Sexual Health Advice - Patient Information Leaflets

HIV and AIDS

What are HIV and AIDS?

HIV stands for Human Immunodeficiency Virus. It is a retrovirus. HIV destroys specific cells in the body called CD4 T-cells. These cells are part of the body's immune system (the body's defence against disease) so it can no longer fight off certain infection and diseases.

AIDS stands for Acquired Immunodeficiency Syndrome. This is a term which covers the range of infections and illnesses which can result from a ‘weakened' immune system caused by HIV.

Note: when you are first infected with HIV you do not have AIDS. There is usually a time lag of several years between first being infected with HIV, and then developing infections and other AIDS related problems.

People with HIV can pass the virus on to others whether or not they have any symptoms.

How is HIV passed on?

HIV is passed from one person to another if the blood, semen; pre-ejaculate (precum), vaginal fluids or breast milk of an infected person enters the body of an uninfected person:

By having unprotected vaginal, anal or oral sex or sharing sex toys with someone who has HIV (unprotected sex means having sex without using a condom).

By using a needle or syringe (‘works') which has already been used by someone who is infected with HIV.

When a woman with HIV passes the virus to her baby before or during birth, or by breastfeeding.

By infected blood, blood products or donated organs. This is now very rare in the UK as all blood products are checked for HIV before being used. However some countries do not have the same strict standards of medical and dental care as in the UK , so there may be a risk of getting HIV from infected blood products or unsterile medical equipment.

You cannot catch HIV from ordinary contact with someone with HIV such as hugging, kissing, holding hands, sharing baths or towels, sharing eating utensils, from swimming pools or toilet seats.

How common is HIV?

In the UK over 60,000 cases of HIV infection have been diagnosed since 1982. However, the number of AIDS-related deaths in the UK has greatly fallen since 1995 due to improved treatment.

Men who have sex with men are the most commonly affected group in the UK . However, more heterosexual men and women have been diagnosed in the recent years. Most of these were infected with the virus outside the UK i.e. in countries which have very high rates of HIV e.g. African countries.

How can I protect myself from HIV?

Always:

Use a male or female condom every time you have vaginal sex. The spermicide nonoxynal 9, used to lubricate some condoms, does not protect against HIV and may even increase the risk of infection. So if possible avoid using condoms or spermicide containing nonoxynal 9.

Use condoms for anal sex. Standard strength condoms can be just as effective as extra strong condoms if used with plenty of water-based lubricant. Make sure the condos and lubricant do not contain nonoxynol 9.

For oral sex, cover the penis with a condom or the female genitals with a latex or polyurethane (plastic) square (dam). If it is not possible to do this try to avoid:

ejaculation into the mouth

oral sex with a woman during her period

oral sex if your throat or mouth is inflamed or if you have cuts, sores or abrasions in your mouth or gums

brushing or flossing your teeth before oral sex.

However, most people with HIV live in developing countries and do not have access to effective drugs. Therefore the HIV epidemic worldwide continues to claim millions of lives each year.

Symptoms of AIDS

The term AIDS is used to describe the most advanced stages of HIV infection. AIDS is a general term which includes various diseases which can result from a severely weakened immune system. Typically, a person with AIDS has:

A very low level of CD4 T-cells (around 200 cells per cubic millimetre of blood or below), and/or:

One or more severe opportunistic infections such as pneumocystic carnii pneumonia, severe thrush in the vagina or mouth, severe fungal infections, tuberculosis (TB), mycobacterium avium complex, serious eye infection. These infections can cause a range of symptoms such as severe sweats, fever, cough, diarrhoea, weight loss and generally feeling unwell. Without treatment the severe infections which develop are commonly fatal. Worldwide TB infection is one of the most common causes of death in people with HIV

In addition, people with AIDS have an increased risk of developing other conditions such as:

Certain cancers. Kaposi's sarcoma is a cancer which is usually only seen in people with AIDS. There is also an increased risk of developing cancer of the cervix, and lymphoma.

An AIDS-related brain illness such as HIV encephalopathy (AIDS dementia).

How will I know if I have the HIV virus?

You will not know unless you have a test for HIV. This involves giving a blood sample. There are a number of tests available:

HIV antibody test

When HIV enters your body your immune system tries to fight off the infection by producing antibodies to the virus.

