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HIV-AIDS Questions and Answers

Introduction

Below are frequently asked questions about HIV and AIDS.

  1. What is the difference between HIV and AIDS?

    HIV (Human Immunodeficiency Virus) is the virus that causes HIV disease. It damages the body’s immune system, making it increasingly difficult for the body to fight off other diseases and infections. AIDS (Acquired Immunodeficiency syndrome) is the last stage of HIV disease.
  2. What is a virus?

    A small infectious agent that needs another living cell, called a host cell, to reproduce.
  3. What are the symptoms of HIV disease?

    Many of the symptoms of HIV disease resemble those of other health problems. Also, many people with HIV have no symtoms. Early symptoms can include headaches, fevers, aching muscles, nausea, diarrhea, low-grade infections, and fatigue. If a person has symptoms, they should see their doctor--not try to self-diagnose.
  4. Does someone have to have symptoms to be infectious?

    No. In fact, many HIV-infected people have no symptoms and may not yet know they are carrying the virus--yet they are infectious.
  5. How can I be sure whether or not someone else is infected with HIV?

    You can’t.
  6. Who can get HIV?

    Anyone who engages in a behavior that exposes them to the virus can become infected. It is not true that just because someone is gay they will get HIV, or that just because someone is straight they will not get HIV. It’s not what you are, it’s what you do that results in infection.
  7. How do I know whether or not I have HIV?

    The only way to know for sure is to get an HIV test.
  8. How accurate are the current tests for HIV?

    According to the Centers for Disease Control and Prevention, the current HIV antibody test is 95-96% accurate when done 12 weeks after a suspected exposure, and 98-99% accurate when done 6 months after a suspected exposure. For a test to be as accurate as possible, the immune system must react to the virus’ presence and produce antibodies in enough quantity so that they will be picked up by the test. The test is so sensitive that, if it makes a mistake, it is more likely to give a false-positive result than a false-negative.
  9. What is the difference between an antibody test and an antigen test?

    An antibody test looks for antibodies that have been produced in response to the presence of HIV. Antigen tests look for the virus (the antigen) directly. Antigen tests are more expensive and less accurate than anitbody tests.
  10. What are the names of the tests for HIV?

    The EISA or EIA (enzyme-linked immunosorbent assay) is the most common test. The IFA (immuno-florescent assay) and Western Blot are confirmatory tests. The PCR (polymerase chain reaction) is an antigen test for HIV. The brand name of the oral antibody test is Orasure.
  11. What is the so-called "window period" in an HIV test?

    The time between initial infection and when a test is accurate is the "window period."
  12. Where can I get an HIV test?

    All county health departments in Oregon and southwest Washington offer confidential HIV testing. Private physicians, clinics, Planned Parenthood, Tribal Health Clinics, some college health centers, and the school-based health clinics in Portland Public Schools also offer HIV testing.
  13. Should I insist my HIV test be done anonymously?

    Whether a person gets an anonymous or a confidential HIV test depends on their personal level of comfort. If you have to provide proof of test results (like to an insurance company) then the test can’t be anonymous. (See Oregon’s HIV Testing Policy.)
  14. What does a T-cell count for an HIV-infected person show?

    T-cells are part of the body’s process of fighting infection. A low T-cell count indicates that the immune system is compromised.
  15. Which body fluids contain the highest concentration of HIV?

    (From the highest concentration to lowest) Blood, semen, vaginal fluids and breast milk contain transmissable amounts of HIV. "Blood" includes menstral blood, and "semen" includes pre-ejaculate. Some other fluids contain HIV, but it is highly unlikely you will ever be exposed to them (for example, lymph fluid, synovial fluid, cerebrospinal fluid, and amniotic fluid).
  16. Which body fluids carry no transmissible amounts of HIV?

    Saliva, tears, sweat, vomit, urine, nasal secretions, and pus. Remember, if any of these fluids is mixed with a high-risk fluid (for example, blood in saliva), the danger increases.
  17. Is it possible to get HIV from a blood transfusion?

