Who is most at risk for HIV?

I tried to look this up myself and found that I’m really bad at understanding different studies and interpreting the data.

Who is at highest risk of HIV? I have been getting tested every year since I was a kid. I just want to know if I’m being logical. I am told black women are now at the highest risk, so I feel I should keep getting checked. And I am FINE with getting checked. I have an active sex life and I have had boyfriends since breaking up with my husband that I have decided to have unprotected sex with. So I am FINE with continuing to get tested. I simply want to know how much sense it honestly makes. I get tested for diabetes and high blood pressure and stuff like that, because I am overweight. I am most at risk for that sort of thing.

But am I actually most at risk for HIV infection? Is there anyone who knows and understands the stats on this and can break it down for me?

I genuflect before the members of the dope and plead with you not to start with a whole bunch of “YOU SHOULD BE GETTING TESTED REGARDLESS!!!” posts. I get it. I will continue to get tested no matter what. I am just asking, academically, what the stats are right now. Thanks.

We can imagine a “most at-risk” individual, and it’s not you. That would be someone who does intravenous drugs with shared needles, has gay receptive (“bottom”) anal sex without a condom, has one or more STI’s (“venereal diseases”) and works as a nurse for a living. But he would also be a black man, if we want to really stack the statistical deck against him.

44% of new HIV infections in the US are in African-Americans, although they are only 12% of the population. No other racial group carries such a disproportionate burden.

Just under 30% of those new infections in the African-American population are women.


CDC says you should be getting tested once a year if you’re engaging in unsafe sex, regardless of your race, gender or sexual orientation. Gay and bisexual men may want to be tested every 3 to 6 months.

Working as a nurse for a living actually increases risk?? I thought that was a myth…the whole ‘pricked with a dirty needle’ myth.

Not a myth, no. Think about it like this: who’s more likely to get a paper cut, the person who loads the copier or someone whose only contact with paper is after using the throne? By the same token, someone who works with needles day in and day out is more likely to get a prick or cut than someone like me, whose idea of sharp is “my scissors”. The idea is that it shouldn’t happen, but then, neither should road accidents.
Now, those stats you hear: are they for the US or worldwide? Worldwide, women in subsaharian Africa are getting royally screwed in the HIV lottery, and there is a certain subset of idiots who’s been known to describe any Black person as “African-American”. Add the two together and you may get misreports that “African-American women are at the highest risk of HIV infection”.

Yeah, I understand that. I thought the myth part was that people actually DO get AIDS from things like a needle prick. I had read somewhere that such a thing would actually be rare and that AIDS is hard to get. I don’t know. I’m just way more misinformed about this topic than I am comfortable admitting.

Infection is like pregnancy: while more “incidents” increase the likelihood, it only takes one.

My wife is a Thai government researcher, and she did studies on this over here in the 1990s. Thai fishermen, at least at that time, were at elevated risk. These are uneducated people who spend weeks out at sea and then just go fucking berserk when they get back to shore with all of that pay they have coming to them. She and her crew of assistants administered saliva tests at various locations along Thailand’s coast, and she was seeing an 18% rate among the ones they tested.

It is extremely rare (a CDC manual on managing occupational exposure to HIV says 0.3% risk of transmission (PDF warning)), and you can take a course of post-exposure prophylactic medications if you have a chance of having been infected, but it’s still something to not ignore if it happens to you. Appropriate blood-handling guidelines say you need to treat all blood samples as being potentially highly infectious.

Obviously if you’re working under less-than-ideal conditions, you may have a much higher chance of being stuck - patients who are being combative, actual combat zone medical work (or similar situations), etc.

Groups at risk for AIDS in the US are the same as they have been for the last twenty years - men who have sex with men, and IV drug abusers.

They aren’t. Most of the people in the US who have AIDS got from receptive anal intercourse and/or sharing needles.

The notion that AIDS in America is commonly spread thru vaginal intercourse is largely a myth. The risk of contracting AIDS thru PIV intercourse is on the order of 1 in 2000 per act, even if you are sure that one partner is HIV positive.

AIDS in the US does discriminate. It is not a disease of everybody.

It is rather difficult to get AIDS from heterosexual vaginal intercourse (cite) and most of the time it happened when a woman had repeated, unprotected sex with an IVDA. Getting it from sex with bisexual men is much less common.

Feel free to get tested if you want. Your risk of getting AIDS from your current patterns of behavior is extremely low.


As far as sex, the highest risk sex is receptive anal. The lowest is oral with vaginal in the middle of risk. The risk of anal sex isn’t a little higher, it is something like 15x more risky.

The odds of catching HIV from vaginal sex with someone who has HIV is about 0.08%. They calculated about 1 act out of 1250 where the guy has it and the woman doesn’t will see the disease transmit. But if you are in a relationship with someone with HIV, you have sex 100 times a year then the odds are going to start being more and more dangerous.

I’ve heard a theory that white people, due to our history of diseases like the plague and smallpox are more resistant to HIV than black people. But I have no idea how true that is.

You think people who have been in a relationship for more than a decade have sex 100 times a year.

You’re not married, are you?


It’s not so much a myth as that it rarely happens. We’ve made a lot of changes in the precautions that we take to reduce the risk of nurses and doctors getting HIV from their patients, and those precautions are very very good. But I was attempting to paint a picture of the “most at-risk” individual, and the most at risk profession is still nursing, because of extended and frequent opportunities for contact with bodily fluids. Do I lay awake at night, concerned I’m going to get HIV? No. But I wear my gloves (and goggles when appropriate) when handling fluids or working with open sores, I use needles with safety covers and my used needles go immediately into the Sharps container. I’m not scared *because *I follow those precautions which have reduced our risk to almost (but not quite) nothing.

Very good question. I believe the stats I cited, from the CDC, apply to African-Americans in America. The recommendation for yearly testing for those who engage in unsafe sex is definitely for Americans.

Thank you guys for the hard facts and cites. I appreciate it.

Heh. :o

I’d consider 100 times a year to be not unusual. Understandable to be less often while the kids are young, but one can make up for those years once they move out.


QtM, married 32 years.

Even if blacks have higher infection rates than whites, that doesn’t necessarily mean that being black is a risk factor. More likely, it just means that blacks have a higher rate of intravenous drug use than whites. But a black person who does not use intravenous drugs would not be at any higher risk than a white person who does not use intravenous drugs.

And getting an AIDS test when you don’t have any risk factors isn’t actually all that great an idea. Current AIDS tests are very accurate, with a false positive rate of less than 1%… But on the other hand, the probability that a person with no risk factors would be infected is even lower than that. So if you have no risk factors for AIDS, but take a test and it comes back positive, it’s still probably the case that the test is in error. Put another way, for a person with no risk factors, a piece of paper with “you aren’t infected” written on it in permanent marker is a more accurate test than the standard medical tests.

Wow. Chronos be breakin’ it down!

I started getting tested when I was 16. At the time, I had one boyfriend, an 18 year old kid who had only been with one other girl. I was terrified every time I went for testing. I know tons of people who never got tested at all. I despise fear mongering. I bet if more people knew the truth about HIV infection stats, more people would get tested. And then, more people who DO have it and didn’t know would get the meds they need.

Absolutely. But the OP says, “I have an active sex life and I have had boyfriends …that I have decided to have unprotected sex with.”

Unprotected sex with multiple partners is considered “unsafe sex”, not “don’t have any risk factors.” The CDC’s recommendation is that people who engage in unsafe sex get tested annually.

They know that from 10-18% of certain europeans, especially northern europeans, have a mutation that makes them resistant to contracting HIV. They aren’t totally sure why.