AIDS / HIV

WHAT DOES “AIDS” MEAN?

AIDS stands for Acquired Immune Deficiency Syndrome:

• Acquired means you can get infected with it;
• Immune Deficiency means a weakness in the body’s system that fights diseases.
• Syndrome means a group of health problems that make up a disease.

AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. If you get infected with HIV, your body will try to fight the infection. It will make “antibodies,” special molecules to fight HIV.

A blood test for HIV looks for these antibodies. If you have them in your blood, it means that you have HIV infection. People who have the HIV antibodies are called “HIV-Positive.” Fact Sheet 102 has more information on HIV testing.

Being HIV-positive, or having HIV disease, is not the same as having AIDS. Many people are HIV-positive but don’t get sick for many years. As HIV disease continues, it slowly wears down the immune system. Viruses, parasites, fungi and bacteria that usually don’t cause any problems can make you very sick if your immune system is damaged. These are called “opportunistic infections.” See Fact Sheet 500 for an overview of opportunistic infections.

Where did HIV come from?

The most recent presentation on the origin of HIV was presented at the 6th Conference on Retroviruses and Opportunitistic Infections (Chicago, January 1999). At that conference, research was presented that suggested that HIV had “crossed over” into the human population from a particular species of chimpanzee, probably through blood contact that occurred during hunting and field dressing of the animals. The CDC states that the findings presented at this conference provide the strongest evidence to date that HIV-1 originated in non-human primates. The research findings were featured in the February 4,1999 issue of the journal, Nature.

We know that the virus has existed in the United States, Haiti and Africa since at least 1977-1978. In 1979, rare types of pneumonia, cancer and other illnesses were being reported by doctors in Los Angeles and New York. The common thread was that these conditions were not usually found in persons with healthy immune systems.

In 1982 the Centers for Disease Control and Prevention (CDC) officially named the condition AIDS (Acquired Immune Deficiency Syndrome). In 1984 the virus responsible for weakening the immune system was identified as HIV (Human Immunodeficiency Virus).

 

HOW DO YOU GET AIDS?

You don’t actually “get” AIDS. You might get infected with HIV, and later you might develop AIDS. You can get infected with HIV from anyone who’s infected, even if they don’t look sick and even if they haven’t tested HIV-positive yet. The blood, vaginal fluid, semen, and breast milk of people infected with HIV has enough of the virus in it to infect other people. Most people get the HIV virus by:

• having sex with an infected person
• sharing a needle (shooting drugs) with someone who’s infected
• being born when their mother is infected, or drinking the breast milk of an infected woman

Getting a transfusion of infected blood used to be a way people got AIDS, but now the blood supply is screened very carefully and the risk is extremely low.

There are no documented cases of HIV being transmitted by tears or saliva, but it is possible to be infected with HIV through oral sex or in rare cases through deep kissing, especially if you have open sores in your mouth or bleeding gums.

HOW DO YOU GET INFECTED WITH HIV?

The Human Immunodeficiency Virus (HIV) is not spread easily. You can only get HIV if you get infected blood or sexual fluids into your system. You can’t get it from mosquito bites, coughing or sneezing, sharing household items, or swimming in the same pool as someone with HIV.

Some people talk about “shared body fluids” being risky for HIV, but no documented cases of HIV have been caused by sweat, saliva or tears. However, even small amounts of blood in your mouth might transmit HIV during kissing or oral sex. Blood can come from flossing your teeth, or from sores caused by gum disease, or by eating very hot or sharp, pointed food.

To infect someone, the virus has to get past the body’s defenses. These include skin and saliva. If your skin is not broken or cut, it protects you against infection from blood or sexual fluids. Saliva contains chemicals that can help kill HIV in your mouth.

If HIV-infected blood or sexual fluid gets inside your body, you can get infected. This can happen through an open sore or wound, during sexual activity, or if you share equipment to inject drugs.

HIV can also be spread from a mother to her child during pregnancy or delivery. This is called “vertical transmission.” A baby can also be infected by drinking an infected woman’s breast milk

 

Unless you are 100% sure that you and the people you are with do not have HIV infection, you should take steps to prevent getting infected. People recently infected (within the past 2 or 3months) are most likely to transmit HIV to others. This is when theirviral load is the highest. In general, the risk of transmission ishigher with higher viral loads. This fact sheet provides an overview ofHIV prevention, and refers you to other fact sheets for more details on specific topics.

Sexual Activity

You can avoid any risk of HIV if you practice abstinence (not having sex). You also won’t get infected if your penis, mouth, vagina or rectum doesn’t touch anyone else’s penis, mouth, vagina, or rectum. Safe activities include kissing, erotic massage, masturbation or hand jobs (mutual masturbation). There are no documented cases of HIV transmission through wet clothing.

Having sex in a monogamous (faithful) relationship is safe if:

• Both of you are uninfected (HIV-negative)
• You both have sex only with your partner
• Neither one of you gets exposed to HIV through drug use or other activities

Oral sex has a lower risk of infection than anal or vaginal sex, especially if there are no open sores or blood in the mouth. See Fact Sheet 152 for more information on the risks of various behaviors.

You can reduce the risk of infection with HIV and other sexually transmitted diseases by using barriers like condoms. Traditional condoms go on the penis, and a new type of condom goes in the vagina or in the rectum. For more information on condoms, see Fact Sheet 153.

Some chemicals called spermicides can prevent pregnancy but they don’t prevent HIV. They might even increase your risk of getting infected if they cause irritation or swelling.

 

Drug Use

If you’re high on drugs, you might forget to use protection during sex. If you use someone else’s equipment (needles, syringes, cookers, cotton or rinse water) you can get infected by tiny amounts of blood. The best way to avoid infection is to not use drugs.

If you use drugs, you can prevent infection by not injecting them. If you do inject, don’t share equipment. If you must share, clean equipment with bleach and water before every use. Fact Sheet 154 has more details on drug use and HIV prevention.

Some communities have started exchange programs that give free, clean syringes to people so they won’t need to share.

 

Vertical Transmission

With no treatment, about 25% of the babies of HIV-infected womenwould be born infected. The risk drops to about 4% if a woman takes AZTduring pregnancy and delivery, and her newborn is given AZT. The riskis 2% or less if the mother is taking combination antiretroviral therapy(ART). Caesarean section deliveries probably don’t reduce transmissionrisk if the mother’s viral load is below 1000.

Babies can get infected if they drink breast milk from an HIV-infected woman. Women with HIV should use baby formulas or breast milk from a woman who is not infected to feed their babies.

Contact with Blood

HIV is one of many diseases that can be transmitted by blood. Be careful if you are helping someone who is bleeding. If your work exposes you to blood, be sure to protect any cuts or open sores on your skin, as well as your eyes and mouth. Your employer should provide gloves, facemasks and other protective equipment, plus training about how to avoid diseases that are spread by blood.

 

THE BOTTOM LINE

HIV does not spread easily from person to person. To get infected with HIV, infected blood, sexual fluid, or mother’s milk has to get into your body. HIV-infected pregnant women can pass the infection to their new babies.

To decrease the risk of spreading HIV:

• Use condoms during sexual activity
• Do not share drug injection equipment
• If you are HIV-infected and pregnant, talk with your health care provider about taking ARVs.
• If you are an HIV-infected woman, don’t breast feed any baby
• Protect cuts, open sores, and your eyes and mouth from contact with blood.

If you think you’ve been exposed to HIV, get tested and ask your health care provider about taking ARVs.