HIV AIDS
HIV (Human Immunodeficiency Virus)
People have been warned about HIV and AIDS for over twenty years now. AIDS has already killed millions of people, millions more continue to become infected with HIV, and there’s no cure, so AIDS will be around for a while yet.
AIDS is one of the biggest problems facing the world today and nobody is beyond its reach. Everyone should know the basic facts about AIDS.
What is AIDS?
AIDS (Acquired Immune Deficiency Syndrome) is a medical condition. People develop AIDS because HIV has damaged their natural defences against disease.
What is HIV?
HIV is a virus. Viruses infect the cells that make up the human body and replicate (make new copies of themselves) within those cells. A virus can also damage human cells, which is one of the things that can make a person ill.
HIV can be passed from one person to another. Someone can become infected with HIV through contact with the bodily fluids of someone who already has HIV.
HIV stands for the ‘Human Immunodeficiency Virus’. Someone who is diagnosed as infected with HIV is said to be ‘HIV+’ or ‘HIV positive’.
Why is HIV dangerous?
The immune system is a group of cells and organs that protect your body by fighting disease. The human immune system usually finds and kills viruses fairly quickly.
So if the body’s immune system attacks and kills viruses, what’s the problem?
Different viruses attack different parts of the body – some may attack the skin, others the lungs, and so on. The common cold is caused by a virus. What makes HIV so dangerous is that it attacks the immune system itself – the very thing that would normally get rid of a virus. It particularly attacks a special type of immune system cell known as a CD4 lymphocyte.
HIV has a number of tricks that help it to evade the body’s defences, including very rapid mutation. This means that once HIV has taken hold, the immune system can never fully get rid of it.
There isn’t any way to tell just by looking if someone’s been infected by HIV. In fact a person infected with HIV may look and feel perfectly well for many years and may not know that they are infected. But as the person’s immune system weakens they become increasingly vulnerable to illnesses, many of which they would previously have fought off easily.
The only reliable way to tell whether someone has HIV is for them to take a blood test, which can detect infection from a few weeks after the virus first entered the body.
When HIV causes AIDS
A damaged immune system is not only more vulnerable to HIV, but also to the attacks of other infections. It won’t always have the strength to fight off things that wouldn’t have bothered it before.
As time goes by, a person who has been infected with HIV is likely to become ill more and more often until, usually several years after infection, they become ill with one of a number of particularly severe illnesses. It is at this point in the stages of HIV infection that they are said to have AIDS – when they first become seriously ill, or when the number of immune system cells left in their body drops below a particular point.
Different countries have slightly different ways of defining the point at which a person is said to have AIDS rather than HIV.
AIDS is an extremely serious condition, and at this stage the body has very little defence against any sort of infection.
How long does HIV take to become AIDS?
Without drug treatment, HIV infection usually progresses to AIDS in an average of ten years. This average, though, is based on a person having a reasonable diet. Someone who is malnourished may well progress to AIDS and death more rapidly.
Antiretroviral medication can prolong the time between HIV infection and the onset of AIDS. Modern combination therapy is highly effective and, theoretically, someone with HIV can live for a long time before it becomes AIDS. These medicines, however, are not widely available in many poor countries around the world, and millions of people who cannot access medication continue to die.
How is HIV passed on?
HIV is found in the blood and the sexual fluids of an infected person, and in the breast milk of an infected woman. HIV transmission occurs when a sufficient quantity of these fluids get into someone else’s bloodstream. There are various ways a person can become infected with HIV.
Ways in which you can be infected with HIV:
It is not possible to become infected with HIV through:
HIV facts and myths
Around the world, there are a number of different myths about HIV and AIDS. Here are some of the more common ones:
‘You would have to drink a bucket of infected saliva to become infected yourself’. Yuck! This is a typical myth. HIV is found in saliva, but in quantities too small to infect someone. If you drink a bucket of saliva from an HIV positive person, you won’t become infected. There has been only one recorded case of HIV transmission via kissing, out of all the many millions of kisses. In this case, both partners had extremely badly bleeding gums.
‘Sex with a virgin can cure HIV’. This myth is common in some parts of Africa, and it is totally untrue. The myth has resulted in many rapes of young girls and children by HIV+ men, who often infect their victims. Rape won’t cure anything and is a serious crime all around the world.
‘It only happens to gay men / black people / young people, etc’. This myth is false. Most people who become infected with HIV didn’t think it would happen to them, and were wrong.
‘HIV can pass through latex’. Some people have been spreading rumours that the virus is so small that it can pass through ‘holes’ in latex used to make condoms. This is untrue. The fact is that latex blocks HIV, as well as sperm – preventing pregnancy, too.
