1. What is HIV? What is AIDS?
HIV (Human Immunodeficiency Virus) is a virus. You may hear that someone is HIV infected, has HIV infection, or has HIV disease. These are all terms that mean the person has HIV in his or her body and can pass the virus to other people.
HIV attacks the body’s immune system. The immune system protects the body from infections and disease, but has no clear way to protect it from HIV. Without treatment, most people infected with HIV become less able to fight off the germs that we are exposed to every day. Many of these germs do not usually make a healthy person sick, but they can cause life-threatening infections and cancers in a person whose immune system has been weakened by HIV. HIV treatments can slow this process and allow people with HIV to live longer, healthier lives
People infected with HIV may have no symptoms for ten or more years. They may not know they are infected. An HIV test is the only way to find out if you have HIV.
AIDS (Acquired Immune Deficiency Syndrome) is a late stage of HIV disease. According to the Centers for Disease Control and Prevention (CDC), a person with HIV infection has AIDS when he or she:
• has a CD4 cell count (a way to measure the strength of the immune system) that falls below 200. A normal CD4 cell count is 500 or higher. OR
• develops any of the specific, serious conditions – also called AIDS-defining illnesses – that are linked with HIV infection
2. Who is at risk for getting HIV?
A person of any age, sex, race, ethnic group, religion, economic background, or sexual orientation can get HIV.
Those who are most at risk are:
• people who have “unprotected sex” with someone who has HIV. Unprotected sex means vaginal, anal, or oral sex without using a condom.
• people who share needles, syringes, or other equipment to inject drugs, steroids, or even vitamins or medicine with someone who has HIV.
• Babies can potentially become infected during their mothers’ pregnancy, during delivery, or after birth in the immediate post-partum period. They can also become infected through breastfeeding.
• Health care and maintenance workers who may be exposed to blood and/or body fluids at work sometimes get infected through on-the-job exposures like needle-stick injuries.
Before 1985, some people were infected through blood transfusions or the use of blood products.
You can only get HIV if infected blood, semen, vaginal fluids, or breast milk gets into your body.
A person of any age, sex, race, ethnic group, religion, economic background, or sexual orientation can get HIV.
3. How long can people live with HIV or AIDS?
Medicines that fight HIV have helped many people with HIV and AIDS live years and even decades longer than was possible in the past, before effective treatment was available. HIV treatments are not a cure, and they do not work equally well for everyone, but they have extended the lives of many people with HIV and AIDS.
Without treatment, some people live for just a few years after getting HIV. Others live much longer. Researchers are studying a small number of people with HIV who have not become ill for more than ten years, even without any HIV treatment. However, these people are still infected with HIV and can pass the virus to others.
4. Can I get a vaccine to prevent HIV infection or AIDS?
No. There is no vaccine to prevent HIV infection. Researchers are working to develop a vaccine. Vaccines in development are being tested to find out if they work.
5. Is there a cure for HIV or AIDS?
No. There is no cure for HIV or AIDS. However, there are medicines that fight HIV and help people with HIV and AIDS live longer, healthier lives.
6. How many people are living with HIV and AIDS?
According to the United Nations organization UNAIDS, as of 2003 there were an estimated 40 million persons living with HIV and AIDS worldwide. Of these, 37 million were adults, and 2.5 million were under age 15. The overwhelming majority of persons with HIV live in resource-poor countries.
7. Where can I find updated statistics on HIV and AIDS?
Global HIV/AIDS statistics are available from UNAIDS at www.unaids.org and from the World Health Organization at www.who.int/hiv.
8. How is HIV spread from one person to another?�
HIV is spread when infected blood, semen, vaginal fluids, or breast milk gets into the bloodstream of another person
through:
- direct entry into a blood vessel;
- mucous linings, such as the vagina, rectum, penis, or mouth, eyes, or nose; or
- a break in the skin
HIV is not spread through saliva (spit).
HIV is spread in the following ways:
- Having vaginal, anal, or oral sex without using a condom.
- Sharing needles, syringes, or works to inject drugs, vitamins, hormones, steroids, or medicines.
- Women with HIV infection can pass HIV to their babies during pregnancy, delivery, and breastfeeding.
- People who are exposed to blood and/or body fluids at work, like health care workers, may be exposed to HIV through needle-sticks or other on-the-job exposures.