    Yes, but because of several levels of screening (including testing of all donated blood) the likelihood is very, very small--less than 1 in 1,000,000. However, it is important that people do not donate blood to get an HIV test! That would increase the risk for everyone.
  18. When did they begin to test donated blood for HIV?

    Most blood-service organizations began testing for HIV antibodies in the spring of 1985.
  19. Which blood products are completely safe?

    Red cells and platelets cannot be treated, but they are tested; white blood cells and plasma (including serum albumin, cryoprecipitates, Factor VIII, gamma globulin) are heat or chemically treated to kill HIV.
  20. Is it safe to donate blood?

    Yes. Disposable needles and equipment are used for each donor. Nothing is shared or reused. It has always been safe to donate.
  21. Can I get HIV from an HIV-infected person’s cough or sneeze?

    No. HIV is a blood-borne virus, not an air-borne virus. It is carried in blood, fluids, and tissues that contain blood cells. It can’t be transmitted in the air or water or passed by touching dry skin to dry skin.
  22. Can I get HIV by working with someone who is infected? Are children safe at school?

    Since HIV is spread primarily by having unprotected sex or by sharing needles with infected partners, people are safe from HIV infection in everyday school and work activities. In fact, an HIV-infected child or adult is more at risk from everyday contact because the infectious diseases most people carry may be life-threatening to someone with a compromised immune system.
  23. Can I get HIV by French-kissing?

    There has been only one documented case of passing HIV mouth to mouth--and the risky fluid turned out to be blood, not saliva. HIV is either not in saliva or is found in such low concentrations that it is not transmissible. If there is blood in the saliva, the risk is higher.
  24. Does there have to be a cut or tear in the skin for HIV to get in?

    Yes. HIV cannot pass through intact external skin. But the virus can pass through intact mucosal membranes found in the rectum, vagina, urethra, eye, inner mouth, and nose and ear canals. (These are not equally risky. For example, the rectum is more vulnerable than the mouth.)
  25. What are the three most common ways HIV is spread?

    Unprotected sex (where infected semen, vaginal fluids, or blood are introduced into the rectum, vagina, mouth, or urethra of another person), sharing needles and other injection drug use equipment, and an infected woman can pass HIV to her unborn child during pregnancy, birth, or breast feeding.
  26. Which sexual behaviors can result in infection?

    Anal sex without a condom. Vaginal sex without a condom. Performing oral sex on a man or a woman to orgasm and without a barrier (especially if the woman is on her period). Oral/anal contact without a barrier. Any activity which generates blood and creates tissue damage for both partners.
  27. When it comes to sex, what is 100% safe?

    Abstinence, masturbation, and contact with another person that does not involve semen, vaginal fluids, or blood.
  28. If I do have sex with someone else, how can I protect myself from getting HIV?

    (In order of effectiveness) By engaging only in non-insertive behaviors (hugging, massage, masturbation); by being in a mutually exclusive, long-term, monogamous relationship with an uninfected person; and by correctly using latex barriers during every sexual act where semen, blood, or vaginal fluids are present.
  29. What does the term "water-based lubricant" mean?

    It means a lubricant that does not contain any oil and can be washed off with water. Examples of water-based lubricants are K-Y Jelly and Astroglide. Water-based lubricants do not damage latex barriers, whereas lubricants that contain oil (such as Vaseline, massage oil, or hand lotion) will damage latex.
  30. Should I use a lubricant or a condom that has nonoxynol-9?

    There is no proof that nonoxynol-9 protects against HIV and many people are allergic to it--they experience irritation or soreness. Irritated tissues are even more vulnerable to infection.
  31. If I am allergic to latex, what do I do about safer sex?

    Use barriers made of something other than latex, like polyurethane. About 10% of the population have latex allergies, and a latex allergy can appear where it didn’t exist before because of repeated exposure to latex. A latex allergy feels like soreness or irritation in the affected area.
  32. Which is the best type of condom to protect against HIV?

    Latex or polyurethane (NEVER "natural skin" or "lambskin"), with a receptacle tip and a water-based lubricant.
  33. What is the best way to avoid becoming infected with HIV through injection drug use?

    Don’t use drugs.
  34. If I do inject drugs, how can I protect myself from getting HIV?

