the basic presentation gives you just facts ,if you are newly diagnosed or u are trying to the simple informationHIV attacks the immune system's soldiers - the CD4 cells. When the immune system loses too many CD4 cells, you are less able to fight off infection and can develop serious opportunistic infections (OIs). A person is diagnosed with AIDS when he or she has less than 200 CD4 cells and/or one of 21 AIDS-defining OIs.
- Common myth: "HIV doesn't cause AIDS."
- Truth: If you don't have HIV, you can't get AIDS. If you have AIDS, you have HIV. There is 20 years of solid scientific proof on this. AIDS is not caused by party drugs, AZT, government conspiracies, or anything else but a virus.
- Common myth: "The HIV test can't be trusted."
- Truth: The HIV antibody test is one of the most reliable medical tests. According to the Centers for Disease Control and Prevention (CDC), it is more than 99% accurate. In addition, all positive results are confirmed with another test (called the Western Blot) to insure no mistakes are made.
- Common myth: "It's not AIDS that kills people, it's the medicines they take!"
- Truth: HIV drugs can help keep people healthy for a longer time. People died from AIDS before AZT or any other drugs came out. In fact, death rates have gone down a great deal in the U.S. since new HIV medications came out in the mid-nineties.
- Blood
- Semen
- Vaginal fluids
- Breast milk
The most common ways HIV is passed from one person to another are:
- Reusing and sharing needles
- Unprotected sex
- Mother-to-child
- During pregnancy, during birth, or through breastfeeding
- Do not reuse or share dirty needles: Clean needles with a bleach solution before reusing them or use fresh needles each time.
- Do not have unprotected sex: Use a condom every time you have sex, especially for anal and vaginal intercourse, which are the riskiest sexual activities.
- Get tested if you are pregnant or considering pregnancy: HIV+ mothers can pass the virus to their babies while pregnant, during birth, or by breastfeeding. Advances in treatments have significantly reduced the risk of a baby getting HIV from its mother when precautions are taken.
- Common myth: "HIV can be spread through casual contact.
- Truth: HIV cannot be spread through tears, sweat, and saliva. Casual contact is not risky because it does not include contact with infectious body fluids. Examples of casual contact include: social kissing, use of public facilities (pools, theaters, bathrooms), sharing drinks or eating utensils, etc. Insect bites do not transmit HIV
- Common myth: "Straight people don't get HIV."
- Truth: The majority of HIV+ people worldwide are heterosexual. "Traditional" sex (vaginal intercourse) puts both partners at risk, but the woman is more vulnerable to HIV infection.
- Common myth: "I'm safe because I'm in a monogamous relationship (or married).
- Truth: You might have gotten infected before your relationship. If not, if your partner is unfaithful, or was already HIV+ before you met, you can still get HIV.
- Common myth: "Lesbians don't get HIV."
- Truth: Women who only have sex with women are generally at lower risk. Women who consider themselves lesbians but occasionally have sex with men can get infected that
- Herpes simplex virus (genital herpes)
- Human papilloma virus (warts, dysplasia)
- Pelvic inflammatory disease (PID)
- Fungal Infections (yeast infections, vaginal candidiasis)
- Menstrual (period) Problems
Safer Sex
Most people know that serious, even life-threatening infections, like HIV, hepatitis and other sexually-transmitted diseases (STDs) can be passed from one person to another through sex. One approach to lowering this risk is called "harm reduction." If you do not want to abstain from sex, harm reduction offers options to make sexual activity safer.
Safer sex isn’t only for the prevention of new HIV infections. It’s important for positives, too. A couple where both partners are HIV+ can use safer sex to prevent co-infection with other STDs that can weaken the immune system. Safer sex can also reduce the possibility of getting reinfected (also called superinfected) with a strain of HIV that is resistant to the drug regimen you are taking.
Since every sexual act that involves sexual fluids has at least some risk, safer sex means using barriers every time. Barriers include condoms (male and female), dental dams, latex gloves, and even plastic food wrap (not microwave-style plastic wrap). Barriers help reduce risk substantially.
