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Each year there are more and more new HIV infections, which shows that people either aren't learning the message about the dangers of HIV, or are unable or unwilling to act on it. Many people are dangerously ignorant about the virus - a survey found recently that a third of teens thought there was a 'cure' for AIDS. Education is an important component of preventing the spread of HIV.
Even if education were completely successful, it would still have to be an ongoing process - each generation a new generation of people become adult and need to know how to protect themselves from infection. The older generations, who have hopefully already been educated, may need the message reinforced, and need to be kept informed, so that they are able to protect themselves and inform the younger.
Anyone who is vulnerable to AIDS, and almost everyone is vulnerable, unless they know how to protect themselves. It's not only young people, injecting drug users or gay men who become infected - the virus has affected a cross-section of society. This means that education ought to be aimed at all parts of society, not only those groups who are seen as being particularly high-risk. It is all very well to educate young people but it's usually adults who become infected, and in recent years there has been very little AIDS education targeted at adults. The people who are most urgently in need of HIV education are those who think they're not at risk.
People who have not yet been educated and may be at risk of becoming infected. This usually means young people, who need to know the risks involved in unsafe sex and drug use before they are old enough to find out for themselves.
People who have already been educated for whom the education was not effective. If AIDS education were completely effective, there wouldn't be nearly so many new infections. These infections do not only occur amongst young people - many people who have already experienced AIDS education continue to become infected with HIV.
"A few months after we started having unprotected sex, I fell gravely ill. . . I recovered slowly but . . . I guess the warning signs have been there since I fell sick earlier this year, I'm educated on HIV and some of my symptoms literally had the warning bells ringing inside my head. Still, the shock of discovering my status is something I will never wish on my worst enemy." TK-anonomous
Everyone needs to learn how and why not to discriminate against positive people. People who are not HIV positive must learn about how the virus is transmitted in order that they are able to protect themselves from infection. At the same time, they must also learn how the virus is not transmitted. People need to know that they cannot become infected from such things as sharing food, towels or toilets. This will help to reduce discrimination against positive people by reducing ignorance and fear.
People who are already infected also require education. Initially, this must involve an element of counseling and support, and must teach them how about living well with HIV, the tests they may need to have and the medications they may need to take. They must also learn about HIV transmission and safer sex, for two reasons - they need to know how to live positively without passing the virus on to anyone else, and they need to know how to avoid coming into contact with a strain of the virus which differs from the one they are already have.
The only people who do not fall into one of these groups are those who have received AIDS education, have taken it in, and have the resources to turn knowledge into action. One group who should hopefully fall into this category are AIDS educators. This may seem obvious, but in many cases, teachers may require teaching themselves. They may be called upon to act as AIDS educators when they themselves have little experience or knowledge of the subject. Peer educators must also receive training, even if they themselves are HIV+. Information for teachers and HIV educators will be found here.
If AIDS education that had been done up until now had been fully effective, then there wouldn't have been over five million new infections in 2004. It is clear that the campaigns carried out so far have failed to prevent the spread of the virus, so the message needs to be repeated, in different forms, until people appreciate it, or until, hopefully, education is no longer needed.
HIV is the human immunodeficiency virus. It is the virus that can lead to acquired immune deficiency syndrome, or AIDS. UNAIDS estimates over half a million people in Thailand are living with HIV, and in 2009 28,000 people died from AIDS. HIV damages a person’s body by destroying specific blood cells, called CD4+ T cells, which are crucial to helping the body fight diseases.
REMEMBER: Early diagnosis and treatment are essential for maintaining your health. Take control of your health and your life.
AIDS stands for Acquired Immune Deficiency Syndrome: Acquired means you can get infected with it. Immune Deficiency means a weakness in the body’s system that fights diseases.
Syndrome means a group of health problems that make up a disease. AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. If you get infected with HIV, your body will try to fight the infection. It will make “antibodies,” special molecules to fight HIV.
A blood test for HIV looks for these antibodies. If you have them in your blood, it means that you have HIV infection. People who have the HIV antibodies are called “HIV-Positive.”
Being HIV-positive, or having HIV disease, is not the same as having AIDS. Many people are HIV-positive but don’t get sick for many years. As HIV disease continues, it slowly wears down the immune system. Viruses, parasites, fungi, and bacteria that usually don’t cause any problems can make you very sick if your immune system is damaged. These are called “Opportunistic Infections.”
These activities are: Unprotected sexual intercourse, sharing needles, breastfeeding and/or direct blood to blood contact with an HIV positive person.
