About HIV and AIDS
HIV stands for human immunodeficiency virus, while AIDS stands for acquired immune deficiency syndrome. Although there is currently no widely available cure for HIV, effective treatment means most people living with HIV can lead long, healthy lives without developing AIDS.
Here, MBACP. Reg COSRT. Psychotherapist Andrew Goode discusses HIV and how counselling can help.
Understanding HIV and AIDS
HIV was first identified in the 1980s, although it had been circulating before then. Back then, the disease wasn’t fully understood, and the diagnosis came with a great deal of stigma. Today, we know much more.
In the past, AIDS was a more common outcome following an HIV diagnosis. Today, thanks to advances in treatment, most people living with HIV will not develop AIDS.
The difference between HIV and AIDS
Some people use both terms to describe the same thing, but they are different.
- HIV is a lifelong infection. Most people who receive a positive diagnosis for HIV do not have AIDS.
- AIDS is the most advanced stage of HIV infection and can develop when HIV severely damages the immune system. HIV can be transmitted to other people, but AIDS itself cannot.
Diagnosis and treatment these days are so effective that most people with HIV will not develop AIDS. The key to this is early diagnosis and receiving treatment.
HIV symptoms
Some people experience a short flu-like illness around two to six weeks after contracting HIV, while others have no noticeable symptoms. After this early stage, HIV may not cause any further symptoms for several years.
The symptoms of this short illness can include:
- high temperature
- body rash
- sore throat
- joint pain
- tiredness
- swollen glands.
These symptoms can present for a number of reasons. Illnesses do not necessarily mean you have contracted the virus. If you experience these symptoms and think you may have been at risk of contracting it, however, it is worth getting tested.
Further symptoms will differ from person to person. Some people may feel well for several years without treatment. If the virus isn’t detected and treated, the immune system will get increasingly damaged, which can lead to the following symptoms:
- skin problems
- weight loss
- recurrent infections
- chronic diarrhoea
- night sweats
- other life-threatening illnesses.
Early diagnosis and treatment can prevent these symptoms.
How is HIV transmitted?
The most common way HIV is transmitted in the UK is through having sex without a condom with someone who has HIV. People living with HIV who have a detectable viral load can pass the virus on when they aren’t experiencing symptoms and pass it on more easily in the first few weeks following infection.
Receiving HIV treatment significantly reduces the risk of passing on the virus. Aside from sexual contact, other ways of transmitting HIV include:
- sharing needles and syringes
- sharing sex toys
- during pregnancy, birth, or breastfeeding
- through blood transfusion (this is now very rare in the UK).
Ways in which HIV cannot be transmitted include:
- kissing
- being sneezed or coughed on
- sharing towels or cutlery
- using the same toilets, baths, or swimming pools
- contact with animals or insects like mosquitoes.
People living with HIV who take effective treatment and maintain an undetectable viral load cannot pass HIV on through sex. This is known as undetectable = untransmittable (U=U). Many people achieve an undetectable viral load within six months of starting treatment, although this can vary.
HIV prevention and diagnosis
Pre-exposure prophylaxis (PrEP) is medication that can help prevent HIV in people at higher risk of exposure. Post-exposure prophylaxis (PEP) is an emergency treatment that can reduce the risk of HIV after possible exposure. PEP must be started within 72 hours, so it's important to seek urgent medical advice if you think you've been exposed.
For more information about HIV prevention and treatment, visit the NHS website.
Getting tested for HIV
Getting tested is the only way you will find out if you have HIV. If you think you may have been exposed to HIV, contact a sexual health clinic for advice about testing. You may need a follow-up test depending on when the exposure happened. You can get tested for free on the NHS. If you're at higher risk of HIV, you may be encouraged to have regular tests.
HIV testing is available through sexual health clinics and some other healthcare services. Depending on the test, you may provide a blood or saliva sample, or use a home testing kit. Results can be available within minutes or take a few days.
If a test suggests you may have HIV, you'll need a further test to confirm the result. A healthcare professional can advise which test is suitable and when to take it.
