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Questions and Answers about HIV and AIDS 1
Questions and Answers about HIV/AIDS reporting
Questions and Answers about Viral Hepatitis
What is HIV?
Human Immunodeficiency Virus (HIV) is the virus that causes AIDS. It attacks the human immune system. Over time (and without effective treatment), HIV gradually destroys the body's defenses against disease, leaving it vulnerable to many infections and cancers that would not normally develop in healthy people.
Even without treatment, some people with HIV infection have no symptoms at all, some have mild health problems, while others have severe health problems associated with AIDS.
- Click here for more information about HIV/AIDS from HIVInSite.
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What is AIDS?
Acquired Immune Deficiency Syndrome (AIDS) is a late stage of HIV infection. By the time a diagnosis of AIDS is made, HIV will already have seriously damaged the body's immune system. Often, a person with an AIDS diagnosis will already have had a life-threatening infection or cancer.
Before the use of effective treatment, it commonly took 10 years or more from the time of initial HIV infection to a diagnosis of AIDS; and, on average, it would take another two to four years before death. However, new treatments are radically slowing the destruction of the immune system caused by HIV and lengthening life expectancy. Some people with HIV infection may never developed AIDS.
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How is HIV transmitted?
HIV is transmitted when infected blood, semen, vaginal fluids, or breast milk enter another person's body. This most often occurs during unprotected sex or during injection drug use (when needles or other drug paraphernalia (cottons or cookers) are shared). Anyone who is infected with HIV can transmit it, whether or not they appear sick, have an AIDS diagnosis, or are taking effective treatment for their infection. Infected women who become pregnant can transmit HIV to their newborns and are much more likely to do so if they are not treated effectively.
HIV is spread in the following ways:
- Unprotected sexual intercourse.
HIV can enter the body during sex through the mucous membranes of the anus, vagina, penis (urethra), or mouth; AND through cuts, sores, and abrasions on the skin. Unprotected anal and vaginal sex are the riskiest sexual activities. There are a small, but growing, number of reported cases of HIV transmission through oral sex; however, the risk of oral sex transmission is clearly lower than for anal or vaginal sex. With each of these practices, the receptive partner (vagina, anus, mouth) is at greatest risk; however, the inserting partner is also at high risk.
- Injection drug use.
Using shared, unsterile needles and syringes carries a high risk of HIV transmission. Sharing cookers, cottons, and water for mixing/bleaching can also transmit HIV. After use, small amounts of blood can remain in the used needles, syringes, cookers, and cottons. Blood may also remain in the water used for mixing drugs or bleaching equipment. This remaining blood can enter the body of the next user when any of these items are shared. If this blood is HIV infected, transmission can easily occur.
- From an infected mother to her infant.
HIV can be transmitted from mother to child during pregnancy, during birth, or through breast-feeding. Before treatment with AZT became a routine recommendation, about 1 in 4 or 5 babies born to HIV-infected women became infected. Now, when treatment is taken, the HIV transmission rate from a mother to her baby is greatly reduced. Consequently, all pregnant women should see their doctor, be tested for HIV, and obtain recommended treatment.
HIV is rarely transmitted in the following ways:
- Blood transfusions and organ transplants.
The risk of acquiring HIV from a blood transfusion today is estimated to be about 1 in every 600,000 transfusions. The risk of acquiring HIV from an organ transplantation is probably similar. Before 1985, there were no tests to screen blood and organ donations for HIV. Today, blood and organ banks screen out most potential donors at risk for HIV infection in advance. They then do extensive testing on specimens of blood, blood products, and organs for HIV and other blood-borne germs.
- The health care setting.
There is a very small, but real, risk of health care workers getting HIV from patients as a result of needle stick accidents and other substantial blood exposures. The risk of patients getting infected from health care workers is also very small. A large series of studies of HIV-infected surgeons and dentists have not shown any transmissions to patients. Nonetheless, seven patients may have become infected from a dentist with AIDS in Florida, and several other transmissions have been traced to surgeons.
HIV is not transmitted by:
- Casual contact.
HIV is not spread by casual contact. It dies quickly outside the body and is easily killed by soap and by common disinfectants such as bleach. There is no risk of HIV infection from:
- donating blood
- mosquito bites
- toilet seats
- shaking hands
- kissing
- hugging
- sharing eating utensils
- food or objects handled by people with HIV or AIDS
- spending time in the same house, business, or public place with a person with HIV/AIDS
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Who is at risk for HIV infection?
