HIV HIV is the acronym for Human Immunodeficiency Virus. HIV is a viral sexually transmitted infection (STI) that affects a person’s immune system. There are many strains of HIV, which has made efforts to find a cure or preventative vaccine very difficult. The HIV virus easily mutates, resulting in multiple strains of it. When a person is diagnosed with HIV, they are HIV positive. People who do not have HIV are HIV negative. In 2006, there were approximately 58,000 people in Canada with reported cases of HIV infection. These reports are an underestimation, due to the many undiagnosed and subsequently unreported cases of HIV. In Canada, HIV can be kept under control with the use of antiretroviral medications, which can help boost the immune system and slow down the progression of the virus. There is currently no cure for HIV, nor will the virus go away, even with any amount of treatment. Once you have HIV, you will have it for life. HIV is considered to be a chronic infection; however, it is not a death sentence! With proper care and treatment, the symptoms of HIV can usually be kept under control. People with HIV can still live happy and productive lives, although it does involve a very large lifestyle adjustment. AIDS AIDS is the acronym for Acquired Immuno Deficiency Syndrome. You can only acquire AIDS from having an HIV infection. AIDS is considered to be a latter stage of HIV, when a person’s immune system has been severely compromised or depleted. AIDS diagnoses differ from country to country. Generally speaking, a diagnosis of AIDS will be given when certain opportunistic infections keep recurring in a person with HIV. These infections can include certain AIDS related cancers, pneumonias and other types of health conditions. AIDS diagnoses are done by medical professionals who are qualified to provide them. Most often, when a person has been diagnosed with AIDS, their immune system is very low and they are extremely sick. It is during this time that a person can die from AIDS-related illnesses. When a person’s immune system has been severely damaged, even fighting off a common cold can be very difficult, if not impossible. Some people have bounced back to a regular HIV status from having AIDS but this is very uncommon. Am I at risk for getting HIV? HIV is spread more easily through high risk activities but it tends to be a more difficult STI to transmit than other viruses, bacteria or parasites. For HIV to be transmitted the following three factors need to be present at once: • An infected fluid must be present, which includes blood, semen, vaginal fluid or breast milk. Saliva, urine, feces and other bodily fluids cannot transmit the virus. The fluid has to be transferred from one human being to another. It cannot be contracted through toilet seats, saunas or other objects or through mosquitoes. • A bleeding open cut or wound needs to receive the infected fluid. This is often referred to as a point of entry. This is the point at which an activity takes place, i.e. if vaginal sex takes place, the vagina and penis could contain points of entry. Sex involves a certain amount of friction, during which, tiny microscopic tears can form, which can allow viruses and bacteria to enter the bloodstream. They are not visible tears and they do not hurt. People are completely unaware of them. • A risk activity needs to take place. This risk activity needs to involve a certain amount of friction. When cuts are formed, the blood is pushed out through the cut; therefore, in order for the virus to enter the bloodstream it needs to be forced in. • Activities that involve a large amount of friction in a sensitive area or that involve a direct route into the blood stream are considered high risk activities. Sharing needles and having unprotected vaginal and anal sex are examples of this. • Activities that involve a moderate amount of friction in a sensitive area, or which involve friction in less sensitive areas, tend to be classified as low to moderate risk activities. Examples of this are giving oral sex (because your mouth is less sensitive to tearing than your anus or vagina), sharing rolled up dollar bills for sniffing drugs and sharing crack pipes as both of these activities require some friction and can cause blistering or cuts. • Activities that pose little to no risk of infection are typically classified as nominal risk or theoretical risk activities. These activities do not currently account for any reported cases of HIV infection but in theory, they could lead to an HIV infection under the right circumstances. Examples of theoretical risk activities are sharing marijuana joints and receiving oral sex. These are extremely low risk activities and as far as anyone knows there are no cases of people contracting HIV in those ways. The Following activities can transmit the HIV virus, some of which have been mentioned as examples already: • Performing oral sex on your partner’s penis, vulva or anus • Having vaginal sex • Having anal sex • Sharing needles, crack pipes or rolled up dollar bills for sniffing drugs • Using unsanitary tattooing or piercing equipment • Sharing sex toys such as dildos and vibrators • Mother to baby transmission during the time of delivery or through breastfeeding. *HIV can not be passed through casual contact with someone who has the virus. Kissing, massage and mutual masturbation are examples of risk free activities for contracting HIV. HIV also can not be passed through toilet seats, swimming pools or any of these sorts of objects. If all three factors mentioned above are not present, HIV can not be transmitted. How can I avoid getting HIV? If you are sexually active and engaging in any of the listed risk activities, you are at risk for contracting HIV; however, there are ways to reduce the risk. You can……. • Talk about safer sex with your sex partners • Use a condom every time you have anal or vaginal sex • Use a condom every time you perform oral sex on your partner’s penis • Use a dental dam (made out of a condom or purchased separately) every time you perform oral sex on your partner’s vulva or anus • Get regular testing for HIV. • Use lots of lubrication during sex because this can reduce the amount of tearing that can occur during sex. Plus lubricant can add to your pleasure during sex. • Avoid using spermicides that contain nonoxyl 9, such as sponges, creams, gels and foams or condoms with spermicide on them. Nonoxyl 9 is a chemical that kills sperm but can cause irritation to your genitals, increasing your risk of infection. • Avoid sharing needles, crack pipes and other drug paraphernalia with others. Always