HIV stands for “Human Immunodeficiency Virus”, a virus whose exposure can lead to a diseased condition called AIDS whose full form is Acquired Human Immunodeficiency Syndrome.
HIV and AIDS are often used interchangeably in normal communication, but actually, HIV is the name of the Virus, whereas AIDS is the actual disease.
HIV is a type of Lentivirus that is a sub-group of a retrovirus. Lentivirus is a class of virus that often have a very long incubation period (which means that the virus can remain in the body for a long time without causing the symptoms), but once the symptoms occur, these viruses cause long-duration illnesses.
For example, it is very much possible that a person who is infected with HIV may not have any symptoms shown for as long as ten years, without getting detected by the immune system. However, silently, the virus continues infecting and integrating itself into the target human cells.
Two strains of HIV virus have been reported, namely HIV-1 and HIV-2. Of these, HIV-1 is more dangerous and infective than HIV-2 and is considered the leading cause of HIV infections on a global scale.
Structure of HIV virus
HIV virus is very hard for the human immune system to detect and kill because the outer layer is composed of a lipid bilayer that contains many of the same proteins that a host human cell contains. Very few of the proteins on the outer layer are viral proteins that help the virus to attach to a new target cell and infect them.
HIV virus integrated into and impacts the human body cells that are involved in immunity defense such as macrophages, CD4 T cells, and microglial cells.
After entering these cells, new virus particles get created inside the infected cell and then released outside to target and attack more healthy cells, and the cycle continues.
How does HIV spread?
When a person is having HIV in their blood and engage in activities that result in the exposure of their body fluids such as pre-ejaculate, semen and vaginal fluids to the other person, HIV can be transmitted.
Similarly, when there is contact with infected blood either through cuts or when infected blood transfusion occurs, a healthy person may contract HIV virus.
A mother who is HIV positive can transmit HIV to her baby both while she is pregnant or during childbirth when there is exposure to her blood or vaginal fluids.
There are many myths about how HIV can pass from one person to the other, but here is a comprehensive list backed by credible sources.
First, how HIV is not transmitted or passed from one person to the other.
- Air or water – This means that if you inhale the air that is exhaled by an HIV patient, you are in no risk of getting HIV. Similarly, if you happen to share water with an HIV person, or say were swimming in the same pool with an HIV person, you would not be contracting HIV as a result.
- Body fluids like saliva, sweat, tears or kissing – there is no risk of HIV transmission when you come in contact with any of the above from an HIV infected person. In a rare scenario, when both the partners have bleeding gums and engage in deep mouth kissing, a blood-to-blood contact may occur.
- HIV is not transmitted when you share food or drinks with another person. Likewise, if you use the same toilet as an HIV infected person, there is no risk of transmission.
- Touching the same surface that an HIV infected person may have touched, say a seat on a bus or train, or sharing of utensils or toilets.
- Mosquito bite where mosquito bites an infected person and then bites a healthy person does not lead to HIV transmission because HIV virus cannot survive for long outside the human body, and it cannot reproduce outside a human host.
- Activities like touching a person, hugging etc. do not lead to any risk of transmission.
Now, here is a list of activities that can cause risk of HIV transmission, listed in three different categories.
- Engaging in sexual activities with an HIV infected partner where certain body fluids such as semen, pre-semen, vaginal or rectal fluid come in contact with another person’s mucous membranes or directly blood through a damaged tissue. Mucous membranes are found inside the vagina, penis, rectum and even mouth. In order to minimize or prevent chances of HIV transmission, it is therefore highly recommended to use a condom when having sex with a new partner.
If any of the partners is suffering from an STD, and the sex is carried out without using a condom, the chances of HIV transmission increase further because another sexually transmitted disease may have caused skin irritation and breaking.
Condoms of many popular brands are available easily in nearby pharmacies. If you feel shy to ask for a condom packet because there are people around in the pharmacy, you can basically write the name of the condom you want, and hand it over to the pharmacist quietly.
Another way is to order the products online through online pharmacies and websites like Amazon from here, or Flipkart, 1mg, Netmeds etc.
If you are unaware of the sexual history of the other person, it is always best to follow safe sex practice of using a condom. Remember, life is precious and a simple solution already exists to offer the protection.
- Sharing of needles or syringes such that blood is drawn out from an infected person, and then the same needle is used to inject a drug into a healthy person. HIV can survive in an infected needle for a long time based on temperature and other factors.
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Less common transmission
- HIV may be transmitted to a child by mother during pregnancy or birth, or even later during breastfeeding. The risk of transmission increases if the mother is suffering from HIV but not taking the HIV medicines.
