Sisters in Health

World HIV/AIDS Day December 2015

Marjorie Binette, MD

1st December World Aids Day concept with text and red ribbon of aids awareness. Vector illustration

World AIDS Day is held on the first of December each year to spread awareness about HIV/AIDS.  It’s an opportunity for people all over the world to talk about prevention. According to the Center For Disease Control (CDC) an estimated 36.9 million people are living with HIV/AIDS worldwide.  Here in the United States, approximately 1.2 million people are living with HIV.  In addition,  the CDC reports 1 in 8 people have HIV and don’t know it.  This statistic is alarming, isn’t it?

HIV Statistics

Fast Facts from the CDC:

  1. African-Americans are the racial/ethnic group most affected by HIV.
  2. The rate of new HIV infection in African Americans is 8 times that of whites based on population size.
  3. Gay and bisexual men account for most new infections among African Americans.
  4. Approximately 1 in 4 people living with HIV infection in the United States are women.
  5. Most new HIV infections in women are from heterosexual contact (84%).  (Please keep in mind a woman can be infected with contact with another woman)
  6. An estimated 88% of women who are living with HIV are diagnosed, but only 32% have the virus under control.

New HIV Infection Trends per the CDC:

When comparing groups by race/ethnicity, gender and transmission category, the fourth largest number of all new HIV infections in the United States in 2010 occurred among African American women with heterosexual contact.

What is HIV?

CDC: HIV stands for human immunodeficiency virus.  The virus weakens a person’s immune system by destroying important cells that fight disease and infection. Over time HIV can destroy so many of the immune cells that the body can’t fight off infections and disease.   When this happens, HIV infection leads to AIDS.

What is AIDS?

AIDS stands for acquired immunodeficiency syndrome.  A person infected with HIV has AIDS when certain cells of your immune system fall below a certain number.  When the cells fall below a certain number a person is at more risk for other infections and diseases. Essentially, AIDS represents a progression of HIV.  It is at this stage that the immune system is so weak, that it becomes harder to fight off serious infections.  It is at this stage that people can die from infection or cancer.

How is HIV transmitted?

HIV is transmitted from person to person through body fluids, such as blood, semen and vaginal fluid.  Also, a pregnant woman can transfer the virus to their unborn child. HIV is most commonly transmitted by those having unprotected vaginal, oral or anal sex with an infected person.  Also, improper use of condoms can lead to infection.  Lastly, IV drug users who share needles is another common way HIV is transmitted from person to person.

Who is at risk for HIV infection?

The following is a list of people who are at high risk for HIV infection:

What are the symptoms of HIV?

Up to 50% of people will experience acute HIV infection, otherwise known as HIV Syndrome.  Symptoms can be present as early as one to four weeks after transmission of HIV.    Early symptoms of HIV syndrome are similar to the type of symptoms you would have from the flu and they include:

In later stages of HIV people will begin to feel worse and look worse.  They begin to experience high fevers, diarrhea, weight loss, cough and develop swollen lymph nodes.

Keep in mind 50% of patients with HIV experience no symptoms. They will look and feel normal.

When should you get tested?

HIV does not discriminate, so everyone should get tested.  The CDC recommends that all persons aged 13 to 64 be tested at least once.  Certainly get tested if you engaging in high risk behavior(s). Also, woman who are pregnant should get tested.  And anyone who is sexually assaulted should get tested.

Here is a list of questions from the CDC to help you decide if you should get tested:

  1. Have you had sex with someone who is HIV-positive or whose status you didn’t know since your last HIV test?
  2. Have you injected drugs (including steroids, hormones, or silicone) and shared equipment (or works, such as needles and syringes) with others?
  3. Have you exchanged sex for drugs or money?
  4. Have you been diagnosed with or sought treatment for a sexually transmitted disease, like syphilis?
  5. Have you been diagnosed with or sought treatment for hepatitis or tuberculosis (TB)?
  6. Have you had sex with someone who could answer yes to any of the above questions or someone whose history you don’t know?

