Hi, my name is [PRESENTER NAME]. IÕm [PRESENTER ROLE]. Welcome to ÒIntroduction to HIV and AIDS: What You Need to Know.Ó This video will teach you information that can save your life, so please listen carefully and watch the whole video.


YouÕve probably heard of the disease HIV/AIDS and know that HIV/AIDS can severely affect your life and even kill you. But what can you do to reduce your risk of contracting HIV, the virus that causes AIDS? If you follow the instructions in this video, you can reduce or eliminate your risk of contracting HIV, saving your life, the life of any current or future sexual partner, and if you are a woman, the lives of any future children.


AIDS stands for Acquired Immunodeficiency Syndrome. It is a disease caused by the Human Immunodeficiency Virus (HIV). When a person becomes infected with HIV, the virus begins attacking the personÕs immune system, specifically their white blood cells called T cells or CD4 cells. Initially, and sometimes for many years, the person may show no symptoms of being ill at all. They may appear perfectly healthy. You cannot tell whether a person has HIV by looking at them. A person can be infected with HIV and not even know it. It can take up to six months after being infected with HIV for ordinary tests to show that you are HIV positive. After a person has contracted HIV, even before they test positive, itÕs possible for them to pass on the infection to others.


The uninfected individual has about 800 to 1000 T cells. (Remember that these are the immune fighting cells.) If HIV does enough damage to the personÕs immune system, the personÕs T cells will fall to a dangerously low level.  A personÕs diagnosis changes from HIV positive to AIDS when either their T cells fall below 200 or they develop an infection that takes advantage of their weakened immune system, called an opportunistic infection.  


T cells are one of the bodyÕs defense mechanisms against infection by bacteria, viruses, fungi, and parasites. So when a personÕs T cell count falls too low, they become vulnerable to infections that a healthy personÕs immune system would fight off. This is why people with end stage AIDS are often sick. They are more vulnerable to tuberculosis, pneumonia, and many other diseases and may die as a result of these other infections. And thatÕs why we call the disease AIDS: as a result of contracting the virus HIV, the person has acquired an immune deficiency.


So you know that the virus called HIV causes the disease known as AIDS, and that AIDS can severely affect or even kill you. How does HIV spread?


Fortunately, HIV does not spread easily. You canÕt catch it by shaking a personÕs hand. It canÕt be spread by a sneeze or a cough, or even by light kissing. So you donÕt need to worry about catching HIV if you have friends, family members, or coworkers with AIDS.


HIV is present in an infected personÕs blood, an infected manÕs ejaculation fluid called semen, an infected womanÕs vaginal fluids, and breast milk. HIV is not found in significant quantities in tears, sweat, or saliva. HIV spreads when one personÕs body fluids come in direct contact with another personÕs mucous membranes.  Examples of mucous membranes include the eyes, nose, mouth, and genitals. Less commonly, HIV can also spread when one personÕs body fluids come in contact with a break in another personÕs skin. Though there are other means of transmission, there are four primary ways that HIV can spread from one person to another. They are sexual contact, sharing of needles by injection drug users, mother to child transmission during pregnancy or through breast milk, and receiving infected blood during a blood transfusion. There have also been cases of accidental exposure to HIV positive blood of health care workers. LetÕs talk about each of the primary transmission methods.


Sexual contact. This is by far the most common way that HIV spreads. HIV is present in the semen of an infected man and in the vaginal fluids of an infected woman. When two people have sex and exchange body fluids, HIV may spread from one partner to the other.  Anal sex is riskier than vaginal sex because the anal tissue is more prone to tearing during sex than the vaginal tissue.  HIV is also transmitted through oral sex, though it is much less common.  However, if you contract HIV through oral sex, transmission is 100% for you.  Additionally, women who have sex with women who are HIV positive are also at risk of becoming infected through vaginal secretions, though it is much less common.  Whether you have sex with men or women, the more sexual partners you have, the greater your risk of contracting HIV.


What about sharing of needles by injection drug users? HIV is present in the blood of an infected person. If a person with HIV uses a needle to inject a drug, some of their blood gets in and on the needle. If another person uses that same dirty needle, the other person may contract HIV as a result.  If you inject drugs, the best way to avoid contracting HIV is to use your own needles and not share them.


What about mother to child transmission? If a pregnant woman has HIV, she places the unborn child at risk for infection, most commonly while passing through the birth canal, when the mucous membranes of the infant come in contact with the motherÕs infected vaginal secretion.  After birth, if the child breastfeeds, they may become HIV positive through infected breast milk. A woman can reduce the risk of transmitting HIV to her baby by using antiretroviral drugs under a doctorÕs direction.


What about receiving a transfusion of blood infected with HIV? Early on during the HIV /AIDS epidemic, some people contracted HIV as a result of receiving blood transfusions from infected people. Today in the United States and most developed nations, blood donors are screened for HIV risk factors, and all donated blood is tested for HIV, so the risk of contracting HIV via a blood transfusion is extremely low. ItÕs also important to realize that you cannot contract HIV by giving blood, only by receiving it.


So the virus HIV causes the disease known as AIDS, and it can spread via sex, needle sharing, mother to child, or blood transfusion. But what can you do to reduce or eliminate your risk of contracting HIV?


