What is Human Immunodeficiency Virus (HIV)? (eefo.net user)

PLEASE NOTE - The information given below is intended solely for reference use only and is in no way intended to be used as an alternative for seeking proper medical advice. If you think you may have contracted a sexually transmitted infection after reading the information provided it is vital you seek the opinion of a qualified doctor at your local sexual health clinic as a matter of urgency. Failure to do so can seriously affect your long-term health in some circumstances.

To reduce the need for repetition in this article the term gay is being used to identify any man who has sex with other men regardless of how they identify themselves sexually.

Many different sources of reference have been used to compile the information on sexually transmitted infections and the information is correct at time of writing.

Below is only a short overview of the HIV illness. It is not intended as an in-depth look at the illness but just outlines the basic information you should know about HIV if you are having sex with anyone so you can decide on the level of risk you want to take and how you can prevent yourself from becoming infected with the virus.

More detailed information can be obtained from the section of the eefo web site under HIV INFECTION: WHAT SHOULD I KNOW? or by looking at the links listed below.

What is HIV?

HIV (Human Immunodeficiency Virus) is a virus that targets a specific part of the immune system called CD4 cells so that over time you lose the ability to protect yourself against different types of infection and some cancers, which your immune system without the virus would normally be able to fight off, so preventing you from becoming ill with that particular infection.

These infections that you are unable to fight off as the immune system becomes less and less effective are known as ‘opportunistic’ infections because they have taken the ‘opportunity’ to infect your body whilst you have a poor and weakened immune system. They are infections that are not usually seen in people who have a healthy and strong immune system. When you have been diagnosed with any of these specific infections you are said to be suffering from AIDS or Acquired Immunodeficiency Syndrome

HIV is an extremely serious illness that may lead to you getting some of the opportunistic infections, which are seen in AIDS. These infections can become increasingly difficult to treat and may lead to chronic ill health and possible death.

It is not all bad news though as there are now some very good drugs available that can slow down the progression of the virus and help delay the onset of AIDS allowing people to live a near normal life.

Before the drugs we have now became so effective, people were only expected to live a few years between having the HIV infection and going on to develop AIDS. But now with the arrival of such effective drugs, some people have been HIV positive for over 20 years and have still not been diagnosed with AIDS.

How do I get it?

In the UK gay sexually active men are by far the group of people most at risk of contracting the virus. The virus is found in most body fluids to some extent but the levels of the virus are highest in the blood, semen (cum) or pre-cum (the clear liquid you get at the tip of the penis when you have an erection and before you cum) of an infected person.

If any of these highly infectious body fluids gets into the bloodstream of an uninfected person they run the risk of becoming infected themselves. The most common way for gay or bisexual men to contract the virus is through unprotected anal intercourse (not using a condom) and you run the highest risk if you are the one who is being penetrated or entered by someone who has the virus, especially if that person ejaculates inside you without using a condom.

You are at a lower risk of catching the virus if the person who penetrates is uninfected (HIV negative) and the person who is penetrated is infected (HIV positive) because of a lack of body fluid in this area.

Another reason the anus is so good in the transmission of HIV infection is because during even the most gentle intercourse using lots of lubrication some minor damage to the lining of the anus wall will occur such as small tears, cuts and abrasions that then allows the virus in the HIV+ persons cum to directly enter the bloodstream of the uninfected person who may not even realise that some minor trauma has occurred to the anus as these small areas aren’t usually painful.

Obviously the rougher the anal intercourse and the less lubrication used, the more damage will be sustained to that area and the higher the chances of the virus being passed on.

It has now also become clear that the virus can be passed on during oral sex especially if the HIV+ person cums into his partner’s mouth and there are any breaks in the skin such as a mouth ulcer, bleeding gums, poor teeth or any small areas of damage on the gums due to brushing or flossing your teeth too hard. Though the risk posed from oral sex is by far much lower than from anal sex it has been shown to be how some people contracted the virus.

How common is HIV?

At the end of March 2007 38,939 men in the UK had been diagnosed with the HIV virus having contracted the infection from having sex with another man. It has been estimated that, at the end of 2005, about 44% of all people living with HIV in the UK were men who had sex with men.

The number of heterosexually acquired HIV infections diagnosed in the UK has risen hugely over the last 15 years. In 1999, for the first time, the rate of heterosexually acquired HIV diagnoses overtook the rate in men who have sex with men. At the end of March 2007, 35,709 cases of heterosexually acquired HIV were reported in the UK. However, most of the new diagnoses are in people who probably acquired HIV in other countries, particularly in Africa.

What are the symptoms?

Some people who show signs of having contracted the virus suffer from mild flu like symptoms and often believe this is indeed what they have and so do not get a blood test done or even bother to see a doctor about it. This so-called ‘sero-conversion illness’ shows up around 2-4 weeks after being infected with the virus. During this time the body is trying to fight off the infection by developing antibodies to the virus in the immune system.

The early symptoms of conversion include sore throat, mild fever, headache, general muscle aches, hot/cold sweats etc in fact all the things you would expect if you did indeed have a cold or the flu virus but in this case it is something far more serious than just a cold.

