Here you will find various publications from HIVsport and others that we have contributed to. You can download a PDF of Sport, HIV and AIDS – the facts from our home page. This was originally published in July 2009, the full text is reproduced in this section, © HIVsport Limited.
Sport, HIV and AIDS
What are HIV and AIDS?
Most people will have heard of the terms HIV and AIDS without knowing exactly what they mean. HIV is short for Human Immunodeficiency Virus. It is this virus that can cause AIDS, which stands for Acquired Immune Deficiency Syndrome. AIDS is not yet curable, but the good news is that it can be treated very effectively and better news is that HIV infection can be easily prevented by taking some simple and sensible precautions such as using a condom during sex. Even better news still, is that these sensible precautions can prevent a whole range of other Sexually Transmitted Infections (STIs) such as chlamydia and syphilis. Sexual health is an important part of overall health and wellbeing and someone who is fit should have good sexual health as well.
How can HIV be transmitted?
HIV can only be transmitted from one person to another by an exchange of bodily fluids. In reality there are only four ways in which this can happen, and each of these can be prevented.
1. Unprotected sex (i.e. without using a condom)
This is by far the most common means of transmission and heterosexual couples are equally at risk as homosexual partners. HIV does not discriminate in this way. Condoms are currently the best way to reduce the risk of becoming infected with HIV or giving it to someone else during sex. HIVsport acknowledges that young people and adults make their own decisions about who they have sex with, but we firmly believe that all choices must be with respect to your own health and the health of your partner. Using a condom is a mark of respect.
2. Drug injection with a contaminated needle
Sharing needles is high risk behaviour and a potential cause of HIV transmission. If, for any reason, you are injecting steroids (or any other drug) you should always use a clean needle and dispose of it safely after use. There is a very small risk of a needle-stick injury resulting in HIV transmission which is why all needles must be safely handled and disposed of. HIVsport does not condone the taking of illegal or non-prescribed drugs.
3. Blood and blood products
Due to advances in medical screening, there is negligible risk that transmission could occur through a blood transfusion or during an organ transplant. However, virtually every country now has effective screening mechanisms to ensure that this does not happen and is no reason not to undergo surgery or to have a transfusion when recommended by a qualified physician.
4. Mother to Child Transmission
Children can become infected from their mother at childbirth or through breastfeeding. However, this risk can be prevented provided the mother’s HIV status is known in advance.
What’s all this got to do with sport?
No-one who plays sport at any level would give any thought to the possibilities of contracting HIV while pursuing a healthy activity. Although there is a tiny theoretical possibility of blood being exchanged through a clash of heads for example, the good news is there have been no confirmed cases of anyone contracting HIV while taking part in sport and medical experts agree that the chances of it happening are much less than one in a million. The only exception to this estimate is boxing where experts think there could be a higher chance due to the possibility of boxers exchanging blood through head wounds.
HIV cannot be transmitted through normal bodily contact such as might occur in tackling an opponent. HIV cannot be transmitted by sharing shower and toilet facilities. HIV cannot be transmitted through sharing a glass of water or cutlery. In fact, HIV cannot be transmitted in any way apart from those we have mentioned. So you can relax and enjoy your sport in this knowledge. However, that does not mean that bleeding injuries that occur during sport should not be taken seriously because there are other infections, such as hepatitis, that can be transmitted through sharing things like sponges to treat bleeding injuries. Though rare, there have been instances of members of sports teams contracting hepatitis in this way so some simple procedures and precautions should be taken.
What should you do if someone is bleeding?
The majority of sports do not have injury to the opponent as an aim of the game. But accidents do occur and someone might get a cut as a result of taking part in sport. This is most likely to occur in sports such as rugby where there is a significant heavy bodily contact and we have all seen footballers with cuts as a result of a clash of heads.
The following guidelines may prove useful when someone suffers a bleeding wound when playing sport.
- Insist that your team has a proper, well stocked first aid kit.
- All blood and body fluids should be considered as having possible risks (e.g. of hepatitis infection) regardless of circumstances.
- The prompt reporting of injuries, particularly bleeding, is in the best interests of all concerned.
- All injuries, especially bleeding wounds, should receive proper and adequate first aid using proper equipment – for example, gloves. Clean blood from wounds with soap and water and apply an antiseptic.
- Any skin injuries, for example abrasions, cuts, or wounds should be covered during sports activities.
- Remove athletes with bleeding injury (not necessarily minor cuts or abrasions) from the event as soon as possible.
- Change out of blood soaked kits and ensure they are properly washed.
- Water containers should be available individually for each player in contact sports. Athletes should use squeeze water bottles which do not require contact with the lips.
- Appropriate protective equipment, including mouth protectors, should be used at all times in contact sports.
- Any equipment contaminated with blood should be removed from the sports activity and either sterilised or disposed of.
What are the most likely risk situations where you might possibly contract HIV?
1. Unprotected Sex
All studies indicate that there is virtually no risk in catching HIV while playing sport, however, HIV infection does still pose a real risk to people who play sport in the same way as it does to those who don’t. Let’s remind ourselves how HIV can be transmitted.
First and foremost (and for most people) the only way HIV can be transmitted is through unprotected sex (without using a condom) with someone who is HIV positive. This is the most important thing you need know to keep yourself safe. The good news is that if you use a condom then you are also protected from other STIs such as chlamydia and can help prevent unwanted pregnancies.
