What is HIV?
Human Immunodeficiency Virus (HIV) attacks the white blood cells in your bloodstream. This destroys the immune system leaving you more susceptible to other illnesses or infections. If left untreated, it can develop into AIDS (Acquired Immune Deficiency Syndrome).
There is currently no cure for HIV, but treatment can allow you to live a long, healthy life.
With the current HIV prevention programmes in the UK, it is predicted that there will be an end to new HIV transmissions by the year 2030.
How is HIV Transmitted?
HIV is transmitted through bodily fluids (blood, semen, vaginal fluids and breastmilk). Other bodily fluids (saliva, sweat, urine, etc) do not contain enough of the virus to infect someone.
HIV infects the bloodstream; the most common ways the virus enters the bloodstream is through:
- Unprotected anal, oral or vaginal sex
- Sharing needles with a person living with HIV
- Through cuts, sores or open wounds
- Via the eyes (splash incidents)
HIV is NOT passed on through:
- Spitting
- Kissing
- Being bitten by humans or insects
- Skin-skin contact where there are no open wounds or sores
- Sharing towels, cups or cutlery
- Being sneezed on
- Mouth to mouth resuscitation
- Sharing swimming pools, toilets, saunas or steam rooms
Symptoms
HIV symptoms are generally the same in males and females. Most people develop a flu-like illness 2-6 weeks after infection, which lasts for around 7-14 days. Once these symptoms disappear, you may not experience symptoms for several years, but the virus will continue to damage your immune system.
Why is it important to get tested?
During the asymptomatic stage, you may never know you have acquired HIV, which is why regular testing is important.
If you are engaging in riskier sexual practices, or are at higher risk of catching HIV, it is recommended that you test more frequently and consider taking PrEP.
The people deemed high risk include:
- Sex workers
- People who engage in sex parties, swinging or similar
- Men who have sex with men (MSM), and women who have sex with MSM
- People who engage in chemsex (taking drugs to help or enhance sex)
- Drug users and their partners
- People from areas with higher HIV rates or have partners who are
- Having unprotected sex with partners who are living with HIV
- People with a history of STIs including hepatitis B or C
- People who have multiple sexual partners
- People who have been sexually assaulted
Prevention and protection
PrEP
Taking PrEP offers extra protection against HIV when taken correctly.
Use Condoms
Consistently using condoms during sex can significantly reduce the risk of STIs.
Get Tested Regularly
Regular STI testing is crucial, especially if you have multiple partners.
Communicate with Partners
Open and honest communication with sexual partners about STI testing and protection is essential.
Injectables
Sharing needles increases the risk of HIV and other bloodborne viruses. Never share needles with anyone and dispose of used needles in a sharps bin.
Treatment
Treatment as prevention refers to having a U=U status (Undetectable=Untransmissible) meaning you cannot pass the virus on.
Treatment for HIV
HIV has no cure. However treatment allows people living with HIV to have a long, healthy life. With treatment, HIV is now a manageable, chronic health condition and no longer life-threatening, as it was once thought to be.
HIV treatment involves antiretroviral drugs. These stop the virus from replicating inside the body, giving the immune system a chance to repair itself. Due to the speed which the virus can become resistant, a combination of drugs may be used, and the combination of drugs will be tailored specifically to you.
During treatment, you will have regular blood tests to measure your CD4 cell count. This tells you the amount of HIV virus in your blood (viral load). Once this can no longer be measured, it’s known as undetectable.
Taking your treatment regularly and correctly will result in the virus becoming undetectable in your blood, and you will no longer be able to pass on the virus to others. This is called U=U status, or Undetectable=Untransmissible. Most people become undetectable within 6 months of starting treatment; however, it is important to continue treatment, or the virus can start replicating again.
Where to get help and advice about HIV in Bexley?
Lewisham and Greenwich NHS Trust provide a local service at the Trafalgar Clinic in Woolwich. Find out more on their webpage for HIV Services here.
What happens at your appointment?
Contacting sexual partners It is strongly recommended that you contact your current and/or any previous sexual partners if you are diagnosed with HIV or think you may have been exposed to HIV. Informing them allows them to either get tested, access prevention drugs like PEP, or both. Your doctor or nurse can inform partners on your behalf anonymously.
If you are living with HIV in Bexley, you do not have to disclose your HIV status to future partners if you always have protected sex, however in England and Wales, you may face prosecution if:
- You have unprotected sex with someone who didn’t know you have HIV
- You knew you had HIV at the time
- You understood how HIV was transmitted
- You had sex without a condom, and
- You transmitted HIV to that person
Informing partners is always recommended, even if you are at U=U status. This allows your partner(s) to find out more about protecting themselves, including PEP and PrEP.
How to avoid getting and spreading HIV
To avoid getting HIV:
- Use condoms when you have vaginal or anal sex.
- Use a condom to cover the penis, or a latex or plastic square (dam) to cover the vagina if you have oral sex.
- Test after every new sexual partner, or every year if you do not change sexual partners regularly.
- