HIV/AIDS
The human immunodeficiency virus (HIV) is a pathogen that, in the absence of treatment, results in acquired immunodeficiency syndrome (AIDS), a condition that undermines the body’s natural defense systems, rendering it vulnerable to disease.
There is no cure for HIV/AIDS, but there are treatments that allow HIV-positive individuals to manage the disease. They can live normal lives in spite of their condition, posing virtually no risk to others if taking proper precautions.
An overview
A person is considered HIV-positive when the virus has entered their body and started to multiply. From the moment the body comes into contact with HIV, the immune system begins to produce antibodies—the body's defense against pathogens.
- A seronegative person is someone who has not been infected.
- An HIV-positive person is someone who has been infected with HIV, but still has a functioning immune system.
- An AIDS patient is an HIV-positive person whose immune system has been severely weakened, and can no longer effectively fight against opportunistic diseases.
The first stage of HIV infection is called acute infection. 2–4 weeks after contracting HIV, many experience flu-like symptoms (fever, rashes, headaches, swollen and tender lymph nodes) that last for 1–2 weeks. Some individuals develop opportunistic infections at this stage, others experience no symptoms at all.
During the second stage, an HIV-positive person remains asymptomatic for a period that can last from around 3 to more than 20 years (an average of 8). This is called clinical latency. As the stage comes to an end, an infected person might experience fever, muscle pains, weight loss, enlarged lymph nodes and gastrointestinal problems.
The third and last stage of HIV infection is AIDS. It is defined in two ways: a CD4+ T cell count below 200 cells per µL, and the occurrence of specific illnesses—opportunistic diseases that take advantage of the fact that the body is practically defenseless.
Thanks to developments in medicine, being diagnosed with HIV is no longer a death sentence. The condition can be treated via antiretroviral therapy, which significantly slows the progression of the disease, and can lower the viral load to the extent that it becomes undetectable, which prevents transmission.
Transmission
The AIDS virus is present in all bodily fluids of HIV-positive people, but not all fluids have the same transmissibility. HIV can be transmitted through blood, semen (including pre-cum), vaginal and anal mucus, and breast milk.
HIV cannot be transmitted through tears, sweat, saliva, coughing, sneezing, vomit, feces, insect bites, handshakes, kissing, dancing or swimming together, sleeping in the same bed, sharing clothes, drinking from the same glass, eating from the same dish, or using the same lavatory as an infected person.
1. Transmission via sex
Having unprotected vaginal and anal sex are the most common ways of contracting HIV. The risk of infection increases proportionally with the number of sexual partners. The risk is greater still if you already have an STI—many STIs produce open sores, which act as gateways to further infections.
There is no risk of infection to a person receiving fellatio, cunnilingus and anilingus, however, someone performing these acts on an infected person is at risk, especially if there are sores or lesions in their mouth. Brushing one’s teeth and drinking alcohol before or after unprotected oral sex isn’t recommended for this reason. One can lessen the risk of infection by using dental dams during cunnilingus and anilingus, and condoms during fellatio.
One can also contract HIV by irresponsibly sharing sex toys with an infected person (not maintaining proper sex toy and bodily hygiene, not using barrier protection).
2. Transmission via bodily fluids
People who use intravenous drugs often share syringes. The needles may have blood in them, and blood can carry HIV. It is estimated that people who inject drugs are 22 times more likely to acquire HIV than those who don’t.
Transmission can also occur via an accidental wound caused by infected material, mainly in health care workers (but this risk is considered low).
Blood transfusion from an HIV-infected donor would result in passing the virus on to the recipient, although the risk of this happening is negligible in countries with advanced health systems. Standardised safety measures require each blood donation to be screened. Additionally, the equipment used for each blood donation is kept in a sterile environment, used once, and then disposed of to eliminate the risk of donors infecting each other.
There is some risk involved when getting a piercing or a tattoo. Professional studios have high hygiene standards, a pristine working environment and sterile equipment for good reason.
3. Transmission from mother to child
An HIV-positive mother can pass the virus on to her child during pregnancy, labour, delivery or breastfeeding. It is possible for an HIV-positive mother to give birth to an HIV-negative child. Preventive measures may include a combination of antiviral medications during and after pregnancy, a C-section during delivery, and bottle-feeding instead of breastfeeding. These methods can reduce transmission rates by 92–99%.