Also the CDC states the following:

If you continue having unsafe sex or sharing injection drug equipment, you should get tested at least once a year. Sexually active gay and bisexual men may benefit from more frequent testing (e.g., every 3 to 6 months).

A note on testing according to the CDC:

The immune system usually takes 3 to 8 weeks to make antibodies against HIV, but tests differ in how early they are able to detect antibodies. Although most HIV tests look for these antibodies, some look for the virus itself. The period after infection, but before the test becomes positive is called the window period.

Deciding when to get tested therefore depends on when you may have been exposed and which test is used. You can ask your health care provider about the window period for the HIV test you are taking. If you are using a home test, you can get that information from the materials included in the packaging of the test.

A few people will have a longer window period, so if you get a negative antibody test result in the first 3 months after possible exposure, you should get a repeat test after 3 months. Ninety-seven percent of people will develop antibodies in the first 3 months after they are infected. In very rare cases, it can take up to 6 months to develop antibodies to HIV.

What tests are available?

Blood samples are the primary body fluid used to test for HIV.  Blood is tested for the HIV antibody. The antibody is what you body uses to fight the HIV.  It can take up to to 3  to 12 weeks before the HIV antibody becomes detectable from the time of infection.  Once a blood test is positive, other blood tests are done to confirm the infection.

When acute HIV syndrome is suspected, a doctor can order tests that can detect HIV as early as 10  to 15 days from the time of infection.

What HIV tests are available to do at home?

There are two HIV testing kits that you can do yourself at home.  The Home Access HIV-1 Test System involves pricking your finger to collect a blood sample.  The blood sample is sent to a lab for testing and results are available as early as 24 hours.  It is important to know the Home Access HIV-1 Test System detects HIV later than lab based blood collected from your vein.  The OraQuick In-Home HIV Test is a rapid test.  It involves swabbing your mouth for oral fluid.  Results are available within 20 minutes.  The disadvantage of testing with oral fluid is that it contains less of the HIV antibody compared to that found in blood.  The advantage to both tests, is that both provide anonymity.  If either, test is positive an individual see a doctor as soon as possible.

What treatments are available?

Fortunately medical science has come a long way since HIV was first discovered.  It used to be those infected with HIV/AIDS died of their disease in 6 to 18 months.  Today with a class of medications called the antiretrovirals,  those infected with HIV can expect to live a long life.  In addition to antiretrovirals, certain medications can be taken to reduce other life threatening infections.  Lastly, certain vaccines are important for HIV positive individuals.

What can I do to prevent HIV?

Here is a list of things you can do to decrease your chance of HIV infection:

  1. Use a condom every time you have sex.
  2. Know your partner.  Ask him or her about prior history of high risk behavior.  Also, ask your partner when was the last time he or she was tested for HIV.  A verbal affirmation is not enough proof.  Ask to see the copy of the test results.
  3. Seek medical attention as soon as possible if you think you have been exposed to HIV.  There are medications that can be given for post-exposure prophylaxis.
  4. PrEP, Pre-exposure prophylaxis.  Antiretroviral medication that can be taken to prevent HIV infection in people who are at high risk for contracting HIV.  Consider this If you engage in high risk behavior such as sharing IV drugs or you have unprotected sex.  Also, if you are in a sexual relationship with someone known to be HIV-positive, PrEP may be an option. Talk to your doctor about the disadvantages and advantages about PrEP.

Bottom-line

There is a lot to know about HIV/AIDS.  This article although lengthy does not  cover all you need to know, thus I encourage you to visit the CDC here for more information.

Get screened for HIV.  Know your status. Know your partner’s status and know his or her sexual history.  Don’t take someone’s word for it, have them show you proof of a recent blood test.  If the person isn’t willing to give you proof then you shouln’t have sex with that person.  Also, keep in mind that a recent negative blood test does not protect you. Remember the window period between the time of infection to detection is 4 – 12 weeks. Also, remember people can look and feel absolutely normal and be HIV positive.

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