What is HIV?

HIV (human immunodeficiency virus) is a virus which attacks the body’s immune system, specifically CD4 cells (also known as T-cells or T-helper cells), making it harder for the body to fight off infections and diseases. There is no cure but there are medications that can manage the condition and mean it is possible for people living with HIV to grow just as old, grey and wrinkly as people who are HIV negative.

What is the difference between HIV and AIDS?

HIV is the name of the virus, and a person is said to be HIV positive if they have the virus. AIDS stands for Acquired Immunodeficiency Syndrome and refers to late stage HIV, when a person’s immune system is so badly damaged that they contract opportunistic infections. Due to advances in treatments, few people progress to late stage HIV in the UK.

How common is HIV in the UK?

Probably more common than you think. Around 1 in 620 people in the UK are HIV positive. At the end of 2014 there were 103,700 people living with HIV in the UK. If those numbers shock you, that might be for a couple of reasons. Firstly, not everyone chooses to disclose they are HIV positive and, as people living with HIV can be extremely healthy, you would never suspect they were HIV positive. Secondly, around 1 in 6 people don’t know they are HIV positive. Those who are unaware of their status are more likely to transmit HIV as they are less likely to take precautions to prevent transmission.

[clickToTweet tweet=”HIV is probably more common than you think” quote=”HIV is probably more common than you think”]

What are the symptoms of HIV?

In the first six weeks after infection some, but not all, people experience a seroconversion illness that usually lasts about one to two weeks. The immune system is reacting to the virus and producing antibodies to HIV. Symptoms are diverse but can include a sore throat, swollen lymph nodes, aching muscles, a rash, fever and fatigue. A person may have only a few of these symptoms or many and it can range from mild to severe. If it is on the milder end, people can mistake it for flu.

As the symptoms overlap with many other illnesses, it is important not to worry unless you have had a recent risk of exposure to HIV. Speak to your doctor or visit a GUM clinic if you are concerned.

After the initial infection, people living with HIV are usually asymptomatic for a number of years, although the immune system will be progressively damaged by HIV if they do not begin treatment.

Without treatment, people living with HIV will begin to show symptoms as a result of their CD4 count dropping. Some people who are receiving treatment may also progress to this stage. The factors affecting who progresses include response to medication and lifestyle factors such as smoking, exercise and diet. The symptoms can include night sweats, weight loss, swollen glands, long-lasting diarrhoea, tiredness, oral thrush and increased outbreaks of herpes (also known as cold sores).

Late stage HIV (sometimes called AIDS) occurs when a person’s CD4 count drops very low. A severely weakened immune system means they are vulnerable to opportunistic infections. With treatment for HIV, many people have recovered from late stage HIV and have lived long, healthy lives.

How is HIV transmitted?

HIV is found in the body fluids of a person with HIV. HIV can be passed on through direct contact with blood, breast milk, rectal mucus, vaginal and cervical secretions, semen and pre-cum. Rectal mucus is the body fluid with the highest concentration of HIV. These fluids would need to come into contact with mucus membranes, damaged tissue or directly enter into the blood stream for a person to contract HIV.

The highest risk for contracting HIV is receptive anal sex with a HIV positive partner because the mucus membranes of the anus are delicate. The second highest risk is vaginal sex.

HIV can be passed through sharing sex toys, oral sex (very rarely), from sharing needles or needle stick injuries in healthcare settings. It can also be transmitted from mother to baby at birth, in the womb or in breast milk, although this is extremely rare in the UK because HIV is routinely screened for in pregnancy and women who are HIV positive can take medication to prevent this happening.

In countries that do not screen blood, sperm or organ donations, there is a risk of transmission.

How is HIV NOT transmitted?

It is not possible for HIV to be transmitted by hugging, holding hands, giving mouth to mouth resuscitation, sharing toilets, sharing dishes or sharing towels. HIV also cannot be transmitted through urine so watersports enthusiasts can enjoy their kink without worry.

[clickToTweet tweet=”It is not possible for HIV to be transmitted by hugging” quote=”It is not possible for HIV to be transmitted by hugging”]

Who is at risk?

Everyone! HIV doesn’t discriminate so everybody should take precautions to prevent HIV. Some groups in the UK do have an increased risk of HIV, such as black Africans and men who have sex with men, but being a white British heterosexual definitely doesn’t mean you can be complacent. There are more heterosexuals than gay, bisexual or pansexual people living with HIV in the UK (54,000 vs 44,980) and of the 54,000 heterosexuals living with HIV in the UK, 45% are not from black African communities.

[clickToTweet tweet=”Who is at risk of HIV? Everyone!” quote=”Who is at risk of HIV? Everyone!”]

Prevention

There are a number of ways people can prevent transmission of HIV.

• Condoms: Male condoms are cheap, easily accessible and extremely effective so they are an excellent choice for preventing HIV transmission, as well as other STIs. Lambskin condoms, however, do not protect against HIV and other STIs. Female condoms are a little harder to find and pricier but they can be put in hours before sex which may appeal to some people. To be effective, both male condoms and female condoms must be used correctly so make sure you know how to use them, be careful not to tear them with your nails, and ensure the lube you are using is compatible with the condom material. Lube is important as condoms are more likely to break if there is a lot of friction.
• PEP: PEP stands for post-exposure prophylaxis. It is sometimes compared to the morning after pill (emergency contraceptive) as it is used as an emergency measure when other methods have not been used or have failed. Unlike the morning after pill, a PEP regimen lasts for 28 days and consists of 2-3 tablets a day. It must be started within 72 hours of a possible exposure to HIV. Although it is effective, it is not 100% effective and it can have some unpleasant side effects. PEP is available free on the NHS if a doctor considers you to be at high risk of contracting HIV from the recent event.
• PrEP: PrEP uses one of the same drugs as PEP (Truvada) but whereas PEP is used after exposure, PrEP is used before. Clinical trials have shown excellent results. For people at high risk of contracting HIV, and society as a whole, this is an amazing new treatment but it is currently not available on the NHS. Hopefully this will change soon.
• HIV medication: People living with HIV can reduce the risk of transmission by taking medication. Medication reduces the viral load (number of copies of the virus per millimetre of blood). An undetectable viral load means the number of copies per millimetre of blood is extremely low so low the tests can't even detect any. It does not mean a person no longer has HIV. Having a lower viral load means there is less chance of transmission and if the viral load is undetectable it is extremely unlikely HIV will be transmitted. There is still a small risk so using condoms in addition is recommended.
• Managing drug and alcohol use: Everyone can reduce their risk by managing their drug and alcohol use to ensure loss of inhibitions doesn't lead to increased risky sexual behaviour.
• Getting tested: This is a vital step in preventing HIV as knowing your status means you can know how best to manage risks.
• Using clean needles: Sharing needles is a risk factor for HIV and hepatitis C. This risk can be prevented by using clean needles. You should be able to find details of your nearest needle exchange online.

Treatment

There are a range of medications, called anti-retroviral therapy (ART), available to manage HIV. The different classes of medications work at different stages of the HIV life cycle.

How you can help end the ignorance

• Wear a red ribbon on World AIDS Day
• Get tested regularly and speak to friends about testing
• Share awareness campaigns and interesting articles about HIV on social media
• Correct people when they say AIDS but really mean HIV
• Call people out when they make hurtful or discriminatory comments about people living with HIV
• Donate to HIV charities like the Terrence Higgins Trust
• Most importantly, listen to and learn from people who are living with HIV