- In some rare scenarios, a health-worker may get exposed to HIV virus due to a contaminated needle or another sharp cut.
Extremely rare scenarios
- There is a very rare chance of HIV transmission when the person engaged in oral sex, though it is possible to get other kinds of sexually transmitted diseases. A theoretical possibility of HIV transmission still exists if the partner that provides oral sex has sores or bleeding gums, and the receiving partner is infected with HIV.
- Adequate testing is now performed while collecting blood from blood donation camps, but if one receives a blood unit that is contaminated from HIV, a possibility arises to contract HIV.
- HIV infected person bites that lead to exposure to infected blood from the infected person to the healthy person.
- Rare contact between broken skins, wounded area.
- In very rare cases if both the partners are suffering from bleeding in their gums, blood from the HIV partner might merge with the blood of HIV negative partner. Exchange of saliva alone does not lead to HIV transmission.
- Transmission of HIV because of using equipment that has someone else’s blood on it or the ink is shared.
- Transmission of HIV because the barber used a razor that had infected blood on it and subsequently caused a cut on your skin as well. Very rare but it is always a good practice to ask the barber to clean the razor with a disinfectant like Dettol before use.
When HIV test is suggested
Some people may suffer from anxiety and have questions about do they suffer from HIV, especially after they have engaged in any activity that is deemed risky from an HIV infection perspective. In some cases, a partner may have been forced to have an unsafe sex against his or her will and may suffer from a remorse or anxiety.
In most cases, these are the kind of times where you should seriously think about getting tested.
- Have you engaged in unprotected sex with another man or woman, whose sexual history is unknown to you?
- Have you injected drugs or shared needles with other people recently?
- Have you been diagnosed with any other sexually transmitted disease?
A most common test for detecting HIV infection is called ELISA test or EIA. In this test, an attempt is made to detect the antibodies that are usually present when a person has HIV infection.
Usually, ELISA test is reliable for detecting a recent HIV exposure but may fail to detect if the exposure has just occurred, since the body may not have created enough antibodies yet. This is also called as the window period.
Therefore, if you get a negative result but you suspect that you may have had an exposure, it is best to repeat it again after few weeks or certainly again after three months.
ELISA test can also sometimes give a false positive, so it is very important to perform repeat tests if the result is positive, instead of panicking. There have been a few unfortunate cases where the test came out as false positive, but the person went into depression or shock and caused self-harm.
A positive ELISA test is usually followed-up with tests that determine the type of HIV infection, such as HIV-1 or HIV-2. Western Blot test is also used as a follow-up test to detect the presence of antibodies.
Other kinds of tests also exist that allow confirming the presence of HIV infection, but those are much costlier to undergo and not usually suggested as part of the screening tests.
Detected HIV positive – now what?
A person who has undergone an HIV test can get into tremendous mental stress on hearing the news about being HIV positive. However, the first and foremost need is to undergo a further confirmatory set of tests as explained.
It is also important for the doctor and family members (if they are aware of the information) to provide comfort and mental support to the person.
It is important to know that unlike another type of diseases, HIV patient can live a normal and long life by taking the medicines regularly called Anti-Retroviral Therapy or ART.
The most important point to understand is that HIV infection does not mean that you now have AIDS.
By taking medicines, the virus load in the body can be kept in check for many years. In fact, as per the conducted research, an HIV positive person who has started the ART therapy early and has kept a good lifestyle can expect to have a similar life expectancy like an HIV negative person.
The Anti-Retroviral Therapy includes medicines that keep the HIV virus in check and allow a person to maintain a healthy count of immunity cells called CD4. If the person can manage to maintain a healthy count of CD4 cells above 200 cells per each ml of blood, one can be protected from advancing into the AIDS stage.
In some cases, the HIV virus may actually be pushed back into remission, and the person may regain increase in the CD4 cell count to the normal healthy level.
How does HIV progress and what are its symptoms?
When a person is first infected by HIV, just like any other viral infection, one may experience flu-like symptoms such as mild fever, body ache, headache etc.
This phase is called the acute infection phase, and during this time, the virus is basically reproducing within the body and taking shelter in key areas of the body such as lymph nodes where they can survive and grow for many years to come.
Acute infection is just like any other viral fever, so people may not even realize that they are suffering from HIV. However, if one has a doubt that he or she has probably been exposed; it is advisable to take a test, and repeat the test again after few weeks to be sure that you are not having HIV infection.
A person suffering from an acute HIV infection has a high load of HIV virus in their blood along with the antibodies, and can easily pass the same infection to another person through activities that fall into the risky scenarios listed above.
