HIV Facts

HIV Transmission and Prevention

HIV is a virus that is transmitted through infected blood, semen, vaginal secretions, and breast milk. To enter the body, the virus must come into direct contact with another person’s bloodstream, mucous membrane, or broken skin. HIV is most often transmitted through sexual contact and shared needles.
HIV is often transmitted through anal and vaginal intercourse. While it is possible to acquire HIV while performing oral sex on a man, transmission rates are much lower. It is unlikely that other types of sexual activity, such as oral sex on a woman or manual contact with the genitals, will transmit the virus. The presence of other sexually transmitted infections (STIs), such as syphilis, gonorrhea, or genital herpes, increases the risk of sexual transmission of HIV. Even if an HIV-infected individual has no symptoms, he or she can still transmit the virus.
Many people have contracted HIV through sharing needles, syringes, and other “works” to inject drugs. People may also acquire HIV through the needles used for tattooing and body piercings. Health-care workers may contract HIV through needle-sticks or other accidental exposures on the job. In the past, many people contracted HIV through blood transfusions; today, donated blood is tested and heat-treated and is considered very safe.
HIV can also be transmitted from mother to child during pregnancy or birth (this type of transmission is referred to vertical or perinatal transmission among medical professionals) or through breast-feeding. Vertical transmission is more likely if the mother has a high viral load. Use of antiretroviral drugs, such as AZT or Nevirpine, can reduce the risk of vertical transmission from about 25% to about 5% or less; that is, if a woman responsibly takes her drugs during pregnancy, there is a 95% chance or more that the baby will be born HIV-negative. In the U.S. and other developed countries, it is usually recommended that women with HIV not breast-feed their babies.
There is no evidence that HIV is transmitted through saliva, sweat, tears, or urine. The virus cannot live long outside the human body. HIV is not transmitted through casual or household contact including hugging or kissing, coughing or sneezing, or sharing eating utensils or drinking glasses.
There is currently no vaccine to prevent HIV, although much research in this area is currently underway. If a person has been exposed to HIV, he or she may be eligible for post-exposure prophylaxis (PEP). PEP involves starting anti-HIV drugs within 72 hours of exposure. Although it is unknown whether PEP can help prevent or reduce the severity of HIV disease in people who are exposed to the disease through sex or needle sharing, it has been beneficial to health-care workers who have been accidentally exposed on the job.

Prevention:

How can I avoid sexual transmission of HIV?

- Abstain from sex: the safest way to avoid being exposed to HIV infection sexually is to abstain from having penetrative sex. This can mean delaying sexual initiation or, once sexually active, refraining from having penetrative sex.

- Be faithful with another HIV-negative partner: some of us may be in a relationship where we can discuss the need either to be mutually faithful (*if you both know you are HIV-negative). This approach is not without risks. For example, a significant proportion of women living with HIV became infected by their husbands/partners, whom they trusted and to whom they were sexually faithful.

- Use condoms: when correctly and consistently used, condom are the most effective available tools to reduce the sexual transmission of HIV and other sexually transmitted infections for people having sexual intercourse.

HIV Disease Progression

Many people with primary or acute (early) HIV infection have no symptoms; that is, they display no symptoms of the disease early on. Others may experience an “acute retroviral syndrome,” which is often characterized by fever, fatigue, headache, and enlarged lymph nodes. These symptoms usually disappear within a week to a month, and are easily mistaken for a bout of the flu. During this initial period, it is possible to transmit HIV easily.
After HIV enters the body, it infects various types of cells. It primarily targets a type of immune system cell called CD4 cells. These cells—also called T-helper cells—play an important role in coordinating the body’s immune defenses. When HIV enters CD4 cells, it uses the cell’s machinery to produce new viral particles (virions), before eventually killing the host cell.
HIV disease progresses slowly, and people with HIV may be asymptomatic (without symptoms) for ten years or longer. Infants and children infected with HIV tend to become ill sooner. As more and more CD4 cells die, the immune system is weakened and the body is less able to fight infections and cancers. As this happens, people may develop symptoms such as swollen lymph nodes, fever, fatigue, and weight loss. These early symptoms may come and go. Some people do not develop symptoms, even without treatment.
AIDS is the advanced stage of HIV disease. Once the CD4 count falls below 200 (and particularly below 50), people become susceptible to a variety of opportunistic illnesses (OIs). These are infections or cancers that usually do not cause symptoms in healthy people, but may cause serious illness in people with compromised immune systems. There are more than 20 AIDS-defining conditions.
In recent years, the incidence of OIs has fallen due to improved anti-HIV treatments. Effective treatment can keep HIV under control and help prevent the loss of CD4 cells. With appropriate treatment, some people may be able to hold off late-stage disease and the development of OIs indefinitely.