Anyone can become infected with HIV. In the United States, men who have sex with other men and people who use needles to inject illicit drugs are at the highest risk of HIV infection. Female partners of injection drug users and bisexual men account for a growing number of reported AIDS cases in the United States.
About 750,000 persons are believed to be infected with HIV in the United States, including approximately 2,000-3,000 in Hawai‘i.
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How can HIV transmission from injection drug use be prevented?
The surest way to completely avoid HIV infection from injection drug use is to abstain. The next surest way is to use a brand new syringe every time you inject. If brand new syringes are not available, properly bleaching a used syringe may be an effective method of reducing HIV transmission.
In addition to needles, sharing cookers, cottons, other parts of the syringe (e.g., the barrel and plunger), or water used for mixing/bleaching also can transmit HIV. To avoid infection, these items must not be shared.
Syringe Exchanges trade new needles/syringes for used ones free of charge. For more information, call CHOW.
Drugs -- injected or not -- can also increase a person's risk for HIV by impairing judgement, decision-making ability, and/or by enhancing sexual drive. Studies have shown that - even when drunk or high - people can successfully use condoms and clean needles/syringes. Nonetheless, people who are drunk or high often take more risks than if they were sober.
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How can sexual transmission of HIV be prevented?
The surest way to avoid the sexual transmission of HIV infection is to abstain from sexual activity with other people. The next surest way is to have sex with only one partner who is known to be uninfected with HIV AND who only has sex with you.
For those with a new sex partner , abstain or use condoms for at least 3 months and then get tested for HIV antibodies. If you and your partner are both HIV negative and each of you are not engaging in other risk behaviors (e.g., sharing needles or having other sex partners), then you won't have to worry about HIV infection.
For someone with an HIV positive partner, a partner who does not know their HIV status, or multiple sexual partners , touching, dry kissing, body rubbing, and mutual masturbation are the safest sexual activities. For any penetrative sex acts such as vaginal, anal, or oral sex, condoms are highly effective at reducing the risk of HIV transmission especially when used consistently and correctly.
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What is the HIV Antibody Test?
There are several types of HIV antibody tests used today. All are highly accurate at detecting HIV antibodies, specific proteins made in response to an HIV infection. After infection with HIV, however, it can take up to 3 months for HIV antibodies to develop.
A negative HIV antibody test result means that a person does not have detectable HIV antibodies at the time of the test. Since it can take up to 3 months after HIV infection for antibodies to develop, a negative test result is reliable only if the person has not had any sexual or needle-sharing risk behavior during the 3 months prior to testing. Some people with recent risk behavior will test HIV antibody negative, yet may have actually been infected during the previous 3 months; these people will also likely be highly infectious and may easily transmit HIV to their sex and needle-sharing partners. Finally, a negative test result does not mean that a person is safe from future HIV infection. People who test HIV antibody negative are urged to continue to follow HIV prevention guidelines to avoid becoming infected. And people who continue risk behaviors should retest at least every 6 months.
A positive HIV antibody test result means that HIV antibodies are present and that the person has HIV infection. It does not mean the person has AIDS, although many HIV-positive people may develop AIDS after years of infection with HIV. Anyone who tests HIV-positive can transmit the virus to others, regardless of how long they have been infected, whether they have AIDS or other symptoms, or whether their HIV infection is being treated effectively. It is extremely important that HIV-positive people follow HIV prevention guidelines, not only to protect their partners from getting HIV infection, but also to protect themselves from infection with other germs that could cause HIV/AIDS-related disease.
An indeterminate HIV antibody test result is neither a positive or negative result. Although uncommon, an indeterminate result can happen for a variety of reasons. The important thing to remember is that you should take the test again. Talk with your HIV Counselor and Tester about when is a good time to retest
People at increased risk of HIV infection should NEVER donate blood, plasma, or other organs, or go to such facilities to be tested. Department of Health offers HIV antibody testing and counseling to all people at risk for infection. All test results are confidential; anonymous testing is also available. HIV antibody testing is also available at a variety of other sites. Click here for testing site.
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Do condoms provide 100% protection from HIV?
