HIV/AIDS

WHAT IS HIV?

HIV stands for human immunodeficiency virus. It is the virus that causes AIDS. HIV attacks the immune system. When a person is infected with HIV, the virus enters the body and lives and multiplies, progressively destroying a type of white blood cell (called T-cells or CD4 cells) that the immune system must have to fight disease. As the virus damages or kills these and other cells, the immune system breaks down, and the body is unable to fight off infections and other illnesses.

This virus is spread by sexual contact with an infected person; by blood-to-blood contact, including the sharing of needles and/or syringes with an infected person, and transfusions of infected blood or blood clotting factors; and by infected pregnant women passing HIV to their babies during pregnancy, delivery, or breast feeding.

In British Columbia, gay men and men who have sex with men (MSM) are the population most at-risk for HIV infection. Studies have found that nearly 1 in 5 gay men in Vancouver are living with HIV. In 2008, MSM made up 62% of new HIV infections in the Vancouver Coastal Health Authority (BC CDC).

Drug-users are also a particularly vulnerable population. After MSM, drug-users are the second highest risk group for HIV infection. As mentioned earlier, in the Downtown Eastside, studies have shown that 30% of injection drug users are HIV-positive.

WHAT IS AIDS?

AIDS stands for acquired immunodeficiency syndrome. AIDS is the final stage of HIV infection. When the immune system has been weakened by the HIV virus to the point where the body has a difficult time fighting infection, and a person develops one of more infections, certain cancers, or a very low number of T cells, he or she is considered to have AIDS. Most people infected with HIV carry the virus for years before enough damage is done to the immune system for symptoms of AIDS to develop, and in fact the majority of people with HIV are unaware that they are infected.

While there is no cure for AIDS, a number of drugs are now available to help some people who have HIV to live longer, healthier lives. Highly active antiretroviral therapy (HAART) can reduce the amount of HIV in the bloodstream to very low levels and sometimes enables the body’s immune cells to rebound to normal levels. Several drugs can be taken to help prevent a number of opportunistic infections and the cancers that commonly occur in AIDS.

For this reason, and also because HIV can be spread even when no symptoms of AIDS have developed, it is important that people be aware of their HIV status.

Protecting Ourselves, Protecting One Another

Anyone who has had unprotected sex with someone who is HIV positive (or of unknown status), shared a needle (for piercings, tattoos or drugs) or had other body fluid-to-blood contact is at risk for HIV infection and for spreading the disease to others. The only sure way to avoid transmission of HIV is to abstain from sexual intercourse with people whose status you do not know (casual partners) or to be in a long-term mutually monogamous relationship with a partner who has been tested and who you know to be uninfected. For many people, for various reasons, this solution is not realistic, or possible. However, there are proven ways to reduce the risk of contracting or transmitting the HIV virus.

If You are Sexually Active, You Can Protect Yourself Against HIV by Practising  Safer Sex.

Learn Your Partner’s Sexual and Drug History.

Use Condoms – Correctly – Whenever You Have Sex. Latex condoms, when used consistently and correctly, are highly effective in preventing sexual transmission of HIV, the virus that causes AIDS. Gay men and MSM who are partying in the Davie Village can find free condom dispensers at various gay bars and clubs.

Use a Dental Dam during oral-genital and oral-anal sex. Though the transmission rate of HIV through oral sex is much less than with vaginal or anal intercourse, oral-genital contact does pose a risk of HIV infection, particularly when ejaculation occurs in the mouth. This risk goes up when either partner has cuts or sores, such as those caused by sexually transmitted infections (STIs), recent tooth-brushing, or canker sores, which can allow the virus to enter the bloodstream.

Use Only Latex Condoms or Dental Dams. Lambskin products provide little protection against HIV.

Use Only Water-Based Lubricants. Latex condoms are virtually useless when combined with oil- or petroleum-based lubricants such as Vaseline® or hand lotion. (People with latex allergies can use polyethylene condoms with oil-based lubricants).

If You Are an Injection Drug User, You Can Protect Yourself Against HIV and Other Blood-Borne and Injection-Site Infections by Always Using Clean Needles and Learning to Inject Properly.