HIV Treatment

Since 1997, there are medicines which delay the progress of HIV and weaken its effects. Several different types of medicines exist to treat HIV infection. These medicines attack various aspects of the process used by the virus to replicate itself. Because HIV quickly mutates to become resistant to any single drug, patients must take a combination of medicines to achieve maximum suppression of HIV.
The combination of medicines for therapy is known as antiretroviral therapy; some people use the term ARV (antiretroviral) treatment. Antiretroviral medications or drugs are used to treat children and adults infected with HIV, to prevent transmission of HIV from mother-to-child, and as a preventive therapy after exposure to HIV infection [also called post-exposure prophylaxis]. Starting antiretroviral therapy early in the course of HIV infection in infants and children has also led to significant positive changes in the survival of children living with HIV.
Antiretroviral therapy changes the natural course of HIV infection, significantly delaying the development of symptoms. To achieve this, it is important to diagnose HIV infection early in order to initiate therapy before AIDS symptoms develop, although patients who start on therapy even after being diagnosed with AIDS often receive major and long-lasting health benefits.
Although antiretroviral therapy is effective in slowing the progression of HIV-related disease and can prolong one’s life up to a normal life expectancy, it is not a cure, and a person may still develop AIDS one day. Antiretroviral therapy should not be disrupted and needs to be taken for life. Any exception to this should be carried out in consultation with a specialised medical doctor based on the individual case. In addition to treatments for HIV infection itself, therapies exist to prevent and/or treat many HIV-related opportunistic infections..

HIV Transmission and Prevention

HIV is a virus that is transmitted through infected blood, semen, vaginal secretions, and breast milk. To enter the body, the virus must come into direct contact with another person’s bloodstream, mucous membrane, or broken skin. HIV is most often transmitted through sexual contact and shared needles.
HIV is often transmitted through anal and vaginal intercourse. While it is possible to acquire HIV while performing oral sex on a man, transmission rates are much lower. It is unlikely that other types of sexual activity, such as oral sex on a woman or manual contact with the genitals, will transmit the virus. The presence of other sexually transmitted infections (STIs), such as syphilis, gonorrhea, or genital herpes, increases the risk of sexual transmission of HIV. Even if an HIV-infected individual has no symptoms, he or she can still transmit the virus.
Many people have contracted HIV through sharing needles, syringes, and other “works” to inject drugs. People may also acquire HIV through the needles used for tattooing and body piercings. Health-care workers may contract HIV through needle-sticks or other accidental exposures on the job. In the past, many people contracted HIV through blood transfusions; today, donated blood is tested and heat-treated and is considered very safe.
HIV can also be transmitted from mother to child during pregnancy or birth (this type of transmission is referred to vertical or perinatal transmission among medical professionals) or through breast-feeding. Vertical transmission is more likely if the mother has a high viral load. Use of antiretroviral drugs, such as AZT or Nevirpine, can reduce the risk of vertical transmission from about 25% to about 5% or less; that is, if a woman responsibly takes her drugs during pregnancy, there is a 95% chance or more that the baby will be born HIV-negative. In the U.S. and other developed countries, it is usually recommended that women with HIV not breast-feed their babies.
There is no evidence that HIV is transmitted through saliva, sweat, tears, or urine. The virus cannot live long outside the human body. HIV is not transmitted through casual or household contact including hugging or kissing, coughing or sneezing, or sharing eating utensils or drinking glasses.
There is currently no vaccine to prevent HIV, although much research in this area is currently underway. If a person has been exposed to HIV, he or she may be eligible for post-exposure prophylaxis (PEP). PEP involves starting anti-HIV drugs within 72 hours of exposure. Although it is unknown whether PEP can help prevent or reduce the severity of HIV disease in people who are exposed to the disease through sex or needle sharing, it has been beneficial to health-care workers who have been accidentally exposed on the job.

