Human Immunodeficiency Virus (HIV)

HIV (human immunodeficiency virus) attacks the body’s immune system and can lead to AIDS (acquired immunodeficiency syndrome) if left untreated. HIV and AIDS are not curable though treatment is available, and discussed further. HIV is more prevalent in the LGBT+ community, with 69% of new HIV diagnoses being from men who have sex with men in 2018 compared to 24% from heterosexuals (CDC, 2020). HIV spreads via contact with certain bodily fluids from an HIV carrier with a high enough viral load; the bodily fluids that can transmit HIV are blood, semen, rectal fluids, vaginal fluids, and breast milk. For transmission to occur these fluids must enter the bloodstream of an HIV-negative person through open wounds or a mucous membrane. The most common activity that causes transmission is having vaginal or anal sex with an HIV-positive person or sharing injection needles with an infected individual. It is also possible to pass HIV from mother to child during pregnancy, birth, or breastfeeding. In rare cases HIV can be transmitted through oral sex, blood transfusion or transplants, open-mouth kissing, eating pre-chewed food from an HIV-positive individual, or being bitten by an HIV-positive induvial.

For an HIV infected person to pass the virus along, they must have a viral load high enough to transmit the virus. Individuals with HIV that take the prescribed medication will have a low enough viral load that it is undetectable. If the viral load is undetectable then the chance of spreading the virus is considered impossible; if you would like to read more about viral load check out U=U. It is possible for someone to become infected with HIV without noticing any change, therefore it is extremely important to test regularly or before starting a new sexual relationship. For those infected with HIV symptoms may include swollen lymph nodes, night sweats, mouth ulcers, fatigue, chills, muscle aches, rash, or fever. The symptoms of HIV occur two to four weeks after exposure and may feel flu-like in nature.  

Prevention from HIV is simple, make sure to get tested, use condoms every time you have anal or vaginal sex, practice oral sex, and do not share needles used for injection. In recent years PrEP or Pre-exposure Prophylaxis medication prevents at risk individuals from becoming infected with the virus through sex or needles used for injection. PrEP is safe, though some experience side effects such as diarrhea, nausea, headache, fatigue, or stomach pain. If taking prep and you experience any of these side effects, contact your care team and make them aware. Programs such as Ready, Set, Prep and Co-pay assistance programs exist to help at risk individuals gain access to PrEP for lower or no cost depending on qualifications.

HIV has three distinct stages of infection, the last stage being AIDS (Acquired Immunodeficiency syndrome). The first stage is acute HIV infection, individuals have a high viral load and are contagious. In stage one some feel flu-like symptoms as this is the body’s natural defense to any infection, though some never experience these symptoms. The only way to diagnose an acute HIV infection is by taking a NATs (antigen test or nucleic acid test) to search for antibodies created natural in response to an HIV infection.

Stage two of HIV infection is the chronic HIV infection stage. In this stage individuals are asymptomatic; HIV is still active though the viral load is extremely low. Without medication this stage may last years, though the virus develops at different rates depending on the person. By the end of this stage the viral load increases and CD4 cell count goes down. If the viral load continues to increase the infected induvial moves to stage three. If the infected is taking prescribed HIV medication, they never reach stage three.

Stage three of HIV infections is AIDS (Acquired Immunodeficiency Syndrome) and is the most severe stage of HIV. Individuals with AIDS have a damaged immune system and become susceptible to an increasing number of sever illnesses. To be diagnosed with AIDS the CD4 cell count must drop below 200 cells/mm, or through developing opportunistic infections. However, with treatment it is possible to lower the viral load and see an CD4 cell count back above a AIDS diagnosable level. Opportunistic infections are illnesses that are more prevalent in those diagnosed with HIV, they are more prevalent due to the damaged immune system. Individuals diagnosed with AIDS have extremely high viral loads and without medication, are extremely infectious. Without treatment most only survive three years living with AIDS. The CDC has good documentation about AIDS and how it affects the immune system.   

There are still stigmas around HIV. That it can only be caught be certain groups or that it was the persons fault for not taking steps to prevent HIV. These are not true, HIV, like any other human virus can infect anyone who is not careful. Some may not be aware they have been infected and show no symptoms until later stages of HIV.

The CDC also has a HIV 101 guide that can be downloaded here.


Sources

Written by: Alex Baity

CDC.gov. (2020, October 22). Facts about hiv stigma. Retrieved March 01, 2021, from https://www.cdc.gov/hiv/basics/hiv-stigma/index.html

CDC.gov. (2020, October 21). Opportunistic infections. Retrieved March 01, 2021, from https://www.cdc.gov/hiv/basics/livingwithhiv/opportunisticinfections.html

CDC.gov. (2020, November 03). Do you have health insurance? Retrieved March 01, 2021, from https://www.cdc.gov/hiv/basics/prep/paying-for-prep/index.html

TrialCard. (n.d.). Ready, set, prep. Retrieved March 01, 2021, from https://www.getyourprep.com/

Gilead’s Advancing Access. (n.d.). Gilead’s advancing Access® program is here to help you. Retrieved March 01, 2021, from https://www.gileadadvancingaccess.com/

HRC. (n.d.). HIV and the LGBTQ Community. Retrieved March 01, 2021, from https://www.hrc.org/resources/hrc-issue-brief-hiv-aids-and-the-lgbt-community

HIV.gov. (n.d.). Lesbian, gay, BISEXUAL, & Transgender health. Retrieved March 01, 2021, from https://www.hiv.gov/topics/lgbthealth

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