No, condoms are not 100% effective at preventing HIV transmission; however, when used correctly and consistently, condoms are highly effective and reliable in reducing the risk of transmitting and acquiring HIV and other sexually transmitted diseases (STDs). The surest ways to avoid the sexual transmission of HIV (and other STDs) is:
1. |
to abstain from sex, or |
2. |
to have sex with only one partner known be uninfected. The next surest way is to use condoms consistently and correctly during all penetrative sexual acts. When condoms do fail, it is most often because of improper and/or inconsistent use. |
The following these basic rules will further reduce the small chance of condom failure:
1. |
Use latex (rubber) or polyurethane condoms. These are preferable to "natural skin" condoms, which may have tiny holes through which HIV may pass. |
2. |
Choose a condom that fits. Condoms come in different sizes, shapes, and styles. Experiment with different condoms and practice putting them on before intercourse. Also practice your negotiating skills by talking with a close friend about your desire and intention to use condoms. |
3. |
Open and handle condoms carefully. Never use a condom in a damaged package or one that is past its expiration date. Do not store condoms in hot or sunny places (for example, in a wallet or by a window). |
4. |
Use plenty of water-based lubricant to reduce the friction that can cause breakage. Never use oil-based lubricants like Vaseline, hand cream, Crisco, or mineral oil which can rapidly break down latex and allow the virus to pass through. Water-based lubricants include K-Y Jelly, Slippery stuff, ForPlay, and most contraceptive jellies. |
5. |
Put the condom on after erection but before insertion. Leave some room at the tip for the discharged semen (some condoms have a reservoir tip for this). It is important to pinch the tip as you roll it down onto the penis to be sure that there are no air bubbles that could pop under pressure. If the penis is uncircumcised, pull back the foreskin before unrolling the condom all the way down to the base of the penis. |
6. |
After intercourse, withdraw the penis while still erect, holding the base of the condom to prevent it from slipping off or spilling semen. Remove the condom and wash the penis with soap and water. |
7. |
Use a condom only once and dispose of it in the garbage; do not flush condoms down the toilet. Never reuse a condom. |
8. |
Use a condom EVERY TIME during sex when transmission or acquisition of HIV is possible. |
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What are the symptoms of a new HIV infection?
Approximately 50-90% of people with new HIV infections have mild to severe "flu-like" symptoms approximately 2 weeks to 3 months after the HIV exposure. Some people do not have any symptoms. In general, symptoms are not a reliable indicator of HIV infection. Many people with HIV infection do not experience symptoms for many years after infection. Likewise, many people with the symptoms listed below do not have HIV infection. An HIV antibody test taken 3 months after a potential exposure can tell you if infection has occurred.
Many of the symptoms of HIV infection are the same as for other, less serious illnesses.
People who may have been exposed to HIV should see a doctor promptly if the following symptoms occur within 3 months of the exposure:
- A persistent fever of over 101 degrees that lasts for more than 2 days that is without a known cause.
- Night sweats that soak your pajamas or sheets when the room is not hot and heavy covers are not being used.
- A persistent rash of unknown cause.
- Persistent swollen glands (lumps under the skin) which occur in several places at once (especially the neck, armpits and groin).
- Sore throat
- Constant tiredness
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Is there a cure for HIV and AIDS?
At this time, there is no cure, but HIV and AIDS can be prevented and treated. First of all, it is important to know your HIV status. If you might have HIV, get tested.
If you do not have HIV, you can take steps to stay HIV negative. If you have HIV, there are many things you can do to keep yourself healthy and to live longer.
The first step for anyone who has HIV is to see a doctor who is knowledgeable about HIV treatment. The doctor will perform blood tests to determine your viral load (how much HIV is in your blood) and your T cell (CD4+) levels (how strong your immune system is). Knowing these test results and the symptoms you have experienced will allow the two of you to decide when to begin treatment and which therapies to use.
In recent years, drug development has helped to change the face of the disease. Whereas HIV infection once implied certain death, drug therapy has helped to prolong and improve the quality of life for many individuals.
HIV is a retrovirus, so drugs that target the virus are called antiretroviral (ARV) drugs. There are many different types of ARVs, but they all work by slowing the growth or inhibiting the replication of the virus. Although these drugs do not kill the virus, they effectively reduce the levels of HIV in the blood.
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Where can we get HIV/AIDS data?
HIV/AIDS Surveillance Program
3672 Kilauea Avenue, Room306
Honolulu, HI 96816
Tel: 808-733-9010
Fax: 808-733-9015.
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Where can we get case report forms to report?
HIV/AIDS Surveillance Program
3672 Kilauea Avenue, Room306
Honolulu, HI 96816
Tel: 808-733-9010 |
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OR |
Click here to download the report forms. |
(Report only by mail and by phone to the above address.)
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What are the reporting requirements for HIV and AIDS in Hawai‘i?
