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Sexual Health

STIs: HIV/AIDS
What is HIV/AIDS?

HIV is an infection caused by the human immunodeficiency virus. AIDS, or acquired immunodeficiency virus, is an advanced stage of HIV. HIV is an infection that attacks the immune system and makes it difficult for the body to fight infection and disease, often leading to opportunistic infections such as cancer. While it is well-known that there is no cure for HIV, there are currently treatments available that help manage the disease and prolong life.

How is HIV transmitted?

HIV is most commonly transmitted through contact with blood, semen, vaginal fluid, or breast milk. Transmission can occur during unprotected sexual intercourse, sharing needles or syringes, being punctured by a contaminated needle or surgical instrument, or by getting infected body fluids in an open wound or sore. Transmission can also occur from a mother to a fetus during pregnancy or birth. Transmission during a blood transfusion is rare because all donated blood has been tested for HIV since 1986. HIV is not transmitted through casual contact such as kissing, drinking from the same glass, or hugging. It is also not transmitted by sharing a toilet seat or by being bitten by an insect.

How common is HIV?

The CDC estimates that through the end of 2003, up to 1,185,000 persons in the United States were living with HIV/AIDS, with 24-27% undiagnosed and unaware of their infection. HIV occurs in people of all classifications of our population and does not discriminate based on sexual preferences, gender, ethnicity or race.

In 2004, there were 372 new cases of HIV reported in Indiana. As of December 2005, there were 7,201 people living in Indiana with HIV; 81% were male and 19% were female. Most cases (37%) were diagnosed between the ages of 30 and 39, while 34% were diagnosed between the ages of 20 and 29.

What are the symptoms and complications of HIV/AIDS?

Many people will not experience any symptoms when they first become infected with HIV. Sometimes, however, a person who has contracted HIV may experience a flu-like illness within a month or two after exposure to the virus. At this point, symptoms might include fever, headache, fatigue, or enlarged lymph nodes. These symptoms usually disappear within a month and often mistaken for symptoms of another viral infection. During this period, HIV is present in large quantities in body fluids and people are very infectious.

Following the early symptoms (if an individual experiences these at all), the virus can remain in the body without causing any symptoms for months or years. During this period, the virus is multiplying, infecting, and killing cells of the immune system.

As the immune system weakens, symptoms begin to appear. These symptoms can include:

  • Swollen lymph nodes
  • Lack of energy
  • Weight loss
  • Frequent fevers and sweats
  • Persistent or frequent yeast infections
  • Persistent skin rashes or flaky skin
  • Pelvic inflammatory disease that does not respond to treatment
  • Short-term memory loss
  • Frequent or severe herpes outbreaks for shingles

As HIV moves into the later stages and AIDS develops, those infected may begin to experience opportunistic infections that generally do not affect healthy people. People with AIDS are particularly prone to developing cancers such as Kaposi’s sarcoma, which is often characterized by lesions on the skin and in the mouth. Symptoms of opportunistic infections may include:

  • Coughing and shortness of breath
  • Seizures and lack of coordination
  • Difficulty swallowing
  • Confusion and forgetfulness
  • Severe and persistent diarrhea
  • Fever
  • Vision loss
  • Nausea, abdominal cramps, and vomiting
  • Weight loss
  • Extreme fatigue
  • Severe headaches
  • Coma
How is HIV/AIDS diagnosed?

HIV is diagnosed by testing your blood or saliva for the presence of HIV antibodies, which appear within six months of infection. Current guidelines require written informed consent prior to testing. The test you receive will depend on where you go for testing. A traditional blood test known as the enzyme-linked immunosorbent assay (ELISA) might be used to test for HIV antibodies in your blood. It the test is positive, a Western blot test, which tests for the presence of HIV proteins, will be performed. The combination of the two types of tests helps to ensure accuracy; but, depending on your testing site, the results can take up to two weeks to obtain.

Rapid testing options currently are available and provided at IUPUI Health Services. Both rapid testing options test for the presence of HIV antibodies. Depending on the testing site, the results of the rapid test could be available in as little as 20 minutes. If a rapid test result is positive, confirmatory, traditional blood tests may be performed.

How is HIV/AIDS treated?

While currently there is no cure for HIV/AIDS, the virus and corresponding opportunistic infections can be treated to prolong life and suppress symptoms. Current guidelines suggest that treatment should focus on achieving the maximum suppression of symptoms for as long as possible. Highly active antiretroviral therapy (HAART) is used to reduce the amount of virus in the blood by using a combination of three or more drugs (often referred to as a “cocktail”). These antiretroviral drugs inhibit the growth and replication of HIV at various stages of its life cycle. All of the drugs used have varying degrees of side effect severity, which might include nausea, diarrhea, decrease of red or white blood cells, nerve damage, pneumonia, difficulty breathing, chills and fever, and skin rash.

In addition to treating the virus itself, treatment might include therapy to boost the immune system, treatment for side effects, and treatment of opportunistic infections. These drugs are also used to decrease risk of transmission, most often for healthcare workers exposed to blood and bodily fluids on the job.

Does my partner need to be treated?

If you learn you are HIV positive, it is essential that you inform your partner(s) so that he/she may be tested. Even though there is no cure for HIV/AIDS, the treatments available do have the ability to suppress symptoms and prolong life. Therefore, the sooner you talk to your partner, the sooner he/she can begin treatment if also HIV positive.

Are there special considerations in the prevention of HIV?

In addition to following the Disease Prevention and Safer Sex tips, to prevent HIV:

  1. Be aware of what to do if you sustain a needlestick or contaminated injury.
  2. Do not share needles.
  3. If you become pregnant, consent to an HIV test. Treatment can be provided to you that will reduce risk of transmission to your baby.
Reporting

HIV/AIDS is a reportable disease and cases are reported to the Indiana State Department of Health. Partner notification is mandatory. A trained health department worker will contact your partners to inform them that they have been exposed to HIV. Your name will not be shared with those partners—only that they have been exposed.

Withholding a positive HIV status from a sex partner is a crime. People who knowingly expose others to HIV without telling them of their infection have been imprisoned.