Transmission

We and our family members can be exposed to HIV in the following three ways:

• Quicklinks to questions about HIV transmission

   
  

  • How is HIV transmitted?
  • Are you sure that these are the only ways that HIV can be transmitted?
  • Is it safe to work with people who are infected with HIV?
  • Is it safe to hire people who are HIV-positive to work in our homes?
  • More Information
   
  
  Unprotected sexual contact, primarily through unprotected vaginal or anal intercourse with an infected partner. Worldwide, sexual intercourse is the leading mode of HIV transmission. Oral sex is much less likely than vaginal or anal intercourse to result in the transmission of HIV. Women are more likely to contract HIV from men than vice versa. Among females, the risk is greatest for adolescent girls and young women, whose developing reproductive systems make them more likely to become infected if exposed to sexually transmitted infections (STIs), including HIV.

• Exposure to infected blood. The most efficient means of HIV transmission is the introduction of HIV-infected blood into the bloodstream, particularly through transfusion of infected blood. Most blood-to-blood transmission now occurs as a result of the use of contaminated injection equipment during injecting drug use. Use of improperly sterilized syringes and other medical equipment in health-care settings can also result in HIV transmission. We in the UN system are unlikely to become infected this way since the UN-system medical services take all the necessary precautions and use only new or sterilized equipment. Extra precautions should be taken, however, when on travel away from UN-approved medical facilities, as the UN cannot ensure the safety of blood supplies or injection equipment obtained elsewhere. It is always a good idea to avoid direct exposure to another person's blood-to avoid not only HIV but also hepatitis and other bloodborne infections.
• Transmission from a mother with HIV infection to her child, during pregnancy, during delivery or as a result of breastfeeding.

Yes. HIV/AIDS is the most carefully studied disease in history. Overwhelming evidence indicates that you cannot become infected in any of the following ways:

• Shaking hands, hugging or kissing
• Coughing or sneezing
• Using a public phone
• Visiting a hospital
• Opening a door
• Sharing food, eating or drinking utensils
• Using drinking fountains
• Using toilets or showers
• Using public swimming pools
• Getting a mosquito or insect bite
• Working, socializing, or living side by side with HIV-positive people

Yes. Because HIV cannot be transmitted as a result of casual contact, it is perfectly safe for an uninfected person to work with people living with HIV and with those who have progressed to AIDS. UN personnel policies strictly prohibit discrimination against employees living with HIV or AIDS. The United Nations HIV/AIDS Personnel Policy ensures a safe workplace while protecting the dignity and human rights of all employees.

Yes. Many of us in the UN have people working in our homes as cleaners, nannies, cooks, gardeners, security guards and drivers. We want to make sure that these people are not only well qualified to carry out their tasks, but that they present no health or other threat to our families, especially our children. When it comes to HIV, some of us may fear that employing people living with HIV may present a risk to our families.

After all, they spend a lot of time with us, cook for us and care for us. UN policy is very clear that HIV should not be a factor in determining whether we employ someone or not. Testing for HIV is not mandatory for employment and no one living with HIV is required to disclose her or his status. While this is the UN system employment policy, it would certainly be appropriate for UN staff members to follow the same policy in hiring household help, since this is also the standard encouraged by ILO for all employers worldwide.

While we certainly encourage voluntary confidential counselling and testing for all who may be affected, whether inside or outside the UN, the choice should be a personal one and not one imposed by any employer. And even if someone tests negative today, there is no guarantee that they will test negative in the future.

We recommend screening (but not HIV-testing) potential household employees to make sure that they are the most qualified and caring people possible. Once they are on the job, we need to be very clear about what we expect and then monitor their performance, just as we would inside the UN system. When it comes to our children, for example, we should make it very clear to a nanny that breastfeeding is not permitted, and give clear instructions about what to do in case of an emergency. It is also a good idea to either give HIV and AIDS information and education directly to our household help or to find out where this can be done locally and encourage our employees to learn about HIV and AIDS.

It is important to bear in mind that HIV is not easily transmitted. In the case of household employees, we assume that they will not be having sex with our family members, will not be sharing needles with them or giving them blood and will not be breastfeeding our children. These are the primary ways that HIV can be transmitted. Having our help around us, preparing our food, and hugging, kissing, feeding and playing with our children are perfectly safe.

We in the UN system should be setting an example of tolerance. We must not condone HIV-related stigma or discrimination in our professional or personal lives.

• For more information about transmission, visit Planned Parenthood.
• For information about mother-to-child transmission, visit Avert.org.