If HIV antibodies are present this means you are infected with HIV (HIV positive). It can take between 3 weeks and 3 months for there to be enough antibodies in your blood to show up on an HIV test. This means that if you are worried about something that happened a few days ago, it can be up to 3 months before a HIV antibody test can give a definite result. A test is often recommended straightaway, even if a further test is required at a later time.

HIV p24 antigen test

The p24 antigen is a protein that is part of HIV. Early in the infection it is produced in excess and can be detected in the blood. The p24 antigen test can detect HIV infection before the HIV antibody test. It is recommended that the test is done 2 – 3 weeks after possible risk exposure.

Combined HIV antigen and antibody test

This gives a more accurate HIV detection and can be done 2 – 3 weeks after a possible risk exposure. The result of the test will usually be known within 3 days.

If you are found to have a positive HIV test a repeat test will be performed to confirm the result.

Can HIV be treated?

Once HIV is diagnosed a number of tests to monitor the stage of the infection can be done to indicate whether treatment should be started.

At present there is no cure for HIV or AIDs. However, there are a number of antiretroviral drugs that stop HIV from replicating itself. They reduce the level of HIV in the blood and delay the development of AIDs. Most people who use these drugs feel better and live longer. Often a combination of drugs may have to be used and sometimes they can have unpleasant side effects.

If you are HIV positive and pregnant you can benefit from antiretroviral drug treatment to help prevent transmission of the virus to your baby before and during birth. You may be advised to have a caesarean section and not to breastfeed, to avoid infecting your baby through breast milk.

Can HIV go away on its own?

No. Once you are infected with HIV you will remain infected with the virus for the rest of your life. There is currently no way of removing it from the body. Although antiretroviral drugs reduce the amount of virus in the body, you will still be infectious and should use condoms for vaginal, anal and oral sex.

How will I know how long I have had HIV?

It can be impossible to know, particularly as there are usually no symptoms. This can be hard to deal with. Do not be afraid to talk to clinic staff about how you are feeling.

Should I tell my partner about my HIV?

If you have HIV, or think you might be at risk of having HIV, then it is very important that your current sexual partner and other partners are also given the opportunity to consider having a test. If you feel it is too difficult the clinic can contact your partner(s) for you. They will explain to the person that may have been exposed to an STI and recommend they go for a check up. They will not give our or your name, so your confidentiality will be protected.

Does anyone else need to know that I have had a HIV test?

You can decide who to tell. Information about your HIV test (whatever your result) should only be passed on to someone else with your permission.

There are some circumstances where you might be asked if you have ever had a test e.g. when applying for jobs, insurance or mortgage. Nowadays, it is more common to be asked if you have had a positive HIV test or if you are having treatment for HIV. It is important to understand how the answers to these questions might affect you. Before you decide to have a test you may wish to talk to someone about the implications that this could have in all aspects of your life. The clinic staff can help you with this.

What is the prognosis (outlook) of HIV?

Before the mid 1990s, most people did not survive more than 1 – 2 years after AIDS had developed. Since the introduction of antiretroviral drugs in the mid 1990s the outlook has greatly improved for those who have access to such treatment. Many people with HIV and AIDS in richer countries are now living much longer than previously.

What are the symptoms of HIV and AIDS?

Primary infection with HIV

When you first become infected with HIV it is known as the ‘primary infection'. You may not have any symptoms at this time. However, many people develop symptoms similar to flu or glandular fever. This commonly happens 2 – 6 weeks after becoming infected. This is sometimes called ‘seroconversion illness' as it is the time when antibodies first appear in the blood stream (see below). Symptoms may include: fever, sore throat, blotchy red rash, feeling sick, diarrhoea, swollen glands, tiredness and general aches and pains. These symptoms only last a week or so, and are often just thought of as ‘flu' or a ‘virus illness', and then forgotten about. This is not AIDS but just an initial reaction to being infected with HIV.

After the primary infection

After any primary infection settles, without any treatment you can remain without any symptoms for several years. As there are often no symptoms during this time, many people do not realise that they are infected with HIV. However, the virus continues to multiple, the number of CD4 T-cells gradually falls and you can pass on the virus to others. During this time some people with HIV, who are otherwise well, develop persistent swollen lymph glands (persistent generalised lymphadenopathy) and/or night sweats.

In time you may start to develop problems such as recurring mouth ulcers, recurring herpes or shingles, or severe seborrhoeic dermatitis (a skin condition caused by a yeast). Old tuberculosis (TB) infection may ‘reactivate' in some cases even before ‘full blown' AIDS develops, especially in people in the developing world.

Download PDF file pdf document