HIV/AIDS

HIV  – the Human Immunodeficiency Virus, is the virus that causes Acquired Immune Deficiency Syndrome (AIDS) and is transmitted by blood and body fluids.

There are an estimated 34 million people around the world who are living with HIV, and 6 million of them live in South Africa. Approximately 1000 – 1500 new infections occur per day in South Africa.

The condition that is referred to as AIDS is caused by HIV damaging the immune system cells until the immune system can no longer fight off other infections that it would usually be able to prevent.
If left untreated, it takes around ten years on average for someone with HIV to develop AIDS. However, this average is based on the person with HIV having a reasonable diet, and someone who is malnourished may well progress from HIV to AIDS more rapidly.

Key facts

• HIV continues to be a major global public health issue, having claimed more than 35 million lives so far. In 2015, 1.1 (940 000–1.3 million) million people died from HIV-related causes globally.
• There were approximately 36.7 (34.0–39.8) million people living with HIV at the end of 2015 with 2.1 (1.8–2.4) million people becoming newly infected with HIV in 2015 globally.
• Sub-Saharan Africa is the most affected region, with 25.6 (23.1–28.5) million people living with HIV in 2015. Also sub-Saharan Africa accounts for two-thirds of the global total of new HIV infections.
• HIV infection is often diagnosed through rapid diagnostic tests (RDTs), which detect the presence or absence of HIV antibodies. Most often these tests provide same day test results; essential for same day diagnosis and early treatment and care.
• There is no cure for HIV infection. However, effective antiretroviral (ARV) drugs can control the virus and help prevent transmission so that people with HIV, and those at substantial risk, can enjoy healthy and productive lives.
• It is estimated that currently only 54% of people with HIV know their status. In 2014, approximately 150 million children and adults in 129 low- and middle-income countries received HIV testing services.
• By end-2015, 17.0 million people living with HIV were receiving antiretroviral therapy (ART) globally.
• Between 2000 and 2015, new HIV infections have fallen by 35%, AIDS-related deaths have fallen by 28% with some 7.8 million lives saved as a result of international efforts that led the global achievement of the HIV targets of the Millennium Development Goals.
• Expanding ART to all people living with HIV and expanding prevention choices can help avert 21 million AIDS-related deaths and 28 million new infections by 2030.

How is HIV transmitted from one person to another?

There are various ways a person can become infected with HIV:
• Unprotected sexual intercourse with an infected person: Sexual intercourse without a condom carries the risk of HIV infection.
• Contact with an infected person’s blood: If sufficient blood from somebody who has HIV enters someone else’s body, then HIV can be passed on in the blood.
• Use of infected blood products: Many people in the past have been infected with HIV by the use of blood transfusions and blood products which were contaminated with the virus. In much of the world this is no longer a significant risk, as blood donations are routinely tested for HIV.
• Injecting drugs: HIV can be passed on when injecting equipment that has been used by an infected person is then used by someone else. In many parts of the world, often because it is illegal to possess them, injecting equipment or works are shared.
• From mother to child: HIV can be transmitted from an infected woman to her baby during pregnancy, delivery and breastfeeding.

Questions about HIV

Question 1: Can a patient with HIV have a HIV negative baby?

Yes,  she can.

• They need to go for counselling before trying to fall pregnant.
• The mother and father need to be on ARV’s and have a undetectable viral load in their blood before they try to fall pregnant.
• Once the mother is pregnant she has to continue taking ARV’s right through the pregnancy.
• When the baby is born, the baby will be given ARV drops for 6 weeks after birth and then have a blood test to make sure the baby is negative.
• The mother continues with ARV’s and is encouraged to breastfeed.
• South Africa has nearly eradicated mother-to-child transmission with this regime.

Question 2: What can a patient expect within the first 6 months of ARV therapy?

Common symptoms include gastrointestinal and flu-like symptoms, headache, dizziness, vivid dreams, rash, and hepatitis. A patient can also experience a worsening of symptoms.

Question 3: Where did HIV come from?

We do not know.

Scientists have different theories about the origin of HIV, but none have been proven. The earliest known case of HIV was from a blood sample collected in 1959 from a man in Kinshasa, Democratic Republic of Congo. (How he became infected is not known.) Genetic analysis of this blood sample suggests that HIV-1 may have stemmed from a single virus in the late 1940’s or early 1950’s. We do know that the virus has existed in the United States since at least the mid- to late-1970’s. From 1979-1981 rare types of pneumonia, cancer, and other illnesses were being reported by doctors in Los Angeles and New York among a number of gay male patients. These were conditions not usually found in people with healthy immune systems. In 1982 public health officials began to use the term “acquired immunodeficiency syndrome,” or AIDS, to describe the occurrences of opportunistic infections, Kaposi’s sarcoma (KS), and Pneumocystis carinii pneumonia (PCP) in previously healthy men. Formal tracking (surveillance) of AIDS cases began that year in the United States.

