FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS

If you have any questions about HIV/AIDS not addressed on this page please feel free to email the Foundation at info@pacificaids.org.

BASIC FACTS

What is HIV?
HIV stands for “Human Immunodeficiency Virus.”
HIV attacks the body's immune system, making it hard to fight off infections. HIV particularly attacks the white blood cells called CD4 cells, which trigger the immune system when an infection enters the body. HIV infects CD4 cells and uses them to make new copies of HIV, which go on to infect more cells. The lower a person's CD4 count, the weaker their immune system will be. (www.tht.org.uk)

What is AIDS?
AIDS stands for “Acquired Immune Deficiency Syndrome.”

A - Acquired: because it's a condition one must acquire or get infected with; not something transmitted through the genes.
I - Immune: because it affects the body's immune system, the part of the body which usually works to fight off germs such as bacteria and viruses.
D - Deficiency: because it makes the immune system deficient (it stops working properly).
S - Syndrome: because to have AIDS actually means to have a collection of diseases or infections, such as an Opportunistic Infections.

Over time the HIV virus damages the immune system to the point that you become vulnerable to illnesses that a person with a healthy immune system would be able to fight off. These illnesses are frequently referred to as Opportunistic Infections. These Opportunistic Infections become more frequent as your immune system weakens. People who die from AIDS die from these infections, not from the disease directly.
AIDS is collection of diseases and illnesses (usually severe) that develop over a period of time after a person has contracted HIV. This usually occurs after a significant period of time, usually years.
Diagnosis with AIDS rather than HIV depends on the level of a person’s CD4 T-cell count. In medical terms, a person is diagnosed with AIDS when their T-cell count is below 200.

How long does it take for a person to develop AIDS after contracting HIV?
It varies. For some it develops as early as 3 years or as late as 12 years.

If a person contracts HIV is it inevitable that they will develop AIDS?
Yes.

Can you tell by looking at someone if they have HIV?
No. The only way to know is by a blood test.

How can you get HIV?
For someone to become infected, a sufficient amount of HIV must get into his or her blood. The body fluids that contain enough HIV to infect someone are blood, semen, vaginal fluids including menstrual blood, and breast milk. (www.tht.org.uk)
A person can be infected with HIV by having sex without a condom, by sharing needles, and by a mother passing it on to her unborn child (although by using drug treatments this risk can be reduced) during pregnancy/delivery or breast feeding.
HIV is not transmitted by day-to-day contact. Saliva, sweat and urine do not contain enough virus to infect someone. HIV cannot pass through intact external skin, or through the air like a cold or flu virus. (www.tht.org.uk)

You cannot get HIV by:

Being a friend,
Sharing a drink,
Sharing a cigarette,
Shaking hands,
Kissing,
Hugging,
Coughing or sneezing,
Having protected/safe sex,
Sharing food,
Toilets or other objects an HIV positive person has come into contact with,
Mosquito bites.

Are there symptoms of HIV?
There are no symptoms for HIV. However there may be some warning signs of infection with HIV, but these vary from person to person:

rapid weight loss
dry cough
recurring fever or profuse night sweats
profound and unexplained fatigue
swollen lymph glands in the armpits, groin, or neck
diarrhea that lasts for more than a week
white spots or unusual blemishes on the tongue, in the mouth, or in the throat
pneumonia
red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
memory loss, depression, and other neurological disorders
(National Center for HIV, STD & TB Prevention)

Testing

Where can you get tested?
You can go to a hospital, local health department, or private doctor to get the blood test. It is important to seek testing at a location that also provides counselling about HIV and AIDS.
Tell a doctor that you wish to be tested for HIV. They will refer you to a testing location, if there is not one at your doctor’s office.You should receive counseling/information before and after your test regardless of your results. When you receive the results of your blood test it will either be positive or negative. “HIV positive” means you have tested positive for the virus.

How does the HIV test work?
The most commonly used test is an HIV antibody test. Antibodies are produced by the body in response to the presence of HIV, and this test looks for those antibodies. (www.tht.org.uk)
The test does not come out positive until 3 months after you have been infected, but you can still pass the virus to someone else during this time called the “window period”.

What is the "window period"?
When someone becomes infected with HIV, it can take up to three months for their immune system to produce enough antibodies to show up on an HIV test (although in a few cases it can take up to six months). This gap is known as the “window period” or seroconversion. Because this HIV test looks for antibodies, taking an HIV test less than three months after possibly getting infected might not give an accurate result. However, throughout the window period, the infected person has enough virus in the blood, breast milk or sexual fluids to infect another person even though it won't show on an antibody test. (www.tht.org.uk)

Condoms

How do condoms protect people against HIV?
Condoms provide a barrier for semen, blood and other fluids that can cause the virus to pass between two people.