What does ’safe sex’ mean?
Safe sex refers to sexual activities which do not involve any blood or sexual fluid from one person getting into another person’s body. If two people are having safe sex then, even if one person is infected, there is no possibility of the other person becoming infected. Examples of safe sex are cuddling, mutual masturbation, ‘dry’ (or ‘clothed’) sex.
In many parts of the world, particularly the USA, people are taught that the best form of safe sex is no sex – also called ’sexual abstinence’. Abstinence isn’t a form of sex at all – it involves avoiding all sexual activity. Usually, young people are taught that they should abstain sexually until they marry, and then remain faithful to their partner. This is a good way for someone to avoid HIV infection, as long as their husband or wife is also completely faithful and doesn’t infect them.
What is ’safer sex’?
Safer sex is used to refer to a range of sexual activities that hold little risk of HIV infection.
Safer sex is often taken to mean using a condom for sexual intercourse. Using a condom makes it very hard for the virus to pass between people when they are having sexual intercourse. A condom, when used properly, acts as a physical barrier that prevents infected fluid getting into the other person’s body.
Is kissing risky?
Kissing someone on the cheek, also known as social kissing, does not pose any risk of HIV transmission.
Deep or open-mouthed kissing is considered a very low risk activity for transmission of HIV. This is because HIV is present in saliva but only in very minute quantities, insufficient to lead to HIV infection alone.
There has only been one documented instance of HIV infection as a result of kissing out of all the millions of cases recorded. This was as a result of infected blood getting into the mouth of the other person during open-mouthed kissing, and in this instance both partners had seriously bleeding gums.
Can anything ‘create’ HIV?
No. Unprotected sex, for example, is only risky if one partner is infected with the virus. If your partner is not carrying HIV, then no type of sex or sexual activity between you is going to cause you to become infected – you can’t ‘create’ HIV by having unprotected anal sex, for example.
You also can’t become infected through masturbation. In fact nothing you do on your own is going to give you HIV – it can only be transmitted from another person who already has the virus.
Is there a cure for AIDS?
HIV medication can slow the progress of the virus
Worryingly, surveys show that many people think that there’s a ‘cure’ for AIDS – which makes them feel safer, and perhaps take risks that they otherwise shouldn’t. These people are wrong, though – there is still no cure for AIDS.
There is antiretroviral medication which slows the progression from HIV to AIDS, and which can keep some people healthy for many years. In some cases, the antiretroviral medication seems to stop working after a number of years, but in other cases people can recover from AIDS and live with HIV for a very long time. But they have to take powerful medication every day of their lives, sometimes with very unpleasant side effects.
There is still no way to cure AIDS, and at the moment the only way to remain safe is not to become infected.
HIV Transmission: How u can and can’t be infected?
HIV is a virus that damages human immune cells. It weakens the immune system and, without treatment, leads most infected people to develop AIDS. Like all viruses, HIV infects the cells of a living organism in order to make new copies of itself. HIV can only be transmitted in certain ways and the purpose of this page is to explain how you can and can’t become infected.
HIV is found in blood and other body fluids such as semen and vaginal fluids. It cannot live for long outside the body, so to be infected with HIV you need to allow some body fluid from an infected person to get inside your body. The virus can enter the body via contact with the bloodstream or by passing through delicate mucous membranes, such as inside the vagina, rectum or urethra.
The most common ways that people become infected with HIV are:
How HIV is passed on…
Vaginal sex
HIV is found in the sexual fluids of an infected person. For a man, this means the pre-come and semen fluids that come out of the penis before and during sex. For a woman, it means HIV is in the vaginal fluids which are produced by the vagina to keep it clean and to help make intercourse easier.
If a man with HIV has vaginal intercourse without a condom then HIV can pass into the woman’s body through the lining of the vagina, cervix and womb. The risk of HIV transmission is increased if the woman has a cut or sore inside or around her vagina; this will make it easier for the virus to enter her bloodstream. Such a cut or sore might not always be visible, and could be so small that the woman wouldn’t know about it.
If a woman with HIV has sexual intercourse without a condom, HIV could get into the man’s body through a sore patch on his penis or by getting into his urethra (the tube that runs down the penis) or the inside of his foreskin (if he has one).
Any contact with blood during sex increases the chance of infection. For example, there may be blood in the vagina if intercourse occurs during a woman’s period. Some sexually transmitted infections – such as herpes and gonorrhoea – can also raise the risk of HIV transmission.
Anal sex
Receptive anal intercourse (i.e. being the “bottom”) carries a higher risk of HIV transmission than receptive vaginal intercourse. The lining of the anus is more delicate than the lining of the vagina, so is more likely to be damaged during sex. Any contact with blood during sex increases the risk of infection.