The symptoms will begin to disappear by themselves within a few weeks. Also a large number of people newly infected with the virus don’t have any symptoms during their sero-conversion illness and just carry on as normal totally unaware they have contracted the HIV virus and are now at risk of passing it on to others.

It can be many years after the initial infection before more serious symptoms begin to appear because in the first few years the immune system is able to mount a very effective attack against the invading virus but eventually it is unable to continue as it becomes ‘over run’ with the amount of new virus being produced every day. The first line of the immune system to be seriously affected are the CD4 cells; when they reach a critically low level in the bloodstream the infected person then begins to pick up many of the opportunistic infections and so begins to become more and more unwell over time.

How is HIV diagnosed?

HIV is most commonly detected by having a blood test which looks for antibodies to the virus that have been made by the persons immune system, it does not look for the virus itself but looks to see if the immune system has any signs of fighting off the virus and if the antibodies are found you are said to be ‘HIV positive’ or ‘HIV+’ and that you do indeed have the virus. Newer tests, which are being used in some areas, can be used on urine or saliva (spit).

From the time you may have been exposed to the virus and there being enough antibodies to show up in a blood test can be as long as 3 months or more, which has serious implications for what you do in that time.

If you HAVE been infected with the virus you won’t know for sure as you have to wait the full 3 months for enough antibodies to show up in the bloodstream and you may not have had any of the flu like illness that can happen to some people during the seroconversion part of the infection. Yet it is during this 3 months (known as the ‘window period’) that you are at the highest risk of passing the virus on to someone else as this is the time you are the most infectious and indeed is when most new infections are acquired by people.

What is the treatment?

At this time there is no cure for the infection though there are some very powerful drugs that can help to keep the virus under control for long periods of time if used in specific ways known as combination therapy.

When this combination begins to fail because the body is building up a resistance to the drugs a different combination can be used and in this way the life of an infected person can be almost as good as that of a HIV- person.

Now it is common for HIV positive people to be living normal lives for 10, 15 even 20+ years following infection, whereas before, the ideas of combination therapy when we had far fewer drugs to offer people the life expectancy for a positive person was often less than 2 years, so there have been huge steps forward into understanding the illness and the hope is that one day a cure or vaccine will be developed. The drugs used today are known as ‘antiretroviral’ and have the ability to reduce the amount of virus in the blood so allowing time for the immune system to recover slightly so it is better able to fight of infections.

Treating HIV infection is very complicated and you don’t normally begin treatment in the UK until your immune system has begun to suffer serious damage and the CD4 immune cells, which are looked for as a way of seeing how healthy the immune system is, are very low indeed.

Once you start the drug treatment you will need to take them every day for the rest of your life because if you were to stop the virus would soon overwhelm the immune system and you could become much more ill far more quickly than if you had never started the medication.

The drug regime is very difficult to stick to sometimes as many of them need to be taken at very specific times in the day and in a specific order so it is easy to miss a dose or get confused as to which pill to take when. They can also have some very nasty side effects including mouth ulcers, stomach cramps and diarrhoea, which can prevent some people from wanting to take them.

Some of the drug companies have realised this and are making newer drugs which only need to be taken one a day instead of the usual 2-4 times so this should help HIV+ people stick to the regime better.

HIV and its relationship to other STI’s

Having HIV can seriously affect the way that other STI’s affect the body. Most STI’s are worse or take longer to resolve in an HIV+ person because they have a compromised immune system and so are unable to mount the same level of immune response as someone who does not have the HIV virus. Therefore any illness or infection will have worse symptoms and take a longer period of time to heal, but even so, most infections do usually resolve with on going treatment it just takes longer.

Who do I tell?

When you have an HIV test you will be asked to try to identify someone who you know you will be able to totally rely on should you have a positive result and this is extremely important as their help and support will be vital in adjusting to the news you are now HIV+ even if the chances of you having the virus is remote….in theory if you have EVER had unsafe, high-risk or unprotected anal intercourse with someone you have potentially put yourself at risk of getting the virus so it is just possible you may have the virus and at this stage not realise.

It can be the most difficult thing to do telling someone you have the HIV virus as it can be with any diagnosis of a serious illness. But sometimes the reaction you get from people to news of the illness is totally different to the reaction you would get if you were telling them you had cancer or heart disease and a possible reason for this is with these types of serious illness the sufferer does not usually get blamed for having the illness as some do when it comes to HIV.

That’s why it is so important to know the person you tell is someone you can really trust and who won’t put the ‘blame’ on you as after all its no-ones fault. Obviously you can choose never to tell anyone you have been given a positive result and some people do decide to do this but by doing so they may miss out on a lot of help and support, not just from family and friends, but also from the statutory agencies such as benefit system, counselling services, HIV help and support groups etc…

The important thing to remember is at the end of the day it is your decision! No one can tell you what you have to do. They can advise you as they may have more experience and so can offer help and advice but who you tell and when is totally up to you.

One of the most important things you will need to do is tell any previous or current sexual partners and most specialist HIV clinics or sexual health clinics will have trained advisors who will help guide you through this difficult time and help you deal with any fall-out or negative responses from people.

Any future sexual partner should be told about the diagnosis so they can decide for themselves the level of risk they want to take when having sex with you.

How do I prevent it?

Use a condom at all times for all oral and anal sex.

Written by an eefo.net user

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