Prevention:

How can I avoid sexual transmission of HIV?

Abstain from sex: the safest way to avoid being exposed to HIV infection sexually is to abstain from having penetrative sex. This can mean delaying sexual initiation or, once sexually active, refraining from having penetrative sex.

Be faithful with another HIV-negative partner*: some of us may be in a relationship where we can discuss the need either to be mutually faithful (*if you both know you are HIV-negative). This approach is not without risks. For example, a significant proportion of women living with HIV became infected by their husbands/partners, whom they trusted and to whom they were sexually faithful.

Use condoms: when correctly and consistently used, condom are the most effective available tools to reduce the sexual transmission of HIV and other sexually transmitted infections for people having sexual intercourse.

HIV Disease Progression

Many people with primary or acute (early) HIV infection have no symptoms; that is, they display no symptoms of the disease early on. Others may experience an “acute retroviral syndrome,” which is often characterized by fever, fatigue, headache, and enlarged lymph nodes. These symptoms usually disappear within a week to a month, and are easily mistaken for a bout of the flu. During this initial period, it is possible to transmit HIV easily.
After HIV enters the body, it infects various types of cells. It primarily targets a type of immune system cell called CD4 cells. These cells—also called T-helper cells—play an important role in coordinating the body’s immune defenses. When HIV enters CD4 cells, it uses the cell’s machinery to produce new viral particles (virions), before eventually killing the host cell.
HIV disease progresses slowly, and people with HIV may be asymptomatic (without symptoms) for ten years or longer. Infants and children infected with HIV tend to become ill sooner. As more and more CD4 cells die, the immune system is weakened and the body is less able to fight infections and cancers. As this happens, people may develop symptoms such as swollen lymph nodes, fever, fatigue, and weight loss. These early symptoms may come and go. Some people do not develop symptoms, even without treatment.
AIDS is the advanced stage of HIV disease. Once the CD4 count falls below 200 (and particularly below 50), people become susceptible to a variety of opportunistic illnesses (OIs). These are infections or cancers that usually do not cause symptoms in healthy people, but may cause serious illness in people with compromised immune systems. There are more than 20 AIDS-defining conditions.
In recent years, the incidence of OIs has fallen due to improved anti-HIV treatments. Effective treatment can keep HIV under control and help prevent the loss of CD4 cells. With appropriate treatment, some people may be able to hold off late-stage disease and the development of OIs indefinitely.

HIV Treatment

Since 1997, there are medicines which delay the progress of HIV and weaken its effects. Several different types of medicines exist to treat HIV infection. These medicines attack various aspects of the process used by the virus to replicate itself. Because HIV quickly mutates to become resistant to any single drug, patients must take a combination of medicines to achieve maximum suppression of HIV.
The combination of medicines for therapy is known as antiretroviral therapy; some people use the term ARV (antiretroviral) treatment. Antiretroviral medications or drugs are used to treat children and adults infected with HIV, to prevent transmission of HIV from mother-to-child, and as a preventive therapy after exposure to HIV infection [also called post-exposure prophylaxis]. Starting antiretroviral therapy early in the course of HIV infection in infants and children has also led to significant positive changes in the survival of children living with HIV.
Antiretroviral therapy changes the natural course of HIV infection, significantly delaying the development of symptoms. To achieve this, it is important to diagnose HIV infection early in order to initiate therapy before AIDS symptoms develop, although patients who start on therapy even after being diagnosed with AIDS often receive major and long-lasting health benefits.
Although antiretroviral therapy is effective in slowing the progression of HIV-related disease and can prolong one’s life up to a normal life expectancy, it is not a cure, and a person may still develop AIDS one day. Antiretroviral therapy should not be disrupted and needs to be taken for life. Any exception to this should be carried out in consultation with a specialised medical doctor based on the individual case. In addition to treatments for HIV infection itself, therapies exist to prevent and/or treat many HIV-related opportunistic infections..