Am I At Risk of Getting HIV?

A Practical Guide to Identifying and Mitigating HIV Risk

Credit: Vetta/Getty Images

When trying to determine whether you, as an individual, are at risk of HIV, it's important to understand the four conditions that must be satisfied in order for an HIV infection to take place:

  1. There must be body fluids in which HIV can thrive, such as semen, blood, vaginal fluids or breast milk. HIV cannot thrive in the open air or in parts of the body with high acid content (such as the stomach or bladder).
  1. There must be a route of transmission, such as through certain sexual activities, shared needles, occupational exposure, or transmission from mother to child.
  2. There must be a means for the virus to reach vulnerable cells inside your body, either through a rupture or penetration of the skin, absorption through mucosal tissues, or both. HIV cannot penetrate intact skin.
  3. There must be sufficient levels of virus in the body fluids, which is why saliva, sweat, and tears are unlikely sources since the level of virus in these fluids is considered insufficient for infection.

Once you establish that these conditions must take place for an infection to occur, you can then start to identify the factors that either increase or decrease your personal risk for HIV.

Do You Perceive Yourself to be At Risk?

When assessing risk, it's important to consider what your perceived risk of HIV may be. A perceived risk is simply your belief as to how vulnerable you are as an individual, whether it be to HIV or any other potential risk.

Oftentimes we see certain groups as being more "at risk" for HIV than those we personally identify with, based either on age, ethnicity, sexual orientation, income, education or any number of other social factors.

The problem is that perception can sometimes place people at even greater risk of infection, none more so than with young adults and teen.

In a study conducted by the HIV/AIDS Research & Policy Institute at Chicago State University, 58% of college students under the age of 20 believed that they were at absolutely no risk for HIV infection. This correlated to only 54% reporting consistent condom use, with 54% stating that they had multiple sexual partners over a period of three months.

Similarly, older adults and seniors generally consider themselves at low risk for exposure, despite the availability of erectile dysfunction drugs like Viagra and Cialis. As a result, adults over 50 make up nearly 20% of new HIV diagnoses in the U.S. each and every year.

Even in groups with high prevalence rates—such as men who have sex with men (MSM)—perceptions about advances in antiretroviral therapy (i.e., increased life expectancy, effectiveness of post-exposure prophylaxis) have led to an associative reduction in condom use.

Understanding the Modes of HIV Transmission

The mode of transmission (also known as "exposure type") is the route by which HIV enters the body and causes infection.The predominant modes of HIV transmission are:

Modes of transmission can range from "high risk" to "negligible risk" to anywhere in between.

Generally speaking, unprotected receptive anal and vaginal sex, as well as shared unclean needles, are considered the highest risk activities for HIV infection.

While statistically less risky, unprotected insertive anal and vaginal sex, as well as untreated HIV during pregnancy, still offer a significant potential for transmission. By contrast, unprotected oral sex and occupational needlestick injuries are both said to offer a potential for HIV infection, while blood transfusions and sex with condoms are considered to have minimal to negligible risk.

However, when assessing transmission risk, it's important to understand the co-factors that can increase or decrease the potential for infection, either by allowing easier entry into vulnerable tissue or exposing the body to greater amounts of HIV.

For example, while the risk of HIV from oral sex may be considered low on paper, an ulcerative sore from an STD like syphilis can increase the transmission potential by offering the virus a more direct route into the body. And if the infected partner also has a high viral load, the risk increases even further.

So What Does This To Me?

Ultimately, assessing risk is based an honest evaluation of your personal vulnerabilities to HIV—whether it be your perception of risk; the practices that can place you at increased risk; or your understanding as to what constitutes high and low risk behaviors

In the end, HIV prevention is not so much a set of rules as it is a process, one that can only benefit for the support of others such as family, friends or trained health professionals. If in need of support or referrals, contact your regional 24-hour AIDS hotline or visit your nearest community health center.


Adefuye, A.; Abiona, T.; Balogun, A. et al. "HIV sexual risk behaviors and perception of risk among college students: implications for planning interventions." BMC Public Health. 2009; 9:281.

U.S. Centers for Disease Control and Prevention (CDC). HIV/AIDS Surveillance Report, 2011. Atlanta: U.S. Department of Health and Human Services; June 2012; Volume 23.

Belcher, L.; Sternberg, M.; Wolitsky, R., et al. "Condom Use and Perceived Risk of HIV Transmission Among Sexually Active HIV-Positive Men Who Have Sex With Men." AIDS Education and Prevention. 2005; 17(1):79-89.

Thornton, R. "The Demand for, and Impact of, Learning HIV Status." American Economic Review. December 1, 2008; 98(5):1829-1863.

Continue Reading