HIV/AIDS

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HIV stands for Human Immunodeficiency Virus. AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is a result of the development of the HIV virus into a more serious condition. AIDS was first recognised by the U.S. Centers for Disease Control and Prevention in 1981 and its cause, HIV, identified in the early 1980s.

The nature of HIV

HIV is a contagious infection which attacks the immune system, reducing its effectiveness and leaving the body susceptible to infections. The HIV infection damages the cells the body needs to fight illnesses. AIDS can be diagnosed when the number of immune system cells (CD4 cells) in the blood of a person with HIV drops below a certain level.

There is no cure for HIV or AIDS, but there are treatments that can slow down the disease, and help prevent the onset of AIDS. It takes around ten years for someone with HIV to develop AIDS, but it can be prevented with early detection and treatment of the HIV.

HIV is caught through direct contact of a mucous membrane of the blood stream with an infected bodily fluid, such as blood, semen, fluids generated through vaginal or oral sex, contaminated needles, or from mother to baby during pregnancy. HIV is diagnosed through a blood test. However, the HIV virus may only show up in the blood 3 months after contracting the infection, which is why it is important to be tested regularly.

Those with HIV are able to live a normal, healthy life with the aid of medication. However, early detection of HIV is essential to prevent it developing to AIDS.

HIV and AIDS are often stigmatised as a ‘gay disease’. This is not true – HIV is a global pandemic, affecting people all over the world from all walks of life. AIDS is widespread in African countries such as South Africa, Mozambique and Zimbabwe. Over three-quarters of deaths from AIDS have been in these areas. Lack of money, a stigma against using condoms, natural disaster and poor infrastructures contributes to this.

Being HIV positive is a hugely challenging situation to accept and deal with. As well as learning to live with the health problems, it can be difficult to tell people about the illness, due to prejudice, ignorance and stigmatisation of the illness.

Many people confuse HIV and AIDS, but it is important to remember that HIV is the initial virus that can be treated and kept under control, preventing the on-set of AIDS.

There is an annual World AIDS Day to raise awareness about AIDS and how people can protect themselves from it.

Symptoms

There are no specific symptoms caused by HIV or AIDS, which is why it is important to be tested. Instead, it is the symptoms caused by the illnesses the individual contracts due to their weakened immune system, caused by bacteria, viruses, fungi and parasites.

Shortly after the initial HIV infection, some people may experience a flu-like illness, develop a rash or have swollen glands. However, as these symptoms are so similar to many common viruses or colds, they cannot be used as a reliable indicator for contracting HIV.

An opportunistic infection is one that a healthy person without HIV can fight off. However, if a HIV positive person contracts these illnesses, in combination with a low CD-4 cell levels it may mark the development of AIDS.

Opportunistic illnesses encompass a range of illnesses. However, there are some that are far more common than others. These include:

• bacterial diseases such as tuberculosis, pneumonia, and septicaemia.
• gastrointestinal infections such as chronic diarrhoea and esophagitis
• neurological and psychiatric involvement such as toxoplasmosis and AIDS dementia complex
• tumours and malignancies – Kaposi’s sarcoma is the most commonly contracted tumour, and there is a higher risk of developing certain cancers including cervical, Hodgkin’s disease, oral, rectal, head, neck and lung cancers
• fungal diseases such as PCP and penicilliosis
• viral diseases such as herpes

If HIV goes untreated, in the later stages symptoms may include weight loss, diarrhoea, blurred vision and a dry cough.

Cause

HIV is a retrovirus that infects and attacks the vital organs of the immune system, causing the body to be unable to defend itself against illnesses. The virus breaks down the genetic code of cells used by the immune system, stopping it from making enough CD-4 cells to fight off illnesses.

When is the right time to seek help?

As the symptoms of HIV are similar to many common illnesses, the infection cannot be diagnosed on this alone. The definitive method is the HIV test, which tests blood for the presence of the virus. However, the virus will only show up three months after the initial infection, so those in high-risk groups must get tested regularly.

The high-risk groups are:

• gay men who have had unprotected sex
• people who have travelled extensively or lived in sub-Saharan Africa, or have had sex with someone who has
• people who inject illegal drugs, or have had sex with someone who has
• people who have had a blood transfusions in Africa, eastern Europe, countries of the former Soviet Union, or central or southern African

If the results of a HIV test come back positive, the individual will be referred to a whole network of support at a HIV clinic, and have access to a counsellor, social worker, dietician, dentists, specialist doctors and a pharmacist.

A HIV test is a blood test, done either from a pin prick on the finger or taking blood from the arm. Tests are available from a GUM clinic, a GP, a private clinic or a Terrence Higgins Trust facility.

After a positive diagnosis, it is important for the individual to contact current and previous sexual partners to let them know there is a risk they may also be infected, and that they need to get tested. This can be a difficult process, but professionals are on hand to help.

It is also important to inform employers of a HIV positive diagnosis, as those with HIV are protected under the Disability Discrimination Act. The individual is not obliged to inform their employer, but will not be covered by the act unless they do so.

For friends and family of someone with HIV, it can be difficult to accept the diagnosis. Counselling can help work through issues that have arisen, and offer advice on how best to support the individual.

PEP (Post Exposure Prophylaxis) is a treatment that can be taken within 72 hours after suspected HIV infection that may prevent the infection developing. It is not guaranteed to work, and does involve taking the drug for four weeks. There are also side effects, including diarrhoea, sickness and vomiting and headaches. PEP is available from GUM clinics or Accident and Emergency. It is not available in all parts of the country, and GPs are not able to prescribe it.

Treatment

There are many regular procedures HIV patients need to undergo as part of their ongoing treatment. Everyone diagnosed with HIV will be offered counselling, and this can prove invaluable in coping and explaining the illness to others.

There is treatment available for HIV which will slow down the progression of the virus, allowing people to lead a normal live. This treatment is called highly active antiretroviral therapy (HAART), and is a combination of medicines administered in two or three pills to be taken once or twice daily. The medication involves commitment – the individual will have to take these drugs every day for the rest of their life, as well as making sure they stay healthy, eat well, exercise regularly and try and avoid being exposed to illnesses where possible. They will also need to have regular blood tests to monitor the HIV.

In the later stages of AIDS, a person will need palliative care and emotional support as they prepare for death. Counselling can provide support to both those diagnosed with the disease, and their friends and family.

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