Sex may not be your biggest risk for HIV
One of the long-standing puzzles in Africa’s HIV/AIDS epidemics is why so many people with modest, or conservative, or even no sex lives (ie, virgins) have HIV. In national surveys throughout Africa, more than 90% women with HIV report 0-1 sex partners in the last year. Even more striking – across most of Africa, among women who are married and HIV-positive, more than half of their husbands are HIV-negative (see Tables 7.1 and 7.5). Similarly, across Africa, more than 3 out of 4 men with HIV report 0-1 sex partners in the last year, and approximately half of married men with HIV have HIV-negative wives (same link).
If you’re married to someone who is HIV-positive, and you don’t know their status, or you know it but don’t take any precautions such as using condoms, you have about a 10% chance to get HIV from your spouse in a year. In that case, sex is probably your biggest risk.
But if you’re not married, and you have sex with someone only occasionally or not at all, or if you’re married to an HIV-negative spouse and have little or no sex with anyone else, sex is probably not your biggest risk.
If you are married, it is not only your own blood exposures that could infect you with HIV, but also your spouse’s and breast-feeding baby’s blood exposures. Once someone brings HIV into a home, it can go sexually from one spouse to the other, or from an infected child to a breast-feeding mother.