You are not at risk of contracting HIV if you hug or kiss someone, or share cups, drink bottles or utensils with someone. Body fluids like saliva, sweat or urine do not contain enough of the virus to infect another person.
There may not be a cure for HIV but it is 100% preventable. Most new HIV transmissions are the result of unprotected sex and sharing needles. The good news is we have a few tips and tricks to keep you safe and lower your risk of transmission.
One of the most effective tools to fight against sexually transmitted HIV is the male condom. Condoms are easy to use, cheap to buy and extremely efficient at preventing HIV transmission. Condoms come in all shapes, sizes, textures, tastes and materials. If you or a partner doesn’t like one type, try another – the possibilities are endless!
Remember: All condom packages should carry an expiry date. Throw them away if the date has passed. Try not to store condoms in direct sunlight or in very warm or cold places.
Female condoms, also called insertive condoms, are a thin piece of polyurethane that acts like a loose lining inside the vagina.
Pro tip: Don’t use a male and female condom at the same time. This increases the risk of slipping or breaking. Insertive condoms are designed for vaginal sex. Male condoms are the best choice for anal sex, but if decide to use an insertive condom it’s best to remove the inner ring and check frequently to make sure the condom doesn’t slip inside the rectum.
Pre-Exposure Prophylaxis (PrEP)
PrEp is a new HIV prevention method in which people who do not have HIV take a daily pill to reduce their risk of becoming infected. When used consistently, PrEP has been shown to reduce the risk of HIV infection among adult men and women at very high risk for HIV infection through sex or injection drug use.
Post-Exposure Prophylaxis (PEP)
PEP involves taking anti-HIV medications as soon as possible after you may have been exposed to HIV to try and reduce the chance of becoming HIV positive. These medications keep HIV from making copies of itself and spreading through your body. To be effective, PEP must begin within 72 hours of exposure, before the virus has time to make too many copies of itself in your body. PEP consists of 2-3 antiretroviral medications and should be taken for 28 days.
To prevent HIV transmission when injecting drugs, use a new, clean needle and rig every time. You can get new needles and other resources at any HIV Community Link office as well as Safeworks in Calgary. Know what’s yours and never share. After you inject, recap the needle and put it in a sealed, puncture proof container like a plastic pop bottle and bring it to a needle exchange. Never dump it where someone could find it and get hurt.
Picture: www.plannedparenthood.org, www.cdc.gov
At HIV Community Link, we offer a wide range of programs and services, as well as referrals to other service providers. For more information on our support services for People Living with HIV, click here.
There is no cure for HIV, but treatment can help people stay healthy for many years. In fact, it is estimated that with early diagnosis and proper care and treatment, many People Living with HIV can expect to live a normal life-span. With access to treatment and other healthy lifestyle choices, HIV is not a “death sentence” as some people may think.
Although there is no cure, HIV can be treated successfully with anti-HIV medications. With daily and continuous treatment the virus is well controlled inside the body and wellness, quality of life and life expectancy are significantly improved. The current standard in HIV treatment is a combination of at least 3 different classes of medications that work together tostop HIV’s ability to replicate and damage the immune system. Some common terms for HIV treatment include ARVs (antiretrovirals), ART (antiretroviral therapy), HAART (highly active antiretroviral therapy) or CAART (combination antiretroviral therapy).
HIV treatment can cause uncomfortable and serious side effects for some people. Treatment is individualized and different people will have different experiences with their treatment. Some side effects may be short term and only last the first 2 to 6 weeks after starting treatment (nausea, headaches and dizziness for example), while others may cause long-term changes that can take years to develop or be noticeable. Debilitating side effects have been experienced with some classes of HIV medication. Fortunately, many of the newer medications cause much fewer side effects for many people.
The decision to start HIV treatment should always be made in consultation with a medical doctor. When HIV treatment is started, it is very important that people take their medications as prescribed and do not skip doses or take unsupervised “breaks” from their treatment schedule. When treatment is interrupted in this way, there is concern that the virus will begin replicating quickly and may become resistant to the medication. If resistant virus develops, that type of medication will stop working. When working with a doctor to determine when and how to start HIV treatment, resistance should be discussed and considered carefully.
HIV treatment works by controlling the amount of virus in the body so the immune system can stay healthy. In addition to medications, many people living with HIV find their overall health is improved or maintained by making other healthy lifestyle choices including good nutrition, exercise, reducing or eliminating drug and alcohol use, and managing stress. For more information on HIV treatment and healthy lifestyle choices for People Living with HIV.
Other needs and services
When you are beginning treatment for HIV, you may need other services and/or support. During your initial few visits your healthcare provider or case manager may ask you if you need access to the following:
It’s possible that you will have to complete additional forms or show that you meet eligibility requirements to get access to these programs. Talk with your provider to determine which programs may be right for you.
