1st December 2018 will mark the 30th anniversary of international World AIDS Day. This day is dedicated to raising awareness of Acquired Immune Deficiency Syndrome (AIDS) caused by the spread of the Human Immunodeficiency Virus (HIV), supporting those living with and commemorating those who have died of the disease. It also aims to highlight progress made with prevention, treatment and care.
What is HIV & AIDS?
HIV is a virus that progressively damages the cells in the immune system weakening an individual’s ability to fight common infections and diseases. It is this virus, that if left untreated can result in an individual having AIDS. The term ‘AIDS’ describes a number of potentially life threatening infections and illnesses that occur when the immune system has been severely damaged by the HIV virus.
How is HIV transmitted?
HIV is found in certain body fluids of an infected individual, such as semen, vaginal and anal fluids, blood and breast milk. These fluids must come in to contact with a mucous membrane (found in areas such as inside the rectum, vagina, penis and mouth), damaged tissue, or be injected directly in to the blood stream for transmission to occur.
HIV is commonly transmitted through having anal or vaginal intercourse without the use of a condom. It can also be transmitted through sharing needles, syringes or other injecting equipment or from mother to baby during pregnancy, birth or breastfeeding. For more information about HIV in pregnancy and breastfeeding, please click here.
Other body fluids such as urine, sweat and saliva do not contain enough of the virus for it to infect another person.
HIV is not transmitted by spitting, kissing, sharing cutlery, swimming pools, toilets or contact with animals or insects such as mosquitos.
Who is most at risk of HIV?
- Men who have unprotected intercourse with men.
- Women who have unprotected intercourse with men who have intercourse with men.
- People who use drugs to help or enhance intercourse (chemsex) this can be associated with risky sexual behaviours such as having multiple sexual partners and not using a condom.
- People who have unprotected intercourse with a person who has lived or travelled in Africa.
- People who inject drugs and share equipment.
- People who have received blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. However, this is less of an issue now due to the thorough screening of blood, tissues and organs.
What are the symptoms of HIV?
Up to 80% of people infected with the HIV virus experience a flu-like illness that can manifest 2 - 6 weeks after an infection. However, these symptoms are relatively common and can occur due to other causes. If an individual has flu-like symptoms and believes they may be at risk of HIV, a test to confirm diagnosis is highly recommended.
How is HIV diagnosed?
A HIV test is the only way to diagnose and confirm HIV. Symptoms of HIV may not become apparent for a number of years following infection, the sooner it is diagnosed, the quicker treatment may be initiated avoiding serious illness.
There are 4 main types of HIV tests available (see table 1 below), a blood test is the most accurate method for testing and usually gives reliable results from 1 month after infection. Results will be presented as either positive, where the infection is found or negative where there are no signs of infection.
Table 1: Types of HIV tests available
|HIV Test||Sample Taken||Availability of Results|
|Blood test||Blood in clinic||Same day or up to a few days|
|Point of care test||Saliva or finger prick blood in clinic||Few minutes|
|Home sampling kit||Saliva or finger prick blood at home and post sample to lab||Few days, contacted by phone or text|
|Home testing kit||Saliva or finger prick blood at home||Few minutes|
Where can you get a HIV test?
- Home sampling and testing kits are available for anyone who does not want to visit a clinic
- Sexual health or genito-urinary medicine clinics
- GP surgery
- Drug dependency services
- Antenatal clinic (if pregnant)
- Private clinic
How is HIV treated?
No cure for HIV exists, treatment aims to control the virus enabling an individual to live a long and healthy life.
Antiretroviral drugs are recommended to treat HIV. These drugs prevent the virus from replicating allowing the immune system to repair itself, preventing any further damage. The aim of antiretroviral treatment is to bring the level of virus in the body to low levels such that a blood test cannot detect it, it is ‘undetectable’. There is no risk of passing on HIV if an individual is classed as ‘undetectable’, however, they must continue taking treatment as on discontinuation, the viral load increases. Combination treatment is often used to avoid resistance.
Emergency HIV treatment or post exposure prophylaxis (PEP) is prescribed for patients who have been exposed to the virus. PEP may stop an individual becoming infected, however, treatment must be initiated within 72 hours of coming into contact with the virus in order for it to be effective. PEP may be accessed from sexual health or genito-urinary medicine clinics or from hospital accident and emergency departments.
Patients taking antiretroviral medicines should not take any over the counter, herbal or alternative therapies without consulting with a doctor or pharmacist first due to potentially serious interactions.
Removing the stigma of HIV & AIDS
UNAIDS and the World Health Organisation (WHO) have found that people are reluctant to get tested, disclose their HIV status and take antiretroviral drugs due to the fear of stigma and discrimination.
How can transmission be prevented?
- Pre-exposure prophylaxis (PrEP) medication may be recommended for HIV negative individuals to reduce their risk of HIV infection. It does not protect against sexually transmitted infections.
- A condom is the most effective form of protection against HIV and other STIs.
- Water based lubricants can make intercourse safer by reducing the risk of vaginal or anal tears and can also prevent a condom splitting.
- Do not share needles, syringes or injecting equipment. Many local authorities and pharmacies offer needle and syringe exchange services where used injecting equipment can be exchanged for clean ones.
- Screen for HIV in pregnancy.
What is the theme for World AIDS Day 2018?
This year’s theme is ‘know your status’. Due to fear of stigma and discrimination, people are deterred from taking a HIV test. Many people only present for testing when they have symptoms of HIV. This World AIDS Day aims to raise awareness about the importance of individuals knowing their HIV status and removing barriers to accessing testing services.
What can be done to help?
#ROCKTHERIBBON The red ribbon is the universal symbol of awareness and support for individuals living with HIV. Red ribbons can be purchased from selected branches of Morrisons, all MAC cosmetics stores and counters or from the National AIDS Trust.
The Leicestershire AIDS Support Service (LASS) and National AIDS Trust (NAT) have kindly provided Buttercups Training with ribbons which are a great way to raise money and awareness. All proceeds raised at Buttercups will be divided equally between the NAT and LASS.
Where can more information, advice and support be found?