If a man takes the insertive (“top”) position in anal sex with a man or woman who has HIV, then he too risks becoming infected.
Oral sex
Oral sex with an infected partner does carry a small risk of HIV infection. If a person gives oral sex (licking or sucking the penis) to a man with HIV, then infected fluid could get into their mouth. If the person has bleeding gums or tiny sores or ulcers somewhere in their mouth, there is a risk of HIV entering their bloodstream.
The same is true if infected sexual fluids from a woman get into the mouth of her partner.
There is also a small risk if a person with HIV gives oral sex when they have bleeding gums or a bleeding wound in their mouth. Saliva does not pose a risk.
HIV infection through oral sex alone seems to be very rare, and there are things you can do to protect yourself.
Injecting drugs
Injecting drug users are a high-risk group for exposure to HIV. Sharing injecting equipment is a very efficient way to transmit blood-borne viruses such as HIV and Hepatitis C. Sharing needles and “works” (syringes, spoons, filters and blood-contaminated water) is thought to be three times more likely to transmit HIV than sexual intercourse. Disinfecting equipment between each use can reduce the chance of transmission, but does not eliminate it entirely.
Mother to child transmission
An infected pregnant woman can pass HIV on to her unborn baby during pregnancy, labour and delivery. HIV can also be transmitted through breastfeeding.
If a woman knows she is infected with HIV, there are drugs she can take to greatly reduce the chances of her child becoming infected.
Blood transfusions
Some people have been infected through a transfusion of infected blood. These days, in developed countries all the blood used for transfusions is tested for HIV. In those countries where the blood is tested, HIV infection through blood transfusions is now extremely rare. In some developing countries, testing systems are not so efficient and transmission through blood transfusions continues to occur.
Blood products
Blood products, such as those used by people with haemophilia, are now heat-treated to make them safe.
Infection in the health care settings
Hospitals and clinics should take precautions to prevent the spread of blood-borne infections. These measures include using sterile surgical instruments, wearing gloves, and safely disposing of medical waste. In developed countries, HIV transmission in health-care settings is extremely rare. However, cases continue to occur in less-resourced areas where safety procedures are not so well implemented.
Health-care workers have on rare occasions become infected with HIV by being stuck with needles containing HIV-infected blood. A few have also become infected by HIV-infected blood getting into the bloodstream through an open cut, or splashing onto a mucous membrane (e.g. the eyes or the inside of the nose).
There have been only a very few documented instances of patients acquiring HIV from an infected health-care worker.
Tattoos / piercing
Anything that potentially allows another person’s blood to get into your bloodstream carries a risk. If the equipment has not been sterilised before having a tattoo or piercing, there could be a significant risk of exposure if the person before was HIV positive.
In most developed countries there are hygiene regulations governing tattoo and piercing parlours to ensure all instruments used are sterile. If you are thinking of having a tattoo or piercing, ask staff at the shop what procedures they take to avoid infection.
You cannot get AIDS from. . .
Kissing
To become infected with HIV you must get a sufficient quantity of the virus into your body. Saliva does contain HIV, but the virus is only present in very small quantities and as such cannot cause HIV infection.
Unless both partners have large open sores in their mouths, or severely bleeding gums, there is no transmission risk from mouth-to-mouth kissing.
Sneezing, coughing, sharing glasses/cups, etc
HIV is unable to reproduce outside its living host, except under strictly controlled laboratory conditions. HIV does not survive well in the open air, and this makes the possibility of this type of environmental transmission remote. In practice no environmental transmission has been recorded.
This means that HIV cannot be transmitted through spitting, sneezing, sharing glasses, cutlery, or musical instruments.
You also can’t be infected in swimming pools, showers or by sharing washing facilities or toilet seats.
Insects
Studies conducted by many researchers have shown no evidence of HIV transmission through insect bites, even in areas where there are many cases of AIDS and large populations of insects such as mosquitoes. Lack of such outbreaks, despite considerable efforts to detect them, supports the conclusion that insects do not transmit HIV.
HIV only lives for a short time and cannot reproduce inside an insect. So, even if the virus enters a mosquito or another sucking or biting insect, the insect does not become infected and cannot transmit HIV to the next human it feeds on or bites.
Injecting drugs with sterile needles
Injecting with a sterile needle and works will not transmit HIV as long as clean equipment is used each time and none of it is shared.
However, there are still many other risks associated with injecting drug use. If a person is on drugs (including alcohol) then their judgement may be clouded, making them more likely to become involved in risky sexual behaviour, which increases the chance of exposure to HIV.