use your own clean equipment if you choose to use drugs which require it. • Sterilize sex toys between use. Do not transfer a dildo or vibrator from your partner’s anus, vagina or mouth into yours or visa versa without sterilizing it first. • If you get a piercing or tattoo, make sure the piercer/tattooist takes a clean needle out of the package in front of you. How do I know if I have HIV? Many people with HIV have no symptoms at all. You cannot know if you have HIV without getting a test done. Lots of people have HIV for over 10 years or more without knowing they have it. The following are symptoms that people with HIV may experience: • Tiredness or fatigue • Weight loss • Night sweats • Chronic diarrhea • loss of appetite • Yeast infections that keep recurring even after treatment *These symptoms can all easily be attributed to other types of illnesses or infections; therefore, it is extremely important for sexually active individuals to get tested regularly. Unfortunately, in reality, those who are young, live in remote or rural areas, do not have provincial health cards or immigration status have a much more difficult, if not impossible time accessing sexual health or other health care services. Canadians for Choice actively promotes access to sexual health services both nationally and world-wide and will make its best efforts to continue raising awareness about issues such as these, which impact on people’s health. How can I get a test for HIV? You can get tested for HIV at your doctor’s office, walk-in clinic or sexual health centre; however, depending on where you go, different recording methods will be used. If you go to a regular doctor’s office or walk-in clinic or any other medical centre where you are required to show your health card, your HIV test and results will show up on your permanent medical record. Your medical records are not available to the general public but various professionals and experts have access to it. This type of testing is confidential but it is not anonymous. It should be noted that some people have been discriminated against when trying to access housing, employment, immigration and other services on the basis of their HIV status. If you go to a special Anonymous HIV testing location, only you will know the results of your test. It is your choice whether or not you choose to have a confidential or anonymous test or not to get tested at all. Some people who don’t have access to an anonymous testing clinic may not be able to choose that option. With an anonymous test, your blood is taken and tested; you are given a business card with a number on it; in 2 weeks you return to the anonymous testing site, where you will receive your test results when you present the numbered card. If you lose your card you will have to retest. If you are not sure whether a particular location offers anonymous HIV testing, you can ask them. To find out about anonymous testing locations in Canada, you can call your local AIDS organization. For a list of provincial and territorial HIV/AIDS hotlines, provided by the Public Health Agency of Canada: http://www.phac-aspc.gc.ca/aids-sida/info/4_e.html#find To find a local HIV/AIDS organization through the Canadian AIDS Society: http://www.phac-aspc.gc.ca/aids-sida/info/4_e.html#find There are some members of the Canadian Federation for Sexual Health, located throughout Canada, which have STI testing available on site. If your local member does not provide testing, they will be able to direct you as to where you can go. To find a member close to http://cfsh.ca/ppfc/find.asp How is the test for HIV done? HIV testing is done through a blood test. Blood is taken, and sent to a lab for testing, which tests for the presence of HIV antibodies. Only people with HIV develop HIV antibodies. These antibodies take approximately 3-6 months to develop in an infected person’s system. This is often referred to as the window period. This means, if you contract HIV today, it will not show up in your blood until 3-6 months later. Because of this window period, sexually active individuals and intravenous drug users are encouraged to be tested regularly every 3-6 months. It is important to reinforce, however, that getting tested is a choice that only you can make for yourself. How is HIV Treated? There is currently no cure for HIV. Researchers and scientists are currently trying to test different microbicides, which may help prevent the transmission of HIV and other STIs. There are currently no microbicides on the market, which can prevent HIV. Microbicides are gels, suppositories, films and creams (which are used in a similar way to contraceptive spermicides), which are inserted into the vagina or anus to help prevent infection. The microbicide helps kill the infection. There are treatments available for those who are HIV positive, which can help slow down the effects of the virus. These medications are called antiretroviral drugs. By detecting HIV early on, establishing an optimal treatment plan and maintaining a healthy lifestyle, a person can live for 15+ years before developing AIDS. Positive Sex: Being diagnosed with HIV can be very devastating for a person. Many of the medications cause very unpleasant side effects and people with HIV are subject to discrimination along with the many myths that surround the virus. One such myth is that people with HIV cannot or should not have sex. People with HIV are just as deserving of a happy and healthy sex life as those who do not have HIV. People with HIV are sexual beings like everyone else and they can and do have fulfilling sex lives. It may be difficult to find sex partners that are accepting of a person’s HIV status but it can be done. Some people with HIV have HIV negative partners who never end up contracting the virus. When two people with HIV have sex, it is important to still use protection. You and your partner can get each other’s strains of the virus, which can worsen your symptoms. What happens if I get HIV and don’t get treated? People can live for several years with HIV and have no ill effects; however, some strains of the virus progress into AIDS more rapidly. The sooner you start your treatment, the better off your immune system will be. If you are not treated for HIV, the virus will progress into AIDS more quickly and you can die of AIDS-related illnesses. HIV can also be passed on to a foetus in utero and pregnant women who choose to parent can pass HIV on to their babies during delivery or through breast feeding. There are precautions that can be taken, which vastly reduce the chances of passing HIV on to a foetus or child. =