AIDS & HIV
HIV is a virus that can damage the body's defence system so that it cannot fight off certain infections. If someone with HIV goes on to get certain serious illnesses, this condition is called AIDS.
HIV stands for Human Immunodeficiency Virus.
AIDS stands for Acquired Immune Deficiency Syndrome.
Is there a cure?
At the moment, there is no cure for HIV or AIDS. But there are cures and treatments for many of the illnesses that people with HIV are prone to. There are also combination treatments that most people with HIV benefit from, and many people have definite and major health improvements. The drugs reduce the level of HIV in the blood and delay the development of AIDS. Research shows that most people who are on these treatments live longer and feel better. However, the drugs can have unpleasant side effects and many different drugs have to be taken every day, and some people cannot cope with this. The long-term effects of being on combination therapy are not yet known.
There is no vaccine against HIV.
How big is the problem?
HIV infection is spread throughout the world. But there are some parts of the world - such as sub-Saharan Africa, Southern Asia and Eastern Europe - where known levels of infection are higher than in others. The risk is higher in countries with more people infected with HIV, but the risk of infection is everywhere. World-wide, the commonest way of becoming infected with HIV is by sex between men and women.
In the UK, over 2,500 people test positive for HIV every year and the number of people living with HIV continues to rise with most infections being amongst gay and bisexual men. The rate of HIV infection amongst heterosexual men and women is also rising. Most of these are among people from Sub-Saharan Africa.
How is HIV passed on?
In the UK there are three main ways in which HIV can be passed on by:
having vaginal or anal sex without a condom with someone who has HIV. Unprotected oral sex also carries some risk
a mother with HIV to her baby during pregnancy, at birth or through breastfeeding; and
sharing needles, syringes or other drug-injecting equipment that is contaminated with HIV infected blood.
You cannot get HIV through:
kissing, touching, hugging or shaking hands;
sharing crockery and cutlery;
coughing or sneezing;
contact with toilet seats;
insect or animal bites;
swimming pools; or
eating food prepared by someone with HIV.
Is it safe to give blood?
Donating blood in the UK is completely safe. All equipment is sterile and used only once. If you go to give blood, staff will ask you questions to assess whether you may have come into contact with HIV. If they think you might have been at risk, they will ask you not to give blood.
Is it safe to receive blood?
As an extra safety measure, all blood, blood products, organs and tissues for transplant in the UK are screened for antibodies to HIV. Blood products are also heat-treated.
Can I get HIV from being treated by my doctor or dentist?
Doctors, dentists and other healthcare workers use precautions when dealing with patients to prevent any risk of infection.
What about giving first aid?
It makes sense for anyone giving first aid to follow standard hygiene and safety precautions and avoid direct contact with the injured person's blood. If you do get someone else's blood on your skin, simply wash it off.
What if I come across a used needle or syringe?
Don't touch the metal needle. If you are pricked by a used needle, pinch the wound to make it bleed, clean the area and wash it with soap and water. Cover it with a plaster and get medical advice.
What about skin piercing?
Anything that punctures the skin, including tattooing, acupuncture needles and equipment for ear-piercing, body-piercing or removing hair by electrolysis, could pass,on HIV and other viruses carried by blood (for example, Hepatitis B and C). Reliable practitioners will use disposable equipment or sterilise it before use. Ask if you are unsure and only go ahead with the procedure if you are satisfied that sterile equipment is being used.
What about medical treatment abroad?
As some countries do not have the same standards of medical and dental care as in the UK, there may be a risk of getting HIV from infected blood transfusions, blood products and from unsterile medical equipment. When you are visiting certain countries, you may want to take your own first-aid kit, including sterile needles and syringes.
What about having sex abroad?
Many people work, travel or take holidays abroad. No matter where you are, or how widespread the virus is in the country you're visiting, the main ways of passing on HIV are the same. It's important to plan ahead. If you think you might meet a new partner, take a supply of quality condoms and water-based lubricant with you.
What is safer sex?
In terms of protection against HIV, a simple way of understanding safer sex is to see it as any sex that does not allow an infected partner's blood, semen, or fluid from the vagina to get inside the other partner's body. Some kinds of sex - such as kissing or masturbation - carry no risk of HIV.
