TransmissionJAMA In the context of HIV disease: HIV is spread most commonly by sexual contact with an infected partner. The virus can enter the body through the mucosal lining of the vagina, vulva, penis, rectum or, very rarely, the mouth during sex. The likelihood of transmission is increased by factors that may damage these linings, especially other sexually transmitted diseases that cause ulcers or inflammation. Studies of SIV infection of the genital membranes of nonhuman primates suggest that the sentinel cells known as mucosal dendritic cells may be the first cells infected. Infected dendritic cells may migrate to lymph nodes and infect other cells. HIV also is spread through contact with infected blood, most often by the sharing of drug needles or syringes contaminated with minute quantities of blood containing the virus. Children can contract HIV from their infected mothers either during pregnancy or birth or postnatally, via breastfeeding. Current research indicates that HIV may be 100 to 1000 times more contagious during the first 2 months of infection, when routine HIV tests are unable to tell whether people are infected. See also Lymph Nodes; Simian Immunodeficiency Virus.
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