1. How is HIV spread?
HIV is spread through blood-to-blood contact or sexual contact with an infected person. There are three basic ways in which HIV can be transmitted:
- Sharing needles and syringes with someone who has the virus
- Having sex - vaginal, anal, oral - with someone infected with HIV
- A baby's exposure to his or her infected mother during pregnancy, birth, or through breast-feeding.
Prior to testing for HIV in 1985, some people became infected with HIV through receiving blood transfusions, blood components or blood clotting factors, or transplants of infected organs. Since 1985, testing has improved greatly, and this type of transmission is very low.
There are four basic body fluids that contain enough HIV to infect someone:
- Vaginal Fluids
- Breast Milk
If someone has come into contact with these body fluids that contain HIV, they may become exposed to the virus. HIV has to have entry into the body for there to be a true exposure. Entry can be sexual openings, cuts, scraps, open wounds, open blisters, and through mucus membranes such as the eyes, nose, ears, and mouth. You cannot get HIV through casual everyday contact such as hugging, using public toilets, drinking fountains, or swimming pools.
People cannot get HIV from saliva, tears, sweat, vomit, urine, or feces. These fluids do not contain enough HIV to infect someone. There is no evidence that anyone in the United States has become infected with HIV from these body fluids. A potential risk to HIV may be the presence of blood, semen, vaginal fluids or breast milk in saliva, tears, sweat, vomit, urine, or feces and these fluids enter into an opening in the body.
2. Learn about exposure through sharing needles
Someone can become infected with HIV from sharing a needle or syringe that contains blood from an infected person. Because blood can be injected directly into the body, the person sharing a contaminated needle or syringe is at risk of becoming infected. Sharing needles and syringes with anyone for any reason - such as injecting drugs (including steroids, insulin, and other legal and illegal drugs), body piercing, and tattooing - can spread HIV. There are several ways in which someone can reduce their risk for HIV infection through sharing needles:
- Don't use illegal drugs
- Don't share needles, syringes, or equipment for any reason
- Use unused, sterile equipment and needles
- Sterilize needles and syringes with chlorine bleach and water (chlorine bleach destroys HIV)
- Get tattoos and body piercing done at a shop that is licensed with the state department of health
- Do not share ink for tattooing
3. Learn about exposure through sex
HIV is considered a sexually transmitted disease and the most common way in which HIV is spread is through sex. HIV can infect anyone who has sexual contact with someone who has HIV. Sexual contact includes anal, oral, and vaginal sex and a person may be exposed to the virus if they come into contact with an infected persons blood, semen, or vaginal fluid. Anyone is at risk for HIV infection through sexual contact regardless of age, race, or gender. In the United States, the total number of people with AIDS infected through men to women sex is lower than the total number infected through men to men sex. Nevertheless, the rate of new HIV infections among men who have sex with men is decreasing, while the rate of men to women sex is increasing. There are several ways in which someone can reduce their risk for HIV infection through sexual contact:
- Abstain from having sex (oral, anal, or vaginal)
- Stay in a committed, monogamous relationship (had sex only with one partner who does not have HIV and who only has sex with you) and both be tested for HIV
- Know your partner. Talk opening about past behaviors and HIV testing to all sexual partners prior to having sex
- Use latex or polyurethane male condom consistently and correctly every time during sex
- Use a polyurethane female condom consistently and correctly every time during sex
4. Testing for HIV
People who think they are at risk of HIV infection are encouraged to seek individual counseling and testing. People are at risk for HIV if they:
- Share needles or syringes for injecting drugs
- Have sex with anyone who injects drugs
- Have had sex with a man or woman who has other sexual partners
- Have shared needles or inks for tattooing or body piercing
An HIV test is the only way to tell whether someone is infected. The standard screening tests look for HIV antibodies, not the virus itself. If HIV antibodies are present, it generally means that the person being tested has HIV. If no antibodies are present, it means that someone does not have HIV. A person can take several different types of HIV tests:
- Standard blood test
- Rapid HIV test - done by a finger prick or mouth swab
- OraSure test - done by placing a swab in the mouth
It can take up to two weeks to receive results from the standard blood test and OraSure test while the rapid HIV test will take up to 20 minutes for the result.
Because the test is an HIV antibody test, it can take anywhere between 3 weeks to 3 months for enough antibodies to show up on a test after exposure. This 3 weeks to 3 months is called the "window period". If people get tested during the window period, their test results may be negative even though they have HIV. If someone feels that they have been at risk for HIV infection, they should test as soon as possible and then wait three months to be tested again. If someone is in the 3 weeks to 3 month "window period" they should avoid taking risks related to HIV to get an accurate HIV test result. If someone tests negative but continues to take risks associated with HIV such as unprotected sex or sharing needles, they will need to get retested every three months. Stopping and reducing behaviors related to HIV transmission can help people protect themselves and others from HIV infection.
In Indiana, there are two common methods of testing - anonymous or confidential. The two methods differ regarding who has access to the HIV test results.
If people decided to test confidential -
Their tests results are linked to their identities and recorded in their file held by the agency conducting the HIV test.
Tests results cannot be revealed to anyone other than the person being tested without their written permission, except as required by law. (Indiana reports HIV-positive test results to the Indiana State Department of Health as required by law and all information is kept highly confidential.)
If a person tests confidential they are eligible for care coordination services, medical treatment, and state and local assistance programs if they test HIV-positive. A written copy can also be given to the person if they so desire.
If a person decides to test anonymously -
Neither their names nor any identifying information that could link their HIV tests results to them is recorded.
Only people who are tested can find out their HIV test result. (Results are sent to the Indiana State Department of Health but no name or identifying information is given).
If a person tests anonymously they are not eligible for care coordination services, medical treatment, or state and local assistance programs if they test should test HIV-positive, and a written copy cannot be given. If someone tests HIV-positive and tests anonymous, it is recommended that they retest confidential so that they can receive the appropriate services and medical treatment.
Whichever method of testing is used, people need to get counseling both before and after being tested even if the result is negative. Deciding to be tested is not always easy. Although there is no cure for HIV, early detection and early treatment of HIV can extend a persons life and improve the quality of life for people with HIV.
5. Treatment for HIV
There are a growing number of drugs that can attack HIV. Doctors combine these drugs to block the ability of HIV to multiply, thus protecting the immune system for some time. There are other drugs available to help control the opportunistic infections that occur in people with HIV when their immune system no longer is healthy. Although these medications can prevent or lessen opportunistic infections, they do not attack the virus itself. Doctors monitor both the quantity of the virus in the blood (viral load) and the level of certain cells (CD4) in the body's defense system to help them make treatment decisions. It is always recommended for persons who are HIV-positive to seek care coordination services at a local AIDS organization. Care coordinators can help people living with HIV receive the necessary medical treatment as well as refer them to various assistance programs in the state.