What are the riskiest kinds of sex?
Vaginal and anal sex without a condom carry the highest risk. HIV can be passed on to either partner - male or female - during penetrative sex (where the penis enters the vagina, anus or mouth) without a condom.
How safe is oral sex?
Oral sex is where one partner uses their tongue or mouth to stimulate their partner's genitals. There is a very small risk of infection through oral sex, but it is less risky than vaginal or anal sex without a condom. You can reduce this risk by doing the following:
Avoid getting semen in your mouth, particularly if you have any cuts, sores or ulcers in your mouth.
If the penis is being stimulated during oral sex, consider using a condom.
Use a dental dam (a latex square) for oral sex with a woman. Hold the dental dam over the woman's genital area to protect you against infection from vaginal fluid and menstrual blood. They are not widely available but you may be able to get them from some sexual health clinics, chemists, shops and some mail-order agencies. Call the National AIDS Helpline for details on freephone 0800567123.
How important are condoms?
Condoms provide a very effective barrier against HIV. They also help protect against other sexually transmitted infections as well as unplanned pregnancies. Condom basics:
Condoms come in a range of shapes, sizes, thickness, colours and flavours.
Always use condoms with the European CE mark or CE and British kitemark.
Most condoms come already lubricated but some people find using extra water-based lubricant can make sex more comfortable, and help prevent the condom tearing.
For anal sex always use plenty of water-based lubricant to help prevent the condom splitting.
There is also a female condom (the Femidom) that fits inside the vagina.
There is a type of condom (the Avanti) which is made of thin plastic. The Avanti is suitable for most people who are allergic to latex. It is said to reduce the loss of sensitivity that some people complain of with latex condoms. Avanti comes with a CE mark, but its use for anal sex has not been tested.
Male and female condoms will only protect you if you use them properly. Check the pack for instructions.
You may already be using some form of contraception, such as the contraceptive pill. But a good-quality condom, used properly every time you have sex, can help protect you against unplanned pregnancy and sexually transmitted infections including HIV.
If I stick to one partner do we need to use condoms?
If you and your partner are both HIV negative, stay negative, and have not had other sexual partners, then you cannot get HIV through sex. But what if you or your partner have taken risks with injecting drugs, for example, or you are starting a new relationship? If for any reason you're thinking of not using condoms, consider the following:
You can have the virus and look and feel fit and healthy
Many people may not know for sure whether they or their partner have HIV
The only way to find out if you're both HIV negative is to have an HIV test
And if I don't stick to one partner?
Always use condoms with other partners you may have. The more partners you have unprotected sex with, the more likely you are to come into contact with HIV and other sexually transmitted infections.
Remember - condoms also protect against other sexually transmitted infections and unplanned pregnancy.
How can I avoid HIV if I inject drugs?
Always use your own equipment or 'works' - syringe, needle, spoon, bowl and water. See the advice given earlier about sex and staying safe. Needle exchanges provide free supplies of sterile equipment and condoms, and can safely dispose of used drug-injecting equipment.
What if I use someone else's works?
You can reduce the risk of HIV by cleaning used works thoroughly, first with water, then with bleach. But this is never as safe as using your own sterile equipment and may not protect you against other viruses that are carried in blood (particularly hepatitis).
For details about needle exchanges, cleaning with bleach, or local drug services, call the 24-hour National Drugs Helpline on 0800 77 66 00. This service is completely free and confidential.
What is an HIV test?
You may have heard or read about 'the AIDS test', but the test does not show whether someone has AIDS. The test looks for antibodies to HIV, in other words, whether someone has been infected with HIV - the virus that causes AIDS. It's called 'the HIV-antibody test' or 'HIV test' for short.
Antibodies are substances in the blood that your body makes to defend itself when you get an infection. Some antibodies protect against specific infections, but HIV-antibodies do not protect an infected person from developing HIV-related diseases and eventually AIDS.
Where can I get the test?
Most tests are carried out by NHS sexual health clinics.
NHS sexual health (GUM) clinics offer free HIV testing and screening for other infections. Your GP will not be told you have had the test without your permission. All information is kept strictly confidential. You can go to any clinic, anywhere in the country. You don't have to use a local one and you don't have to be referred by your GP. You can also get the test from your GP. If you take the test with your GP, the result will probably be entered in your medical records.
