Editing Misconceptions about HIV/AIDS (section)

==HIV infection==
[[File:Symptoms of acute HIV infection.svg|thumb|Symptoms of acute HIV infection ]]

===HIV can be spread through casual contact with an HIV infected individual===
[[File:Symptoms of AIDS.svg|thumb|Symptoms of AIDS]]
One cannot become infected with HIV through normal contact in social settings, schools, or in the workplace. Other examples of casual contact in which HIV infection will not occur include shaking someone's hand, hugging or "dry" kissing someone, using the same [[toilet]] or drinking from the same glass as an HIV-infected person, and being exposed to [[coughing]] or [[sneezing]] by an infected person.<ref name="Madhok, 1986">{{cite journal | last1 = Madhok | first1 = R. | last2 = Gracie | first2 = J.A. | last3 = Lowe | first3 = G.D. | last4 = Forbes | first4 = C.D. | year = 1986 | title = Lack of HIV transmission by casual contact | journal = Lancet | volume = 328 | issue = 8511| page = 863 | doi=10.1016/S0140-6736(86)92898-9 | pmid = 2876307 | s2cid = 28722212 }}</ref><ref name="Courville, 1998">{{cite journal | doi = 10.1177/000992289803700303 | last1 = Courville | first1 = T.M. | last2 = Caldwell | first2 = B. | last3 = Brunell | first3 = P.A. | year = 1998 | title = Lack of evidence of transmission of HIV-1 to family contacts of HIV-1 infected children | journal = Clin. Pediatr. | volume = 37 | issue = 3| pages = 175–78 | pmid = 9545605 | s2cid = 30065399 }}</ref> [[Saliva]] carries a negligible viral load, so even open-mouthed kissing is considered a low risk. However, if the infected partner or both of the performers have blood in their mouth due to cuts, open sores, or [[gum disease]], the risk increases. The [[Centers for Disease Control and Prevention]] (CDC) has only recorded one case of possible HIV transmission through kissing (involving an HIV-infected man with significant gum disease and a sexual partner also with significant gum disease),<ref name= "Kissing and HIV">[http://www.thebody.com/content/art2287.html "Kissing and HIV"]</ref> and the [[Terence Higgins Trust]] says that this is essentially a no-risk situation.<ref name="THT">{{Cite web |url=http://www.tht.org.uk/informationresources/hivandaids/howhivistransmitted/wayshivisnottransmitted/ |title=THT: "Ways HIV is not passed on" |access-date=2007-10-10 |archive-url=https://web.archive.org/web/20150601202401/http://www.tht.org.uk/informationresources/hivandaids/howhivistransmitted/wayshivisnottransmitted/ |archive-date=2015-06-01 |url-status=dead }}</ref>

Other interactions that could ''theoretically'' result in person-to-person transmission include caring for [[nose bleed]]s and home health care procedures, yet there are very few recorded incidents of transmission occurring in these ways. A handful of cases of transmission via [[biting]] have occurred, though this is extremely rare.<ref>{{cite journal|last1=Bartholomew|first1=Courtenay F|last2=Jones|first2=Avion M|title=Human bites: a rare risk factor for HIV transmission|journal=[[AIDS (journal)|AIDS]]|volume=20|issue=4|pages=631–32|doi=10.1097/01.aids.0000210621.13825.75|pmid=16470132|year=2006|doi-access=free}}</ref>

===HIV-positive individuals can be detected by their appearance===
Due to media images of the effects of AIDS, many people believe that individuals infected with HIV always appear a certain way, or at least appear different from an uninfected, healthy person. In fact, disease progression can occur over a long period of time before the onset of symptoms, and as such, HIV infections cannot be detected based on appearance.<ref>{{cite web|author=Piya Sorcar|title=Teaching Taboo Topics Without Talking About Them: An Epistemic Study of a New Approach to HIV/AIDS Prevention Education in India|url=http://teachaids.org/download/dissertation-teaching-taboo-topics.pdf|publisher=[[Stanford University]], [[TeachAids]]|date=March 2009|author-link=Piya Sorcar}}</ref>

===HIV cannot be transmitted through oral sex===
Contracting HIV through [[oral sex]] is possible, but it is much less likely than from [[anal sex]] and [[human reproduction#copulation|penile–vaginal intercourse]].<ref>{{cite journal|last=Yu|first=M|author2=Vajdy, M|title=Mucosal HIV transmission and vaccination strategies through oral compared with vaginal and rectal routes|journal=Expert Opinion on Biological Therapy|date=August 2010|volume=10|issue=8|pages=1181–95|pmid=20624114|doi=10.1517/14712598.2010.496776|pmc=2904634}}</ref> No cases of such a transmission were observed in a sample of 8965 people performing receptive oral sex.<ref>{{Cite journal|last1=Patel|first1=Pragna|last2=Borkowf|first2=Craig B.|last3=Brooks|first3=John T.|last4=Lasry|first4=Arielle|last5=Lansky|first5=Amy|last6=Mermin|first6=Jonathan|date=2014-06-19|title=Estimating per-act HIV transmission risk: a systematic review|url= |journal=AIDS|language=en-US|volume=28|issue=10|pages=1509–1519|doi=10.1097/QAD.0000000000000298|pmid=24809629|issn=0269-9370|pmc=6195215}}</ref>