Finding an HIV/AIDS Doctor
Finding the right HIV/AIDS doctor for you is one of the most important health care decisions you will make. This person will work closely with you, guiding you through many treatment decisions. Although it's important to seek care as soon as possible, don't rush into making a choice. Here are some things to consider.
If you already have a primary care physician with whom you feel comfortable, find out if this person also has the skills and experience to be your HIV/AIDS doctor. If not, they can refer you to a specialist. If you need to find a new HIV/AIDS doctor, and don't know where to begin, here are a few ideas to help you get started:
Resource: www.aids.gov, www.webmd.com
“PrEP” stands for preexposure prophylaxis. The word “prophylaxis” means to prevent or control the spread of an infection or disease. The goal of PrEP is to prevent HIV infection from taking hold if you are exposed to the virus. This is done by taking a pill that contains 2 HIV medications every day.
PrEP is not for everyone. Doctors prescribe PrEP for some patients who have a very high risk of coming in contact with HIV by not using a condom when they have sex with a person who has HIV infection. You should consider PrEP if you are a man or woman who sometimes has sex without using a condom, especially if you have a sex partner who you know has HIV infection. You should also consider PrEP if you don’t know whether your partner has HIV infection but you know that your partner is at risk (for example, your partner inject drugs or is having sex with other people in addition to you) or if you have recently been told by a health care provider that you had a sexually transmitted infection. If your partner has HIV infection, PrEP may be an option to help protect you from getting HIV infection while you try to get pregnant, during pregnancy, or while breastfeeding.
a) Post -Exposure Prophylaxis (PEP) is antiretroviral drug treatment that is started immediately after someone is exposed to HIV. The aim is to get the drugs inside the body as quick as possible to fight the virus allow a person’s immune system a chance to provide protection against the virus and to prevent HIV from becoming established in someone’s body. In order for Post exposure prophylaxis PEP to have a chance of working the medication drugs needs to be taken as soon as possible, definitely within 72 hours, after possible exposure to HIV. Left any longer and it is thought that the effectiveness of the treatment is severely diminished.
Post exposure prophylaxis (PEP) usually consists of a month long course of two or three different types of the antiretroviral drugs that are also prescribed as treatment for people with HIV. As with most antiretrovirals these can cause side effects such as diarrhea, headaches, nausea/vomiting and fatigue. Some of these side effects can be quite severe and it is estimated that 1 in 5 people give up the treatment before completion. The most common drugs prescribed for Post exposure prophylaxisPEP are tenofovir, emtricitabine (or lamivudine), and efavirenz or lopinavir/ritonavirzidovudine, lamivudine and nelfinavir.
b) Post-Exposure Prophylaxis (PEP) is a course of antiretroviral drugs which is thought to reduce the chance of HIV establishment risk of seroconversion in one's body after events with high risk of exposure to HIV (e.g., unprotected anal or vaginal sex, or needle-stick injuries, or sharing needles).
To be most effective, one need to begin treatment antiretroviral drugs should begin within an hour of as soon as possible after possible exposure infection, and no longer than 72 hours post-exposure. Prophylactic treatment course for HIV typically lasts four weeks.
While there is compelling data to suggest that PEP after HIV exposure is effective, there have been cases where it has failed. Failure has often been attributed to the delay in receiving treatmentPEP, the level of exposure (i.e., the viral load received), or both. However, for non-occupational exposures, the time and level of exposure are based on patient-supplied information; absolute data is therefore unavailable. PEP can also slow down the development of antibodies, potentially causing false negatives on a later HIV test. Doctors will advise patients who received PEP to get anti-HIVa test at the completion of PEP course and at 3-6 months after that at 6 months post-exposure as well as the standard 3 month test.
The antiretroviral regimen used in PEP requires close compliance and can have unpleasant side effects including malaise, fatigue, diarrhea, headache, nausea and vomiting.
PEP is not a cure for HIV and is not guaranteed to prevent HIV from taking hold once the virus has entered the body. Condoms and lube for sex remain the most efficient way of staying safe from HIV
What are condoms?
A condom is a tube made of thin, flexible material. It is closed at one end. Condoms have been used for hundreds of years to prevent pregnancy by keeping a man’s semen out of a woman’s vagina. Condoms also help prevent diseases that are spread by semen or by contact with infected sores in the genital area, including HIV. Most condoms go over a man’s penis.