Even though it is the safest thing to do, some couples do not always use barriers. If this is the case, you can still practice some kind of harm reduction.
Sometimes the place to start in safer sex is to identify the riskiest thing you do and then think about how you could make that activity less risky. The following are some safer sex tips, starting with the most risky activities and moving to less risky activities:
Penetrative sex is considered the highest-risk activity. For both vaginal and anal sex, use latex condoms and lots of water-based lubricant (lube) to prevent the condom from breaking. Lube also helps condoms feel better.
If you’re not going to use condoms, try to reduce the friction by using a heavier lube that will help prevent small cuts or tears in the vagina, rectum or penis. (Because you’re not using latex, Vaseline or Crisco are better than water-based lubes since they last longer.) Also avoid getting semen in the body by having the man pull out before cumming.
Different studies report different levels of risk for HIV infection during unprotected oral sex. However, most studies find that the risk is low. To make it safer, use latex condoms for oral sex on a man. If you perform oral sex without a condom, finish up with the hand, or spit semen out and rinse with a dental wash rather than swallowing.
Dental dams are large squares made from latex. Plastic food wrap (not microwave-style plastic wrap) is just as effective. Put some water-based lube on one side of the dam or plastic wrap. Then stretch the dam over the vagina or anus with the lubed side facing down. This gives you a thin barrier between your mouth and the vagina or anus.
If you don’t use a barrier, avoid getting precum, semen or vaginal fluids in your mouth. Avoid vaginal oral sex during menstruation to prevent contact with blood. Bad oral hygiene (bleeding gums, ulcers, gum disease) can make oral sex much riskier. Use a mint instead of brushing your teeth before sex.
Paper cuts and other openings in the skin can make your hands vulnerable to infection. Wearing latex gloves keeps you protected during hand-vagina or hand-anus sex. Adding lube to the outside of the gloves will increase your partner’s pleasure.
Other safer sex tips: Limit the time and frequency of penetrations. Try non-penetrative sex for a change. For example, consider mutual masturbation. Also get medical attention for any infections or health problems in the genital area.
Try and change your ways of thinking that make it difficult for you to practice safer sex. The things you think influence how you act.
Thought: "We slipped once and forgot to use a condom, so it's too late now."
New idea: It's never too late. Yes, even one exposure can be dangerous, but it's not as dangerous as a hundred exposures! If you slipped once, it's time to get back on the wagon.
Thought: "Safer sex is such a drag. It's no fun."
New idea: Here's a great chance to spice up your sex life. Why not take one of the workshops offered on "Eroticizing Safer Sex?" How about getting a book, video, or DVD about hot safer sex?
Thought: "I can't feel anything through condoms!"
New idea: Time to change brands! Getting free condoms at the health office or buying them at a drugstore may be cheap, but you're probably not getting the best around. Try some of the variety packs offered by mail-order sex supply catalogs or hit the "adult love" stores in your area for a better selection. The best condoms are thin but tough and transmit heat and sensation well.
Thought: "My partner absolutely refuses to use a condom."
New idea: How comfortable are you with someone who is willing to put your life at risk? This sounds like a serious issue, and it's probably not the only one in your relationship. Have you considered individual or couple's counseling?
Thought: "I can't suggest to my girl/guy that we get an HIV test. We've been together so long that s/he would take it as an insult."
New idea: How about presenting it as an act of love? "You know, I really love you. We've been together for a while, but we never got tested for HIV. I hate the thought that I could be putting you at risk, because I couldn't stand to hurt you. Why don't we go get tested together for our peace of mind?"
Sometimes the safest thing you can do in sex is keep a clear head. Sex when you are drunk or under the influence of drugs may be most likely to be unsafe.
Many of the stories and rumors about HIV are exaggerated or just made up. In dealing with HIV, it's important to know reality from myth. Believing myths can result in fear, in denial, and even in damage to your health.
The myth: "HIV doesn't cause AIDS."
