Questions and Answers about HIV and AIDS

How many people get HIV?

Anyone who has unprotected sex, shares needles, or has certain other risks can get HIV. Each year about 350 - 400 people get infected with HIV in King County. There are about 6,000 - 9,000 people living with HIV now in King County. Local experts believe that about one out of five people who have HIV don’t know it because they have not yet been tested or have not been tested recently.

How can I get HIV?

HIV can be found in the blood, vaginal fluid, semen, and breast milk of people infected with HIV. You can only get HIV if one of these fluids gets into your body. This can happen through:

vaginal or anal sex (when no condom is used)
an open sore or wound in the skin
getting one of the fluids into your eyes, nose or mouth
sharing equipment to inject drugs

If there is no way for someone else’s blood or sexual fluids to get into your body, there is no risk.

You can not get HIV from:

sweat, saliva, tears

hugging, touching, kissing

coughing or sneezing

mosquito bites

sharing household items

toilets, swimming pools

donating blood

HIV is spread in 3 main ways:

1.	Unprotected sex
	Vaginal or anal sex without a condom is very unsafe. During sex, HIV in semen or in vaginal fluid can enter the other partner’s body through the soft, moist lining inside the rectum, vagina or mouth. Although HIV is more likely to infect the receptive partner, it can also enter the penis. Risk from oral sex is very low. It is possible to get HIV when giving oral sex if you have any cuts or openings in your mouth or gums (after brushing or flossing, for example).
2.	Sharing items to inject drugs
	Any needle, syringe, cooker, or cotton can have blood in it after it has been used. Blood may also stay in the water used to mix drugs or bleach equipment. If any of these items are shared, this blood can enter the body of the next user.
3.	From an infected mother to her infant
	An HIV-infected mother can pass HIV to her baby during pregnancy, birth, or breast-feeding. This is called "vertical transmission." If the mother is taking HIV medications, the risk to the baby is much smaller.

Getting HIV from a blood transfusion or an organ transplant is very rare today. Anyone who has any risk of HIV exposure cannot donate blood. All donated blood, blood products, and organs are also tested for HIV and other blood-borne germs.

How can I stay safer if I have sex?

There is no risk for HIV from:

abstinence (not having sex)
sex with just one partner who is not infected and neither one of you ever has sex or shares needles with anyone else
masturbation or hand jobs (where you keep your fluids to yourself)
non-sexual massage or touch

Most other sexual activity carries some risk of spreading HIV. Talk with your partner(s) about HIV and other STDs before you have sex. Work out a safety plan that feels good for both of you.

To reduce your sexual risks, don’t let blood or sexual fluids get into your body:

Be aware of your body and your partner's. Cuts, sores, other STDs, or bleeding gums increase the risk of spreading HIV. Rougher sex can cause bleeding or small tears that give HIV an easier way to get into the body.
Always use a safety barrier. For vaginal and anal sex, use a latex condom or polyurethane female condom. Pieces of latex or plastic wrap over the vagina, or latex condoms over the penis, are good barriers during oral sex.
Lubricants reduce the chance that condoms or other barriers will break. Oil-based lubricants (Vaseline, Crisco, oils, or creams) can damage latex condoms. Be sure to use only water-based lubricants.
Have sex with fewer people. More partners = more risk!

Birth control methods (the pill, patch, ring, or shot) do not protect you from HIV!

How do I use a condom?

Condoms can reliably prevent HIV and other STDs if they are used correctly and used each time you have sex. If a condom breaks, it’s usually because the person did not use it the right way.

Using a Male Condom

1.	Use only latex or polyurethane condoms. “Natural skin" condoms can have holes large enough to let HIV through. Don’t use a condom if its package is torn or if it has expired (check the date). Do not store condoms in hot or sunny places.
2.	Condoms come in many sizes and styles. Try different brands to see which one fits you best. Practice putting them on before having sex.
3.	Friction can cause condoms to break. Put some water-based lubricant inside the tip of the condom. Add more lube outside the condom during sex.
4.	Put the condom on when your penis is erect and before it touches your partner's mouth, vagina, or rectum.
5.	If you are not circumcised, push your foreskin back before you put on a condom.
6.	Squeeze air out of the tip of the condom to leave room for semen (cum). Unroll the condom down the penis. Do not use two condoms at the same time. The extra friction may cause them to break.
7.	After orgasm, hold the condom on the penis while you pull out. Never re-use a condom.