Are condoms safe?
Yes. Condoms are safe when they are used properly and with lubricant

Are condoms reliable?
Yes. Condoms are reliable when used properly.
Proper condom use means:
· One condom for one use with one partner.
· Use water-based lubricant (not oil or Vaseline).
· Checking the expiry date on the condom’s a packaging
· Holding the teat before rolling on the condom. This prevents pressure from ejaculation from breaking the condom.

Is the withdrawal method effective?
No, not for evading HIV/AIDS, Sexually Transmitted Infections (STI’s) or pregnancy. Sexual fluids are still being shared before ejaculation, from both partners.

I don’t like using condoms, what can I do?
You can abstain from sex. Or you can do other things like masturbate or avoid penetration.
Most people don’t like using condoms because they are not used to them and think that they interfere with sex. Condoms can actually make sex more interesting as you and your partner get more familiar with them. There is huge diversity of condoms such as colored condoms, ribbed condoms and different thicknesses. You can have a lot of fun finding out what works best for you.

My partner does not like or want to use condoms, what can I do?
You must negotiate with him/her. You have the right to protect yourself. If you partner refuses to use condoms than try other less risky sexual practices.
Women can also use a female condom. Ask your doctor or pharmacist about these.

Can you get HIV from oral sex?
It has always been said that oral sex carries a potential risk when it comes to HIV transmission, and that although it is much safer than anal sex, it is not risk free. Although oral sex carries a much lower risk than unprotected anal sex, recent studies in the USA and the UK have suggested that this risk may be higher than previously estimated.
Other STIs are also transmitted by oral sex. Indeed, the risk of acquiring gonorrhea or syphilis by oral sex is considered to be much higher than for HIV. (www.tht.org.uk)

Treatment

Can you treat HIV?
There is no vaccine or cure for HIV.
However, anti-HIV drugs (antiretroviral treatment or ARTs) are available and taking a combination of anti-HIV drugs (combination therapy) can slow down the damaging effect of HIV on the immune system.
When combination therapy is successful, it can improve the health of someone with HIV making them less likely to develop what used to be called 'AIDS-defining conditions' and prolonging their life expectancy. In order for the anti-HIV drugs to be most effective a certain level has to be maintained in the body at all times. However, taking anti-HIV drugs can be complicated. Some people have take a large number of pills every day with restrictions about when they have to be taken and with dietary instructions which can make it very difficult to stick to. Some of the treatments have side effects as well.
The key to HIV treatment is early detection and sticking to the regiment of medicines that your doctor has prescribed.
If you are HIV positive make sure that you get adequate sleep, nourishment and exercise. Take your meds religiously.

What does ‘drug adherence’ mean?
Adherence means taking doses of drugs and sticking to the treatment plan exactly as prescribed. It means taking the correct amount of drugs, at the correct time and in the correct way.
At least 95% adherence is needed for ARTs to work effectively. Missing even a few doses can cause treatment to fail, and opportunistic infections or drug resistance to start.
Adherence is especially difficult if people are isolated, depressed, forgetful or worrying too much about the effects of their medication.
A person who is HIV positive should work with their doctor, pharmacist and treatment supporters to find ways to help with adherence. These might include: getting support from family and friends; having regular check ups; getting prompt help with side effects; and being able to talk to others who take ARVs.
(aidsalliance)

Other information

Where did HIV come from?
The most widely accepted theory as to where HIV came from is believed to be a descendant of a Simian Immunodeficiency Virus (SIV). (AVERT.org)
SIV is believed to have transferred to humans through hunters coming into contact with monekys' blood. (Centre for Disease Control http://www.cdc.gov/hiv/pubs/faq/faq3.htm)
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). (Centers for Disease Control)

Can you have children when you have HIV?
Yes, but you do need to take precautions not to transmit the virus to your baby.
HIV positive men can take combination therapy that reduces the level of HIV in a man’s semen, which should reduce the risk of HIV transmission to a woman. However, it cannot be assumed that suppressing the virus in the blood will suppress it in the semen too, or from the nucleus of cells in the semen. It is depends on the particular ARV drugs used.
In principle, babies can be exposed to HIV while growing in the womb, or during childbirth, or subsequently, through breast-feeding. The risk of HIV transmission from a HIV positive mother has been greatly reduced by a woman with a combination of ARVs that suppress her own viral load during her pregnancy. It may also help to treat with one or more drugs that can cross the placenta and achieve levels in the fetus, which should be high enough to prevent infection. This is a reason why the combination of nevirapine, AZT and 3TC is widely recommended for treatment during pregnancy, when a mother needs ARV treatment for her own health. However, there may be increased risks from nevirapine, in particular, when it is given as treatment to women with higher CD4 counts - in the form of relatively rare but very serious liver damage associated with an immune reaction. (AIDSmap, Julian Meldrum)