After the initial phase of infection is over, a person may progress on to a phase called the dormant or inactive HIV. During this phase, the HIV virus is still present in body but reproduces at a very low level. It is basically getting slowly integrated into the body’s own cells and working to create a much wider and stronger foothold in the body. In some people, this phase can actually extend to almost 9-10 years without the person showing any major symptoms or discomfort.
People who are in dormant HIV stage can still transfer the HIV virus to other people, but if the person is taking the ART medicines, then the viral load in their body fluids may be too low to pose a risk. Still, it is not advisable to engage in unprotected sex or other risky activities.
The last phase is when the HIV virus again becomes active and the body is at a stage where the HIV has badly damaged the body’s immune system. This is the stage when one enters the AIDS or Acquired Immunodeficiency syndrome.
If a person had advanced to the AIDS stage, he or she is now susceptible to catching many secondary illnesses like Tuberculosis, Pneumonia which are called opportunistic illness. The main issue is that by now the person’s own immunity is very much weakened, so even simple infections become very strong and difficult to treat.
Symptoms at this stage include
- Suffering from body chills and fever
- Having profuse sweating
- Having swelling in the lymph nodes
- Loss of weight and extreme body weakness
If a person has reached the AIDS stage, they have to be given treatments to protect them from secondary infections and also a regimen of ART drugs to keep a low count of viral load in their body. Without treatment and medicines, such a person may not survive for more than 3 years.
Management of HIV – Drugs, Cost, and Lifestyle
A person who has been recently diagnosed with HIV infection may need counseling and mental support, in addition to the regimen of the ART drugs.
Here are the few points to be aware of.
- Taking the ART therapy medicines can help you keep the viral load low in your body, so it is important to take the medicines regularly under the care of the doctor.
- There may be times when an HIV patient may feel depressed either because of certain side-effects of the medicines one is taking or due to the social stigma attached to HIV. At such times, it is important to talk to people you love and trust, and equally important that you do not stop the ART treatment.
- It is useful to join a forum or community where you can meet other HIV patients, so it helps in both mutual encouragement and the sharing of information. There are a number of such groups nowadays on platforms like Facebook, Patients Like Me.
- If one is aware that he or she has HIV infection, always take care that you are not passing the infection to another person.
- Our government is trying to create awareness about the social stigma and myths surrounding HIV, but you may still come across people who out of their ignorance, may discriminate or perform actions that can cause mental hurt. Learn to forgive and forget, and not let negative emotions overwhelm you.
Cost of Treatment of HIV
It may be possible that one is wondering how to afford the cost of taking the HIV medicines regularly, especially if a person is economically poor.
Here is the good news. Our government is doing a lot of good work in this area by providing the ART medicines from the ART centers that are located in various medical colleges, district hospitals, and some charitable hospitals.
Here is the link for the center where ART medicines are available.
Best of all, these treatments are completely FREE and sponsored by the government!
If you contact any of these centers and face any difficulty in getting the treatment, please drop an email to [email protected] and we will try out best to reach the right authority to help you.
We hope that you found this information helpful.
If you are a healthy person, you may have learned about the ways in which HIV can spread, and you will now use this knowledge to protect yourself. You have also known that how HIV does not spread, so if you come across someone in your circle, you will not cause them unnecessary mental pain by isolating them and will be a good supportive human being.
If you are someone who may have just contracted HIV infection, we hope that you will not panic and instead, start the ART therapy regime with positivity. You will also know that how it is important to keep other people safe from contracting HIV from you, as well as how you can get involved with the HIV community to share your pain with them, and get the support.
If you are someone who has a loved one suffering from HIV infection, you may have learned about the ways to keep them away from progressing into the more advanced AIDS stage. HIV patient can sometimes fall into depression and stop taking the HIV medications, so as a family member or a friend, it is your responsibility to ensure that they overcome these challenges, and take the medicine regularly.
There is one very nice mobile application that is developed by United States Center for Disease Control (CDC) that allows an HIV patient to regularly keep track of their medicines, as well the count of CD4 cells.
Here is the link to this android application.
The same application is also present in Apple iOS
Let us know how we can make this article more useful to you. Have we missed anything you wanted to know?
Dr. Kaleem Mohammed graduated as a Bachelor of Physiotherapy in 2014 from Deccan College of Physiotherapy, affiliated to Dr. N.T.R. University of Health Sciences, Vijayawada, India. Dr. Kaleem is an expert at handling physiotherapy needs of patients suffering from orthopedic and spinal conditions and post-surgery rehabilitation. Dr. Kaleem is associated with HealthClues since its inception where he facilitates diagnosis and advanced consultation with senior doctors. He is also a medical researcher and prolific writer who loves sharing insightful commentaries and useful tips to educate the patient community about fitness, treatment options, and post-treatment recovery.