HIV 101

Understanding HIV, Prevention, Care, and Treatment

Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS).

HIV (human immunodeficiency virus) is the virus that causes AIDS.

HIV can spread from person to person during anal, vaginal, or less commonly during oral sex. HIV can also be spread while sharing needles or reusing equipment to inject drugs, tattoo or body pierce. HIV can also be passed from an infected mother to her baby during pregnancy, childbirth or breastfeeding.

The following body fluids have been proven to spread HIV:

• Blood
• Semen
• Vaginal fluid
• Breast milk
• Other body fluids containing blood

HIV attacks and weakens the immune system making people infected with HIV vulnerable to a variety of infections and some cancers (SEE COMMON OPPORTUNISITC INFECTIONS). When an individual begins to develop these symptoms a doctor may diagnose that person as having AIDS. With early identification, behavior modification, support, and medical treatment people living with HIV live longer and healthier. Currently there is no vaccine to prevent HIV infection nor is there a cure.

What is HIV?

HIV is the Human Immunodeficiency Virus, the virus that causes AIDS. This virus attacks the CD4+ T cells and reduces the individual’s ability to fight off infections. HIV is spread through unprotected anal, vaginal, oral sex; sharing needles; and mother to child during pregnancy, childbirth, or through breastfeeding.

What is AIDS?

AIDS is the Acquired Immune Deficiency Syndrome, and is the result of HIV infection. AIDS is an acute form of HIV infection that can only be diagnosed by a doctor. A diagnosis of AIDS means that an individual is living with HIV and also has a CD4+T-cell count of 200 or less and an opportunistic infection.

What are CD4+ T cells?

CD4+ T cells are a type of white blood cells that assist in protecting the body from various forms of infection. These specific white blood cells are responsible for instructing the immune system how to perform in the presence of infection. HIV targets and destroys these cells to weaken the immune system.
How is HIV spread?

HIV has 3 primary routes of transmission:

• Unprotected vaginal, anal, or oral sex*
• Sharing Needles (i.e. drug use, tattooing, body piercing) and Needle stick injury
• Mother – to – Child during pregnancy, childbirth, or breastfeeding.

4 body fluids transmit HIV, they are:

• Blood
• Semen (e.g. thick whitish secretion released from a man’s penis during sexual arousal)
• Vaginal Fluids (e.g. natural lubricant found in a woman’s vagina during sexual arousal and fluid released during sexual climax)
• Breast Milk

* Unprotected sex refers to vaginal, anal, or oral penetration without the use of a latex or polyurethane condom. Vaginal sex refers to penetration of the vagina by a penis, finger, or sex toy. Anal sex refers to penetration of the anus (butt) by a penis, finger, or sex toy. Oral sex refers to using one’s mouth to stimulate the sexual organs (i.e. penis, vagina, or anus).

How is HIV not spread?

HIV is not spread through casual contact. Casual contact can be considered to be any activities, in which an individual does not come into contact with another’s blood, semen, vaginal fluids, or breast milk. Specifically HIV cannot be spread by:

• Shaking hands
• Dry kissing
• Using the same eating or drinking utensils
• Restroom facilities
• Hugging
• Coughing
• Sneezing
• Attending the same church, school, or work place

How is the risk of HIV reduced?

The risk of HIV is eliminated when abstinence and universal precautions are practiced.

Safer sex and not sharing needles greatly reduces the risk of HIV.

Abstinence is refraining from vaginal, anal, or oral sex and drug and alcohol usage. Drugs and alcohol are included in the understanding of abstinence for two reasons. First injecting drugs and sharing needles is a primary risk for HIV infection. Secondly, when a person is “high” or intoxicated he/she may participate (willing or unwilling) in sexual activities that may put them at risk for HIV infection.

Universal precautions refer to the activities that health and childcare workers should undertake to prevent HIV, hepatitis B, and other blood-borne pathogen infection when coming into contact with blood or bodily fluids containing blood.

Specific guidelines for universal precautions include:

• Wearing latex gloves when coming into contact with blood, skin and mucous membrane cuts, or any open skin lesion.
• Using gloves only for the care of one child, then discard the gloves.
• Washing hands after discarding the gloves.
• Properly disposing of contaminated materials exposed to blood, such as needles.

Childcare workers and teachers often believe that they will be confronted with a blood spill when they are unprepared, such as a child's fall on the playground or an unexpected nosebleed. If gloves are not readily available, the use of a barrier -- such as a diaper or towel between the staff member and the blood can be used until appropriate materials are available. Older children can be taught to hold the towel or gauze over the bleeding area themselves. A practical approach used by one school system is to give all teachers pocketsize kits, consisting of gloves, and gauze in a zippered plastic sandwich bag, to keep in their desks and carry on the playground or field trips. Hands should be washed thoroughly and immediately if the should come into contact with blood.

Safer Sex refers to the use of a latex condom for vaginal, anal, or oral sex. Some people have an allergy to latex and for these individuals a polyurethane condom such as Durex Avanti Polyurethane Condoms. Contact your doctor or primary care physician to determine if you have an allergy to latex.

Not sharing needles is a harm reduction method specifically for individuals that use injection drugs. Injection drug use alone can have damaging affects on an individual’s health. To reduce the possibility of HIV, hepatitis B, or other blood-borne pathogen exposure individuals should not share needles.

In some cases an individual may share needles for tattooing, body piercing, or medicinal purposes (i.e. diabetes medication), this should be avoided because of the potential risk of infection. Remember you cannot look at someone and tell that they are infected with HIV, hepatitis B, or some other blood-borne pathogen. If you are about to receive a tattoo or body piercing make sure that new sterile needles are being used.

More information on Universal Precautions can be found in the following article: Centers for Disease Control. Recommendations for prevention of HIV transmission in health-care settings. MMWR 1987;36 (suppl no. 2S) http://www.cdc.gov/mmwr/preview/mmwrhtml/00023587.htm

For more general information about HIV/AIDS check out the CDC’s HIV/AIDS Page at: http://www.cdc.gov/hiv