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23 November, 2009

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HIV and AIDS

The human immunodeficiency virus (HIV) causes acquired immune deficiency syndrome (AIDS). ‘Acquired’ means not inherited. ‘Immune deficiency’ means a breakdown in the body’s immune system. ‘Syndrome’ refers to a range of diseases that may be associated with another disease.

In this case, diseases that take advantage of the body’s weakened immune system are used to define the onset of AIDS. In Australia, HIV is most commonly spread by sexual intercourse without a condom and through sharing needles, syringes and other injecting equipment.

Symptoms
Symptoms of HIV are common to a number of other illnesses. If you think you have been put at risk of getting HIV, or if you have any of the signs below (or a combination of them) for a month or longer, you should consult your doctor. Symptoms can include:

Flu-like symptoms
Extreme and constant tiredness
Fevers, chills and night sweats
Rapid weight loss for no known reason
Swollen lymph glands in the neck, underarm or groin area
White spots or unusual marks in the mouth
Skin marks or bumps, either raised or flat, usually painless and purplish
Continuous coughing or a dry cough
Diarrhoea
Decreased appetite.

How it is spread
Someone who has HIV may not have any symptoms, but they carry the virus and could pass it on through blood or body fluids. HIV can be spread in a number of ways, including:

Unprotected vaginal or anal sex with someone who has HIV
Sharing injecting equipment and needles with someone who has HIV
From a mother who has HIV to a child during pregnancy, birth or via breastfeeding
Unprotected oral sex with someone who has HIV (this is less common).

HIV can’t be spread by social contact
There is no evidence to suggest that HIV is spread by ordinary social or family contact such as hugging, shaking hands, sharing household items or through toilets seats, swimming pools or pets. HIV doesn’t live long outside of the body. It can be killed by ordinary household bleach, or soap and warm water.

Safe sex explained
Safe sex means sex where semen, vaginal secretions or blood are not exchanged between sexual partners. Some safe sexual activities include:

Mutual masturbation
Touching
Cuddling
Body-to-body rubbing
Erotic massage.

Condoms
Using condoms properly during intercourse (anal and vaginal) will greatly reduce the risk of spreading HIV. Condoms must be used correctly and with plenty of lubricant. Water-based lubricant should be used, as other types of lubricants will cause condoms to break. Female condoms are also available and should also be used with lubricants. Dams are thin pieces of latex placed over the anal or vulval area during oral sex and can also be used to help prevent the spread of infections.

Condoms for men can be bought from supermarkets, chemists and other outlets. Female condoms and dams are available through Family Planning Victoria and may be available from selected shops. Latex free condoms are also available from some outlets. Male condoms and lubricant are available free from the Melbourne Sexual Health Centre, along with female condoms and dams on request.

Safe sex can prevent infection
HIV can be spread by unprotected anal or vaginal sex with someone who has HIV. Safe sex is recommended if either partner has HIV or if either partner is unsure of whether they have HIV. Other sexually transmissible infections (STIs) such as herpes, chlamydia, syphilis and gonorrhoea can also be spread by unprotected sex. If either partner has an STI, or if either partner is unsure of whether they have an STI, safe sex is also recommended. HIV infection is more readily acquired or transmitted if either partner is infected with another STI.

HIV and oral sex
Unprotected oral sex is low risk for spreading HIV but using a condom or dam or avoiding ejaculation into the mouth is recommended when either partner has ulcers or bleeding gums, or has recently brushed or flossed their teeth. Condom and dam use may also prevent the spread of other STIs such as herpes, chlamydia, syphilis and gonorrhoea. These STIs may be spread more easily by unprotected oral sex.

HIV and deep kissing
Only very small amounts of HIV are found in the saliva of people who have HIV. For you to get HIV, a lot of saliva would need to get into your blood via ulcers or bleeding gums. Deep kissing is a low risk behaviour for spreading HIV.

HIV and blood products
Since May 1985, all blood donations in Australia have been tested for HIV. This means that blood transfusions in this country are now an extremely low risk for HIV. It is impossible to get HIV when donating blood in Australia, because needles, packs, swabs, finger-pricking lancets and so on are never re-used.

