Because there is no cure or magic bullet presently available to destroy HIV/AIDS, knowledge and preventive/risk reduction behavioral practices remain our greatest weapons against its continued global spread.
What is HIV?
HIV stands for Human Immunodeficiency Virus.
- Human - refers to who is infected.
- Immunodeficiency – refers to the body system effected, immune system, and how it is negatively effected.
- Virus – refers to what type of pathogen causes the infection.
What is AIDS?
AIDS stands for Acquired Immune Deficiency Syndrome. It is the most advanced stage of HIV infection.
- Acquired – refers to several ways in which an individual can “catch” the virus.
- Immune - refers to the human system "host" or vulnerability to this virus, the immune system. The immune system is responsible for protecting the body against foreign bodies such as bacteria, protozoa, fungi, and virus that cause infections, illness and disease.
- Deficiency – refers to the virus’ effect on the immune system. HIV attacks the immune system's healthy fighter cells (white blood cells also called CD4, T4 or T-helper cells), rendering them useless. In the process HIV takes them over to replicate itself. Over time the immune system is overwhelmed, resulting in the body having more HIV antibodies than CD4 cells. This reduces the body’s ability to fight off infections, illness, disease and neurological problems. It is the body’s inability to protect itself against opportunistic infections that ultimate lead to death.
- Syndrome – a collection of symptoms representative of particular illnesses, diseases or infections.
AIDS Definition - The change from a diagnosis of HIV positive to "full-blown" AIDS is given when an HIV infected individual has:
- a CD4 count less than 200, or
- One CDC AIDS case defined Opportunistic Infection, or
- Three non-defined CDC AIDS case OIs
HIV Progression to AIDS Diagram
Progression of HIV Infection - The progression of HIV varies from person to person and depends on several factors, including the individual's health status and health-related behaviors.
- Point of Infection - HIV antibodies cannot be detected however the virus can be transmitted; disease most readily spreads during this period; typically lasts two weeks to 3 months
- Window Period - The time frame from point of infection to the development of detectable antibodies (seroconversion); typically last two weeks to 3 months.
- Immune System Decline - Asymptomatic (no detectable symptoms) phase of HIV infection
- AIDS - Results from a compromised immune system in an HIV infected individual; a state of health in which the immune system is no longer able to fight off various illnesses and other health conditions that it once could. In effect, as HIV destroys CD4 cells, the immune system weakens and the viral load increases. Over time this makes HIV positive individuals more susceptible to illnesses and diseases that otherwise would not have been a problem for their body to fight off.
HIV life cycle - How does HIV multiply in the body?
- For HIV to thrive in the body it must reproduce itself. Over time as it replicates itself the immune systems' CD 4 count decreases resulting in a weakened immune system. For HIV Replication and Therapy Animations, follow this link: HIV Replication
- The purpose of HIV therapy is to interrupt the virus' replication process so that it does not reproduce itself. For more information about this therapy, follow this link: Targeting HIV Replication
Can HIV/AIDS be treated? While there is no cure for HIV/AIDS, there is an effective therapy for infected individuals. Anti-retrovirals(ARV) function to greatly slow down the weakening of the immune system by interfering with HIV replication within the body.
Effective therapy strives to:
- viral load as much as possible for as long as possible.
- Restore or preserve the immune system.
- Improve the patient's quality of life.
- Reduce sickness and death due to HIV infection.
HIV medications fall into 4 classes with each effecting the HIV replication process differently. Each class of drugs has both risks and benefits. ARV drug classes are:
- Nucleoside/Nucleotide Reverse Transcription Inhibitors
- Non-Nuceoside Reverse Transcription Inhibitors
- Protease Inhibitors
- Fusion Inhibitors
How is HIV transmitted? HIV is transmitted through behaviors/activities with an HIV infected person that allow for an exchange of certain body fluids. These fluids are:
- Semen, including pre-seminal fluid (pre-cum)
- Vaginal Secretions
- Breast Milk
Of these four listed fluids, blood and semen have the highest concentrations of HIV.
Are there any specific activities that place you at risk of becoming HIV infected?
It is most important to keep in mind that it's not who you are but what you do that places you at risk of becoming HIV infected. Any activity becomes risky where there is an opportunity for the exchange of body fluids. Therefore, the question one must ask before engaging in a particular activity is, "If I do this, is there a possibility that there will be an exchange of body fluid(s) - blood, semen, vaginal secretions, breast milk?" If the answer is yes, that activity is risky and risk reduction strategies should be utilized.
Activities that place one at risk of HIV exposure fall into three primary categories:
1. Unprotected Sexual Contact With an HIV Infected Person
- This includes both hetero- and homosexual activity
- With respect to vaginal sex, there is a greater risk of transmission from male to female than female to male.
- Anal Sex - riskier for the receptive partner.
2. Vertical Transmission (mother to child transmission) HIV antibodies pass from HIV infected mother to child:
- In utero (before birth)
- During birthing process
- Through breastfeeding
3. Sharing Needles/Syringes/Injection Equipment - IDU (Intravenous Drug Users)
- This includes occupational exposure to sharps
HOW IS HIV NOT TRANSMITTED? HIV is not spread through casual contact, such as:
- Shaking hands
- Touching objects an HIV positive person has touched
- Sleeping in the same bed (no sexual activity)
- Eating from the same dish
- Sitting next to a HIV positive person
Is there anything a person can do to reduce their risk of HIV infection or re-infection?
There are steps an individual can take to prevent or reduce their risk of becoming HIV infected; or in the case of an HIV positive person to prevent or reduce their risk of transmitting the virus to another. These include:
- Mutually monogamous relationship between two uninfected partners.
- Use of latex/polyurethane dental dams, male and female condoms.
- No sharing of sex toys without disinfection
Male and Female Condom Use:
Center for Disease Control and Prevention Protocol
"The ABCs of Smart Behavior"
to avoid or reduce the risk of HIV
A - abstinence
B - be faithful; mutually monogamous relationship, or
C - condom use consistently and correctly
Vertical Transmission (Mother to Child)
- Seek medical care from OB/GYN perferrably before becoming infected.
- If mother to be is HIV positive under OB/GYN care begin therapy.
- Do not breastfeed if HIV positive.
Sharing Needles/Syringes/Injection Equipment - IDU
- Seek drug treatment to discontinue use.
- No sharing of "works," injection drug paraphernalia.
- Clean works
- Change your drug of choice to a non-injection form.
- Use of universal precautions
How do you know if you're HIV infected? The only way to know if you are infected with HIV is to be tested. for the presence of HIV antibodies.
HIV Antibody Testing
- Elisa - The traditional blood test; usually performed in a clinic, doctor’s office, or other testing site. It requires a needle drawing blood from a vein which is tested in a lab; results are available within a few days to 2 weeks, depending on where the blood was sent to be tested.
- Rapid Tests - use either oral mucosa tissue cells (swab) or blood to detect HIV antibodies; results are available within 20 minutes. Some non-HIV antibodies can trigger a positive result in this test, so if the result is positive, that test is sent to a lab for a secondary confirmation (typically a Western blot test).
- Home Testing Kits - Specimen is collected in privacy of home; kit is mailed to a central laboratory. For results, the individual calls a toll free number for a recorded message or a live counselor.
ADDITIONAL INFORMATION ON HIV/AIDS