What does the test involve?
If you ask for a test at an NHS sexual health (GUM) clinic, you will see a doctor, a trained counsellor (health adviser) or a nurse practitioner in private. He or she will explain what the test involves and what the results mean. The test will go ahead only if you agree to have it done. A small sample of blood will be taken from your arm, sent to a laboratory and tested. Ask your doctor or counsellor to explain how you will be told of the result.
How long before the result comes through?
It can take anything from a few hours to a week or longer to get the result back. Some clinics can give you the result the same day, but you may have to book an appointment beforehand. If your test is positive, you will have to have another test to check the result.
What does the result tell me?
No antibodies to HIV were found in your blood. This usually means that you do not have HIV
However, a single negative test result may not be enough to rely on. It can take up to three months, and sometimes longer, for HIV-antibodies to show up in the blood test after someone becomes infected. Because of this 'waiting period', some
people who test negative may be advised to have another test. The clinic staff will be able to tell you when this will be done
Also, even if you get a negative result, you can still become infected in the future if you put yourself at risk
Antibodies to HIV were found in your blood. You have HIV. This does not tell you whether you have AIDS
Being HIV positive means you will need to look at ways of taking particular care of your own health. It also means that you can pass on the virus to others, but only in certain
always use a condom for vaginal, anal or oral sex
if you inject drugs, do not let other people use your equipment; and
remember, you cannot pass on the virus through everyday social contact
Are all pregnant women tested for HIV?
All pregnant women are urged to have an HIV test, along with other antenatal screening tests. However, you do not have to have a test if you do not want one. There are major benefits of knowing you are HIV positive during pregnancy. The combination treatments mean that the chances of a woman with HIV passing it on to her baby can be reduced in different ways. There are treatments that can be taken during pregnancy, and different options for giving birth. Another way to reduce the risk is not to breastfeed, and there are treatments that can be given to the baby after birth.
If a woman with HIV has a baby, it can take from one to four months to tell whether the baby has the virus. Your doctor or midwife can explain this in more detail.
The staff at your clinic can give you more advice and support, including information on medical and other treatments. There are many groups and organisations that offer advice and support to people with HIV and their family, partners and friends (contact the National AIDS Helpline 24hrs a day free 0800 567123).
Who gets to know the result?
If you have the test at a clinic, the result is strictly confidential to you and the staff directly concerned with your medical care. Staff will advise you about consulting your GP. Nobody will be told of the result without your permission.
How do I decide if I should have the HIV test?
Talking to a trained counsellor at an NHS sexual health (GUM) clinic will give you the chance to discuss your concerns and can help you decide. The final decision will be left to you. Or you can call the National AIDS Helpline free and in confidence on 0800 567123.
What are some of the practical effects of having the test?
Looking after yourself - if your test results are positive, knowing you have HIV will allow you to get advice and counselling about your own future health. There are combination treatments that can help delay the onset of AIDS. You can discuss whether or when to start the treatments with medical staff at the clinic. Starting your treatment at the right time can affect how well it works.
Life insurance - if you apply for life insurance you will be asked if you are HIV positive. If you are, your application is likely to be turned down. By law, the insurance contract will not be valid if you do not give accurate information. You will also be asked to give permission for your GP to provide information from your medical records about any positive HIV test result. These days, you should not be asked if you have ever had an HIV test and tested negative.
Employment protection - a number of employers now have a policy that prevents discrimination against people because they are HIV positive. And in some cases, it is illegal to discriminate against someone with HIV.
Visas - some countries do not allow people with HIV to enter the country, or need proof of a negative test result before they will issue a visa or-work permit.
What do I say or do if I know someone has HIV?
Someone with HIV or AIDS is just like everybody else and should be entitled to privacy and respect. The last thing someone with HIV needs to have to deal with is other people's fears and prejudices. Remember, you are not at risk of infection from someone with HIV through everyday social contact. Don't break up a friendship because someone you know has HIV or AIDS. Friendship and support are two of the most important things you can offer.
Source: Health Promotion England, 2000