection]]s<ref name=CochraneSTI2012>{{cite journal |vauthors=Ng BE, Butler LM, Horvath T, Rutherford GW |title=Population-based biomedical sexually transmitted infection control interventions for reducing HIV infection |journal=[[The Cochrane Database of Systematic Reviews]] |issue=3 |page=CD001220 |date=March 2011 |pmid=21412869 |doi=10.1002/14651858.CD001220.pub3 |editor1-last=Butler |editor1-first=Lisa M}}</ref> and [[genital ulcer]]s.<ref name=Boily2009/> Genital ulcers appear to increase the risk approximately fivefold.<ref name=Boily2009/> Other sexually transmitted infections, such as [[gonorrhea]], [[Chlamydia infection|chlamydia]], [[trichomoniasis]], and [[bacterial vaginosis]], are associated with somewhat smaller increases in risk of transmission.<ref name=Dosekun2010/> The [[viral load]] of an infected person is an important risk factor in both sexual and mother-to-child transmission.<ref>{{cite journal |vauthors=Anderson J |title=Women and HIV: motherhood and more |journal=Current Opinion in Infectious Diseases |volume=25 |issue=1 |pages=58β65 |date=February 2012 |pmid=22156896 |doi=10.1097/QCO.0b013e32834ef514|s2cid=6198083 }}</ref> During the first 2.5 months of an HIV infection a person's infectiousness is twelve times higher due to the high viral load associated with acute HIV.<ref name=Dosekun2010/> If the person is in the late stages of infection, rates of transmission are approximately eightfold greater.<ref name=Boily2009/> Commercial sex workers (including [[Sexually transmitted infections in the pornography industry|those in pornography]]) have an increased likelihood of contracting HIV.<ref>{{cite book |url=https://books.google.com/books?id=f60h4OyZu_QC&pg=PA1 |title=The Global HIV Epidemics among Sex Workers |last=Kerrigan |first=Deanna |publisher=World Bank Publications |year=2012 |isbn=978-0-8213-9775-6 |pages=1β5 |access-date=June 27, 2015 |archive-url=https://web.archive.org/web/20150919020557/https://books.google.com/books?id=f60h4OyZu_QC&pg=PA1 |archive-date=September 19, 2015 |url-status=live }}</ref><ref>{{cite book |last=Aral |first=Sevgi |title=The New Public Health and STD/HIV Prevention: Personal, Public and Health Systems Approaches |year=2013 |publisher=Springer |isbn=978-1-4614-4526-5 |page=120 |url=https://books.google.com/books?id=eBbQ5QuqL9IC&pg=PA120 |access-date=June 27, 2015 |archive-url=https://web.archive.org/web/20150924071934/https://books.google.com/books?id=eBbQ5QuqL9IC&pg=PA120 |archive-date=September 24, 2015 |url-status=live }}</ref> Rough sex can be a factor associated with an increased risk of transmission.<ref>{{cite journal |vauthors=Klimas N, Koneru AO, Fletcher MA |title=Overview of HIV |journal=Psychosomatic Medicine |volume=70 |issue=5 |pages=523β30 |date=June 2008 |pmid=18541903 |doi=10.1097/PSY.0b013e31817ae69f|s2cid=38476611 }}</ref> [[Sexual assault]] is also believed to carry an increased risk of HIV transmission as condoms are rarely worn, physical trauma to the vagina or rectum is likely, and there may be a greater risk of concurrent sexually transmitted infections.<ref>{{cite journal |vauthors=Draughon JE, Sheridan DJ |title=Nonoccupational postexposure prophylaxis following sexual assault in industrialized low-HIV-prevalence countries: a review |journal=Psychology, Health & Medicine |volume=17 |issue=2 |pages=235β54 |year=2012 |pmid=22372741 |doi=10.1080/13548506.2011.579984|s2cid=205771853 }}</ref> Summary: Please note that all contributions to Christianpedia may be edited, altered, or removed by other contributors. 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