We know that this sounds all too easy and, of course, it is. Nothing in life is quite so simple and the same applies here. People don’t use condoms for all sorts of reasons – they don’t have one handy; they are embarrassed to mention it; they think it makes them look ‘easy’; they don’t want to make it look like they have other partners; they got a bit drunk and just plain couldn’t be bothered; they didn’t think it was necessary; it makes sex more difficult and less ‘natural’; it ruins the moment and so on.
All of these reasons are understandable which is why it is even more important to take care and to think about what you are doing. For example, if you are in a monogamous relationship, there is probably no need to use a condom if you and your partner have both recently tested HIV negative. However, problems may arise when one or both of you start to ‘play away from home’ or have multiple partners with or without the other partner’s knowledge.
HIVsport understands life is not simple, and supports individual choice but encourages choices that are right for your own health and the health of your partner.
People who play sport may find themselves in social situations when they need to think about what they are doing in respect to sex. After a match, on tour, or at a training camp then it is likely that you may go to bars and clubs for a night out. Meeting other people is a natural and good thing to do. Quite often it may lead to more than just ‘a couple of drinks at the bar’ and that is when you need to make sure you know what you are doing to keep yourself and your partner healthy. If you decide to have sex with someone you have met in a bar or club then it would make sense to use a condom. So the choices are, either to stay faithful in your monogamous relationship or if you have multiple partners, make sure you keep a condom handy and, most importantly, make sure it gets used.
2. Sharing Needles
A second, but much less likely, way of contracting HIV is through sharing a contaminated needle with someone who is HIV positive. This mainly applies to illegal drug users (e.g. heroin addicts) who inject. For sportspeople the most likely scenario would be injecting steroids, so if you are doing this (and you should only do so under medical supervision) then make sure you use a new sterile needle every time, do not share it with others and make sure you dispose of it safely.
What should I do if a team mate has HIV?
Discovering that someone you know has HIV can be a bit of a shock. It is just something many prefer not to think about. Unfortunately there is still a lot of stigma and discrimination against people who are HIV positive. Normally this is because people do not really understand HIV and are frightened by it and turn that fright into hatred or anger against people who are living with it. These feelings are natural but only make matters worse. Remember that HIV cannot be caught while playing sport, sharing changing facilities or in normal social situations so in fact, there is nothing to worry about. If you know of someone who is HIV positive then the right thing to do is just to treat them as you would anyone else.
Can I play sport if I am HIV positive?
Most definitely yes. HIV infection is not a reason to prevent anyone from taking part in sports activities. There has been at least one Olympic Gold Medal Winner who was HIV positive so it is no barrier to participation at any level. Anyone who is diagnosed HIV positive should take advice from their doctor but generally, regular physical activity is strongly recommended for most individuals infected with HIV.
Participation in regular exercise/sports can have significant beneficial effects both psychologically and with regard to boosting the immune system. Similarly, progressive resistance training (circuit weight training) can also help to develop muscle mass, muscle strength and play a key role in maintaining bone mass.
Unquestionably, regular physical exercise has definite benefits for people living with
HIV and is an effective means of ongoing management of the condition. There may be times, such as when starting on a treatment regime, when it is best to limit the amount and degree of physical activity. HIVsport recommends that the appropriate amount of physical activity be discussed with medical supervisors.
Fortunately here in the UK there is a low prevalence of HIV .Other parts of the world are not so fortunate, especially sub-Sahara Africa and some parts of the Caribbean.
If you go on tour to countries where there is a much greater prevalence of HIV you will almost certainly come into contact with people who are HIV positive even if you don’t know it. The good news is that you have nothing to worry about provided you follow the safety precautions set out in this leaflet. In particular, make sure that you use a condom in all sexual encounters you may have while away.
Regrettably there are countries that refuse access to people who are HIV positive.
HIVsport condemns this practice as discriminatory, unnecessary and futile. If you are
HIV positive and need to travel abroad for competition or training then you should make enquiries as to whether there are any entry bans in place. Please contact HIVsport for advice if you are in any way unsure as to what to do.
- HIV infection and AIDS is preventable and can be treated with modern drugs.
- It cannot be cured and if left undiagnosed and untreated can cause early death.
- HIV can only be transmitted through unprotected sex with someone who is HIV positive, sharing contaminated needles, through exchange of infected blood products or from mother to child during birth or breast feeding.
- There are no confirmed cases of HIV being transmitted through sporting contact.
- Bleeding wounds should be treated by following Universal Precautions in respect to First Aid.
- HIV cannot be contracted by sharing changing, shower and toilet facilities or during any other social situation such as sharing a glass or cup.
- If you have multiple sexual partners then it is makes sense to use a condom to prevent HIV and other STI infections, including chlamydia.
Encyclopaedia of Sports Medicine
HIVsport has been commissioned to write a section on ‘HIV and the Athlete’ for the Encyclopedia of Sports Medicine covering the following issues:
- Clinical effects of HIV
- The importance of early diagnosis
- Effects of exercise on HIV
- Prevention of HIV transmission in sport and recreation
- Legislation, including travel restrictions
This publication will be divided into four volumes and contain 700 alphabetically listed entries totalling over one million words. It is expected to become a mainstay in libraries around the world. The Encyclopedia of Sports Medicine will be published by Sage Publications, which publishes textbooks, reference books, and over 460 journals, including the American Journal of Sports Medicine.
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