Abstaining from engagement in any behavior that carries risk of acquiring HIV (e.g., sexual intercourse or using and injecting drugs) is the most effective way to avoid HIV, but not always the most realistic. To minimize risk for those who choose to be sexually active, the CDC recommends the following: engage in sex that does not involve vaginal, anal, or oral sex; have intercourse with only one uninfected partner; and/or use latex condoms every time you have sex. For IDUs who cannot or will not stop injecting drugs, the following steps are recommended to reduce risk: never reuse or “share” syringes, water, or drug preparation equipment; only use syringes obtained from a reliable source (such as pharmacies or needle exchange programs); use a new, sterile syringe to prepare and inject drugs; if possible, use sterile water to prepare drugs; otherwise, use clean water from a reliable source (such as fresh tap water); use a new or disinfected container (“cooker”) and a new filter (“cotton”) to prepare drugs; clean the injection site prior to injection with a new alcohol swab; safely dispose of syringes after one use. If new, sterile syringes and other drug preparation and injection equipment are not available, then previously used equipment should be boiled in water or disinfected with bleach before reuse.
Medical therapy (ZDV—zidovudine, also known as AZT or Retrovir) is available to effectively reduce the chance of an HIV-infected pregnant woman passing HIV to her infant before, during, or after birth. In 1998, the U.S. Public Health Services released updated recommendations for offering antiretroviral therapy to HIV positive pregnant women.
Programs focusing on reducing the transmission of HIV among women should include an increased emphasis on prevention and treatment services for young women and women of color; address the intersection of drug use and sexual HIV transmission; develop and widely disseminate effective female-controlled prevention methods; and better integrate prevention and treatment services for women across the board, including the prevention and treatment of other STDs and substance abuse and access to antiretroviral therapy. More options are urgently needed for women who are unwilling or unable to negotiate condom use with a male partner.