===HIV is transmitted by mosquitoes===
When [[mosquito]]es bite a person, they do not inject the blood of a previous victim into the person they bite next. Mosquitoes do, however, inject their [[saliva]] into their victims, which may carry diseases such as [[dengue fever]], [[malaria]], [[yellow fever]], or [[West Nile virus]] and can infect a bitten person with these diseases. HIV is not transmitted in this manner.<ref name="Webb, 1989">{{cite journal | last1 = Webb | first1 = P.A. | last2 = Happ | first2 = C.M. | last3 = Maupin | first3 = G.O. | last4 = Johnson | first4 = B.J. | last5 = Ou | first5 = C.Y. | last6 = Monath | first6 = T.P. | year = 1989 | title = Potential for insect transmission of HIV: experimental exposure of Cimex hemipterus and Toxorhynchites amboinensis to human immunodeficiency virus | journal = J. Infect. Dis. | volume = 160 | issue = 6| pages = 970–77 | pmid = 2479697 | doi = 10.1093/infdis/160.6.970 }}</ref> On the other hand, a mosquito may have HIV-infected blood in its gut, and if swatted on the skin of a human who then scratches it, transmission is hypothetically possible,<ref name="Siemens, 1987">{{cite journal | last1 = Siemens | first1 = D.F. | year = 1987 | title = AIDS Transmission and Insects | journal = Science | volume = 238 | issue = 4824| page = 143 | pmid = 2889266| doi=10.1126/science.2889266 | bibcode=1987Sci...238..143S}}</ref> though this risk is extremely small, and no cases have yet been identified through this route.

===HIV survives for only a short time outside the body===
HIV can survive at room temperature outside the body for hours if dry (provided that initial concentrations are high),<ref name="Resnick, 1986">{{cite journal | doi = 10.1001/jama.255.14.1887 | last1 = Resnick | first1 = L. | last2 = Veren | first2 = K. | last3 = Salahuddin | first3 = S.Z. | last4 = Tondreau | first4 = S. | last5 = Markham | first5 = P.D. | year = 1986 | title = Stability and inactivation of HTLV-III/LAV under clinical and laboratory environments | journal = JAMA | volume = 255 | issue = 14| pages = 1887–91 | pmid = 2419594 }}</ref> and for weeks if wet (in used syringes/needles).<ref name="Heimer, 2000">{{cite journal | last1 = Heimer | first1 = R. | last2 = Abdala | first2 = N. | year = 2000 | title = Viability of HIV-1 in syringes: implications for interventions among injection drug users | journal = AIDS Reader | volume = 10 | issue = 7| pages = 410–17 | pmid = 10932845 }}</ref> However, the amounts typically present in bodily fluids do not survive nearly as long outside the body—generally no more than a few minutes if dry.<ref name="Kissing and HIV"/>

===HIV can infect only homosexual men and drug users===
{{see also|Gay-related immune deficiency|Anal sex#Health risks|History of HIV/AIDS#Unsterile injections}}
HIV can transmit from one person to another if an engaging partner is HIV positive. In the United States, the main route of infection is via homosexual [[anal sex]], while for women transmission is primarily through heterosexual contact.<ref name=CDC>{{cite web|title=HIV Surveillance –Epidemiology of HIV Infection (through 2008)|url=https://www.cdc.gov/hiv/topics/surveillance/resources/slides/general/|publisher=Center for Disease Control|access-date=1 March 2011|url-status=dead|archive-url=https://web.archive.org/web/20110304014448/http://www.cdc.gov/hiv/topics/surveillance/resources/slides/general/|archive-date=4 March 2011}}</ref> It is true that anal sex (regardless of the sex of the receptive partner) carries a higher risk of infection than most sex acts, but most penetrative sex acts between any individuals carry some risk. Properly used [[condom]]s can reduce this risk.<ref name="Condoms">{{cite web | title = Condoms and STDs: Fact Sheet for Public Health Personnel | publisher = [[Centers for Disease Control and Prevention]] | date= 10 February 2010 | url = https://www.cdc.gov/condomeffectiveness/latex.htm | access-date = 5 January 2011 }}</ref>