The lubrication on condoms varies. Some condoms are not lubricated at all, some are lubricated with a silicone substance, and some condoms have a water-based lubricant. The lubrication on condoms aims to make the condom easier to put on and more comfortable to use. It can also help prevent condom breakage.
What are they made of?
Condoms used to be made of natural skin (including lambskin) or of rubber. That’s why they are called “rubbers.” Most condoms today are latex or polyurethane.
Lambskin condoms can prevent pregnancy. However, they have tiny holes (pores) that are large enough for HIV to get through. Lambskin condoms do not prevent the spread of HIV.
Latex is the most common material for condoms. Viruses can not get through it. Latex is inexpensive and available in many styles. It has two drawbacks: oils make it fall apart, and some people are allergic to it.
Polyurethane is an option for people who are allergic to latex. One brand of female condom and one brand of male condom are made of polyurethane.
How are condoms used?
Condoms can protect you during contact between the penis, mouth, vagina, or rectum. Condoms won’t protect you from HIV or other infections unless you use them correctly.
Condoms don’t work: Studies show condoms are 80% to 97% effective in preventing HIV transmission if they are used correctly every time you have sex.
Condoms break a lot: Less than 2% of condoms break when they are used correctly: no oils with latex condoms, no double condoms, no outdated condoms.
HIV can get through condoms: HIV can not get through latex or polyurethane condoms. Don’t use lambskin condoms.
When used correctly, condoms are the best way to prevent the spread of HIV during sexual activity. Condoms can protect the mouth, vagina or rectum from HIV-infected semen. They can protect the penis from HIV-infected vaginal fluids and blood in the mouth, vagina, or rectum. They reduce the risk of spreading other sexually transmitted diseases.
Condoms must be stored, used and disposed of correctly. Male condoms are used on the penis. Female condoms can be used in the vagina or rectum.
What are STDs and how do they relate to HIV infection?
STD stands for "sexually transmitted disease." STDs are infections that are passed on through the close, intimate contact that usually accompanies sexual activities.
Some common STDs include the following
HIV is the human immunodeficiency virus. It is the virus that can lead to acquired immune deficiency syndrome, or AIDS.
Chlamydia infection is a common sexually transmitted infection (STI) in humans caused by the bacterium Chlamydia trachomatis. The term Chlamydia infection can also refer to infection caused by any species belonging to the bacterial family Chlamydiaceae. Watch Dr. Amanda explaining about Chlamydia's cause and symptoms.
For those who have the symptoms which are non-specific, should seek proper diagnosis before getting treatment.
Trichomoniasis is a genital infection caused by a parasite. It prefers to live in the vagina, but can also live in the urethra (inside the penis) in men. Most women do not have symptoms, however, some women may have a frothy, yellowish vaginal discharge, genital itching or vulval pain. Symptoms are rare in men but it may cause pain on urinating. Trichomonas can be transmitted by vaginal sex without using condoms withsomeone who has the infection.
Gonorrhea is a sexually transmitted disease (STD). Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (urine canal) in women and men. The bacterium can also grow in the mouth, throat, eyes, and anus.
HPV is the most common sexually transmitted infection (STI). HPV is a different virus than HIV and HSV (herpes). HPV is so common that nearly all sexually active men and women get it at some point in their lives. There are many different types of HPV. Some types can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems from happening
Herpes is a very contagious disease, and is easily spread through contact with the affected area. Herpes can be transmitted not only through sexual intercourse, but also through oral and anal sex with your partner who might not even know or show no signs of herpes. Herpes can be treated but can not be cured and once infected the virus stays in skin and nerve cells for life. Condoms can help reduce the risk against Herpes however condoms only protect certain area that they cover. Most of the time it is dormant and causes no symptoms, but from time to time it can flare up. This tends to happen when the immune system is weakened, in situations of stress, during a cold or on exposure to strong ultraviolet light, even in people without HIV. Such attacks occur more frequently in children and the elderly, since these groups tend to have less efficient immune systems than adults.
Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. It has often been called “the great imitator” because so many of the signs and symptoms are indistinguishable from those of other diseases.
Hepatitis B virus (often known as HBV, but to avoid possible confusion with HIV, this abbreviation isn’t used in this booklet) is an infection that can cause severe damage to your liver, sometimes resulting in death.
Hepatitis C, although unrelated to hepatitis B, often causes similar symptoms. Sexual transmission of hepatitis C is less common but does occur. It is more likely to happen if you also have another sexually transmitted infection (STI). Also, anal or rough sex is more likely to pass on the infection. Oral sex is of low risk. The virus is present in saliva, but kissing is not usually a risk unless both partners have cuts in the mouth or bleeding gums.
