 AIDS
The human immunodeficiency virus (HIV) is a virus that damages the body’s immune system. The immune system is made up of groups of cells and organs that keep the body healthy by fighting viruses and infections. CD4 cells, also known as T-helper or T-cells, are one of the primary types of cells in this process. When someone is infected with HIV, the virus uses the individual’s CD4 cells to multiply. As a result, the cells are destroyed and unable to function properly to keep the individual healthy. Over time, the number of healthy CD4 cells declines. When HIV has destroyed enough of the body's CD4 cells, an individual can be diagnosed with AIDS - Acquired Immune Deficiency Syndrome. This diagnosis means that the body’s immune system is no longer able to effectively fight off illness. Because of these other illnesses, an individual may become very sick or possibly die.
HIV Symptoms
Soon after infection, mild, flu-like symptoms or swollen lymph glands may be experienced, although most individuals will experience no symptoms during the period between infection and AIDS diagnosis. For those infected with HIV who do have symptoms, these symptoms often related to AIDS and include unexplained weight loss, fatigue, flu-like feelings that don’t go away, diarrhea or white spots in mouth. There is a simple test that can determine if someone is infected with HIV, but only a medical doctor can diagnose someone with AIDS.
HIV Antibody Testing
There is a widely available test to find out if you are infected with HIV. The test looks for the presence of HIV antibodies, which are the body's attempt to fight off the infection. Unfortunately, it may take up to three months after infection for enough antibodies to be present for an accurate test. This period of time is known as the “window period”. During the window period the test could provide a false negative, even though the person being tested could still transmit HIV to someone else. There are many locations in the area to obtain free and confidential HIV antibody testing and counseling. Some test sites offer HIV Rapid Testing, a new test that can offer results while you wait.
HIV Treatment
Without treatment the time between infection with HIV and an AIDS diagnosis can be as long as 8 to 10 years for a man. Progression to AIDS is faster for women. There are now very effective treatments to slow down this process even though medication side effects are frequently severe. However, there is currently no vaccine or cure for HIV. A doctor can run specific blood tests to identify which treatments will be most effective for someone infected with HIV and when is the optimum time to start treatment. It is very important for individuals with HIV to enter care as soon as possible. Appropriate treatment is a critical part of maintaining good health for a long, long time. Many people with HIV have survived the disease in good health for over twenty years after infection.
Prevention
As with other viruses, HIV lives inside the body of someone who is infected. Because of the virus’ need for CD4 cells to reproduce, it is highly concentrated in certain body fluids: blood and semen in men. When these body fluids are exchanged in a way that may allow for entry into someone else’s bloodstream, there is a high risk for the transmission of HIV. Only traces of HIV can be found in other body fluids like saliva or mucous, but not in sufficient concentrations to transmit the virus. The most common ways HIV is transmitted in gay men are:
- Unprotected, receptive anal sex with ejaculation;
- Sharing drug-injecting equipment, especially needles and works but also inhalation straws;
The best way to prevent infection is not to engage in behaviors that involve risk of transmission, that is, unprotected anal sex and injection drug use. However, if you or your partner are unsure of your HIV status and still choose to engage in activities that do involve risk, there are still ways to reduce the amount of risk. Specifically, use of plenty of lube to prevent abrasions, withdrawal before ejaculation, choice of oral sex or use of sex toys instead of anal sex.
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 Condom Use |
Using latex condoms and plenty of water-based lubricant during anal sex can greatly reduce risk. While not 100% effective, most studies show that consistent and correct use make them at least 98% effective, which is the “failure” rate for those who use condoms for birth control. Although the risk of HIV transmission during oral sex is significantly less, it may still be possible, especially if the receptive partner has cuts, sores or has had recent dental work. Using a latex barrier, condom or dental dam when performing oral sex can further reduce the risk. Getting screened and treated for STDs is also a way of reducing your risk because untreated STD sores and lesions can provide direct pathways for HIV into the body.
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| Injection Drugs & HIV |
Not sharing syringes or other injecting equipment is the most effective way to reduce the risk of transmission, including steroid or vitamin injections. If sharing equipment, use of bleach and water to clean the equipment can offer some protection. For syringes, an effective method includes rinsing the syringe three times with water, then three times with bleach and then three more times with clean water. If you want it, there is also support to help reduce or stop using drugs all together. If you or someone you know think you might have been exposed to HIV, please click on the following link for more complete information: www.thebody.com
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| Post Exposure Prophylasis (PEP) |
The jury is still out on the effectiveness of taking anti-HIV medications soon after exposure to prevent infection, but “PEP” has been used for several years now in the medical professions for those who have had needle sticks or other exposure to the blood of HIV infected patients. Once reserved for health care workers who were concerned with needle-stick HIV infections, the trend has been to offer the public a regimen of HIV drugs for up to 30 days after possible sexual exposure to HIV. Medical facilities that offer or even know what PEP treatment is are very hard to find and so most HIV clinics do not offer this service to those exposed to HIV sexually not in a health care setting. There are many questions about PEP that are currently under study even though in the past treatment appears to have worked for four out of five health care workers who received PEP for needle sticks. The problem is that no one is sure that these health care workers were actually exposed to HIV in the first place. The same four out of five may not have contracted HIV even if they had not received PEP treatment. With the advent of rapid HIV testing, it is now possible to test a possibly infected patient to see if they actually do have HIV when a health care worker is exposed to their blood. HIV drugs have many side effects, sometimes serious side effects, and the chances of HIV infection from a single sexual exposure is 1 in 100-200 chances so PEP has to be administered by knowledgeable health care professionals. Still, studies have shown that programs offering PEP after individuals have unsafe sex does not increase the rate of unsafe sex and none of the 400 test subjects in one study tested positive. Researchers are quick to point out that this is not proof that PEP works to prevent HIV infection. Still, New York’s Beth Israel Medical Center has begun to offer PEP to the general public and some other big-city clinics and hospitals are doing the same. At the 2006 Outgames, Canadian health officials stocked up on PEP drugs as part of a safer sex campaign as thousands of gay men flocked to Montreal for the gay games. It is likely that PEP for possible sexual exposure to HIV will become more and more common and available as time goes on. For now, most will have to use the tried and tested methods of HIV prevention. For more information on PEP click on the following links: www.hivandhepatitis.com/recent/ad/ or www.poz.com/articles/191_7451.shtml
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