Diagnosing HIV
Blood tests can detect HIV infection. If you think you may have been exposed to HIV, see your doctor, health centre or STI clinic. If HIV infection is found in a person’s blood, this person is said to be HIV positive.

There is a short period where a person may have been infected by HIV but the HIV antibodies can’t be detected. This may require a follow-up test. Testing should be voluntary and only carried out with informed consent, except in exceptional circumstances.

Information should be provided about what is involved in the test, and information and discussion should take place about what it means to get tested. All people who request an HIV test must receive pre-test and post-test counselling.

Diagnostic testing for HIV is available on the Medicare Benefits Schedule. This means your doctor can order this test free of charge.

Post-test counselling
Post-test counselling is important regardless of the outcome of the test. If the test is positive, post-test counselling can provide emotional support, further information about the disease and referral to the support services available. If the test is negative, post-test counselling can provide education about HIV and how a person can avoid getting HIV.

The progression from HIV to AIDS
Someone who has HIV may not have AIDS. HIV weakens the body’s immune system, leaving it open to various infections and cancers. For most people who have HIV, the progression to AIDS is fairly slow. It may take several years from HIV infection to the development of AIDS.

Without treatment, people who have HIV eventually become ill and can develop AIDS within five to 10 years. However, there are a small percentage of people who don’t show any deterioration in their health, even after 10 years. AIDS diagnosis may require a number of special laboratory tests to be performed.

HIV and AIDS treatments
Currently, there is no vaccine or cure for HIV or AIDS. However, drug treatments are available that work against HIV. For the majority of people, these drugs can postpone, and possibly prevent, HIV-related illnesses and delay moving on to AIDS.

These drugs aren’t easy to take because of the side effects and difficult courses of treatment. It should be noted that once someone begins drug treatments for HIV, they should continue to take them for life.

There are also treatments for many of the specific illnesses associated with HIV and AIDS. Complementary therapies are used by some people who have HIV to manage the side effects of drug treatment and improve health and wellbeing. New drugs and therapies are being trialled all the time.

HIV and viral loads
People living with HIV, who are taking antiviral medication may still have undetectable ‘viral loads’ of HIV at certain stages of their treatment. A viral load is the amount of virus in body fluids such as blood, semen or vaginal secretions.

Research suggests that when the viral load is undetectable in the blood, the risk of HIV transmission is reduced. However, it is still possible to transmit the virus. Safe sex is an important part of reducing the risk of HIV transmission and should always be practised, regardless of the ‘viral load’.

Where to get help

Your doctor
Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
Victorian AIDS Council/Gay Men’s Health Centre Tel. (03) 9865 6700 or 1800 134 840
Education + Resource Centre at The Alfred Tel. (03)9076 6993
The Centre Clinic, Northcote Tel. (03) 9481 7155
The Centre Clinic, St Kilda Tel. (03) 9525 5866
Family Planning Victoria Tel. (03) 9257 0100
Action Centre (for youth 25 years and under) Tel. (03) 9660 4700 or 1800 013 952
The Annexe Sexual Health Clinic Ballarat Tel. (03) 5338 4540
BBV/STI Resource Centre Bendigo Tel. (03) 03 5430 0500
Geelong Sexual Health Clinic Tel. (03) 5226 7254
STD Clinic Wodonga Tel. (02) 6051 7535
STD/AIDS Clinic Traralgon Tel. (03) 5173 8111
HIV & Sexual Health Connect Line Tel. 1800 038 125

Things to remember

In Australia, HIV is most commonly spread by sexual intercourse without a condom and through sharing needles, syringes and other injecting equipment.
Someone who has HIV may not have any symptoms, but they carry the virus and could pass it on through blood or body fluids.
Drug treatments are available that can postpone, and possibly prevent, HIV-related illnesses developing.

You might also be interested in:
HIV and AIDS - infection control in hospitals.
HIV and gay men - safe sex.
HIV and men - safe sex.
HIV and women - having children.
HIV and women - safe sex.
HIV testing.
HIV treatment.
Infections - bacterial and viral.
Kissing and your health.
Sexually transmissible infections - avoid the risk.
Sexually transmissible infections - overview.
Sexually transmissible infections - signs and symptoms.

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