Protected sex
If used correctly and consistently, condoms are highly effective at preventing HIV transmission. A small minority believe condoms are not adequate protection and that ’some very small viruses can pass through latex’. Scientific tests have disproved this theory.1
Condoms are effective at preventing HIV during both vaginal and anal sex and can help to reduce the risks during oral sex too.
What are the symptoms of HIV and AIDS?
It is not possible to reliably diagnose HIV infection or AIDS based on symptoms alone.
People living with HIV may feel and look completely well but their immune systems may nevertheless be damaged. It is important to remember that once someone is infected they can pass on HIV right away, even if they feel healthy.
The only way to know for sure whether a person is infected with HIV is for them to have an HIV test.
As time passes without effective treatment, HIV weakens an infected person’s immune system, making them much more vulnerable to opportunistic infections. These infections are caused by germs that are around us all the time but which can normally be fought off by a healthy immune system. Once HIV has broken down the body’s defences, such infections can take hold and produce any of a wide range of symptoms – some of them very severe. Certain cancers also become more common when the immune system is weakened.
Such symptoms are, however, not caused directly by HIV, and they can’t by themselves be interpreted as definite signs of HIV infection or AIDS. A diagnosis of AIDS requires signs of severe immune deficiency, which cannot be explained by any factor except HIV. This generally requires an HIV test.
The only way to know for sure whether a person is infected with HIV is for them to have an HIV test.
So does HIV by itself have any symptoms?
Some people who become infected with HIV do not notice any immediate change in their health. However, some suffer from a brief flu-like illness within a few weeks of becoming infected, or develop a rash or swollen glands. These symptoms do not indicate the development of AIDS, and they usually disappear within a few days or weeks.
“I have flu-like symptoms/swollen glands – could it be HIV?”
Many illnesses have flu-like symptoms or cause swollen glands. You cannot have HIV unless you have been directly exposed to the virus. HIV can be transmitted during sexual intercourse with an infected person, through contact with infected blood or breastmilk, or during unsafe injections or medical procedures.
10 Tips for People Newly Diagnosed With HIV
Based upon the book ‘HIV and Me’ by Kozby Kritzer 2004 and revised by Raphael Meyer (Action for AIDS, Singapore)
1. To begin healing after the shock of hearing your diagnosis, first acknowledge your fears and feelings about having HIV, and then take ownership of them. Joining a support groups will help in the healing process. Try not to tell the whole world and anyone about your diagnosis during this time as it might be done in haste. Remember there is still much stigma and discrimination about HIV in Singapore so a much as you would like those around you to understand, you must be wary that they might have a hard time to relate. Call Action for Aids and speak to a HIV counsellor there for more help and advice.
2. Instead of reliving the past or imagining a grim future for yourself, keep your mind focused on the present as that is where your healing happens. Today’s world HIV is a disease that can be managed with the right therapy and medications. People live a normal, healthy and productive life. But understand that feeling down and low is normal. You will get better as time goes on.
3. Forget other people’s stories with HIV/AIDS and make it your own experience, as what you do each day creates your own future.
4. Whenever you feel stressed, filled with anxiety or just plain overwhelmed, stop and focus on your breathing to clear your mind and give it and your body a moment’s peace. Close your eyes, count to ten and tell yourself as you exhale you are exhaling the negativity in your life. It helps no matter how funny this action may sound.
5. Control the flow of information that you absorb about HIV/AIDS to prevent your mind from either overloading or from slipping into complete denial about your diagnosis. Don’t spend every waking moment on reading HIV information and then relating it to you. Most of the information may be irrelevant and even unreliable. Confirm the info with your HIV doctor or HIV counsellor.
6. Regardless of your current health status, never forget that you are in complete control of your medical treatment and have the right to change it at any time. You should be informed about your anti-retro viral medication. No one has the authority to dictate to you what you need to take but discuss with your doctor your financial situation and get a second opinion if necessary.
7. Use your support network of family, friends and/or counselors to remind yourself that you are not in this alone, and that there are people ready and eager to provide the comfort and compassion that you need right now.
8. Once you are feeling more centered, work to build a strong foundation for your future including making lifestyle changes and utilizing community resources available to support your healing and long term health.
9. After your foundation is in place, spend some time managing how HIV affects your daily life both in social situations and in respect to financial and legal matters. Talk to a financial counsellor or seek legal advice. AfA has both these services for free. Call and seek the right info for yourself.
10. Finally, to complete your journey towards a place of peace with HIV, strive to balance your mind, body and spirit, using activities like exploring your spirituality, doing volunteer work or experiencing holistic therapy if needed. There are Christian, Buddhist and Muslim and other support groups that can cater to your needs. For more info on this call AfA.
