Facts about HIV and AIDS


Facts and Questions: HIV and AIDS

 

HIV Prevention Specific facts and questions

 

For more information, please call 0243362447 – WAAF’s onsite clinic to speak to a professional health care worker.

 

  • What is the difference between HIV and AIDS?
    • HIV is the virus that causes AIDS.
      • H— Human: because this virus can only infect human beings.
      • I— Immuno-deficiency: because the effect of the virus is to create a deficiency, or a failure to work properly, within the body’s immune system.
      • V— Virus: because this organism is a virus, which means one of its characteristics is that it is incapable of reproducing by itself. It reproduces by taking over the machinery of the human cell.
      • A— Acquired: because it is a condition one must acquire or get infected with; not something transmitted through the genes
      • I— Immune: because it affects the body’s immune system, the part of the body which usually works to fight off germs such as bacteria and viruses
      • D— Deficiency: because it makes the immune system deficient (makes it not work properly)
      • S— Syndrome: because someone with AIDS may experience a wide range of different diseases and opportunistic infections
  • How is HIV spread? – the common ways to get infected with HIV is:
    • Having sex (anal, vaginal, or oral) with a person who has HIV
    • Sharing sharp objects such as needles, shaving sticks with someone who has HIV
    • Women with HIV can pass it to their babies before or during birth, and through breastfeeding.
  • Can latex condoms prevent HIV?
    • When used consistently and correctly, they’re very good at stopping the spread of HIV during sex. But condom use can’t give you perfect protection.
    • If either partner is allergic to latex, try plastic (polyurethane) condoms. You can get them for both men and women.
    • The surest ways to avoid getting HIV are to not have sex or to be in a long-term relationship with a partner who’s tested negative and you’re exclusive with each other.
  • Can I get HIV from Oral sex?
    • Yes, it’s possible — whether you’re giving or getting oral sex. While no one knows exactly how risky it is, evidence suggests it has less of a risk than unprotected anal or vaginal sex.
    • You should use protection for oral sex, too: A latex condom on a man, and a latex barrier between a woman’s vagina and her partner’s mouth. This barrier could be a natural rubber latex sheet, a dental dam, or a cut-open condom that makes a square.
  • Can I get HIV from anal sex?
    • In fact, anal sex without a condom is very risky behavior. Either sex partner can become infected with HIV.
  • How can I tell I have HIV? What are the symptoms?
    • Many people who have HIV don’t have any symptoms at all for many years. The only way to know if you’re infected is to get tested.
    • Don’t wait for symptoms to show up. If you find out you’re infected soon after it happens, you’ll have more options for treatment and care to help prevent you from getting sick.
    • There are no specific symptoms that can tell you for sure that one is infected with HIV however depending on the severity of some infections one can be suspicious and go in for a test.

 

TESTING:

  • How do I get tested for HIV?
    • Most often, a technician or other health care worker or trained tester will use a finger prick from one of your fingers to check to see if there are antibodies for HIV. You can also test other body fluids— oral fluid (not saliva, collected from your mouth using a special device that comes with a test kit known as oraquick. . Some rapid screening tests can give results in 15 to 20 minutes.
    • HIV antibodies is found using the rapid test kits which are only useful once a person has been exposed to HIV for at least a month or more. If one tests earlier than a month after exposure, it may be likely the test kit will not pick up the antibodies and you will not know you are infected.
    • Other blood tests can find both antibodies and a part of the virus itself. These could give a positive result as soon as 3 weeks after HIV exposure.
    • If any of these screening tests say you’re positive, follow up with a doctor and more testing to confirm it.
  • I have heard there are many different types of HIV tests. How do I know which one I should take?
    • Where we are (in Ghana) the tests we use as first line tests are called First Response and “Oraquick,” both of which are known as the “rapid test.” First response is able to detect both HIV type 1 and 2 antibodies whilst Oraquick detects only HIV-1 antibodies. They are both highly accurate and the results can be determined within 20 minutes. It provides same day results and counseling. The First Response is used to do the initial test and You should however be aware that if the results of the test come out to be “preliminary positive,” which is the same at REACTIVE, there is a high probability that you have HIV, but it will be necessary to have a confirmatory test to be sure and this is done using the Oraquick test kit.
    • Other tests that you will hear about are Viral Load. These tests are used by physicians to monitor their patients who have already tested positive for HIV antibodies. Viral Load tests are very costly and have never been approved  for HIV status diagnosis because of the possibility of false-positive and false-negative results. Therefore, they should not be used to determine if one is HIV-positive.
  • What do the test results: REACTIVE / POSITIVE and NON- REACTIVE / NEGATIVE mean?
    • A positive result means that:
      • You are HIV-positive (carrying the virus that causes AIDS), and
      • You can infect others and should try to implement precautions to prevent doing so.
    • A negative result means that:
      • No antibodies were found in your blood at this time.
      • A negative result does NOT mean:
        • You are not infected with HIV (you could still be in the window period),
        • You are immune to AIDS,
        • You have a resistance to infection,
        • You will never get AIDS.
  • Where can I get tested for HIV?
    • Common places include your local health facility. Many of the health facilities these days, even CHPS compounds are able to provide HIV testing services, a clinic, your doctor’s office, a hospital, and other sites set up specifically for HIV testing such as special outreaches organized by various NGOs.
  • How long after an exposure should I wait to get tested for HIV?
    • Most people will develop enough antibodies to test positive within 2 to 8 weeks after they’re exposed to the virus. The average is 20 days to 25 days. Even so, there’s a chance it could take longer. If your HIV test within the first 3 months was negative, get another test at 6 months to confirm the test was indeed negative
  • Why should all pregnant women get tested for HIV?
    • HIV-positive mothers who get treatment during pregnancy are often healthier. They have a much lower chance of passing HIV to their baby before, during, or after birth.
    • The sooner you start treatment, the more effective it is
  • What if I do an HIV test and I test positive?
    • Prompt, early medical treatment and a healthy lifestyle can help you stay well. We have more and better treatments today, and people are living longer and with a better quality of life than ever before.
    • You’ll need to take your HIV medicines exactly as directed, and take steps so others don’t get the virus from you
  • How long does it take for HIV to become AIDS?
    • How long it takes for AIDS symptoms to appear varies greatly from person to person. It depends on things like your health in general and how you’re taking care of yourself.
    • Averagely it takes about 7 years but it can be as early as 1 or 2 years and as late as 15 years before symptoms of your infection will start to show.
  • Is there a cure for HIV / AIDS?
    • Although there have been many advances in HIV treatments and therapies in recent years that have dramatically improved the quality of life and life expectancy of persons with HIV/AIDS around the globe, there is, as of yet, no cure.
  • What are the risks of getting HIV if you put on a condom after you’ve already started having sex?
    • Condoms work well to prevent HIV infection when one partner is HIV infected and the other isn’t. Studies show that HIV-uninfected partners are 80% less likely to become infected, if they use condoms properly and consistently, compared with those who do not. Consistent condom use means using a condom for every act of vaginal (penis in vagina) or anal (penis in anus) sex.