HIV treatment
Currently, there is no cure for HIV. This means that once you receive a positive diagnosis, you will always have HIV. If caught early and treated effectively, you should go on to live a long life.
The treatment of HIV involves antiretroviral medications. These stop the virus from replicating in the body, allowing the immune system time to repair itself and prevent further damage. A combination of drugs is needed as the virus adapts quickly and can become resistant.
Effective HIV treatment can reduce the amount of virus in the blood to levels that standard tests cannot detect. This is known as having an undetectable viral load. It doesn't mean HIV has gone away, but maintaining an undetectable viral load means HIV cannot be passed on through sex.
The importance of taking your medication
Taking HIV medication as prescribed helps keep the virus under control and reduces the risk of drug resistance. If you miss a dose, speak to your HIV care team or follow the advice provided with your medication.
During the first few weeks of taking medication, you may experience some side effects such as headaches, fatigue, feeling nauseous and diarrhoea. Your doctors will work with you closely to ensure you get the best combination of drugs with minimal side effects.
Living with HIV
While HIV treatment can protect your immune system and reduce the amount of HIV in your body, it cannot cure the infection. This means that once you’ve been diagnosed with HIV, it is something you’ll live with.
Thanks to effective treatment and early detection, however, those with HIV can live just as long as those without HIV, with fewer HIV-related illnesses. This means you should be able to live a full and healthy life.
As well as taking your medication, looking after your overall health can help reduce the risk of you falling ill. This can mean taking regular exercise, eating a well-balanced diet, quitting smoking, and reducing your alcohol intake.
Other things to bear in mind when you have HIV:
- People living with HIV can join and serve in the UK armed forces, subject to medical eligibility requirements.
- You will not be able to donate blood.
- People living with HIV may be able to donate organs in certain circumstances. Specialist teams assess whether donation is suitable.
- Some countries have travel or residency restrictions for people living with HIV. It's worth checking the latest guidance before travelling.
- You may be able to get life insurance, although your options and premiums can vary depending on your circumstances. UK government-backed financial guidance service MoneyHelper explains more.
Psychological impacts
While effective treatment means people living with HIV can lead long, healthy lives, receiving a diagnosis can still bring a range of emotions. Everyone responds differently, and some people may find it difficult to adjust.
If you've previously experienced mental health difficulties, such as anxiety, depression or low self-esteem, an HIV diagnosis may affect how you're feeling. Even if you haven't experienced these difficulties before, you may benefit from emotional support.
You may have questions or concerns about your health, the future or telling other people about your diagnosis. You may find you start to isolate yourself. Sadly, there can still be a stigma surrounding HIV as well as a lack of understanding. This can all affect how you feel about yourself.
Telling people you have HIV
When you are diagnosed with HIV, it’s important to tell your current sexual partner and any partners you’ve had since becoming infected. Doing this can be a tough experience; you may feel upset, embarrassed or even angry. Talk this through with your medical team as they can advise who you need to tell and the best way to get in touch – they may even be able to contact them for you.
You may also be wondering whether you need to tell your employer about your HIV diagnosis. In most jobs, you are not legally required to disclose your HIV status, although some roles have specific occupational health requirements.
People living with HIV are protected against discrimination under the Equality Act 2010. Employers are generally restricted from asking questions about health conditions before offering someone a job, although there are some exceptions.
You may choose to tell your employer if you need support or reasonable adjustments, such as time off for medical appointments. For more information about your rights at work, visit the National AIDS Trust.
Educating people about HIV and what your diagnosis means will hopefully help to ease any fears or concerns they may have.
Getting support
If you find yourself struggling after your diagnosis, isolating yourself, experiencing low mood or finding it difficult to adjust, you could benefit from seeking support. You may find it helpful to speak to other people who have HIV. You could join a support group (online or in-person), or you could try group therapy.
Speaking to a counsellor who has experience supporting people living with HIV may be beneficial, as they may have a greater understanding of what you’re going through and the psychological impacts.
Living with HIV can bring different experiences and emotions, and support is available if you need it. If you'd like a confidential space to talk about how you're feeling, you can find a therapist offering HIV counselling.