Sexual contact is the most common way HIV spreads. To reduce your risk of contracting HIV through sexual contact, remember your ABCs: Abstain from sex before marriage, Be faithful to a single partner if you are sexually active, and use a latex Condom every time you have sex. Of course, if you live in a culture where you do not have equal rights, you may not be able to follow these guidelines. LetÕs talk about each of these things as they are very important.


Abstinence from sex until marriage to an uninfected spouse, and being mutually faithful with your spouse after marriage, is the only way to guarantee that you will not contract HIV through sexual activity. If you and your spouse wait to have sex until you are married, you are faithful to each other, and neither of you use injection drugs, then you will not contract HIV through sexual activity.


If you choose to have sex before marriage, it creates a risk that you will contract HIV. But there are a number of things you can do to greatly reduce your risk.


If you choose to have sex before marriage, make sure that both you and your partner know your HIV status. Do not assume that you donÕt have HIV, and donÕt assume that your partner doesnÕt have HIV. Anyone who has been sexually active may have been exposed to HIV. A simple, quick blood test or oral sample where they take a swab of the inside of your mouth, can tell you whether you are HIV positive. In most countries, this test is available free of charge. Both you and your partner should know your HIV status. Remember that it can take up to six months after being exposed to HIV for your HIV test to turn positive, so you only know for sure that you are HIV negative if you have tested negative for HIV six months after your last possible exposure to HIV.


If you choose to have sex before marriage, be mutually faithful with a single partner. Being mutually faithful with a single partner reduces your risk of contracting HIV because it means that neither you nor your partner are exposing yourselves to other people who may have HIV.


Most importantly, if you choose to have sex before marriage, use a latex condom correctly every time you have sex, every way you have sex.  HIV can be transmitted through a sheep skin condom because the pores are too big.  If you are allergic to latex, you can use a polyurethane condom.  A latex condom is not a guarantee against HIV transmission, but when used correctly, it greatly reduces the risk that one partner will infect the other.


This point is worth emphasizing. For a latex condom to provide the best protection against HIV, you must use it every time for every sexual act, even oral sex. If you only use a latex condom some of the times you have sex, you will still have a much higher risk of contracting HIV during the other times that you donÕt use the latex condom. ItÕs possible to contract HIV even if you only have unprotected sex one time, so if you are sexually active, make sure you use a latex condom every time.


For a condom to provide the best protection against HIV, you must also use it correctly.  Condoms must be stored in a cool, dark place. Do not expose them to oil-based lubricants like Vaseline, because they will weaken the condom. To use a condom correctly, you must put it on the hard penis before any contact between the penis and the partnerÕs mouth, vagina, or anus. When putting the condom on the penis, leave a little extra space at the tip to hold the semen, and unroll the condom down the shaft all the way. Do not pull the condom over the penis like you would pull a sock over a foot. After the man ejaculates, he should hold the condom at the base of his shaft to make sure it doesnÕt fall off and immediately remove his penis from his partner before the penis becomes soft. This will reduce the risk that the condom will leak. Afterwards, throw the condom away.


For oral sex on a woman, it is important to use a barrier like a square of latex, called a dental dam.  You can also cut the tip of a latex condom and cut it up the side to make a dental dam.   Never reuse a condom. There is another video on this web site that demonstrates how to correctly use a condom.


If you or your partner were sexually active or injected drugs before marriage, a number of situations need to be discussed. One of you might be HIV positive and either know it or not.  Additionally, though not expected, one of you may eventually have sex outside of the marriage or use injection drugs again.  If this is the case, it is important not to ignore it.  Seek counseling and, if you are not currently using condoms, begin using them.  This is not an easy situation and ignoring it could make it much worse. 


Also, do not use injection drugs, or if you do, make sure you never use a dirty needle to inject. You cannot contract HIV from a new, clean, unused, sterile needle that you just removed from its package. Many places have needle exchange programs where you can turn in dirty needles and get free new needles in return. It is extremely dangerous to use a needle that has already been used by another person to inject anything into your body.  As an absolute last resort, if you are about to use a dirty needle to inject a drug, you can clean the needle and syringe thoroughly inside and out with bleach solution to reduce your risk of contracting HIV. There is another video on this web site that demonstrates how to clean a syringe and needle with bleach.


So you understand now that AIDS is caused by the virus called HIV, and the virus is transmitted through sexual contact, sharing of needles, mother to child, and blood transfusions. The virus is not spread by kissing, hugging, or shaking hands. The best way to eliminate your risk of acquiring HIV is to abstain from sexual activity and to never inject drugs. If you choose to be sexually active, you can reduce your risk of acquiring HIV by being mutually faithful with a single partner and using a condom every time you have sex. If you choose to inject drugs, you can reduce your risk of acquiring HIV by never sharing needles.


No matter who you are, you are a valuable individual, and your life matters as do the lives of those in your community. Take care of yourself and those around you. Make healthy choices that eliminate or reduce your risk of contracting HIV.


For AIDSvideos.org, this is [PRESENTER NAME].


This script was reviewed for accuracy and approved by Becky Kuhn, M.D. on April 29, 2006.