Understanding the risk
If you have ever had an STD, you may have been exposed to HIV as well, and should consider getting tested for HIV.
If you currently have an STD, you need to see a medical provider as soon as possible. Having an STD causes the skin to break down and can increase the risk of getting HIV, or passing HIV to others if an HIV-infected person has an STD. STDs also can cause problems of their own, which can range from minor and annoying in nature to serious and life-threatening. Some STDs can be present without causing symptoms. Therefore, if you think you are at risk of contracting STDs, you should be tested routinely for both HIV and STDs, even if you have no symptoms.
Taking steps to protect yourself from HIV, such as using condoms and other latex barriers if you are having sex, will also provide protection against many other STDs. Some STDs (such as herpes and genital or anal warts), however, can still be passed by skin-to-skin contact during sex even if you are taking steps to protect yourself from HIV.
Source: www.hivinsite.ucsf.edu, www.adamslove.org
Can I get HIV from sharing a drinking glass with someone living with HIV?
No, HIV can only be transmitted via unprotected sexual intercourse, sharing needles, breastfeeding and/or direct blood to blood contact with an HIV positive person.
Can I get HIV from hugging someone living with HIV?
Absolutely not. HIV is not transmitted via skin contact.
Can I get HIV from sharing food with or having it prepared by someone living with HIV?
No. HIV is not transmitted through saliva and, even if the food contained small amounts of HIV-infected blood or semen, exposure to the air, heat from cooking, and stomach acid would destroy the virus.
Is there any risk being around a flatmate, friend or colleague who is living with HIV?
No. HIV is not spread by day-to-day contact with other people. HIV is not spread through shaking hands, hugging, or kissing. You cannot become infected from a toilet seat, a door knob, dishes, drinking glasses, food, or cigarettes.
“I’m never the receptive partner during anal sex, so I’m not at risk, right?”
Wrong. Although unprotected receptive anal sex carries the highest risk, it is still possible to contract HIV if you are the insertive partner and you are not wearing a condom. HIV can enter the body through vulnerable skin cells under the head of the penis or possibly through the urethra.
“I can take a pill called PrEP to stop HIV, right?”
Pre-exposure prophylaxis or PrEP refers to the use of HIV medication by people who are HIV negative in order to reduce their risk of HIV infection. When taken on a daily basis, PrEP ensures there is enough HIV medication in the body to significantly reduce the risk of becoming infected with HIV if exposed during unprotected sex.
The HIV medication used is called Truvada and it contains two antiviral medicines, Tenofovir and Emtricitabine, which are also used to treat people who already have HIV infection. These are the same drugs used to suppress the virus in people living with HIV.
When considering the role of PrEP in preventing HIV, there are other things to think about – especially STIs which PrEP does not protect from, whether you're able to adhere to taking a daily pill, and possible side effects.
Using condoms and lube for anal and vaginal sex is the most effective way to prevent sexual transmission of HIV as well as other STIs.
“Some people say that if they are on HIV medication and have an undetectable viral load, it’s safe for them to have unprotected sex. Is this correct?”
Evidence shows that if an HIV positive person is taking HIV medication resulting in an undetectable viral load, they have a substantially reduced risk of passing on HIV to sexual partners. This is great news, but it isn’t as simple as it may seem. When considering the role of undetectable viral load in preventing HIV, there are other things to think about, in particular: if the HIV positive person has other STIs or the flu, which can increase viral load; whether they have been consistent in taking medication; when the last viral load test was and if it is still valid; as well as legal responsibilities.
Using condoms and lube for anal and vaginal sex is the most effective way to prevent sexual transmission of HIV as well as other STIs.
“If I have sex with a prostitute, or sex worker, am I at risk of HIV?”
The risk of getting HIV from kissing or having unprotected oral sex with any person, including sex workers, is very low. It's also very low risk if you've had anal or vaginal sex with a condom. If you didn't use a condom for anal or vaginal sex then the risk is much higher and you should get tested.
“If I have unprotected oral sex with an HIV positive person, am I at risk?”
The risk of HIV transmission via oral sex is extremely low. The enzymes in saliva act as a natural defence to HIV. The risk of contracting HIV increases if there are open sores or cuts in the mouth. Unprotected oral sex does expose you to the risk of other sexually transmitted infections (STIs)
“If I contract another STI like gonorrhoea or syphilis, does my risk of getting HIV increase?”
Yes. The presence of another sexually transmitted infection (STI) substantially increases the risk of contracting HIV. This is because the immune system is already considerably compromised in the presence of an existing STI, therefore, making a person more vulnerable to HIV transmission