Hawai‘i State and Department of Health Administrative rules require reporting of HIV (by code) and AIDS by name. For more information, click here (link to Disease Reporting Information> HIV/AIDS Reporting Rules & Policy).
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What is viral hepatitis?
The term “hepatitis” means inflammation of the liver and viral hepatitis refers to a collection of viruses that can affect the liver. There are three main hepatitis viruses: hepatitis A, B and C. Because many of the same behaviors that put one at risk for HIV and STDs can also transmit viral hepatitis, the STD/AIDS Prevention Branch has a Viral Hepatitis Education and Prevention Program to raise awareness about viral hepatitis.
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What is hepatitis A?
Hepatitis A virus (HAV) is spread through fecal/oral contact when fecal matter infected with hepatitis A enters the body through the mouth. The most common way to get hepatitis A is through close personal contact or through contaminated food and water. Hepatitis A an acute or short term disease and there is a vaccine available to prevent infection. For more information on hepatitis A, click here.
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What is hepatitis B?
Hepatitis B virus (HBV) is spread through blood and other bodily fluids. The most common way to get hepatitis B is through unprotected sex or from mother to baby. Hepatitis B is usually an acute or short term disease though some people develop chronic, or long term hepatitis B. There is a vaccine available to prevent infection. For more information on hepatitis B, click here.
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What is hepatitis C?
Hepatitis C virus is spread through direct blood-to-blood contact. The most common way to get hepatitis C is through sharing injection drug use equipment or getting a blood or blood product transfusion prior to 1992. Hepatitis C is usually a chronic, or long term infection and there is no vaccine available to protect against hepatitis C. For more information on hepatitis C, click here.
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How do you get hepatitis C?
Hepatitis C is spread through direct blood-to-blood contact. The most common way to hep hepatitis C is though sharing injection drug use equipment or getting a blood or blood product transfusion prior to 1992. Hepatitis C can also be spread by a healthcare exposure such as a needle stick or blood splash and from mom-to-baby. While hepatitis C can be sexually transmitted, this is not common. There may also be a low risk of hepatitis C transmission through the sharing of personal items such as toothbrushes, razors or clippers, through unsterile tattoos and piercings, and through sharing other drug equipment such as nose straws. Hepatitis C has been able to survive outside the body for at least four days. If you think you may be at risk, you should be tested for hepatitis C here.
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How do you prevent hepatitis C?
If you currently inject drugs or other substances, you can prevent hepatitis C by using new, sterile equipment every time you inject. For information on how to obtain new equipment, contact CHOW. You can also prevent blood from entering your body by covering open cuts and sores, not sharing a personal care or other items that may have blood on them, and using gloves when coming in contact with any blood. For more information on reducing harm with injection drug use, click here
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Should I be tested for hepatitis C?
Hepatitis C testing is recommended for anyone that has EVER used a needle, even once, to inject drugs, hormones, vitamins or any substance. People with a healthcare exposure (needle stick) are also recommended to be tested. Testing may be recommended for other groups such as partners of people who inject drugs or people who have gotten non-professional tattoos. For more information on hepatitis C testing, click here.
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What does it mean if I have hepatitis C?
Finding out you have hepatitis C can be very scary. Many people live with hepatitis C for many years before they have symptoms, and some people may never get sick from their hepatitis C. Other people may get very sick from hepatitis C and get liver damage such as cirrhosis (scarring). Hepatitis C is not a death sentence and there are many things you can do to take care of yourself and your liver. Find a doctor who knows about hepatitis C. You will need some more tests to find out how your liver is doing and how far your hepatitis C has progressed. It is important to get vaccinated against hepatitis A and B, reduce your alcohol intake (it is very hard on the liver) and to take care of yourself. Find a support group in your area and get support from people in your life – it is hard to deal with hepatitis C alone. For more resources on living with hepatitis C, click here
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Can hepatitis C be cured?
There are treatments available to fight against hepatitis C and some people think these treatments may get rid of the virus forever. Other people think the virus may still be hiding in the body somewhere and may come back in the future. We aren’t sure yet if the treatment is a cure, but there is hope. The treatments are expensive, have many side effects and don’t work for everyone. Depending on the type of hepatitis C you have (called genotype) the treatments may work very well and may help you get rid of the virus. Talk to your doctor and other people who have gone through the treatment to help you make your decision about whether treatment is right for you. For more resources on living with hepatitis C, click here
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Reference:
1 King County Public Health (www.metrokc.gov)
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