The reality: If you don't have HIV, you don't get AIDS. If you have AIDS, you have HIV. There is 20 years of solid scientific proof on this. AIDS is not caused by party drugs, AZT, government conspiracies or anything else but a virus.
The myth: "It's not AIDS that kills people, it's the medicines they take!"
The reality: HIV medications, known as antiretrovirals, don't cure HIV, but they can help keep people healthy for a longer time. People died from AIDS before AZT or any other drugs came out. In fact, death rates have gone down a great deal in the U.S. since new HIV medications came out in the mid-nineties. Unfortunately, the drugs do have side effects and toxicities (for some people) which in very rare cases have resulted in death.
The myth: “The 'AIDS test' can't be trusted.”
The reality: The 'AIDS test' measures your body's response to HIV, called antibodies. The HIV antibody test (called ELISA) is one of the most reliable medical tests. According to the Centers for Disease Control and Prevention (CDC), it is more than 99% accurate. In addition, all positive results are confirmed with another test (called the Western Blot) to insure no mistakes are made.
The myth: “Viral load tests don’t really tell anything about a person's health.”
The reality: Viral load measures the amount of HIV in a person’s blood. Many studies have shown that people with high viral loads are much more likely to become ill or die than those with low viral loads.
The myth: "Straight people don't get HIV."
The reality: The majority of HIV+ people worldwide are heterosexual. Men infect women, and women infect men. Risk is not about labels, it is about behavior. A 'straight' woman who has unprotected sex with men is at more risk for HIV than a 'gay' man who always practices safe sex.
The myth: "I'm safe because I'm in a monogamous relationship (or married)."
The reality: Were you tested for HIV before you got into the relationship? Was your partner? Were both tests negative? And do you spend 24 hours a day together? If you're faithful, but he or she is not, or he or she was already HIV+ before you met, you can still get HIV.
The myth: "I'm safe because I'm a virgin."
The reality: Again, virgin is just a label. If you have had no sexual contact at all, you're fine. If you have had oral or anal sex, but consider yourself a 'virgin' because you haven't had vaginal sex, you are still at risk.
The myth: "Lesbians don't get HIV."
The reality: Women who only have sex with women are generally at lower risk, because of the sexual activities they engage in. But they can still get HIV. A recent case was reported where a lesbian was infected through sharing sex toys with her HIV+ partner. Also, many women who consider themselves lesbians occasionally have sex with men, and can get infected that way.
The myth: “HIV can be spread through tears, sweat, mosquitoes, pools or casual contact.”
The reality: HIV can only be transmitted through infected blood, semen, vaginal fluids and breast milk. The most common ways for HIV to be transmitted are through unprotected sexual contact and/or sharing needles with an HIV+ person. HIV can also be passed from mother to baby.
The Stages of HIV Disease
HIV Is a Continuum
Most of us are used to thinking of disease in very simple terms: if you feel sick, you are sick; if you feel healthy, you are healthy. However, because HIV may begin causing subtle changes in the immune system long before an infected person feels sick, most doctors have adopted the term "HIV disease" to cover the entire HIV spectrum, from initial infection to full-blown AIDS (which is also called "advanced HIV disease").
The HIV continuum described below is representative of the experience of many people with HIV. The time that it takes for each individual to go through these stages varies. For most people, however, the progression of HIV disease is fairly slow, taking several years from infection to the development of severe immune suppression.
Infection
Following exposure to the virus, HIV enters the bloodstream and begins to take up residence in the cells; this is when HIV infection occurs. People with HIV are considered to be infectious (able to transmit HIV to others) immediately after infection with the virus.
A person with HIV is infectious at all times. Also, a person does not need to have symptoms or look sick to have HIV. In fact, people may look perfectly healthy for many years despite the fact that they have HIV in their bodies. The only way to find out if you are infected is by taking an HIV test.
Primary Infection (or Acute Infection)
Primary HIV infection is the first stage of HIV disease, typically lasting only a week or two, when the virus first establishes itself in the body. Some researchers use the term acute HIV infection to describe the period of time between when a person is first infected with HIV and when antibodies (proteins made by the immune system in response to infection) against the virus are produced by the body (usually 6 to 12 weeks) and can be detected by an HIV test.