The cause of AIDS is a virus that scientists isolated in 1983. The virus was at first named HTLV-III/LAV (human T-cell lymphotropic virus-type III/lymphadenopathy-associated virus) by an international scientific committee. This name was later changed to HIV (human immunodeficiency virus).

Question 4: How long does it take for HIV to cause AIDS?

Since 1992, scientists have estimated that about half the people with HIV develop AIDS within 10 years after becoming infected. This time varies greatly from person to person and can depend on many factors, including a person’s health status and their health-related behaviors.

Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS, though the treatments do not cure AIDS itself. As with other diseases, early detection offers more options for treatment and preventive health care.

Question 5: Can I get HIV from kissing on the cheek?

HIV is not casually transmitted, so kissing on the cheek is very safe. Even if the other person has the virus, your unbroken skin is a good barrier. No one has become infected from such ordinary social contact as dry kisses, hugs, and handshakes. Animals cannot transmit the disease either.

Question 6: Can I get HIV from open-mouth kissing?

Open-mouth kissing is considered a very low-risk activity for the transmission of HIV. However, prolonged open-mouth kissing could damage the mouth or lips and allow HIV to pass from an infected person to a partner and then enter the body through cuts or sores in the mouth. Because of this possible risk, the CDC recommends against open-mouth kissing with an infected partner. One case suggests that a woman became infected with HIV from her sex partner through exposure to contaminated blood during open-mouth kissing.

Question 7: Can I get HIV from performing oral sex?

Yes, it is possible for you to become infected with HIV through performing oral sex. There have been a few cases of HIV transmission from performing oral sex on a person infected with HIV. While no one knows exactly what the degree of risk is, evidence suggests that the risk is less than that of unprotected anal or vaginal sex. Blood, semen, pre-seminal fluid, and vaginal fluid all may contain the virus. Cells in the mucous lining of the mouth may carry HIV into the lymph nodes or the bloodstream. The risk increases:

•     if you have cuts or sores around or in your mouth or throat;
•     if your partner ejaculates in your mouth; or ·
•     if your partner has another sexually transmitted disease (STD).

If you choose to have oral sex, and your partner is male, use a latex condom on the penis; or if you or your partner is allergic to latex, plastic (polyurethane) condoms can be used. Research has shown the effectiveness of latex condoms used on the penis to prevent the transmission of HIV. Condoms are not risk-free, but they greatly reduce your risk of becoming HIV-infected if your partner has the virus.

If you choose to have oral sex, and your partner is female, use a latex barrier (such as a dental dam or a cut-open condom that makes a square) between your mouth and the vagina. Plastic food wrap also can be used as a barrier. The barrier reduces the risk of blood or vaginal fluids entering your mouth.

Question 8: Can I get HIV from someone performing oral sex on me?

Yes, it is possible for you to become infected with HIV through receiving oral sex. If your partner has HIV, blood from his or her mouth may enter the urethra (the opening at the tip of the penis), the vagina, the anus, or directly into the body through small cuts or open sores. While no one knows exactly what the degree of risk is, evidence suggests that the risk is less than that of unprotected anal or vaginal sex.

If you choose to have oral sex, use a latex condom on the penis or, if you or your partner is allergic to latex, a plastic (polyurethane) condom can be used. Research has shown the effectiveness of latex condoms used on the penis for preventing the transmission of HIV. Condoms are not risk-free, but they greatly reduce your risk of becoming HIV-infected if your partner has the virus.

If you choose to have oral sex and you are female, use a latex barrier (such as a cut-open condom that makes a square or a dental dam) between their mouth and the vagina. Plastic food wrap can also be used as a barrier. The barrier reduces the risk of blood entering the body through the vagina.

Question 9: Can I get infected with HIV from mosquitoes?

No. From the start of the HIV epidemic there has been concern about HIV transmission of the virus by biting and bloodsucking insects, such as mosquitoes. However, studies conducted by the CDC and elsewhere have shown no evidence of HIV transmission through mosquitoes or any other insects — even in areas where there are many cases of AIDS and large populations of mosquitoes. Lack of such outbreaks, despite intense efforts to detect them, supports the conclusion that HIV is not transmitted by insects.

10. Can HIV be transmitted through breast milk?

HIV transmission from mother to infant mostly occurs in utero, but HIV has been isolated in breast milk, implicating breast-feeding as a means of transmission. The main problem in estimating the risk of HIV transmission from breast milk stems from the inability to determine whether an infant is infected at birth. The actual risk of transmission of HIV through breast milk is unknown. It is thought to be more likely if a mother is newly infected with primary infection and may therefore be more infectious. Women who are less viraemic (who are on ARV’s) are thought to be less likely to transmit HIV through breast milk.

For more information on pregnancy and preventing mother -to-child transmission : http://www.avert.org/fact-sheet-hiv-pregnancy.htm