Transmission
HIV is a virus that enters the body and begins to destroy T cells. T cells are required to fight infections. The virus is transmitted in bodily fluids that include: blood, semen, vaginal and rectal fluid, breast-milk. Some of the ways HIV is spread from person to person include: having unprotected sex with an infected person.
This is the most common route of transmission sharing needles, syringes, and other items for injection drug use with an infected person, passing it on to an unborn child if the mother is HIV-positive, passing it on to a baby through breast milk if the mother is HIV-positive and being exposed to infected fluids, usually through needle sticks.
Having a blood transfusion or organ and tissue transplant can also transmit the virus. But rigorous testing for HIV in blood ensures that this is very rare. HIV does NOT spread through skin-to-skin contact, hugging, shaking hands, or kissing, air or water, eating or drinking items, saliva, tears, or sweat (unless mixed with blood from an infected person), sharing a toilet, towels, or bedding, mosquitoes or other insects.
Symptoms
Some people infected with HIV are asymptomatic at first. Most people experience symptoms in the first month or two after becoming infected. That’s because the immune system is reacting to the virus as it rapidly reproduces. This early stage is called acute stage. Symptoms may last anywhere from a few days to several weeks. These include fever, swollen lymph glands and general aches and pains.
The clinical latent infection, or chronic stage of HIV, can last from a few years to a few decades. During this time the virus is still reproducing, but at lower levels. Some people have few, if any, symptoms.
As the disease progresses, other symptoms may include swollen lymph nodes, recurrent fevers, fatigue, aches and pains, nausea, vomiting, diarrhea, weight loss, skin rashes and oral yeast infections or other infections.
Symptoms may come and go or progress rapidly. Even if there are no symptoms, a person with HIV can still transmit the virus to others. Symptoms of HIV vary from person to person, but they’re similar in men and women.
HIV antibody test
Between 21 and 84 days after infection, almost all of those infected with HIV will develop detectable HIV antibodies, which can be found in the blood or saliva. There’s no preparation necessary for blood tests or mouth swabs. Some tests provide results in 30 minutes or less and can be performed in a doctor’s office or clinic. If you have recent exposure to HIV, but with a negative test result, you need to repeat the test in three months. If you have a positive result, follow up with your doctor to confirm. An antigen is part of the virus that activates the immune system. It takes from 13 to 42 days for antibodies and antigens to be detectable.
False positive test result
When the initial test comes back positive (unless you’ve done the at-home test) you should be offered a confirmatory test, basically a second test to make sure you’re HIV-positive. The likelihood of two false positives is extremely rare. During the first few months of infection, an HIV test may provide a false-negative result. This is because it takes time for the immune system to build up enough antibodies to be detected in a blood test. But the virus is active and highly contagious during this time.
So if you have an HIV test with a negative result within three months of your last possible exposure to HIV, the recommendation is to be retested three months after that first screening test. A negative result is only accurate if you haven’t had any risks for HIV infection in the last six months—and a negative result is only good for past exposure.
Window period
As soon as a person is infected with HIV, it starts to reproduce in the body. The immune system reacts to the antigens by producing antibodies. The time between exposure to HIV and when it becomes detectable in blood is called the HIV window period. Taking HIV test during the window period is likely to produce a negative result. But the virus can still be transmitted to others. If you’ve been exposed to HIV, but test negative during the window, you might benefit from pre-exposure prophylaxis (PrEP). A combination of HIV-approved drugs, PrEP can lower the risk of contracting or spreading HIV when taken consistently.
Sero-discordancy
Sero-discordant simply means one partner has HIV and the other doesn’t. There’s very little research on how successfully sero-discordant, or mixed, couples cope with the complications of HIV. If you’re a mixed couple the HIV-negative partner may want to talk to his or her physician about PrEP; while the positive partner should talk about achieving an undetectable viral load. Couples might also want to see a counselor who specializes in coping with HIV.
HIV and AIDS connection
To develop AIDS, you have to have been infected with HIV. But having HIV doesn’t necessarily mean you’ll develop AIDS. There are three stages of HIV infection: acute stage, the first few weeks after infection, clinical latency, or chronic stage and the last stage –AIDS. As HIV lowers CD4 cell count, immune system weakens. A normal adult CD4 count is 800 to 1,000 per cubic millimeter. A count below 200 is considered AIDS. How quickly HIV progresses through the chronic stage vary significantly from person to person. Without treatment, it can last up to a decade before advancing to AIDS. With treatment, it can last indefinitely.
Treatment options
Treatment should begin as soon as possible after a diagnosis of HIV. The main treatment is anti-retroviral therapy (ART), a combination of daily medications that stop the virus from reproducing. This helps protect CD4 cells, keeping the immune system strong enough to fight off disease. ART helps keep HIV from progressing to AIDS. It also helps reduce the risk of transmission.
A doctor will help you choose a regimen based on your overall health and personal circumstances. These medications must be taken consistently and exactly as prescribed. To strengthen overall health, a healthy diet, exercise regularly, and enough sleep are crucial.
Prevention
There’s no vaccine to prevent HIV infection. Unprotected sex is the most common way for HIV to spread. You can’t completely eliminate this risk unless you abstain from sex, but you can lower risk considerably by taking a few precautions:
*Get tested for HIV to learn your status and your partner’s.
*Get tested for other sexually transmitted diseases (STDs). If you have one, get treated, because having an STD increases the risk of HIV.
*Learn the correct way to use condoms, and use them every time you have sex. Keep in mind that pre-seminal fluids can contain the virus.
*Limit your sexual partners. Have only one sexual partner who only has sex with you.
*If you have HIV, lower the risk of transmitting it to your sexual partner by taking your medicines as directed. Although this will lower your viral load, you still need to use condoms.
*HIV is transmitted through blood. Never share needles or other drug paraphernalia.
Living with HIV
There is no cure for HIV, it is a lifetime condition but it can be controlled. People with HIV often have a near-normal lifespan with early intervention with antiretroviral therapy. Without treatment, HIV is likely to advance to AIDS. At that point, the immune system is too weak to fight off life-threatening disease and infection.
Untreated, life expectancy with AIDS is three years or less.
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