Up to 70% of people newly infected with HIV will experience some "flu-like" symptoms during this stage. These symptoms, which usually last no more than several days, might include fevers, chills, night sweats, and rashes. Afterward, the infected person returns to feeling and looking completely well. The remaining percentage of people either do not experience symptoms of acute infection or have symptoms so mild that they may not notice them.
Given the general character of these symptoms, they can easily have causes other than HIV, such as a flu infection. For example, if you had some risk for HIV infection a few days ago and are now experiencing flu-like symptoms, it is possible that HIV is responsible for the symptoms, but it is also possible that you have some other viral infection instead. If you believe you may have been exposed to HIV, you may want to consider calling an AIDS hotline to discuss whether you were in a situation that put you at risk for HIV infection and whether you should take an HIV test. Within California, you can call the California AIDS Hotline toll-free at 800/367-AIDS. Outside California, call your State's AIDS Hotline or the CDC-Info line toll-free at 1-800-232-4636. To find the number for your state's hotline go to www.aidshotline.org and click on Other Hotlines.
During acute HIV infection, the virus makes its way to the lymph nodes, a process which is believed to take three to five days. Then HIV actively replicates (makes copies of itself) and releases new virus particles into the bloodstream. This burst of rapid HIV replication usually lasts about two months. People at this stage often have a very high HIV "viral load" (amount of virus in the body). However, people with acute HIV infection usually will not test positive for HIV antibodies, since it takes the body approximately one to three months to produce antibodies against HIV.
Some individuals who fear they have recently been exposed to HIV may be curious about PCR and RNA viral load testing, which test directly for the virus itself rather than for antibodies and can therefore be used during the acute infection stage. Viral load testing is generally used by physicians to track the progression of HIV disease in the body--thus helping HIV positive patients make choices about appropriate treatment strategies. Most people concerned about their HIV status do not need viral load testing. The antibody test is the cheapest, easiest, and overall most reliable way for individuals to learn their HIV status. That said, individuals who have been exposed to HIV recently and experience symptoms consistent with acute HIV infection can request a viral load test from their doctor. This test may help identify HIV infection during the "window period" before HIV antibodies have developed, though an antibody test will ultimately be needed to confirm the viral load test result.
Some doctors are treating newly infected people (those in the acute stage of HIV infection) with a combination of anti-HIV drugs. Scientists disagree about whether anti-HIV treatment is useful during primary HIV infection. While some researchers are optimistic about the impact of very early anti-HIV treatment, they are also concerned about drug side effects, long-term effects on the body, and the possibility of developing drug-resistant virus if people use powerful anti-HIV drugs before they become ill due to HIV disease. You should consult with your doctor to make the most informed choice about when to start taking anti-HIV medications.
Seroconversion
This term refers to the time when an HIV positive person's immune system responds to the infection by producing antibodies to the virus. Most people develop antibodies within three months after infection, and some can take up to six months.
If an antibody test is done before seroconversion is complete, it may give a "false negative" result because sufficient antibodies have not yet been developed by the body. A three-month window period between infection and production of antibodies is normal for most of the population. Very, very rarely (i.e., in only a few cases ever), a person may take six months to produce antibodies. To be certain of your HIV status, take an HIV antibody test three months or longer after you were exposed to the virus. For even greater certainty, get tested again six months after the exposure occurred.
The Asymptomatic Stage
After the acute stage of HIV infection, people infected with HIV continue to look and feel completely well for long periods, usually for many years. During this time, the only indication that you are infected with HIV is that you will test positive on standard (antibody) HIV tests and you may have swollen lymph glands.
This means that you look and feel healthy but can infect other people through unprotected sex or through needle sharing--especially if you have not been tested and do not know that you are infected.
Even though an infected person may appear perfectly healthy, HIV is still very active and is continuing to weaken the immune system during this stage. In some individuals, the virus appears to slowly damage the immune system over a number of years. In most people, however, a faster decline of the immune system occurs at some point, and the virus rapidly replicates. This damage can be seen in blood tests before any actual symptoms are experienced.
