How is HIV virus transmitted during sexual intercourse?

Dear doctor; The issue of HIV virus infection is always a hard one in one way or the other. Some say it takes friction during intercourse and that sexual organs must have had bruises for body fluids to exchange and cause a transmission. Others say it is just the sexual fluids in contact that causes it. Which is which? How is HIV really transmitted? Arinaitwe R, Nyagatare. Dear Arinaitwe, It is a fact that HIV gets easy access inside body through abrasions in the protective lining of the body organs. Sexual intercourse does cause some bruises and abrasions over the genital parts because the protective covering (mucosa) of these parts is very delicate. As such, the virus is present in maximum concentration in the blood and transfusion with infected blood remains a sure way of transmitting infection. But since one does sexual activity more frequently, there is greater chances of acquiring and transmitting the virus. All other body fluids can also transmit the virus from an infected person. These include semen pre-seminal fluid, rectal fluids, vaginal fluids and breast milk. Apart from the fluids, the virus can also spread through contaminated tools such as infected syringe, needles, shaving razors, among others. Therefore, it is important to maintain good hygiene of tools used, use disposable tools wherever possible. Use of a condom prevents acquiring and transmitting HIV infection. But condom needs to be of a good quality and should not break during sexual intercourse.