Blood is introduced into needles and syringes at the start of every intravenous injection. Drug preparation equipment, such as “cottons,” “cookers,” water, and syringes should not be reused because they are usually contaminated with blood, therefore reuse carries a substantial risk of transmission of blood-borne infections, including HIV, Hepatitis B, Hepatitis C and other serious infections. Use of alcohol swabs to clean the injection site prior to injection has been shown to reduce the occurrence of cellulitis, injection site abscesses, and, possibly, endocarditis among persons who inject drugs. To inject more safely:

  • Never reuse or “share” syringes, water, or drug preparation equipment.
  • Only use syringes obtained from a reliable source (such as pharmacies or needle exchange programs).
  • Use a new, sterile syringe each time to prepare and inject drugs.
  • If possible, use sterile water to prepare drugs; otherwise, use clean water from a reliable source (such as fresh tap water).
  • Use a new or disinfected container (“cooker”) and a new filter (“cotton”) to prepare drugs.
  • Clean the injection site with a new alcohol swab prior to injection.
  • Safely dispose of syringes after one use.
  • If you cannot get a new, sterile syringe, previously used drug preparation and injection equipment should disinfected with bleach before use, to reduce the risk of HIV transmission. Boiling needles and syringes for 15 minutes between uses can also disinfect the equipment. While disinfecting previously used needles and syringes can reduce the risk of HIV transmission, using disinfected syringes is not as safe as using a new, sterile needle and syringe.

Injection Drug Users and Their Sex Partners Should Also Take Precautions to Reduce Risks of Sexual Transmission of HIV, and Should be Tested Regularly for HIV.

If Both You and Your Partner are HIV Positive, Use Condoms to Prevent Possible Infection With a Different Strain of HIV and Other STIs. Even if you are already infected with HIV, it is possible to become re-infected with a more aggressive or drug-resistant strain. Make sure to use a condom every time you have sex.

If You Think You May Have Been Exposed To Another STI Such as Gonorrhoea, Syphilis, or Chlamydia, Get Treatment. These diseases can increase your risk of getting HIV

Try to Avoid Having Sex When You are Taking Drugs or Drinking Alcohol. Being high can increase the likelihood of risk-taking.

Do Not Share Toothbrushes, Razors, and Other Personal Care Items That Might Be Contaminated With Blood.

If You are Considering Getting a Tattoo or Having Your Body Pierced, be sure to see a qualified professional who uses sterile equipment. Ask staff at the establishment what procedures they use to prevent the spread of HIV and other blood-borne infections, such as the hepatitis B & C virus.

SHOULD YOU GET TESTED FOR HIV?

If you think you might have been exposed to HIV, you should get tested as soon as possible. Here’s why:

  • Even in the early stages of infection, you can take concrete steps to protect your long-term health. Regular check-ups with a doctor who has experience with HIV/AIDS will enable you (and your family members or loved ones) to make the best decisions about whether and when to begin anti-HIV treatment, without waiting until you get sick.
  • Taking an active approach to managing HIV may give you many more years of healthy life than you would otherwise have.
  • If you are HIV positive, you will be able to take the precautions necessary to protect others from becoming infected. It is predicted that 55% of new HIV infections are caused by persons who do not know they have HIV.
  • Newly infected persons are significantly more infectious than those who have been living with HIV for some time. In the initial stages of HIV infection, the viral load is very high, which increases risk of transmission.
  • If you are HIV positive and pregnant, you can take medications and other precautions to significantly reduce the risk of infecting your infant, including not breast-feeding.

If You Have Had Unprotected Sex With a Partner Who is HIV Positive or Whose HIV or Drug-Use Status is Unknown to You, You Should Get Tested.

Women Who Become Pregnant Should be Tested for HIV.

Even if You Have Already Been Tested, if You Have Engaged in High Risk Behaviour Since Then, You Should be Re-Tested.

If You Have Symptoms of Acute HIV Infection and Have Engaged in High Risk Behaviour, You Should Get Tested. Immediately after infection, some people may develop mild to severe, temporary flu-like symptoms or persistently swollen glands. This is called Primary HIV Infection and is experienced by 40-90% of individuals within the first weeks or months after they are first infected. Other symptoms include: malaise, weight loss, loss of appetite, sore throat, mouth sores, joint pain, muscle pain, diarrhoea, fatigue, night sweats, nausea/vomiting, headache and genital sores. Symptoms usually last 7-10 days, and rarely more than 2 weeks.

If you have any of these symptoms, it does not mean you have HIV. However, if there is the slightest chance you were exposed, such as through recent sexual activity or sharing of needles, even with someone who you believe is HIV negative, you should get tested. The viral load in the blood, semen, or vaginal secretions of people who contract HIV is highest during Acute HIV Infection and they are most likely to infect sexual or needle-sharing partners during this time. If you think you have been exposed, and are experiencing signs and symptoms of acute infection, you should get tested right away, so that you can seek medical attention that may save your life, and notify your partners and reduce their risk.