===An HIV-infected person cannot have children===
HIV-infected women remain fertile, although in late stages of HIV disease a pregnant woman may have a higher risk of [[miscarriage]]. Normally, the risk of transmitting HIV to the unborn child is between 15 and 30%. However, this may be reduced to just 2–3% if patients carefully follow medical guidelines.<ref name="Groginsky, 1998">{{cite journal | last1 = Groginsky | first1 = E. | last2 = Bowdler | first2 = N. | last3 = Yankowitz | first3 = J. | year = 1998 | title = Update on vertical HIV transmission | journal = J Reprod Med | volume = 43 | issue = 8| pages = 637–46 | pmid = 9749412 }}</ref><ref name="WHO, 2005">[https://web.archive.org/web/20060321195253/http://www.who.int/reproductive-health/stis/index.htm WHO, 2005]</ref>

===HIV cannot be the cause of AIDS because the body develops a vigorous antibody response to the virus===
This reasoning ignores numerous examples of [[virus]]es other than HIV that can be [[pathogenic]] after evidence of [[immunity (medical)|immunity]] appears. [[Measles]] virus may persist for years in [[brain]] cells, eventually causing a chronic neurologic disease despite the presence of [[antibodies]]. Viruses such as ''[[Cytomegalovirus]]'', [[Herpes simplex virus|''Herpes simplex'' virus]], and ''[[Varicella zoster]]'' may be activated after years of latency even in the presence of abundant antibodies. In other animals, viral relatives of HIV with long and variable latency periods, such as [[visna virus]] in [[sheep]], cause [[central nervous system]] damage even after the production of antibodies.<ref name="NIAID, 1995">"Disease Progression Despite Antibodies", "The Relationship Between the Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome", [[National Institute of Allergy and Infectious Diseases]], September, 1995</ref>

HIV has a well-recognized capacity to [[mutate]] to evade the ongoing immune response of the host.<ref name="Levy, 1993">{{cite journal | last1 = Levy | first1 = J.A. | year = 1993 | title = Pathogenesis of human immunodeficiency virus infection | journal = Microbiol. Rev. | volume = 57 | issue = 1| pages = 183–289 | pmid = 8464405 | pmc = 372905 | bibcode = 1989NYASA.567...58L | doi = 10.1111/j.1749-6632.1989.tb16459.x }}</ref>

===Only a small number of CD4+ T-cells are infected by HIV, not enough to damage the immune system===
Although the fraction of CD4+ T-cells that is infected with HIV at any given time is never high (only a small subset of activated cells serve as ideal targets of infection), several groups have shown that rapid cycles of death of infected cells and infection of new target cells occur throughout the course of the disease.<ref name="Richman, 2000">{{cite journal | doi = 10.1172/JCI9478 | last1 = Richman | first1 = D.D. | year = 2000 | title = Normal physiology and HIV pathophysiology of human T-cell dynamics | journal = J. Clin. Invest. | volume = 105 | issue = 5| pages = 565–66 | pmid = 10712427 | pmc = 292457 }}</ref>  [[Macrophage]]s and other cell types are also infected with HIV and serve as reservoirs for the virus.{{cn|date=January 2021}}

Furthermore, like other viruses, HIV is able to suppress the immune system by secreting proteins that interfere with it. For example, HIV's [[Capsid|coat protein]], [[gp120]], sheds from viral particles and binds to the [[CD4]] receptors of otherwise healthy T-cells; this interferes with the normal function of these signalling receptors. Another HIV protein, [[HIV structure and genome#Genome organization|Tat]], has been demonstrated to suppress T cell activity.{{cn|date=January 2021}}

Infected lymphocytes express the [[Fas ligand]], a cell-surface protein that triggers the death of neighboring uninfected T-cells expressing the [[Fas receptor]].<ref name="Xu, 1999">{{cite journal | doi = 10.1084/jem.189.9.1489 | last1 = Xu | first1 = X.N. | last2 = Laffert | first2 = B. | last3 = Screaton | first3 = G.R. | last4 = Kraft | first4 = M. | last5 = Wolf | first5 = D. | last6 = Kolanus | first6 = W. | last7 = Mongkolsapay | first7 = J. | last8 = McMichael | first8 = A.J. | last9 = Baur | first9 = A.S. |display-authors=etal | year = 1999 | title = Induction of Fas ligand expression by HIV involves the interaction of Nef with the T cell receptor zeta chain | journal = J. Exp. Med. | volume = 189 | issue = 9| pages = 1489–96 | pmid = 10224289 | pmc = 2193060  }}</ref> This "bystander killing" effect shows that great harm can be caused to the immune system even with a limited number of infected cells.{{cn|date=January 2021}}