Patients, families, and friends are instructed about the routes of transmission of HIV. The nurse discusses precautions to prevent transmitting HIV, including using condoms during vaginal or anal intercourse ; using dental dams or avoiding oral contact with the penis, vagina, or rectum; avoiding sexual practices that might cut or tear the lining of the rectum, vagina, or penis; and avoiding sexual contact with multiple partners, individuals known to be HIV infected, people who use injection drugs, and sexual partners of people who inject drugs. Patients and their families or caregivers must receive instructions about how to prevent disease transmission, including hand washing techniques, and in methods for safely handling items soiled with body fluids. Caregivers in the home are taught how to administer medications, including IV preparations. The medication regimens used for patients with HIV infection and AIDS are often complex and expensive. Patients receiving combination therapies for treatment of HIV infection and its complications require careful teaching about the importance of taking medications as prescribed and explanations and assistance in fitting the medication regimen into their lives . Guidelines about infection and infection control, follow-up care, diet, rest, and activity are also necessary. Patient teaching also includes strategies to avoid infection. The importance of personal hygiene is emphasized. Kitchen and bathroom surfaces should be cleaned regularly with disinfectants to prevent fungal and bacterial growth. Patients with pets are instructed to have another person clean areas soiled by animals, such as bird cages and litter boxes. If this is not possible, the patient should use gloves to clean up after pets. Patients are advised to avoid exposure to others who are sick or who have been recently vaccinated. Patients with AIDS and their sexual partners are strongly urged to avoid exposure to body fluids during sexual activities and to use condoms for any form of sexual intercourse. Injection drug use is strongly discouraged because of the risk to the patient of other infections and transmission of HIV infection to others. Patients infected with HIV are urged to avoid exposure to bodily fluids (through sexual contact or injection drug use) to prevent exposure to other HIV strains. The importance of avoiding smoking and maintaining a balance between diet, rest, and exercise is also emphasized. If the patient requires enteral or parenteral nutrition, instruction is provided to patients and families about how to administer nutritional therapies at home. Home care nurses provide ongoing teaching and support for the patient and family. Patients who are HIV positive or who inject drugs are instructed not to donate blood. Injection drug users who are unwilling to stop using drugs are advised to avoid sharing drug equipment with others.