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In July 2010, the White House announced a major change in its HIV/AIDS policy; the "National HIV/AIDS Strategy for the United States" stated that "the continued existence and enforcement of these types of laws [that criminalize HIV infection] run counter to scientific evidence about routes of HIV transmission and may undermine the public health goals of promoting HIV screening and treatment."
Criminal transmission of HIV is the intentional or reckless infection of a person with the human immunodeficiency virus (HIV). Some countries or jurisdictions, including some areas of the United States, have laws that criminalize HIV transmission or exposure. [298] Others may charge the accused under laws enacted before the HIV pandemic.
HIV-1 is more virulent and more infective than HIV-2, [20] and is the cause of the majority of HIV infections globally. The lower infectivity of HIV-2, compared to HIV-1, implies that fewer of those exposed to HIV-2 will be infected per exposure. Due to its relatively poor capacity for transmission, HIV-2 is largely confined to West Africa. [21]
The risk of HIV transmission from mother to child is most directly related to the plasma viral load of the mother. Untreated mothers with a high (HIV RNA greater than 100,000 copies/mL) have a transmission risk of over 50%. [25] For women with a lower viral load (HIV RNA less than 1000 copies/mL), the risk of transmission is less than 1%. [26]
Studies conducted in sub-Saharan Africa have found that circumcision reduces the risk of HIV infection in heterosexual men between 38 and 66% over two years. [27] Based on these studies, the World Health Organization and UNAIDS both recommended male circumcision as a method of preventing female-to-male HIV transmission in 2007. [28]
The main route of transmission for women is through unprotected heterosexual sex. African American women are 19 times more likely to contract HIV than other women. [89] By 2008, there was increased awareness that young African-American women in particular were at high risk for HIV infection. [90]
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