What is the situation of HIV in the world?
There are 35.9 - 44.3 million adults and children infected with HIV. (UNAIDS December 2004 statistic)

What is the situation of HIV in the Pacific?
In comparison to the worst affected parts of the world, the prevalence of HIV in the majority of Pacific Island Countries and Territories (PICTs) remains low.
However, numbers infected and affected are growing and the rate of increase is alarming. Since HIV was first reported in a Pacific Island country in 1984, there have been 11,212 cases of HIV and AIDS infections reported. Over 95% of reported HIV infections have been from five PICTs — French Polynesia, Guam, New Caledonia, Fiji and Papua New Guinea — and 90% of infections occur in Papua New Guinea.
Official statistics reports suggest as many as 10,184 cases, but the World Bank estimates there are at least 50,000 people in PNG living with the virus, and it seems the disease is spreading rapidly. In addition, there are certainly many unreported cases throughout the region due to the unavailability of testing facilities and generally low levels of surveillance.
Although current reported HIV prevalence is relatively low in most countries in the region, significant risk factors for HIV transmission exist. This particularly relates to the very high prevalence of other Sexually Transmissible Infections (STIs), as well as high rates of teenage pregnancies, indicating the high prevalence of risk-taking behaviors and low use of condoms.
Other risk factors common in the Pacific include: a significant amount of travel into, out of and within the region; and practices such as tattooing and polygamy. In addition, uneven levels of development, the inequalities faced by women in all aspects of their lives and the increasing levels of violence against women, and variable accessibility of health services, both preventive and curative, pose further challenges. High rural populations also make access to services and information difficult. Limited economic opportunities and high levels of unemployment sometimes force people to engage in sex work as a means of generating income. In areas of conflict and social unrest, forced sex and gang rapes are high.
Cultural taboos prevent open discussion of sexual matters and further compound the situation. Other customary practices and cultural norms may condone or encourage multiple sex partners. Wet nursing has been found to be spreading the virus in Papua New Guinea. Religious beliefs that are interpreted in a way that discourage the use of condoms may contribute to unsafe sex and unwanted pregnancies, including misconceptions that marriage protects individuals from HIV/AIDS.
The most at-risk population groups in the PICTs are young people and women. Given the youthful population structure of most PICTs, young people are an important sector of the population that needs to be targeted. In Vanuatu for instance, many young people are sexually active and vulnerable to STIs and HIV through unprotected sex. More women are being infected at a younger age now than before. For instance in Fiji, in 1989, within the age group of 19-29 years, females accounted for 25% of cases, however, in recent years (1998-2003) females accounted for more than 40% of HIV positive cases.
Tuberculosis (TB) is a common co-infection with HIV/AIDS and because of this, the relatively high prevalence of tuberculosis in many PICTs with low case detection rates for the past 10 years is a significant cause for concern. It is estimated that 16,000 people in the 22 SPC member PICTs become sick with TB every year, 50% of whom are infectious cases, although only an average of about 9,000 new TB cases have been diagnosed annually since 1995.
In a nutshell, the HIV/AIDS situation in the Pacific region has seen PNG to be having a generalized epidemic, while in the rest of the region the reported cases are low, partly due to inadequate surveillance systems but most importantly, the failure to acknowledge its existence. While countries see sexually transmitted infection (STIs) as priority, they fail to realize most reported HIV+ cases in the region are sexually transmitted and hence should place equal priority as other STIs.
(Secretariat of the Pacific Community)

What advice can you offer to people who know they are HIV positive?
The responsibility for preventing HIV transmission does not rest solely with those who are HIV positive - it is something that everybody must take responsibility for. That is why we want to make the information about the risks widely available. We must also remember that of course not everybody with HIV will know that they are HIV positive - some people with HIV are undiagnosed.
However, for people who know they are HIV positive, the best advice is to discuss their HIV status with their partner and then decide the level of risk that they are both willing to take. If an HIV-positive partner feels unable to do this, then in order to minimise the risk of onward transmission of HIV they should ensure that a condom is always used for penetrative sex. For new and casual sexual relationships where HIV status has not been discussed it is recommended to wear a condom for all penetrative sex (oral, anal and vaginal intercourse) in order to minimise risk. If the HIV positive partner is on antiretroviral therapy and has a consistently low viral load, this is likely to reduce the risk of infection, but will not remove it.

How can you assist and support someone with HIV?
Many people face stigma and discrimination when they tell people they are HIV positive, so it is important that they know who and where they can get support. Reassure them that they are still the same person and support them in any way you can. Make sure that they are getting treatment and counselling.
Emotional support may be very important for HIV positive people because it breaks the isolation and provides a safe way of sharing both feelings and practical information. Their emotional health affects their mental health so it is important that they stay optimistic.