0:00:15.190,0:00:22.190 Sexual intercourse (male/female) is relatively low-risk except when the infection is brand 0:00:26.000,0:00:33.000 new. Most of the spread from person to person seems to occur when the infected person has 0:00:33.489,0:00:39.489 just been recently infected, few days, few weeks perhaps. Viral loads in that setting 0:00:39.489,0:00:46.489 are known to be extremely high meaning that there may be more than 2 million virus particles 0:00:47.879,0:00:52.679 per unit in the blood as opposed to later on in the infection when there may be a few 0:00:52.679,0:00:59.679 hundred. Therefore, when body fluids are exchanged, they are exchanged with a very rich load of 0:01:00.379,0:01:07.379 viruses. So that's where infections seem to cluster. Patients are not particularly ill 0:01:08.090,0:01:13.640 most of the time. A few people feel like they are ill with some fever or sore throat, a 0:01:13.640,0:01:19.690 little headache and maybe some swollen lymph nodes, but no worse than maybe a little more 0:01:19.690,0:01:26.690 severe than an average cold. They aren't always in a major way ill. Which means that they 0:01:29.610,0:01:34.970 are not going be lying in bed waiting for their next dose of aspirin. They're going 0:01:34.970,0:01:41.970 be out living life, including having sexual contact. I think it's important for people 0:01:42.560,0:01:49.160 to understand that you can get HIV from sexual intercourse, but not necessarily each and 0:01:49.160,0:01:56.160 every time. Even without a condom, if a person is in a relatively low viral load in their 0:01:56.470,0:02:03.470 blood it might be less likely for them to transmit the virus. However, that's playing 0:02:05.030,0:02:12.030 Russian roulette. I don't know if Russian roulette translates into all cultures, but 0:02:12.310,0:02:19.310 it's a risky game. If a person gets away with it 19 times maybe the 20th time they'll get 0:02:19.450,0:02:26.450 infected. It's not worth the risk. How do we minimize the risk? Well, one is to use 0:02:29.170,0:02:36.170 condoms. Condoms are typically latex rubber coverings of the penis. This can be used during 0:02:37.120,0:02:44.120 sexual intercourse. Even though it's not perfect, even though sometimes they can break, even 0:02:44.760,0:02:51.760 though sometimes they can slip, it is actually a very effective tool. There have been scientific 0:02:51.760,0:02:58.760 studies done where one person, let's say a man, is infected and their sexual partner, 0:02:59.040,0:03:04.630 let's say a woman, is not infected. They've been counseled but say we are going to have 0:03:04.630,0:03:11.630 sexual intercourse anyway. When people have been counseled to use condoms and followed 0:03:13.150,0:03:20.150 up over a year's time, the couples who said they always used condoms each and every time, 0:03:22.230,0:03:29.230 none of the uninfected people became infected. On the other hand, people who said they rarely 0:03:29.930,0:03:36.930 used condoms, a large number, perhaps 25 percent of the people became infected. But those who 0:03:38.660,0:03:45.400 said they mostly used condoms, were almost as likely to have an infection transmission 0:03:45.400,0:03:51.959 as the ones who almost never used condoms. The only group that escaped was the group 0:03:51.959,0:03:58.959 that consistently used condoms. So that's evidence that condoms work. For all their 0:04:01.290,0:04:06.910 faults they definitely can work, but they have to be used each and every time, and they 0:04:06.910,0:04:13.819 have to be used properly. Education about condoms, the fact of even what they are is 0:04:13.819,0:04:19.989 not universal. There are people in the world who do not know what a condom is no matter 0:04:19.989,0:04:26.690 what name you call it. In addition, there are many of those who generally have an idea 0:04:26.690,0:04:32.630 of what it is but don't know how to use it properly. And finally there are those who 0:04:32.630,0:04:38.930 may know all of those things but can't get the condom, either because of expense or because 0:04:38.930,0:04:45.930 of government prohibition or because of societal prohibition. Finally there are those who can 0:04:45.970,0:04:50.740 know what the condoms are, they know how to use them, they'd like to use them and there's 0:04:50.740,0:04:56.780 availability, they have them, but they run into resistance from their sexual partner. 0:04:56.780,0:05:03.780 The resistance can be... complete. In other words, a woman whose livelihood depends on 0:05:09.120,0:05:15.340 her husband bringing home some money from his job, and she in turn runs the household 0:05:15.340,0:05:22.340 and keeps the children going, if he says if you make me wear a condom I will leave you, 0:05:24.120,0:05:29.720 that woman is very unlikely to insist on using a condom, even if her husband has been known 0:05:29.720,0:05:35.300 to be unfaithful in the past and therefore at risk of having HIV or indeed of having 0:05:35.300,0:05:42.300 HIV. She'll be unwilling to put herself and her children out on the streets of some very 0:05:43.460,0:05:50.460 poor neighborhood with no support. And so there's resistance to the use of condoms, 0:05:51.400,0:05:58.400 governmental resistance and religious resistance occur. Condoms are the only proven tool for 0:06:00.610,0:06:07.610 preventing HIV transmission. Again, it's a proven tool, not 100 percent foolproof in 0:06:10.389,0:06:16.639 every instance forever, but if people would consistently around the world always each 0:06:16.639,0:06:22.669 and every time they have sex use this, there would be several consequences. One, much less 0:06:22.669,0:06:29.509 HIV transmission, much less transmission of other sexually transmitted diseases, and fewer 0:06:29.509,0:06:31.040 unintended pregnancies.