- It is also possible to pass HIV through sharing needles for piercing or tattooing
A person infected with HIV can pass the virus to others during these activities. This is true even if the person:
has no symptoms of HIV;
has not been diagnosed with HIV/AIDS;
is taking HIV medicine; or
has an undetectable viral load
HIV is not spread by casual contact like sneezing, coughing, eating or drinking from common utensils, shaking hands, hugging, or using restrooms, drinking fountains, swimming pools, or hot tubs
You can only get HIV if infected blood, semen, vaginal fluids, breast milk gets into your body.
9. Is it easy to get HIV?
No. HIV is not like the flu or a cold. It is not passed through casual contact or by being near a person who is infected.
You can only get HIV if infected blood, semen, vaginal fluids, or breast milk gets into your body
10. Does everyone who is exposed to HIV get infected?
No. But it is important to know that you can be infected by a single exposure to HIV-infected blood, semen, or vaginal fluids. Whether a person becomes infected after being exposed to HIV depends on how the virus enters the body and the amount of virus that enters the body.
11. How is HIV spread during injection drug use?
Any time you share injection equipment with someone who has HIV or whose HIV status you do not know, there is a high risk that you will get HIV. Small amounts of blood from a person infected with HIV may stay in the needles, syringes, or drug “works” (spoons, bottle caps, and cotton) and can be injected into the bloodstream of the next person who uses the equipment
12. Does having a sexually transmitted disease (STD) affect my risk of getting HIV?
Yes. Having an STD, especially herpes or syphilis sores, increases your risk of getting HIV and giving HIV to a partner. Other STDs, like gonorrhea or chlamydia, also increase your risk of becoming infected with HIV.
STDs change the cells that line the vagina, penis, rectum, or mouth, which can cause open sores to develop. These sores make it easier for HIV to enter the body. Any inflammation or sore caused by an STD also makes it easier for HIV to enter the bloodstream during sexual contact.
If you already have an STD, you are more likely to get infected with HIV during unprotected sex with someone who has HIV.
Studies have shown that STDs increase the amount of HIV in the semen and vaginal fluids of people infected with HIV because of increased inflammation in the area. Therefore, if you have HIV and an STD, you are more likely to pass HIV to your partner during unprotected sex. Studies have also shown that treatment for STDs may reduce HIV transmission.
Many STDs do not cause symptoms, especially in women. It is important for sexually active men and women to get tested for STDs regularly, even if they have no symptoms.
If you already have an STD, you are more likely to get infected with HIV during unprotected sex with someone who has HIV.
13. Can a woman who has HIV pass the virus to her baby?
Yes. A woman who has HIV can pass the virus to her baby during:
pregnancy;
delivery; or
breastfeeding.
There are medicines that women with HIV should take during pregnancy, labor, and delivery and that can be given to their babies just after birth, to greatly reduce the chance that their babies will become infected with HIV. It is best for women to know their HIV status before they become pregnant or very early in their pregnancy so that they can make informed decisions and take full advantage of these medicines. Since HIV is also found in breast milk, women with HIV should not breastfeed their babies
14. Can a person with HIV who is not sick or who has no symptoms pass HIV to someone else?
Yes. Any person infected with HIV, even if he or she has no symptoms, can pass HIV to another person. Risk reduction measures still need to be taken
15. Can I get HIV from kissing?
No one has ever gotten HIV through casual kissing, such as between parents and
children. It is possible, but extremely unlikely, for HIV to be passed during “deep kissing.” There has been just one reported case of this kind: a woman became infected through deep kissing with a man with AIDS whose gums often bled after brushing and flossing his teeth; after this activity, the couple often engaged in deep kissing and protected sex. Although HIV transmission most likely occurred during deep kissing, it was probably the blood in the man’s mouth, not his saliva, which transmitted HIV. Both the man and the woman had gum disease that may also have contributed to the woman becoming infected. It is important to note that in this situation, HIV is not passed through saliva, but rather through direct blood-to-blood contact.
16. Can I get HIV from a human bite?
It is very unlikely that a person would get HIV from a human bite. HIV can only be passed in this manner through direct blood-to-blood contact and not by exchanging saliva. To pass the virus, the infected person would need to have blood in his or her mouth and break the skin of the other person. The break in the skin of the uninfected person could allow infected blood to enter his or her bloodstream. If a person who does not have HIV bites and breaks the skin of a person with HIV, transmission of the virus could only occur if the uninfected person has open sores or cuts in the mouth that allow for blood-to-blood contact.
