Editor’s Note: In this guest blog posting, our Temple University communications student intern Cambriae Bates discusses the health risks, including HIV transmission, involved in tattooing.

Think about the different ways HIV can be transmitted. What was the first way that came to mind?

Most people probably thought of unprotected sex (through the exposure tosemen, pre-seminal fluid, rectal fluids, and vaginal fluids) and secondly many people conceivably thought of injection drug use (the sharing of syringes). Although these two ways of transmitting the virus are the most prevalent, there are also other ways that individuals can become infected with the virus. Some of these ways tend to slip our minds. How many of you left out tattoos?

How Tattoos Work

When a person gets a tattoo, ink is injected into their skin with a tattoo gun. The tattoo gun has a little needle on the tip that punctures the skin between 50-3,000 times per minute. With each puncture, an insoluble drop of ink is deposited into the skin. This process breaks the skin and once it is done the tattoo even goes through a healing process. When first finished the tattoo is considered to be an open wound. Since HIV can be transmitted through blood and a person bleeds when they get a tattoo, it is possible to transmit HIV through a shared tattooing needle or shared ink.

The Growing Trend

Over the last few decades tattoos have become a growing trend. With popular shows like LA Ink, Miami Ink, and the Black Ink Crew, the popularity of tattooing has risen to high levels among the younger generations. In December 2013 Pew Research Center conducted a study showing that 36 percent of people 18-25 and 40 percent of people 26-40 in the U.S. have at least one tattoo. A poll conducted by NBC in 2014 also showed that 40 percent of people live with someone who has a tattoo as compared to 14 percent in 1999.

Most people would not consider tattoo art to be a risky behavior. Many may see it as rebellious, edgy, or artsy, but few see it as dangerous. In most cases tattooing is actually safe. If a person goes to a licensed parlor there is often nothing to worry about. There are health regulations in place by city/state health authorities, which professional parlors must follow, in order to insure the customer’s safety. Some processes required are that the tattooing equipment go through three steps of sterilization, new ink be used with every customer, and the layout of the parlor must be designed in a way that keeps out contamination (for example, the tattooing room cannot be adjacent to a kitchen). The law also states that in order to get a tattoo you must be 18 years of age or have parental consent. However, there are many people who receive their tattoos illegally.

Unsafe Parties

A lot of people may not have heard of tattoo parties, but it has been a growing fad among the youth over the last few years. Tattoo parties are gatherings in which the attendees are usually looking to get an inexpensive tattoo. They are usually held in someone’s house or basement. The artist is often unlicensed, amateur, and s/he often has their own home tattooing kit. These parties frequently take place in low income communities and/or among teens. This demographic partakes in this risky behavior because they cannot afford legitimate tattoos and/or are not yet of legal age to go to a parlor. Due to the environment in which these are done people are at risk of not only transmitting HIV, but Hepatitis C and other blood-borne diseases, skin infections, keloids(abnormal proliferation of scar tissue), and just a bad piece of permanent art.

It’s hard to say how many tattoo parties occur. Usually officials are not aware that they are happening unless the event was advertised prior to taking place. A report on tattoo parties in 2012 highlighted some of the avenues artists use to advertise their discounted services.  It showed that sometimes artists even advertise on craigslist. In 2009 Philadelphia police were able to raid several parties do to flyers being posted and leads from other forms of advertisements, but this is not enough to stop the phenomenon.

Tattoos in Prison

The people most at risk of HIV transmission from tattoos are prison inmates. Tattooing is a large part of prison culture. Prisoners get tattoos for gang reasons, as a way to reclaim pieces of their freedom and individuality, and as a way to express pride for their backgrounds or deeds they’ve done. Often they will create a motor from dryers, fans, radios, or cassette players. They will make the tattoo needle from things such as pens, guitar strings, sewing needles, and even staples from book bindings. The inmates may get the ink from pens or they’ll burn books and make ink with the soot.

This is extremely dangerous because it is done in secret with a limited amount of supplies. The inmates are often sharing materials. One recent article has stated that about 2 percent of the U.S. prison population is HIV positive and 30-40 percent have Hepatitis C. Although more people are infected with Hepatitis, allowing it to spread more frequently, inmates are at risk for both because they can be transmitted the same way.

Why Worry?

It is very hard to say the percentage of people who may have been infected with the virus through tattooing. Most sources say there have been no documented cases of HIV transmission from this activity. Even so, the Centers for Disease Control and Prevention still recognizes thepossibility of becoming infected with HIV through tattooing. We should be aware of the real possibility, especially in the light of growing illegal activities surrounding tattooing. With the increasing popularity of tattoos people are getting inked younger and younger. Teenagers seem to be unaware of the dangers and therefore make riskier decisions. It is good to talk about all the ways people can become infected with the virus because awareness brings about safety and safety precautions will bring about an AIDS-free generation.

–Cambriae Bates, ActionAIDS Development Intern