HIV positive people should seek medical care and begin monitoring their immune systems as soon as possible after receiving a positive test result. Periodic immune monitoring tests, such as CD4 count and viral load tests, can give you and your doctor a better picture of your immune health and disease progression, and can help you make smart choices about treatment.
Seeking early care for HIV disease can give people better chances of survival and improved quality of life. People with HIV are encouraged to see a doctor regularly, even if they feel fine at the moment, because the virus could be already damaging the immune system. Early and regular care enables HIV positive individuals and their medical care providers to take control of their treatment before symptoms appear.
Early- and Medium-Stage HIV Symptomatic Disease
When the immune system is compromised by HIV infection, many people begin to experience some mild HIV disease symptoms, such as skin rashes, fatigue, night sweats, slight weight loss, mouth ulcers, and fungal skin and nail infections. Most, though not all, will experience mild symptoms such as these before developing more serious illnesses. Although one's prognosis varies greatly depending on a number of factors, it is generally believed that it takes five to seven years for the first mild symptoms to appear. These symptoms mark the early and medium stages of HIV symptomatic disease.
As the disease progresses, some individuals may become quite ill even if they have not yet been diagnosed with AIDS, the late stage of HIV disease. Typical problems include chronic oral or vaginal thrush (a fungal rash or spots), recurrent herpes blisters on the mouth (cold sores) or genitals, ongoing fevers, persistent diarrhea, and significant weight loss.
These symptoms are not necessarily specific to HIV or the development of AIDS. However, they should be of concern to people who have tested positive for HIV. Usually, symptoms occur when the virus has already caused considerable damage to the immune system. For that reason, people with HIV should not wait until symptoms appear to get medical treatment. Also, people with high risk for HIV infection should not wait to for symptoms to appear before getting tested.
Late-Stage HIV Disease (AIDS)
When immune system damage is more severe, HIV positive individuals may experience opportunistic infections (called "opportunistic" because they are caused by organisms which do not ordinarily induce illness in people with normal immune systems, but take the opportunity to flourish in people with compromised immune systems). Some of the most common opportunistic infections include Pneumocystis carinii pneumonia (PCP), Mycobacterium avium complex (MAC) disease, cytomegalovirus (CMV), toxoplasmosis, and candidiasis.
According to the Centers for Disease Control and Prevention (CDC), an AIDS diagnosis can be given to an HIV positive person who has a CD4 count of less 200/mm3 or a history of an "AIDS-defining illness" (such as one of the opportunistic infections mentioned above). For more information on what defines AIDS, including a complete list of AIDS-defining illnesses, see "Mortality Trends" from the Winter 2005 BETA.
It is important to note that this definition of AIDS may apply to HIV positive individuals who have never experienced symptoms of HIV disease.
Receiving an AIDS diagnosis does not necessarily mean that the diagnosed person will die soon; some people have lived for many years after their diagnosis. This is even more the case today with the availability of highly active antiretroviral therapy (HAART), which has helped extend the lives of thousands of people living with HIV and AIDS. In addition, many opportunistic infections can be prevented or treated successfully. This has substantially increased the longevity and quality of life of people living with HIV/AIDS.
Does everyone who has HIV eventually develop AIDS? We don't know for certain. Studies show that the majority of untreated people do eventually become ill from HIV. However, with regular medical care and other positive lifestyle factors, such as emotional support, many long-term survivors have been living with HIV/AIDS for upwards of two decades. As existing treatments are used earlier in the course of HIV disease and new treatments are developed, it has become possible to further postpone, and perhaps even prevent, illness.
The following “bodily fluids” are NOT infectious:
- Tears
- Sweat
- Saliva
- Urine
- Feces
Casual contact is not considered risky because it does not include contact with blood or other infectious body fluids. Examples of casual contact include: social kissing, public venues (pools, theaters, bathrooms), sharing drinks or eating utensils, etc. Insect bites do not transmit HIV.
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