    • But sometimes sex gets going before the condom goes on. What are the risks to an HIV-negative person if they start having condomless sex with an HIV positive man, but he puts on a condom before he ejaculates?
    • For an HIV-negative woman, some studies have suggested that the risk of HIV infection is lower if a male partner withdraws before ejaculating than if he doesn’t, but the risk is still higher than it is among those who use condoms properly and consistently. Why? Well, we know that pre-ejaculate, the sticky-yet-slippery clear fluid that a man produces after being sexually aroused but before he ejaculates, can have the virus in it, and in enough amounts to be infectious.
    • For an HIV-negative man who has sex with men (MSM), at least one study has shown that the odds of becoming infected with HIV as a result of having receptive anal sex with delayed condom use were about the same as the odds of becoming infected from having anal sex without condoms (or PrEP).
    • It’s important to mention that PrEP (or pre-exposure prophylaxis), a pill, is very effective at preventing HIV if it is taken every day.
    • Having condomless sex increases the risk of contracting other sexually transmitted diseases (STDs), such as syphilis, gonorrhoea, chlamydia, and genital herpes. Although these infections are treatable and (with the exception of herpes) curable, they often produce no symptoms and can increase the risk of becoming infected with HIV. Hepatitis B and C also can be transmitted through unprotected sex. Using condoms properly and consistently can decrease your risk of contracting these infections as well. And, proper condom use can prevent pregnancy.
    • So the bottom line is this: Putting on a condom after you already have started having vaginal or anal sex is riskier than using a condom from the start. If it is difficult to talk about condom use with your partner, then it’s time to find someone who can talk with both of you.
  • Is it safe for an HIV-positive person to have unprotected sex with another HIV-positive person?
    • Here we are referring to what we call “re-infection” or “superinfection” with another strain of HIV. While the research on this question is not 100% clear, there are only rare reports of someone who already has HIV getting another HIV infection that damages their health.
    • It is true that a person who’s been infected with one strain can become infected with a second strain when exposed to it (such as through unprotected sex), but this appears to be quite uncommon. A person whose first HIV infection is relatively recent may be more susceptible to infection with a second strain. Someone may become sicker once the second strain of the virus enters the system. This happens because the new strain may be more difficult for the immune system to control, or because the new strain is resistant to the HIV medications the person is taking.
    • For a person with HIV who is taking antiretroviral medicine and has an undetectable viral load, the risk of infecting someone else (or becoming re-infected) through sex is much extremely low. If you have (or your partner has) a viral load that is not fully suppressed with HIV meds and a virus that has resistance mutations, it would be a good idea to use condoms to prevent transmission of a difficult-to-treat HIV infection.
    • There are more reasons for two HIV-positive people to use condoms. Correct condom use can prevent the transmission of other sexually transmitted infections (STIs), such as gonorrhoea, chlamydia, syphilis, hepatitis B, and hepatitis C. And, condom use can prevent unintended pregnancy
  • Can two HIV-positive parents have an HIV-negative child?
    • Yes, they can. Although HIV can pass from a woman with HIV to her child during pregnancy, at the time of birth, or when breast-feeding the infant, medical treatment of both the mother and her infant can minimize the chances of that happening. HIV infection in both the mother and the biologic father does not appear to affect the likelihood of having an HIV-infected baby.
    • Women living with HIV ideally should start antiretroviral therapy (ART) before pregnancy, both for their own health and to reduce the risk of HIV transmission during pregnancy. Women already on ART should continue to receive it during pregnancy. The goal is to lower the mother’s HIV viral load (the concentration of HIV in her blood) to “undetectable” levels to prevent infection of the fetus. The lower the mother’s viral load during pregnancy and birth, the lower the risk of infecting her baby. A baby’s chances of being born with HIV are less than 1 in 100 when the mother has a viral load so low that it’s undetectable.
    • After delivery, the infant should receive ART for 6 weeks. In addition, the mother should be adherent to her treatment to be able to give breast-feeding to her baby to prevent transmitting the virus through her breast milk.
    • For their own peace of mind, HIV-infected couples wanting to have children should receive counseling, if possible, before making a decision about conception. During counseling sessions, they should ask about ways to minimize the risk that the infant may become HIV infected, and how to deal with the possibility that infection occurs. If their health is frail, they should discuss the likelihood that they will survive long enough to parent effectively. And they should learn how to cope if members of their family or community judge and stigmatize them or their child.

