HIV/AIDS

What is HIV/AIDS?

In short: AIDS is a chronic, life-threatening disease caused by HIV (a virus).

HIV is short for the Human Immunodeficiency Virus. It is a type of virus which causes disease by infecting and killing blood cells central to the body’s immune system – which helps the body to defend itself against infection and disease. As these cells are progressively wiped out, the body becomes less and less able to defend itself against otherwise common illnesses.

AIDS is short for Acquired Immunodeficiency Syndrome. It is the final stage of HIV infection where a person’s immune system has been weakened to the point where it can no longer fight disease. This leaves the body open to a wide range of potentially deadly diseases known as opportunistic infections. So strictly speaking, AIDS isn’t a specific illness but a collection of many different conditions in the body – thus syndrome.

As such, HIV can be considered the cause and AIDS the effect of the infection.

How do you get infected?

The virus is mainly transmitted through sexual intercourse (vaginal/anal/oral) but can also be passed down from infected mother to her child:

• during pregnancy

• during childbirth

• during breastfeeding or acquired via infected blood:

• when getting a blood transfusion

• through the sharing of needles (e.g. during drug use)

• through needle-stick injuries (if you’re a healthcare worker, for example).

Once you’re infected, the virus remains in your body for life.

It’s important to realise that you cannot get infected through:

• mosquito and other insect bites

• urine or sweat

• public toilets, saunas, showers, gym equipment, swimming pools or water fountains

• sharing towels, linen or clothing

• going to school with, socialising or working with HIV-positive people

• sharing cutlery or crockery

• sneezes or coughs

• touching, hugging, shaking hands with or dry kissing a person with HIV

• (sexual) contact with animals (HIV is strictly a human virus and isn’t carried by animals)

• breathing the same air as someone who has HIV

What are the symptoms?

While it’s impossible to look at someone and know whether they have HIV, the majority of people will have some symptoms about three weeks after they become infected with the virus. The period after infection, but before the production of antibodies (causing the initial symptoms), is called the window period. During this time, an HIV test may be negative.

These initial symptoms usually last 1–2 weeks and may include the following:

• fever and night sweats

• aching muscles and tiredness

• sore throat

• swollen glands

• diarrhoea

• skin rash and ulceration of the inside surface of the mouth and genitals

• headache, sore eyes and sensitivity to light

HIV is regarded as a chronic disease because, after experiencing these initial symptoms, most people don’t have any other symptoms for many years. During this time, they may look and feel perfectly well. This explains why so many people are unaware that they’re infected with HIV. But even though they feel healthy, they can still transmit the virus to others. This is why HIV/AIDS is often called the silent epidemic and why getting tested is so important. Only a blood or fluid sample can reveal the presence of the virus. The length of time it takes for HIV to become AIDS varies from person to person and depends on your access to treatment, health status and health-related behaviours. Therefore, if you’re HIV-positive, you’ll need ongoing monitoring and regular clinic visits to determine the progression of the disease.

When symptoms associated with the advance of HIV to AIDS occur, they appear roughly in the following order:

• unexplained weight loss (more than 10% of body weight)

• swelling of glands in the neck, armpit or groin

• easy bruising

• recurring and unusual skin rashes (often itchy)

• a thick, white coating of the tongue or mouth (oral thrush) or vagina (vaginal thrush), which is severe and recurs

• ongoing vaginal discharge and pain in the lower abdomen

• sinus fullness and drainage

• recurrent herpes

• shingles

• persistent sore throat

• recurring fevers lasting more than 10 days without an obvious cause

• night sweats or chills

• persistent cough and/or shortness of breath

• persistent severe diarrhoea (longer than a month)

• changes in vision

• pain, loss of control and strength of muscles, paralysis

• discoloured or purplish growths on the skin or inside the mouth or nose

• difficulty concentrating, inability to perform mental tasks that have been done in the past, confusion, personality change

Is there a cure?

Although there currently isn’t a cure for HIV, antiretroviral treatment (ART) helps to keep the virus under control and enables people living with HIV to lead a full, productive life. ARTs also help to prevent the onward transmission of HIV, i.e. if you’re HIV-positive, and on ART, there’s a lower risk of transmitting the disease to others.

If left untreated, the average survival time for a person with AIDS is between six and 19 months. By contrast, a 35-year-old started on antiretroviral therapy (ART) can achieve a life expectancy equal to that of the general population.

Ultimately, treatment is key to the avoidance of HIV-related illnesses and the restoration of immune function. Even in persons with advanced disease, the implementation of ART can suppress HIV’s ability to replicate.

Myths about HIV/AIDS

Myth: I’m HIV-positive – my life is over.

Fact: Thanks to ART, people with HIV can now live long and productive lives.

Myth: I would be able to tell if my partner is HIV-positive.

Fact: It’s impossible to look at someone and know whether they have HIV. Many people don’t show symptoms for years. The only way to know for sure is to get tested.

Myth: Male circumcision prevents HIV.

Fact: Circumcision lowers the risk of female-to-male sexual transmission of HIV by about 60%. However, it does not prevent HIV.

Myth: I can get cured if I have sex with a virgin.

Fact: There is no cure for HIV/AIDS.

Myth: I can get cured if I have sex with someone who is HIV-negative.

Fact: In all likelihood, you’ll infect your partner. There is no cure for HIV/AIDS.

Myth: If I test for HIV while I’m taking ART and my result is negative, it means that I am HIV-negative.

Fact: Being on any form of ART will give a false-negative result. You are still HIV-positive.

Myth: If I have HIV, I can’t have a baby.

Fact: It’s possible to have a baby if you have HIV, as long as your viral load is suppressed for at least six months before conception and it remains suppressed.

How do I prevent myself from getting infected?

Know your HIV status. If you don’t get tested, you won’t know if you’re HIV-positive or not. During the first three months of infection (the window period), it’s hard to pick up the virus in the body. That’s why testing every six months is the best way to be sure.

• Avoid having sex. This isn’t easy for most people, but it’s the one way of making sure that you don’t become HIV-positive as a result of sexual contact.

• Stay away from drugs. Note that one of the consequences of drug use is also that being high can make you forget about the rules of safe sex.

• Avoid blood contact. If you’re helping a bleeding person, avoid getting any of their blood into any sores or cuts you may have on your skin. Also protect your eyes and mouth. There should be gloves in all first-aid kits – use them.

• Consider circumcision. This procedure, in which the foreskin of the penis is removed, has been shown to reduce the risk of HIV transmission from women to men.

• Take action if you’ve been exposed to HIV. Post-exposure prophylaxis (PEP) means taking antiretroviral treatment after you’ve been exposed to HIV. It must be taken within 72 hours of exposure and reduces your chances of becoming HIV-positive. PEP is often given to people who work in a medical environment (after a needle-prick incident) and to those who have been sexually assaulted. PEP must be taken for 28 days and has some side effects, such as nausea. Note that it’s not a substitute for normal HIV preventative measures.

• These days, there’s also much focus on treatment as prevention (TasP). This refers to HIV prevention methods and programmes that use antiretroviral treatment (ART) to decrease the risk of HIV transmission. Experts now know that if an HIV-positive person’s viral load is so suppressed that it’s undetectable, they’re unlikely to pass the virus on to others.