Which modes of transmission occur with HIV infection? (Select all that apply)

Choice A reason:
Morphine is not most effective when given orally due to the high first-pass effect. The first-pass effect refers to the metabolism of a drug in the liver immediately after it enters the bloodstream from the gastrointestinal tract, significantly reducing the amount of active drug that reaches systemic circulation. Therefore, oral administration of morphine is not the most effective route because much of it is metabolized before it can exert its effect.

Choice B reason:
Morphine will be more effective when given via a non-enteral route such as intravenous (IV) or subcutaneous (SQ) because these routes bypass the liver, thereby avoiding the first-pass metabolism. This allows a higher concentration of the active drug to reach the systemic circulation, providing a more potent and effective pain relief.

Choice C reason:
Oral and IV administration of morphine do not have the same effect due to the first-pass metabolism. When morphine is administered orally, a significant amount is metabolized by the liver before it reaches the systemic circulation, whereas IV administration delivers the drug directly into the bloodstream, bypassing the liver and allowing a higher active concentration.

Choice D reason:
Morphine is not primarily excreted by the lungs; it is mainly metabolized by the liver and excreted by the kidneys. This statement does not accurately demonstrate an understanding of the first-pass effect or the pharmacokinetics of morphine.

Choice A reason:
HIV can be transmitted through blood products. This mode of transmission occurs when contaminated blood, used in transfusions or other medical procedures, carries the virus to another person. It is one of the primary ways HIV spreads, especially before strict blood screening protocols were implemented.
Choice B reason:
Perinatal transmission refers to the transmission of HIV from a mother to her fetus during pregnancy, childbirth, or breastfeeding. This is a significant mode of transmission, particularly in regions with high HIV prevalence and limited access to antiretroviral therapy.
Choice C reason:
This choice is incorrect because HIV is not transmitted through airborne means. Unlike respiratory viruses, HIV requires direct contact with certain body fluids for transmission. Airborne transmission would imply that the virus could spread through the air, which is not the case with HIV.
Choice D reason:
Sexual transmission is a major route for HIV spread. The virus is present in bodily fluids such as semen, vaginal fluids, and rectal fluids. Unprotected sexual contact allows the virus to pass from one person to another, making this a crucial mode of HIV transmission.