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AIDS/HIV Prevention
Background Information
Acquired immunodeficiency syndrome (AIDS) is a severe, often lifethreatening, illness
caused by the human immunodeficiency virus (HIV). The incubation period for AIDS is very
long and variable, ranging from a few months to many years. Some individuals infected with
HIV have remained asymptomatic for more than a decade. Currently, there is no vaccine to
protect against infection with HIV. Although there is no cure for AIDS, treatments for HIV
infection and prophylaxis for many opportunistic diseases that characterize AIDS are
available. HIV infection and AIDS have been reported worldwide. Comprehensive surveillance
systems are lacking in many countries, so that the true number of cases is likely to be
far greater than the numbers officially reported from some areas, particularly the
non-industrialized nations. The number of persons infected with HIV is estimated by WHO to
be approaching the range of 18 million worldwide. Because HIV infection and AIDS are
globally distributed, the risk to international travelers is determined less by their
geographic destination than by their sexual and drug using behaviors.
Transmission and Prevention Information
The global epidemic of HIV infection and AIDS has raised several issues regarding HIV
infection and international travel. The first is the need of information for international
travelers regarding HIV transmission and how HIV infection can be prevented.
HIV infection is preventable. HIV is transmitted through sexual intercourse, needle or
syringe sharing, by medical use of blood or blood components, and perinatally from an
infected woman to her baby. HIV is not transmitted through casual contact; air, food, or
water routes; contact with inanimate objects; or through mosquitoes or other arthropod
vectors. The use of any public conveyance (e.g., airplane, automobile, boat, bus, train)
by persons with AIDS or HIV infection does not pose a risk of infection for the crew or
other passengers.
Travelers are at risk if they:
- have sexual intercourse (heterosexual or homosexual) with an infected person;
- use or allow the use of contaminated, unsterilized syringes or needles for any
injections or other skin-piercing procedures including acupuncture, use of illicit drugs,
steroid or vitamin injections, medical/dental procedures, ear or body piercing, or
tattooing;
- use infected blood, blood components, or clotting factor concentrates. HIV infection by
this route is a rare occurrence in those countries or cities where donated blood/plasma is
screened for HIV antibody.
Travelers should avoid sexual encounters with a person who is infected with HIV or
whose HIV infection status is unknown. This includes avoiding sexual activity with
intravenous drug users and persons with multiple sexual partners, such as male or female
prostitutes. Condoms, when used consistently and correctly, prevent transmission of HIV.
Persons who engage in vaginal, anal, or oral-genital intercourse with anyone who is
infected with HIV or whose infection status is unknown should use a condom.
In many countries, needle sharing by IV drug users is a major source of HIV
transmission and other infections such as hepatitis B and C. Do not use drugs
intravenously or share needles for any purpose.
Safety of Blood, Blood Products, and Needles
In the United States, Australia, New Zealand, Canada, Japan, and western European
countries, the risk of infection of transfusionassociated HIV infection has been virtually
eliminated through required testing of all donated blood for antibodies to HIV. In the
United States, donations of blood and plasma must be screened for antibodies to HIV-1 and
HIV-2 and HIV-1 p24 antigen. If produced in the United States according to procedures
approved by the Food and Drug Administration, immune globulin preparations (such as those
used for the prevention of hepatitis A and B) and hepatitis B virus vaccine undergo
processes that are known to inactivate HIV and therefore these products should be used as
indicated. In less-developed nations, there may not be a formal program for testing blood
or biological products for antibody to HIV. In these countries, use of unscreened blood
clotting factor concentrates or those of uncertain purity should be avoided (when
medically prudent). If transfusion is necessary, the blood should be tested, if at all
possible, for HIV antibodies by appropriately-trained laboratory technicians using a
reliable test. For WHO blood transfusion guidelines for international travelers. Needles
used to draw blood or administer injections should be sterile, preferably of the
single-use disposable type, and prepackaged in a sealed container. Insulin-dependent
diabetics, hemophiliacs, and other persons who require routine or frequent injections
should carry a supply of syringes, needles, and disinfectant swabs (e.g., alcohol wipes)
sufficient to last their entire stay abroad.
HIV Testing by Countries
International travelers should be aware that some countries serologically screen
incoming travelers (primarily those with extended visits, such as for work or study) and
deny entry to persons with AIDS and those whose test results indicate infection with HIV.
Persons who are intending to visit a country for a substantial period or to work or study
abroad should be informedof the policies and requirements of the particular country. This
information is usually available from consular officials of individual nations.
Source
Division of Quarantine National Center for Infectious Diseases Centers for Disease
Control and Prevention Atlanta, GA
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