Also note: If you engaged in risky behaviours but have no symptoms, it does not prove you are not infected. Between 10 and 60 % of individuals who contract HIV never experience Primary HIV Infection symptoms. If you have engaged in risky behaviour it is important to get tested.

HOW IS HIV TRANSMITTED?

HIV can be found in the blood, semen, vaginal fluid, or breast milk of an infected person. The virus can be transmitted only if such HIV-infected fluids enter the bloodstream of another person. This kind of direct entry can occur (1) through the linings of the vagina, rectum, mouth, and the opening at the tip of the penis; (2) through intravenous injection with a syringe; or (3) through a break in the skin, such as a cut or sore.

The Main Ways HIV is Transmitted Are:

Unprotected Sexual Intercourse (either vaginal or anal) with someone who has HIV. Women are at greater risk of HIV infection through vaginal sex than men, although the virus can also be transmitted from women to men. Anal sex (whether male-male or male-female) poses a high risk mainly to the receptive partner, because the lining of the anus and rectum is extremely thin and is filled with small blood vessels that can be easily injured during intercourse.

Sharing Needles or Syringes with someone who is HIV infected. Infectious HIV can survive in used syringes for a month or more. People who inject drugs should never reuse or share syringes, water, or drug preparation equipment. This includes needles or syringes used to inject illegal drugs, such as heroin, cocaine or amphetamine, as well as steroids. Other types of needles, such as those used for body piercing and tattoos, can also carry HIV.

Infection During Pregnancy, childbirth, or breast-feeding (mother-to-infant transmission). Any woman who is pregnant or considering becoming pregnant and thinks she may have been exposed to HIV – even if the exposure occurred years ago – should seek testing and counselling. Those who test positive can get drugs to prevent HIV from being passed on to a fetus or infant, and they are counselled not to breast-feed.

Unsafe Blood Transfusions can lead to HIV infection. In developing countries, weak health care infrastructures and inadequate supplies of safe blood magnify the risk of contracting HIV from a blood transfusion. Women and children are at greatest risk, due to the frequent use of blood transfusions to treat complications during pregnancy, childhood anaemia associated with malaria, and various trauma incidents.

Unprotected Oral Sex with Someone Who Has HIV. While there is documented risk when having oral sex with an HIV infected partner, the risk is much less than with anal or vaginal intercourse. This fact makes it very hard to calculate the actual risk with oral sex. Another factor that makes risk determination difficult is the fact that most people who engage in oral sex also engage in other types of sexual practices, namely vaginal and anal intercourse. Still, there have been documented cases of HIV transmission strictly from oral sex.

HOW HIV IS NOT TRANSMITTED:

HIV is not an easy virus to pass from one person to another. It is not an airborne, food-borne, or water-borne virus, and it does not live long outside the body. It is not transmitted by coughing, sneezing, or casual contact. There has never been a case where a person was infected by a household member, relative, co-worker, or friend through casual or everyday contact such as sharing eating utensils or bathroom facilities.

You cannot become infected from a toilet seat, a drinking fountain or a door knob.

No one has become infected from such ordinary social contact as hugging, shaking hands, or closed-mouth or “social” kisses. Most scientists agree that while HIV transmission through deep or prolonged “French” kissing may be possible, it would be extremely unlikely.

Sweat, tears, vomit, feces, and urine do contain HIV, but have not been reported to transmit the disease.

HIV is not transmitted by mosquitoes, fleas or other insects. Studies have shown no evidence of HIV transmission through insects even in areas where there are many cases of AIDS and large populations of insects such as mosquitoes.

You cannot get HIV from giving blood at a blood bank or other established blood collection centre.

The risk of health care workers being exposed to HIV on the job is very low, especially if they carefully follow universal precautions. Scientists estimate that the risk of infection from a needle-stick is less than 1 percent.

HIV is a virus that infects humans and thus cannot be transmitted to or carried by non-human animals. The only exception to this is a few chimpanzees in laboratories that have been artificially infected with HIV. Because HIV is not found in non-human animals it is not possible for HIV to be transmitted from an animal bite, such as from a dog or cat.

There are no documented cases of HIV being transmitted during participation in sports. The very low risk of transmission during sports participation would involve sports with direct body contact in which bleeding might be expected to occur. If someone is bleeding, their participation in the sport should be interrupted until the wound stops bleeding and is both antiseptically cleaned and securely bandaged. There is no risk of HIV transmission through sports activities where bleeding does not occur.

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