Getting a tattoo has become mainstream in our generation. Multiple studies and polls have been done to show its increasing acceptance in various career choices as well. Many do not see tattoo art as a risky behavior but rather as a form of wearable art. In most cases, if done at a licensed parlor, it is actually safe due to health regulations put in place by city and state health authorities to ensure customer safety. Required processes include all tattooing equipment go through three steps of sterilization, new ink be used with every customer, and the layout of the parlor be designed in a way that prevents contamination. Additionally, in order to get a tattoo, one must be 18 years of age or have parental consent.
However, this is not always the case. Many people receive their tattoos illegally and in unsanitary environments. This in turn would increase the risk for contracting HIV as well as other blood-born pathogens. Such behavior is mostly associated with jails and prisons as there’s been an increased popularity in use of homemade and internet purchased tattooing machines as well as tattoo parties without proper training in the safe use and practices for operating the machines. Due to the environment in which such tattoos are done, recipients of these tattoos are at risk of not only transmitting HIV, but also Hepatitis C and other blood-borne diseases, skin infections, keloids, and unsatisfactory pieces of permanent art. When a person gets a tattoo, ink is injected into their skin using a tattoo gun. The tip of this gun contains a small needle which punctures the skin causing it to break down. Once this is done, the skin goes through a healing process. Upon initial completion, the tattoo is considered to be an open wound. Because HIV transmission can occur through blood and a person bleeds when they get a tattoo, the possibility of transmitting HIV through a shared tattooing needle or shared ink is very high.
Antiretroviral therapy (ART) is the collection of medications used to treat HIV infection and is recommended for everyone with HIV. Although not a cure, ART has been proven to help people live longer, healthier lives and decrease transmission. These medications prevent the infection from multiplying, thereby reducing the viral load and allowing the immune system a chance to recover. Those who maintain an undetectable viral load of less than 50 copies/mL have no risk of transmitting HIV to their partners through sex. Treatment should be started as soon as possible, especially in pregnancy, AIDS, certain HIV related illnesses and co-infections, as well as early HIV infection.
There are seven HIV drug class medications available for treatment regimens grouped based on their mechanism of action: nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), fusion inhibitors, CCR5 antagonists, post-attachment inhibitors, and integrase strand transfer inhibitors (INSTIs). Initial HIV regimens usually include three medications from at least two different classes. Selection of a proper regimen depends on the side effect profile of the medications and potential drug interactions. Multiple regimens are available to choose from depending on the varying needs of HIV patients. Drug resistance is also possible and can result from HIV mutations as it multiplies in the body. It is a growing concern for many patients as it can be a reason for treatment failure and exclusion of the regimen used. Therefore, it is important that patients have an extensive understanding of HIV as well as adherence to treatment in order to prevent transmission, drug resistance, as well as any other complication.
Baeumler W: The possible health consequences of tattoos. Dtsch Arztebl Int 2016; 113: 663–4. DOI: 10.3238/arztebl.2016.0663
Uptodate. 2020. Overview of antiretroviral agents used to treat HIV. [online] Available at: <https://www-uptodate-com.jerome.stjohns.edu/contents/overview-of-antiretroviral-agents-used-to-treathivsearch=antiretroviral%20therapy&source=search_result&selectedTitle=2~150 &usage_type=default&display_rank=2> [Accessed June 2, 2020].