Using a Female Condom

**Never use a male condom and female condom at the same time.**

1.	The outer ring covers the area outside the vagina or anus. The inner ring is used to insert the condom and hold it in place during sex.
2.	To insert the female condom into the: Vagina: Squeeze the flexible inner ring with your thumb and second finger so it becomes long and narrow. Gently slide the inner ring into the vagina (like putting in a diaphragm). Place a finger inside the condom and push the inner ring up as far as it will go. Be sure the condom is not twisted. Anus: You can use the same method as above. Some people take out the smaller ring once the condom is in. Others put the condom (without the inner ring) over their partner's erect penis and insert both the penis and the condom at the same time into the anus.
3.	The outer ring should lie flat outside of the vagina or anus. Gently guide your partner’s penis into the condom's opening. Be sure that the penis does not enter on the side, between the condom and bare skin.
4.	Add more lube during sex.
5.	To remove, twist the outer ring and gently pull the condom out.

How can I stay safer if I inject drugs?

The only way to be 100% safe is to not use drugs. If that isn’t possible, use a brand new syringe every time you inject. If you don’t have a brand new syringe, bleaching syringes the right way may help reduce HIV transmission.

Cookers, cottons, barrels, plungers, or water used for mixing/bleaching also can transmit HIV. Do not share any of these items.

There are several local needle exchange sites that can trade new syringes for used ones. They also have information on drug treatment and opiate replacement programs. For more information, call the HIV/STD Hotline at 206-205-7837 or click here for the current Needle Exchange Schedule. Pharmacies in WA State may also sell syringes to injection drugs users to prevent the spread of blood-borne disease. For a list of pharmacies, call the HIV/STD Hotline at 206-205-7837.

How can I tell if I’ve been infected with HIV?

You can have HIV and not know it. Only 10% - 50% of people have mild to severe "flu-like" symptoms about 2 weeks to 3 months after infection. Many people with HIV infection do not have symptoms for many years. Many of the symptoms of early HIV infection are the same as other, less serious illnesses. These include:

swollen lymph glands in the throat, armpit, or groin
slight fever or night sweats
headaches
fatigue or muscle aches
rash

Getting an antibody test 1-3 months after exposure is the only way to know for sure if you have HIV.

What is the HIV antibody test?

This HIV test looks for antibodies to HIV in your blood or mouth tissue. If you are infected with HIV, your body makes very specific antibodies to fight the infection. These HIV antibodies are different from antibodies for the flu, hepatitis, or other infections. If you have HIV antibodies, then you have been infected with HIV.

The HIV test does not tell you if you have AIDS or how long you have been infected or how sick you might be. It just tells you that you have the virus.

After you are infected, your body takes time to make enough antibodies for the test to find. In almost everyone, this period is between 2 weeks and 3 months. For a few, it may take up to 6 months.

A negative result means that no HIV antibodies were found in your blood at the time of the test. If you had any sexual or needle-sharing risk during the 3 months before your test, your results may not be accurate. Your body may need more time to develop enough antibodies to show up on the test. To be sure, you must get another test at least 3 months after your most recent risk exposure.

A negative test result does not mean that you are safe from future HIV infection.

A positive result means:

you have HIV.
you can give HIV to others, even if you don’t have symptoms or you are on treatment.
you may or may not have AIDS.

Everyone who is at high risk of HIV infection should get tested every 3-6 months.

In King County, you can get an HIV antibody test through:

a private healthcare provider
Public Health clinic and testing sites
several community health clinics and programs
at-home testing kits sold in pharmacies

For a referral to testing sites in King County, call the HIV/STD Hotline at 206-205-7837. Click here for more information.

Is there a cure for HIV and AIDS?

There is no way to cure HIV or AIDS or to "clear" the HIV virus out of your body. There are drugs that can slow down the HIV virus and protect your immune system. Researchers are still looking for a vaccine to prevent HIV infection.

How are HIV and AIDS treated?

HIV treatment is often called “anti-retroviral therapy” or ARV/ART. The drugs can’t kill HIV, but they can slow down the damage HIV does to the immune system.

There are six classes of ARV drugs. Each class attacks HIV in a different way. As it makes more copies, HIV can change slightly and the drugs can stop working. This is called "developing resistance." It’s very hard for HIV to get past several drugs at once, so most people take at least 3 different drugs. Each drug may also have side effects

People who develop AIDS may also take other drugs to prevent or treat opportunistic infections (OIs). When to start treatment and what drugs to use are very complex decisions. Therefore, everyone with HIV should see a healthcare provider who is an expert in HIV disease and treatment.

There are programs in King County and Washington State to help people access and pay for HIV treatment. For more information and referral to community resources, contact:

HIV/STD Hotline: 206-205-7837
Toll-free: 1-800-678-1595
TTY: 206-296-4843