HIV The Human Immunodeficiency Virus (HIV) causes a viral infection that damages the body’s immune system. The immune system is the body’s protector; it is made up of a group of organs and cells that keep the body healthy by fighting viruses and infections. CD4 cells, also known as T-helper cells or just T-cells, are one of the primary types of these cells involved this process. In many ways, CD4 cells act as the immune system’s alarm. CD4 cells help recognize that your body is under attack and pass on an alert to the rest of the immune system. With CD4 cell help, the immune system then reacts by building a strong defensive response. When someone is infected with HIV, the virus uses the individual’s CD4 cells to multiply. As a result, the cells are damaged, unable to function properly, and the immune system cannot create a strong response to fight an attack. Over time, the number of healthy CD4 cells declines. When HIV has destroyed enough of the body’s CD4 cells, an individual can be diagnosed with AIDS – Acquired Immune Deficiency Syndrome. This diagnosis means that the body’s immune system is no longer able to effectively fight off illness. Because of these other illnesses, an individual may become very sick or possibly die. AIDS Acquired Immune Deficiency Syndrome (AIDS) is the diagnosis given in the later stages of HIV infection. This diagnosis is made by a healthcare provider and is based upon several factors relating to disease progression. First, the individual must be infected with HIV. Next, either blood tests show that the person’s T-cell count is less than 200 cells per cubic centiliter of blood or the person has been diagnosed with one of several diseases, known as opportunistic infections, which do not affect those with healthy immune systems. These infections include: Candidiasis (oral thrush), Tuberculosis, bacterial pneumonia, Herpes outbreak, etc. Click here for more information on opportunistic infections. Symptoms Soon after HIV infection, flu-like symptoms may occur, although some individuals will experience no symptoms. During the period between infection and AIDS diagnosis, there may be no other symptoms. For those infected with HIV, symptoms sometimes related to AIDS include unexplained weight loss or tiredness, flu-like feelings that don’t go away, diarrhea or white spots in the mouth. There is a simple test that can determine if someone is infected with HIV, and only a doctor can diagnose someone with AIDS. HIV Antibody Testing There is a test to find out if you are infected with HIV. The test looks for the presence of HIV antibodies. Antibodies are formed in response to an infection and play a crucial role in the body’s fight against that infection. A suitable sample to test for HIV antibodies requires blood or a swab of the mouth. Blood is obtained through a blood draw or finger stick. It may take from two weeks to six months after infection for enough antibodies to be present for the test to detect HIV. This period of time is known as the window period. During this period the test could show that a person is HIV negative when they are actually infected with the virus. This result is also known as a false negative. A person with a false negative result could still transmit HIV to someone else. Many HIV testing sites offer anonymous or confidential testing. Being tested anonymously allows you to go in for an HIV test without providing any identifying information. During a confidential visit, you will be asked for identifying information but that information will be kept private and it is protected under federal medical information and HIV privacy laws. There are many locations in the area to obtain HIV antibody testing, some of which offer HIV Rapid Testing. Rapid HIV testing can offer test results in as little as 20 minutes after the sample is collected. As technology improves we may see result times decrease. Click here for testing sites Treatment Without treatment the time between infection with HIV and an AIDS diagnosis is about 10 years, but there are very effective treatments to slow down this process. With treatment, many people go on to live long productive lives. Also, we now know that early treatment can greatly reduce the likelihood of an infected person passing the virus on to their partner(s). No current treatment provides a cure for HIV. A doctor can run specific blood tests to identify which treatments will be most effective for someone infected with HIV based on factors such as CD4 cell count and viral load. These treatments typically include different drug regimens that vary according to individual needs and circumstances. A person living with HIV is strongly encouraged to strictly follow their treatment regimen in order to maintain good health and avoid drug resistance. It is very important for individuals with HIV to enter care as soon as possible because appropriate and timely treatment is a critical part of maintaining good health. Prevention HIV lives inside the body of someone who is infected. The virus does not survive for very long outside of the body due to its sensitivity to fluctuations in temperature and the presence of oxygen. Because of the virus’ need for CD4 cells to reproduce, it is highly concentrated in certain body fluids, such as blood and semen (including precum) in men. When these body fluids are exchanged in a way that allows for entry into the bloodstream, there is the possibility of HIV transmission. Traces of HIV can be present in other body fluids like saliva and mucous, but not in high enough concentration to transmit the virus. The most common ways HIV is transmitted in gay men are: * Unprotected anal sex * Sharing injection drug equipment, also known as works The best way to prevent infection is to not engage in behaviors that involve risk of transmission, primarily sex and drug use. However, if you or your partner are unsure of your HIV status and still choose to engage in activities that have high rates of transmission, there are still ways to reduce the risk. These methods include knowing your HIV status and the status of your partners, practicing safer sex and not sharing works. Sex Using latex condoms and plenty of water-based or silicone-based lubricant during anal sex can greatly reduce risk. While not 100% effective, most studies show that consistent and correct use makes them about 98% effective. Although the risk of HIV transmission during oral sex is significantly less, it may still be possible, especially if you or your partner have cuts or sores in the mouth or have had recent dental work. Using a latex barrier during oral sex, such as a condom or dental dam, can further reduce the chance of transmission. Getting regularly screened and treated for STDs is also a way of reducing your risk of HIV transmission and other STDs for a few reasons. Some STDs, such as herpes and syphilis, create open sores that can serve as pathways for the virus to enter the body. STDs also draw T-cells to the infected area – such as the genitals, mouth and anus. If a person with STDs engages in unprotected sex, that person can transmit or be infected with HIV more easily. Injection drugs, including steroids Not sharing syringes or other equipment is the most effective way to reduce the risk of HIV transmission. If you are sharing equipment, using bleach and water to clean the equipment can offer some protection. For syringes, rinsing the syringe three times with water, then three times with bleach and then three more times with clean water is an effective method. While it can be hard to obtain clean syringes because of financial and legal restrictions, it is sometimes possible to find syringe exchange programs. Although it is against the County of San Diego’s policy, a clean syringe exchange program exists in the city of San Diego through Family Health Centers of San Diego (FHCSD). For more information on the FHCSD syringe exchange program, click here. For people who want it, there is support to help reduce or stop using drugs. Click here to find out more. If you or someone you know thinks that they might have been exposed to HIV, please Click here for testing sites.