 

TREATMENT:

  • I was just diagnosed with HIV and my clinician wants me to start treatment right away. Does that sound like the right thing to do?
    • You may know that we currently recommend HIV treatment (called antiretroviral therapy, or ART) for everyonewith HIV. That’s because research studies show that effective ART improves the health of people with HIV no matter the stage of their infection, and it enormously reduces the chance of HIV passing to an HIV-negative sex partner. So, all HIV providers almost always offer ART during one of the first clinic visits.
    • Some clinics and some local health departments go further and recommend that people with a new diagnosis of HIV start treatment immediately, either that same day or within the next few days. This approach sometimes is called “Treatment on Diagnosis” or “Rapid ART.” There are several reasons for starting treatment at the time of HIV diagnosis, but the basic reason is that if early treatment is beneficial, starting treatment at the earliest possible time may be even better, and patients may get the benefits of ART sooner. This may be especially true for people who are diagnosed very soon after they are infected (during the acute HIV infection period). Also, we know that delays or barriers to getting clinic appointments are common, and it may take a while to get a prescription for ART, which can result in worse health outcomes. So, strategies that get newly diagnosed people straight into care and onto treatment may bypass these barriers.
    • For individuals with new diagnoses of HIV who are starting ART immediately, clinicians must choose the treatment regimens carefully, and offer extra support and guidance. Please discuss this more with your health care provider and decide whether you are ready to start treatment. Remember that this is your decision and you should be comfortable with it.

 

  • What should you do if you miss a dose of your HIV medicines?
    • Missing doses of HIV medicines can reduce their usefulness and increase the possibility of developing drug resistance, which makes certain HIV drugs lose their effectiveness.
    • If you realize you have missed a dose, go ahead and take the medication as soon as you can, then take the next dose at your usual scheduled time. (There may be some exceptions to this general rule–for example, if taking a medicine such as efavirenz [Sustiva] in the daytime could cause unmanageable side effects.)
    • If you find you are missing doses of your HIV medications, talk to your provider about ways to help you remember to take the medications at the same time every day, or to figure out the most appropriate regimen for you. One simple reminder technique that many people use is to take their HIV medications at the same time as they do another daily task, such as brushing their teeth before bedtime.

 

  • Can you take a break from your HIV medicines?
    • People may be interested in taking a break from HIV medicines for a many reasons, such as becoming tired of taking pills every day, having trouble with side effects, or wishing to avoid being reminded of their HIV infection when taking pills. However, interrupting HIV treatment can be harmful in several ways.
    • First, HIV drug resistance can develop when patients stop taking certain antiretroviral (ARV) medications, particularly those in the NNRTI class–like efavirenz (Sustiva), and rilpivirine (Edurant)–or the combination pills Atripla, Odefsey, and Complera. Once the HIV develops resistance to a medication, that medicine can no longer be used to effectively treat the virus. So, breaks in treatment can jeopardize the availability of some or all of the interrupted medicines for future treatment.
    • In addition, stopping treatment allows the HIV to actively reproduce and circulate in the blood. That is associated with increased inflammation and with increased risk of heart attacks and kidney and liver problems. We also know that, once the virus is not being suppressed by HIV medicines, the CD4 cell count (T-cell count) will drop, and this can mean serious immune impairment especially for people who have already had a low CD4 cell count in the past.
    • Finally, higher HIV levels in the blood resulting from treatment discontinuation can lead to a “retroviral syndrome,” with fevers, headaches, and swollen glands, similar to the symptoms some people experience when they are newly infected with HIV.
    • So, even though it may be tempting to take a break from HIV treatment, there may be important health consequences of doing so. If you feel strongly that you need a break or if you have to interrupt your treatment for a period of time (for example, owing to surgery that temporarily prevents you from taking pills by mouth), talk to your provider about the safest way to discontinue the HIV treatment. (To reduce the risk of developing drug resistance, it may be necessary to switch to other medications or to stop taking some drugs before others.)

 

For more information, please call 0243362447 – WAAF’s onsite clinic to speak to a professional health care worker.