17. Can I get HIV from a mosquito bite?
No. Studies have shown that mosquitoes and other insects do not pass HIV to humans.
When an insect bites a person, it does not inject its own blood or a previous victim’s blood into the new victim. It injects only saliva. Unlike the germs that cause malaria and other diseases spread by insect bites, HIV does not reproduce (and therefore cannot survive) in insects. So, even if the virus enters a mosquito or another sucking or biting insect, the insect does not become infected and cannot pass HIV to the next human that it feeds on or bites.
18. Can I get HIV from living in the same house as a person with HIV or AIDS?
There have been no reported cases of HIV transmission from casual contact while living with a person with HIV or AIDS, even for a long time. However, there have been reported cases where household members became infected with HIV as a result of direct blood-to-blood contact, such as sharing a razor or toothbrush, getting stuck with a needle, or by getting infected blood on a rash and/or open sore.
19. Can HIV be passed through food, water, or the air?
No. HIV is not passed through food, water, or air, or by touching any object that was handled by, touched by, or breathed on by a person who has HIV.
20. Can I get HIV from swimming pools or hot tubs?
No. HIV cannot live in a hot tub or swimming pool. There have been no cases of HIV transmission through swimming pools or hot tubs.
21. Should I wait for symptoms to appear before getting tested?
No. If you think that you may have been exposed to HIV, you should get tested as soon as possible. You may have HIV and have no symptoms for many years. The sooner that HIV infection is detected, the sooner medical care can begin, which helps people with HIV stay healthier and live longer. In most cases, the immune system will stay healthier for a longer period of time if treatment starts before a person has symptoms.
22. How soon after exposure can HIV infection be detected?
Most people who are infected with HIV will test positive within one month of being infected. The period of time after infection, before the HIV test turns positive is called the window period.
When a person becomes infected with HIV, the body makes antibodies to fight HIV. When enough antibodies are developed, the HIV antibody test will be positive. Each person’s body responds to HIV infection a little differently, so the window period varies slightly from person to person. Most people infected with HIV will develop enough antibodies to be detected by HIV antibody tests four weeks after the exposure (transmission). Virtually all cases of HIV infection can be detected by three months.
During the window period, a person with HIV infection can pass it to others, even if his or her HIV antibody test is negative. In fact, during this period, the person may have very high levels of the virus and be most likely to infect others.
If the HIV antibody test is negative, a person can be sure that he or she does not have HIV only if he or she did not engage in any HIV risk behaviors (having unprotected sex or sharing needles) during the past three months.
A PCR (Polymerase Chain Reaction) test looks for HIV directly instead of detecting antibodies. This test can find HIV infection soon after the person is infected. Doctors may suggest an HIV PCR test if a person has symptoms suggestive of HIV infection (fever, rash, swollen lymph nodes, etc.) and reports high risk behaviors in the past few weeks. It is used to find HIV infection in newborns of mothers known to be infected with HIV. Sometimes doctors use a PCR test to measure viral load. The viral load test shows the amount of HIV in the blood of someone who is already known to be infected.
Window period - the time between the exposure that led to HIV infection and when HIV tests can detect antibodies in the person, indicating HIV infection.
Treatment for HIV infection includes
- Highly Active Anti-Retroviral Treatment (HAART);
- preventive treatment to avoid opportunistic infections;
- treatments for HIV-related illnesses; and
- healthy living practices.
HAART. HAART (Highly Active Anti-Retroviral Therapy) involves taking three or more drugs that fight HIV at the same time. HAART can strengthen the immune system and reduce the amount of HIV in the blood. Many medicines are available, and no one combination is best for everyone. Not everyone with HIV needs HAART, which is usually started only when signs of
immune system damage or symptoms of HIV appear (see question 68).
Drugs that fight HIV are divided into several “classes” or types. The different classes of drugs are used in combinations. Each class of drugs affects HIV in a
different way:
NRTIs (nucleoside and nucleotide reverse transcriptase inhibitors) interrupt the first step that HIV takes to “copy” itself inside a cell.
NNRTIs (non-nucleoside reverse transcriptase inhibitors) also interrupt the first step that HIV takes to copy itself, but in a different way than NRTIs.
Protease inhibitors interrupt the last step that HIV takes to copy itself.
Entry inhibitors (including fusion inhibitors) stop HIV from entering a healthy cell.
New medicines in each of these drug classes are being developed. New drug classes, which attack HIV in new ways, are also being researched.
