What is HIV?

Human Immunodeficiency Virus (HIV) is the virus that causes AIDS. It's only spread from people to people through body fluids. Once inside the body, the virus makes copies of it and kills CD4 white blood cells. These cells are an important part of the body's immune system. Over time, so many CD4 cells die that the immune system gets weak. HIV also causes chronic inflammation. Medication can help slow HIV's impact on CD4 count and can decrease damage caused by chronic inflammation.

What is AIDS?

Acquired Immune Deficiency Syndrome (AIDS) is a collection of illnesses people get due to HIV after their immune system is severely damaged. Some of these illnesses are called opportunistic infections. People with normal immune systems can also get some of these illnesses, but with HIV they at a much higher rate. It also takes longer for a person with HIV to recover. These illnesses occur as a sign of later-stage HIV disease called AIDS. A person with HIV can also be diagnosed with AIDS when their CD4 count falls to 200 or below. HIV antiretroviral drug therapy (ART) can delay the onset of AIDS for many years. We don't know yet, but it could be indefinitely.

How can I get HIV?

HIV can be found in body fluids including blood, semen, vaginal fluid, and breast milk

HIV is spread in 3 main ways:

Unprotected sex

Vaginal or anal sex without a condom is very unsafe with a person who has HIV or an STD, even when they don't know it. During sex, HIV in semen or in vaginal fluid can enter the other partner's body through the soft lining inside the anus or vagina. If one person has an STD, HIV is even more likely to be transmitted. Although HIV is more likely to enter through the vagina or the anus, it can also enter the penis.

HIV risk from oral sex is low, but there are known cases. It is possible to get HIV when giving oral sex if you have any cuts or openings in your mouth or gums, for example after brushing or flossing or if you have an open sore. Other STDs, like syphilis, chlamydia, and gonorrhea, are easily transmitted during oral sex.

Sharing items to inject drugs

Blood is the body fluid that most easily transmits HIV. Any needle, syringe, cooker, or cotton can have blood in it after it has been used. Blood may also stay in the water or other liquid used to mix or divide drugs. If any of these items are shared, this blood can enter the body of the next user. If needles for body piercing or tattooing are shared, there is also risk of passing HIV.

From an infected mother to her infant

An HIV-infected mother can pass HIV to her baby during pregnancy or birth from occur blood transmission, during breast-feeding, or in some cases by sharing chewed food. If the mother is taking HIV medications, the risk to the fetus or baby is much smaller.

Getting HIV from a medical procedure is very rare.

You cannot get HIV from:

Sweat, saliva (spit), tears, urine, or mucous
Hugging, touching, kissing
Coughing or sneezing
Mosquito bites don't
Sharing household items except razors and toothbrushes*
Toilets, swimming pools, or hot tubs
Donating blood
Public Health does not recommend sharing razors or toothbrushes because of possible blood transmission.

How can I stay safer if I have sex?

There is no risk for HIV from:

  • abstinence (not having sex)
  • sex with just one partner who:
    • is not infected and
    • never unprotected sex or shares needles with anyone else (and you don't either)
  • masturbation or hand jobs (where you keep your fluids to yourself)
  • non-sexual massage or touch

Most other sexual activity carries some risk of spreading HIV. Talk with your partner(s) about HIV and other STDs before you have sex. Agree with your partner on things you will do and won't do. You can both get tested for STDs to know you are in the clear or get treated if you are not. To reduce your sexual risks, don't let blood or sexual fluids get into your body. Be aware, withdrawal or pulling out before ejaculating or cumming will not prevent HIV or other STDs.

Here are some risk reduction techniques you can use to decrease your risk of getting HIV:

  • Be aware of your body and your partner's. Cuts, sores, other STDs, or bleeding gums increase the risk of spreading HIV. Rougher sex can cause bleeding or small tears that give HIV an easier way to get into the body.

  • Always use a safety barrier. For vaginal and anal sex, use a latex, polyurethane, or polyisoprene male condom or female condom. Condoms are also recommended if sharing sex toys. Pieces of latex or plastic wrap over the vagina or anus called dental dams, or latex condoms over the penis, are good barriers during oral sex. There are flavored condoms for this purpose. Even if you are HIV positive and your partners are too, it is safest to use condoms to prevent the spread of STDs like syphilis. 

  • Here is a video demonstrating the use of dental dams and how to make one out of a condom:


  • Lubricants reduce the chance that condoms or other barriers will break. Don't use oil-based lubricants (Vaseline, Crisco, oils, or creams). They damage latex condoms. Only use water-based or silicone-based lubricants.

  • Have sex with fewer people. More partners = more risk!

  • Get tested and treated for STDs. If you have an STD, it is easier to get HIV from an infected partner. And if you have HIV, it is easier to get STDs. Insist that your partners get tested and treated for STDs too.

  • Serosorting is when a person chooses a sexual partner known to be of the same HIV status. This can be a helpful strategy when both people know they are positive. But for people who are negative (or think they are negative), it's risky. One may have become infected since his or her last negative test result and not know it yet. 

  • PEP is short for Post Exposure Prophylaxis. It is when a person who does not have HIV takes HIV medications to prevent infection after a possible exposure. PEP should be started within the first 48 hours -- but no later than 72 hours -- after exposure. Obtain medical treatment IMMEDIATELY if you think you were exposed to HIV. 

  • PrEP or Pre Exposure Prophylaxis may become part of comprehensive HIV prevention services. With PrEP, people who are HIV negative take antiretroviral medication daily to lower their chances of becoming infected with HIV if they are exposed to it.

Male circumcision has been shown to reduce the risk of HIV transmission from women to men in Africa. However, there's no clear benefit for men who have sex with men. No one is recommending circumcision as a way to prevent HIV for U.S. adult males at this time.

Birth control methods (the IUD, pill, patch, ring, or shot) do not protect you from HIV!

What is the situation of HIV in Nepal?

The infection rate of HIV/AIDS in Nepal among the adult population is estimated to be below the 1 percent threshold which is considered "generalized and severe". However, the prevalence rate masks a concentrated epidemic among at-risk populations such as female sex workers (FSWs), injecting drug users (IDUs), men who have sex with men (MSM), and migrants. Cultural factors have also been shown to play a significant role in the spread of HIV and AIDS in Nepal. Since Nepal's first cases of HIV/AIDS were reported in 1988, the disease has primarily been transmitted by injecting drug use and unprotected sex. Available data indicate that there was a sharp increase in the number of new infections starting in 1996, coinciding with the outbreak of civil unrest. However, the incidence appears to be leveling off with recent evidence of reduced prevalence and lower overall numbers

As of December 2007, the Government of Nepal reported 1,610 cases of AIDS and 10,546 HIV infections, which has grown to 13,000 infections by World AIDS Day 2008. UNAIDS estimates from 2007 indicate that approximately 75,000 people in Nepal are HIV-positive, including all age groups.Nepal's 1.5 million to 2 million labor migrants account for the majority of Nepal’s HIV-positive population.

The UNICEF report, "Increasing Vulnerability of Children in Nepal", estimates the number of children orphaned by HIV/AIDS to be more than 13,000. The national estimate of children 0 to 14 years of age infected by HIV is 2,500 (2007).