Several technologies are common. Tattoos can be applied with a small hand-held electric machine that moves a small bundle of needles to puncture the skin, or by hand manipulation of needles to make multiple punctures in the skin.
If the tattooist reuses needles or inkpots from an HIV-positive client with no effort to clean, or uses ink left-over after tattooing an HIV-positive client, your risk to get HIV from tattooing may be estimated at greater than 10% (see Blood-borne Risks section). If the tattooist is careful with needles, handpieces, and inkpots, but saves and uses left-over ink, your risk may still exceed 10%: HIV can go from an HIV-infected client to needles, from needles to ink, and then, if the tattooist does not throw away excess ink and contaminated ink, HIV can go to the next client.
There is a lot of evidence tattooing transmits HIV. For example, a study in India that followed and tested adults every 3 months asked about tattoos along with other risks. Those who received a tattoo between visits were 2.4 times more likely to show up with a new HIV infection at their next visit compared to those without new tattoos. A study in the US found that men who became HIV-positive in prison were 4 times more likely than other men to have received a tattoo in prison.[2,3] In a study of men with new HIV infections in prison, many men reported tattooing as their only risk (see also Devon Brewer’s discussion of this paper).
During 1995, as part of research on HIV risks in India, I met with a group of prostitutes’ representatives. They reported standing in line for tattoos during festivals for the goddess Yellamma. Same inkpot, same needles. They thought it was safe because they wrongly believed HIV dies in seconds outside the body.
1. Reynolds SJ, Risbud AR, Shepherd ME, et al. Recent herpes simplex virus type 2 infection and the risk of human immunodeficiency virus type 1 acquisition in India. J Infect Dis 2003; 187: 1513-1521. Available at: https://academic.oup.com/jid/article/187/10/1513/851300 (accessed 4 January 2019).
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10. Panda S, Kumar MS, Lokabiraman S, Jayashree K, Satagopan MC, Solomon S, Rao UA, Rangaiyan G, Flessenkaemper S, Grosskurth H, Gupte MD. Risk factors for HIV infection in injection drug users and evidence for onward transmission of HIV to their sexual partners in Chennai, India. J Acquir Immune Defic Syndr. 2005;39(1):9-15. https://www.ncbi.nlm.nih.gov/pubmed/15851908
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12. Rahbar AR, Rooholamini S, Khoshnood K. Prevalence of HIV infection and other blood-borne infections in incarcerated and non-incarcerated injection drug users (IDUs) in Mashhad, Iran. Int J Drug Policy. 2004;15(2):151-155. Abstract available at: https://www.sciencedirect.com/science/article/abs/pii/S0955395903001518 (accessed 24 December 2018). The abstract does not give details about HIV risk with tattooing.
13. Rodrigues JJ, Mehendale SM, Shepherd ME, Divekar AD, Gangakhedkar RR, Quinn TC, Paranjape RS, Risbud AR, Brookmeyer RS, Gadkari DA. Risk factors for HIV infection in people attending clinics for sexually transmitted diseases in India. BMJ. 1995;311(7000):283-286. Available at (see table 2): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2550353/pdf/bmj00603-0015.pdf (accessed 24 December 2018).
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15. Perez-Agudo F, Alonso Moreno FJ, Urbina Torija J. Prevalencia de infeccion por el virus de la inmunodeficiencia humana tipo 1 y de Mycobacterium tuberculosis en una poblaciÃ³n reclusa entre los aÃ±os 1.989 y 1.995. Med Clin (Barc). 1998;110(5):167. Available at: https://www.ncbi.nlm.nih.gov/pubmed/9547719 (accessed 24 December 2018).
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17. Motevalian SA, Farhoodi B, Motamedi M, Motevali Khamene M, Mohraz M, Rasoulinejad M, Jaafari S, Afshar P, Esmailie I, Mohseni L. Prevalence of HIV and risky behaviors among injecting drug users of a prison in Tehran. Abstract no. MOAC203, 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention, Sydney, Australia, 2007. Available at: https://library.iasociety.org/AbstractView.aspx?confID=2007&abstractID=4241 (accessed 24 December 2018).
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21. Entz AT, Ruffolo VP, Chinveschakitvanich V, Soskolne V, Van Griensven GJP. HIV-1 prevalence, HIV-1 subtypes and risk factors among fishermen in the Gulf of Thailand and the Andaman Sea. AIDS. 2000;14(8):1027-1034. Available at: https://www.ncbi.nlm.nih.gov/pubmed/10853985 (accessed 24 December 2018).
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25. Garland SM, Ung L, Vujovic O, et al. Cosmetic tattooing: a potential transmission route for HIV? Aust N Z J Obstet Gynaecol 2006; 46: 458-459.
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