    (In order of effectiveness) Get into treatment. If you can’t do that, don’t use needles. If you use needles, don’t share them with anyone. (Also, never share other injection drug use equipment.) You can buy needles in Oregon without a prescription, or you can use a needle exchange program. If you are going to share, learn how to clean the needles with bleach.
  35. Which other needle-using activities can transmit HIV?

    Sharing unsterile needles for injecting steroids or insulin, for piercing, tattoos, acupuncture, etc.
  36. If I pick up a needle and stick myself, what should I do?

    First, squeeze the site and get the blood coming out of the opening. Then wash it off with soap and water. Consult a medical provider. If possible, carefully take the object to a testing facility. If the accident happened on the job, report it to a supervisor.
  37. What kind of casual contact does not transmit HIV?

    All casual contact is safe: hugging, shaking hands, using toilets or drinking fountains or hot tubs or swimming pools, using objects or eating food handled by someone with HIV, kissing...ANY behavior where infectious body fluids are not introduced into another person’s body.
  38. Why are people of color disproportionately infected by HIV in this country?

    There are many reasons: language barriers, cultural and religious taboos (such as those against frank discussion of sexual activities or condom use), mistrust of government and medical authorities, homophobia, and fear of additional racist discrimination, higher levels of poverty, substance abuse, and less access to health care.
  39. Is it true that there are more gay men with HIV than any other group?

    In the U.S. gay men are disproportionately infected with HIV. However, worldwide this is primarily a heterosexual disease. Also, injection drug users, women, African-Americans and Hispanic-Americans, and teens are becoming infected at alarming rates.
  40. Do most prostitutes have HIV?

    There are probably no more prostitutes carrying HIV than is seen in any other sexually- or drug-active population. In fact, prostitutes (male or female) often know how to use condoms better than other sexually active people do.
  41. Do mosquitos transmit HIV?

    No. When a mosquito ingests HIV-infected blood, the virus dies (unlike malaria, which lives in the mosquito’s intestinal system and is re-injected out in its oral fluid). The mechanical procedure of feeding wipes blood off of the mosquito’s proboscis--it is retracted into a sheath. Even in geographical areas where mosquitoes proliferate, HIV is still seen only in sexual or blood-sharing adults.
  42. How long will the virus live outside of the body?

    Probably not very long, but the actual time is hard to determine. In a lab, with controlled temperature, moisture, and in artificially increased concentrations, HIV has been kept alive for weeks--but it began to die immediately after removal from the body. In general, if the body fluid is dry, the virus is inactivated. If it’s wet, think barrier!
  43. How risky is performing first aid?

    With suitable universal precautions, the risk is low. With 6 million health care workers in the U.S. and their repeated exposure to blood and body fluids, there have been fewer than 100 documented cases of occupational exposure (as of 1998).
  44. What is the life expectancy of an adult or a child infected with HIV?

    It varies dramatically from person to person and from country to country, depending on many factors, especially access to health care. Asymptomatic HIV disease may last for many years. Based on past trends, an adult’s life expectancy averaged 12 years; a child’s was 7 years. With new treatments, these numbers have increased and become much harder to predict.
  45. Why don’t we have contact tracing for people who have unprotected sex and test HIV+?

    Contact tracing is required by Oregon law in certain specific situations, where a person could not reasonably be expected to know he/she was at risk. This includes where a man’s bisexuality is not known to his female partner and he refuses to notify her of the risk. Otherwise, heterosexuality is not considered to be a factor that would keep someone from suspecting they might be at risk. People can and must protect themselves rather than rely on governmental agencies for protection.
  46. How do we know you can’t get HIV through casual contact?

    HIV has been scientifically studied for over 20 years. With over 800,000 cases of AIDS in the U.S. alone and an estimate of 1 million people infectd with HIV, not one case has been traced to casual contact.
  47. Do condoms fail 1% of the time or 99% of the time? Who is right?

    The failure rate of condoms is primarily user failure, not product failure. Most studies that quote a high failure rate include failure attributed to condoms not being used correctly, as well as breaking or slipping off. Used correctly and consistently, a latex condom greatly reduces your risk.

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