Drugs that fight HIV have improved the health of many people, but these treatments are not perfect. HIV medicines can be hard to take and often have side effects, some of which are serious and even life threatening. Missing or delaying just a few doses of medicine can lead to the person developing “resistance” to the drugs, which means that the drugs will stop working
Preventive medicines. Opportunistic illnesses like PCP (Pneumocystis carinii pneumonia) and MAC (Mycobacterium avium complex) affect people whose immune systems are severely weakened by HIV. However, many of these illnesses can be prevented by taking certain medicines as soon as the immune system becomes weak. Since the immune system can be severely weakened before symptoms appear, it is important for people with HIV to see their doctors so that they can begin preventive treatment as soon as it is needed. A HAART regimen is the most effective way to strengthen the immune system.
Treatments for AIDS-related illnesses. Treatments for AIDS-related cancers, infections, and other conditions are available. Combining these treatments with HAART, as needed, can help people with AIDS live healthier, longer lives.
People with HIV should ask their doctor, nurse, or case manager for more information about these topics before they make any changes to their treatment plan.
Healthy living. Good health habits can play an important role in the treatment of HIV. Important factors include:
• eating healthy foods
• preparing and storing food safely
• taking vitamins as directed by a doctor or nutritionist
• exercise (both aerobic and muscle-building)
• getting enough sleep
• stress management
• avoiding alcohol, cigarettes, street drugs, and other harmful substances.
Smoking increases the risk of bacterial pneumonia, thrush, and other oral
health problems.
HAART can strengthen the immune system and reduce the blood.
24. What is the connection between HIV and TB?
TB (tuberculosis) is one of many diseases that a healthy immune system can usually keep under control. Only about 10% of people with normal immune systems who have the TB bacteria will get sick with active TB.
However, a person with HIV who has the TB bacteria and a weak immune system is much more likely to develop active TB disease. Untreated active TB can be spread to others by coughing. TB can usually be cured with medicines. Active TB can be
prevented by taking medicine before symptoms start. All people with HIV who have not had a positive TB skin test in the past should be tested for TB once a year. That way, if they are infected, they can take medicine to avoid getting sick with active TB.
25. How should parents talk to their children about HIV and AIDS?
Parents should talk with their children about HIV and AIDS for many reasons, including:
• to make sure their children are getting accurate information that is
appropriate for their age; and
• to help their children learn skills to reduce the risk of becoming infected
with HIV and protect themselves later in life.
Parents should look for chances to discuss HIV and AIDS directly with their children before their children are sexually active or experiment with drugs. A good way to approach the subject is to ask children what they are learning about HIV and AIDS in school. Or, parents can use news articles or stories on television, radio, or in the newspaper to start a conversation.
Parents should learn the facts about HIV and AIDS before talking with their children. Health departments, school health teachers, clinics, physicians, AIDS-related community organizations, libraries, and the Internet are good resources.
For a listing of HIV/AIDS educational materials written specifically for parents, call the New York State Department of Health AIDS Institute at visit the website at http://www.health.state.ny.us/nysdoh/aids/index.htm
26. Do adolescents/young adults get HIV?
Yes. HIV infection is an important concern for people of all ages, and young adults are no different. The Centers for Disease Control and Prevention estimate that at least half of all new HIV infections in the United States occur among
people under the age of 25.
The same behaviors that put adults at risk for HIV also put adolescents at risk. These activities include:
• having vaginal, anal, or oral sex without using a condom; or
• sharing drug injection equipment.
Adolescents should also be aware of these high-risk situations:
• Drinking or using drugs. Drugs and alcohol can affect your judgment and lead to unplanned and unprotected sex.
· Injection drug use, including sharing needles, syringes, cotton, spoons, bottle caps, or any other equipment (“works”).
· Experiencing “blackouts” – not being able to remember what happened while using alcohol or drugs.
• Not understanding your own risk of being infected with HIV or your partner’s risk of being infected.
• Having many sex partners, which increases the chances of having sex with someone who has HIV.
• Exchanging sex for money, drugs, food, housing, or other things of value.
• Having sex with older partners, especially partners who use drugs.
• Having sex with partners you do not know well.
• Having a history of sexually transmitted diseases (STDs) or having a partner who has a history of STDs.
• Rape or incest – anyone who has been a victim of rape or incest should seek counseling, including advice about HIV testing.
The same behaviors that put adults at risk for HIV also put adolescents at risk.