PrEP & PEP
Prophylaxis is treatment given or action taken to prevent disease.
PrEP stands for pre-exposure prophylaxis, and is taken before possible exposure to HIV to lessen the risk of infection. For example, a person with an HIV-positive sexual partner would use PrEP in combination with usual safety precautions (e.g. condoms). PrEP is taken every day. If used correctly, it reduces the risk of contracting HIV via sex by 99%, via injection drug use by 75%.
PEP stands for post-exposure prophylaxis, and is taken in emergency situations (such as a broken condom during sex with an HIV-positive person or a person of unknown HIV status, sexual assault, or injury with possible contamination) within 72 hours of possible exposure to prevent infection. The earlier treatment is begun, the more likely it is to be effective.
Never rely on treatment alone to keep you safe from disease when there are other preventative measures you can take. Practice safe sex, and don’t be afraid of talking to your partner about safety-related concerns. You can suggest getting tested together if your HIV status is unknown. Don’t risk your lives just to avoid an uncomfortable conversation.
Symptoms
Millions of people are living with HIV without knowing that they are infected. Acute infection produces symptoms that could be attributed to a number of other, less serious causes, and clinical latency lasts for years. The condition isn’t obvious until the immune system has been severely compromised.
Symptoms of acute HIV infection aren’t unlike those of the flu, except in that they may be unrelenting and unresponsive to regular treatment. These symptoms include: fatigue; fever; chills; loss of appetite; swollen, tender lymph nodes; a sore throat; skin rashes; nausea; vomiting; diarrhea; severe, dry coughing; night sweats.
At this stage, the virus is replicating rapidly. The body’s natural response to the virus is to produce HIV-specific antibodies. Gradually, these antibodies reach detectable numbers—this process is called seroconversion. These symptoms disappear in a couple weeks, but HIV is still present in the body. It continues to spread and slowly destroy the immune system by killing CD4+ T cells.
Over time, the damage HIV does to your immune system leads to AIDS. As it weakens, the body grows increasingly vulnerable to opportunistic diseases. These diseases can include Kaposi’s sarcoma, Non-Hodgkin lymphoma, cervical cancer, pneumonia, herpes, tuberculosis, toxoplasmosis, candidiasis, wasting syndrome, cryptococcal meningitis, and many more.
AIDS symptoms include: a sore throat; oral thrush; severe yeast infections; chronic pelvic inflammatory disease; skin rashes; serious infections; feeling tired, dizzy, and lightheaded; headaches; rapid weight loss; bruising easily; diarrhea; fever; long-lasting night sweats; swollen lymph nodes; a deep, dry cough; shortness of breath; purplish growths on the skin or inside the mouth; bleeding from the mouth, nose, anus, or vagina; numbing in hands or feet; loss of muscle control and strength; slowed reflexes; being unable to move.
Treatment
Antiretroviral therapy is instrumental in preventing and treating HIV.
Treatment keeps the HIV virus from multiplying, and reduces the viral load (the amount of HIV in the bloodstream) to a level too low to be detected by a blood test—a process that usually takes around 6 months.
The earlier treatment is begun, the more effective it will be. A reduced viral load allows the immune system to recover, and an undetectable viral load removes the risk of HIV transmission during sexual intercourse. Taking medicine to treat HIV also reduces a person’s chance of acquiring another strain of HIV, and developing a so-called superinfection.
Today, an HIV-positive person can take a single pill a day to combat the virus, and suffer virtually no side-effects. In the 1980s, it could have been 20 pills, and the side-effects would have been severe. Still, it’s important to discuss treatment beforehand with a health care provider—touching on subjects such as drug interactions and lifestyle changes that will help the body manage the strain it is under.
HIV remains a serious issue, but we are much better equipped to combat it than we were 40 years ago. As with all other STIs, ignoring a possible infection is both irresponsible and dangerous to you and your loved ones—so get tested! If you are clean, you will have put your mind at ease, and if not, there is a wonderful support system that will welcome you with open arms and help you lead a long and vibrant life.
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