Human Immunodeficiency Virus (HIV)

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First the Facts

  • HIV is a sexually transmitted infection (STI) caused by a virus which damages the immune system
  • It is possible to have HIV and not to have any symptoms
  • There is no cure for HIV, but there are lots of treatments that can control the disease and help prevent transmission to other people
  • If you are infected with HIV, it is possible to pass the virus on through vaginal, anal or oral sex
  • If treated early, people living with HIV can have long and healthy lives, with a similar life expectancy to people without the disease
  • If left untreated, it can cause significant long-term complications such as severe infections and cancers. When these conditions occur in someone living with HIV, this is called Acquired Immunodeficiency Syndrome (AIDS)

How Is HIV Transmitted?

  • By having unprotected sex or sharing needles with someone who has the infection
  • This person might not have any symptoms, and might not know that they have HIV
  • Transmission can be through vaginal, anal or oral sex
  • Anyone can have HIV – you do not need to have had a lot of partners
  • You can also catch HIV from sharing uncleaned sex toys with an infected partner
  • If you are pregnant, it is possible you could pass the infection to your baby. This can occur during the pregnancy, at delivery or from breastfeeding
  • You cannot get HIV through the saliva (e.g. kissing or sharing cutlery), hugging, toilet seats, or sharing towels.

How Will I Know If I Have HIV?

The best way to find out is to get tested.
Many people have HIV and do not have any symptoms.

  • Many people do not know that they have HIV until they have a test
  • During the first few weeks of infection, some people develop a flu-like illness with fevers, body aches and a rash
  • Many people do not have any symptoms when they are first infected with HIV
  • HIV infection can be present for years before symptoms develop
  • If you think you may have HIV, you should get tested as soon as possible

Who Is at Risk of HIV Infection?

Anyone having unprotected sex or sharing needles is at risk of catching HIV.

Some groups of people are at higher risk of catching HIV than others. This includes:

  • Having a partner living with HIV or from an area of the world with high rates of HIV
  • Men who have sex with men (MSM)
  • Women who have sex with men who have sex with men
  • People using drugs during sex (chem sex)
  • People who inject drugs or have partners who inject drugs
  • People with other infections such as hepatitis B or C
  • Victims of sexual assault (rape)

How Can I Protect Myself?

  • The use of condoms for vaginal and anal sex as well as condoms or dental dams for oral sex can help to prevent transmission
  • Cleaning sex toys before sharing with your partner
  • If you inject drugs, do not share needles with other people
  • There are medications that can help prevent the transmission of HIV, both of which are available on the NHS:
    • Pre-Exposure Prophylaxis (PrEP): A tablet (Truvada) taken every day to reduce the chance of HIV transmission from unprotected sex. This is particularly important for people who are at higher risk of catching HIV (see above). There are different regimes depending on what type of sex you are having. PrEP is available free of charge from sexual health clinics in England
    • Post-Exposure Prophylaxis (PEP): This is emergency medication for people that have been exposed to HIV. This could be through unprotected sex or sharing needles. This medication is very effective at preventing HIV infection if taken within 72 hours of the exposure (ideally within 24 hours). You can get PEP at any sexual health clinic or emergency department (A&E)

Where and When Can I Get a Test?

  • You should get a test if:
    • You have a new partner
    • You have had unprotected sex
    • Someone you have had sex with has told you they have HIV
    • You have shared needles or drug taking equipment with anyone
  • You can get a test at:
    • A sexual health or genitourinary medicine (GUM) clinic
    • A young person’s/contraception clinic
    • You can order a postal kit online (these are usually free)
    • Your GP

If you think you have been exposed to HIV, you should attend a sexual health/GUM clinic urgently for PEP. If these clinics are closed or you cannot get an appointment, you should attend your nearest A&E.

  • It can take between 4 and 12 weeks after exposure for a test to show HIV infection, depending on the type of test you have. This is because the test looks for your body’s reaction to HIV, rather than the presence of the virus itself.
  • You should take a test as soon as possible. If this is negative, you may be advised to take a further test up to 12 weeks after the exposure
  • This will be a blood test and may be either a fingerprick or with a needle from a vein

What Happens If I Have HIV?

  • If you receive a positive result, a repeat test may be taken to confirm the diagnosis of HIV
  • Although there is no cure for HIV, there are many treatments which can control the disease and help prevent you from developing the long-term complications
  • HIV is treated with anti-retroviralmedicines
  • Anti-retroviral medicines stop the virus from reproducing in the body. This helps to reduce damage to the immune system
  • More than one medication is taken to prevent the virus from developing resistance to the treatment
  • The earlier HIV is diagnosed, the easier it is to control the disease and prevent long-term complications from developing. It also means that you can protect your sexual partners from catching the infection
  • The goal of treatment is to reduce the amount of virus present in the body (viral load). When the viral load is very low, this is known as undetectable and this shows that the treatment is working effectively
  • Where infection is undetectable for 6 months or more, risk of HIV transmission through sexual contact is negligible

What If I Don’t Get Treated for HIV?

  • If you have HIV and are not receiving treatment, infection can be transmitted to your sexual partners, especially if you are having unprotected sex
  • If you are pregnant, you can pass HIV to your baby. This may occur either during the pregnancy, at the time of delivery, or through breastfeeding
  • HIV seriously damages the immune system
  • The immune system helps fight infections and prevents cancers from developing
  • As HIV infection advances, infections or cancers can develop which can be life-threatening
  • When these conditions develop, it is known as Acquired Immunodeficiency Syndrome (AIDS)
  • This can be prevented by getting regular and effective treatment at a specialist HIV clinic

If you have any concerns about HIV, it is best to get tested.

 

Written by: Dr David Rook and Dr Paula Briggs
Last updated: January 2021

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