HIV

What is it?

HIV stands for Human Immunodeficiency Virus.  It is a virus that attacks the immune system.  HIV is often sexually transmitted, though it can also be transmitted through other bodily fluids (such as blood or breast milk).  HIV is not found in saliva and cannot be transmitted through kissing.  It is not possible to transmit HIV through contact with unbroken skin.

The only way to tell if you have contracted HIV is by taking a test.  Tests are usually taken with a local doctor or at a healthcare clinic.  While less common, some people buy and take tests at home, with the tests then being mailed to lab for diagnosis.  HIV tests are highly accurate when taken correctly.

If HIV is acquired, it can be controlled with proper care, and those who have it can live long, healthy lives.    

AIDS (Acquired Immune Deficiency Syndrome) only occurs in the late stages of HIV. And while HIV can eventually lead to AIDS, not everyone who has HIV has or will get AIDS.

How do I get it?

HIV is found in bodily fluid and can be transmitted a number of ways.  Some activities pose a higher risk for transmitting HIV than others.

High risk activities:

* Anal Sex– The tissues in the anus are more susceptible to HIV than other tissues (such as those found in the mouth or the vagina).  Tearing (or anal fissures) in the anus can increase the risk of an HIV transmission.

* Sharing Needles– Blood from one person on the needle can easily be transmitted to any other people using the needle after them.

Medium risk activities:

* Vaginal Sex– Women can contract HIV through their vaginal tissues.  Tearing in the vaginal can increase the risk of an HIV transmission. While it is harder for men to contract HIV from women, it is possible for the virus to enter the penis and infect them.

Low risk activities:

* Oral Sex– While it is possible to contract HIV through oral sex, it is considered an extremely low risk.  However, there is an increased risk during oral sex if the person performing oral sex has cuts, sores, or ulcers in their mouth.  Brushing teeth or flossing right before oral sex can create small cuts in the mouth and is not recommended.

* Blood transfusions-In rare cases, HIV can be transmitted through blood transfusions if the blood is infected. However, this is now extremely uncommon as all blood is tested for HIV before transfusions.

Symptoms

Some people living with HIV have no symptoms, even without treatment; some have mild health problems; and others rapidly develop severe health problems associated with AIDS. 

Some people recently infected with HIV will experience some “flu-like” symptoms. These symptoms are called Acute Retroviral Syndrome and last from a few days to a few weeks. Some people with these symptoms might feel a little unwell or get sick enough to go to the emergency room.  These symptoms might include:

  • Fever
  • Severe Fatigue
  • A non-itchy rash
  • Swollen glands/lymph nodes
  • Muscle aches
  • Sore throat
  • Night sweats
  • Sores or ulcers in the mouth

It is important to remember people experience similar symptoms and it’s not related to HIV. Sometimes, the flu is just the flu.

After the acute phase, the virus typically becomes less active in the body for as long as 10 years, during which HIV positive people might have no symptoms at all. If HIV becomes severe enough in someone’s body and they have a low enough T-Cell count, it might change to a diagnosis of AIDS. There is not one set of symptoms that defines AIDS. When immune system damage is severe in people with HIV or AIDS, they experience opportunistic infections — called “opportunistic” because they are caused by things which our immune systems can usually defend against.

Tests

Anyone can get an HIV test.  No matter what the result, knowing your status and the status of your partner(s) can help you make informed choices about your sex life.

What is an HIV test? 

Most available HIV tests are types of antibody screening tests (also called immunoassays).  A person tests positive for HIV when antibodies are found in their bodies, meaning that they have been exposed to the virus.  If someone tests positive there will be a second test to confirm the results.  HIV antibody tests are done by a medical professional taking a blood or saliva sample. These samples are sent to a lab and analyzed, and time needed to get results vary by test type. There are different types of HIV tests, and doctors will talk to you about which type is best for you.  Different types of tests include:

Tests Performed by Doctors or Clinicians:

antibody and antigen tests

-What they are: These test are used by taking a blood sample.  Such tests look for both antibodies (the “defenses” built in response to the HIV virus) and antigens (which are a part of the actual virus itself).

-Where they can be taken: At local doctor or clinician’s office or authorized HIV testing site.

-When they can be taken: Around 3 weeks after potential exposure to HIV (However tests become slightly more accurate after several months).

-Time needed to get results: Varies by place taken, usually anywhere from several days to several weeks.

rapid test

-What it is: An immunoassay that looks for antibodies.

-Where can it be taken: Not all HIV testing sites offer rapid HIV tests.  Look for authorized testing sites that specifically say that they offer this type of test.

-When can it be taken: Around 3 weeks after potential exposure to HIV (However tests become slightly more accurate after several months).

-Time needed to get results: No more than 30 minutes.

followup testing for diagnosis

-What it is: Tests that are performed if the first immunoassay test is positive.  This involves more complicated tests in order to confirm that the first HIV positive diagnosis is accurate.

-Where can it be taken: Performed by doctors or clinicians in medical settings.

-When can it be taken: Only given if the 1st antibody test is positive, not given at other times.

-Time needed to get results: Varies by provider.

RNA tests

-What it is: These tests are very rare and are usually only done to monitor viral loads of people already diagnosed as HIV positive, OR if someone is nearly positive that they have been exposed to HIV (For example, if two people had sex and afterwards one told the other that that they were HIV positive). Unlike other tests, RNA tests work by detecting the actual virus itself, rather than antibodies.

-Where can it be taken: Only with a doctor or clinician, and only under special circumstances. Most HIV testing sites that ofter HIV antibody tests do not offer RNA tests.

-When can it be taken: For people who qualify, it can be taken about 10 days after exposure to HIV.

-Time needed to get results: Varies by provider.

At Home HIV Tests

Home Access HIV-1 Test System

-What it is: At home, pricking the finger (with instruments that come in a kit) to take a blood sample and then sending that sample to a lab to be tested.

-Where can it be taken: The test may be bought at drugstores or found online.  The blood sample is taken at home and the analysis done at a lab.

-When can it be taken: Around 3 weeks after potential exposure to HIV (However tests become slightly more accurate after several months).

-Time needed to get results: Can sometimes be as soon as one day after mailing it in, but can vary.

OraQuick In-Home HIV Test

-What it is: An at home test done by swabbing the mouth and then testing it yourself with the kit provided.

-Where can it be taken: The test may be bought at drugstores or found online. Both the swabbing and testing are done at home.

-When can it be taken: 3 months after a possible exposure.

-Time needed to get results: 20 minutes, though false negatives are common (1 in 12).

Where can I get an HIV test?

You can get an HIV test from your doctor or a clinic and some drug stores carry at-home tests.  Tests are often confidential, but laws vary, and your doctor will be able to inform you about your rights. For at-home tests, most samples must be mailed to a lab to get a result. In the United States you can find an HIV testing site near you at AIDS.gov.

When can I get an HIV test?

HIV can be detected in most people around 3 weeks after exposure, however in some (very rare) cases it can take up to 6 months for detection. So, the minimum that you should wait before getting tested is three weeks. If you take a test any sooner you risk having a test that is incorrectly negative (also called a “false negative”).  Generally, a negative test means that you do not have HIV. Even if you test negative at 3 weeks you may want to get retested as accuracy increases after 3 months and even more after 6 months. 

If you know that you have been exposed to HIV, there are options for early detection tests, and/or steps to reduce your risk of contracting HIV. Talk to your doctor about early detection options and the possibility of taking Post-Exposure Prophylaxis (PEP).  

With PEP, a person who has (or thinks that they have) been exposed to HIV someone takes antiretroviral drugs for 28 days in order to reduce the likelihood of becoming HIV positive.  PEP works by helping to preventing the multiplication and spread of the HIV virus in the body. These medications are time sensitive and must be taken within 3 days (72 hours) of HIV exposure (or possible exposure). While PEP is not effective at preventing HIV in every case, it can work for many people. 

Prevention

There are several things that people can do to reduce their risk of HIV.  If you choose to have sex or sexual activities, using condoms made of latex or polyurethane can reduce exposure to bodily fluids that may contain HIV.  Condoms made out of animal membranes protect against pregnancy but do not protect against HIV.  Condoms can be especially useful when engaging in higher risk sexual activities, such as anal and vaginal sex.  You can buy condoms at your local drugstore and many local sexual health clinics have them for free.

For people who are higher risk for sexually contracting HIV (such as someone who is HIV negative but their partner is positive, or intravenous drug users), medication called Pre-Exposure Prophylaxis (more commonly called PrEP, also known by its brand name Truvada) can greatly reduce the risk of getting HIV.  PrEP involves taking one pill everyday in order to reduce the likelihood of becoming infected with HIV. These pills consist of two of the medications which are used to treat HIV in HIV positive people.  PrEP is very effective, reducing the risk of HIV infection by up to 92%.

Likewise, if someone has HIV and does not want to pass it on to others, consistently taking prescribed medication (known as Antiretroviral Therapy/A.R.T.) will reduce your risk of transmitting HIV to a partner.

For people who use intravenous drugs (use needles), using new needles and not sharing them with anyone else helps prevent against HIV.

Treatments

While it can be scary to be diagnosed with HIV, with modern medication many HIV positive people are able to live long, healthy lifestyles. It’s generally considered a chronic medical condition.

Even though there are no known cures for HIV,  there are medications that can reduce the negative effects of HIV.  These anti-retroviral drugs work by slowing down the virus and therefore lessening the severity of detrimental effects.  Doctors will work with people diagnosed as HIV positive to find the right combination of medications for their body and preferences. For people who choose to take medication, taking them consistently and as prescribed are crucial towards their effectiveness. These medications can be helpful both in maintaining personal health and in reducing an HIV positive person’s risk of transmitting HIV to others.  However, these medications can be expensive, require many pills be on a daily basis, and can have negative physical side effects.  It is not uncommon for opportunistic infections to stem from HIV, so doctors may put HIV positive patients on additional medications to prevent these illnesses.

Communicating with doctors or healthcare providers can play an important role for HIV positive people in managing their health.  There can be complications from the treatments – frequent communication with doctors can be especially beneficial for HIV positive patients. Likewise, since HIV weakens the immune system, it is helpful for HIV positive patients to see their doctors if they start to feel sick, even if it does not seem severe.   

Resources

Find an HIV testing location (USA only)

https://locator.aids.gov/

Emotional phone support

AIDS/HIV Nightline
,
(800)628-9240 (National)
(415)434-2437 (Bay Area, CA)
(800)303-7432 (Spanish, CA only)

Informational phone support

Project Inform (National HIV/AIDS Treatment Hotline)
(800)822-7422 (National)
(415)558-9051 (Bay Area, CA)
http://www.projectinform.org/helplines/infoline/

Informational Websites

Project Inform, http://www.projectinform.org/
Aids.gov, https://www.aids.gov/
Avert (AVERTing HIV and AIDs), http://www.avert.org/
San Francisco AIDS Foundation, http://sfaf.org/stopaids/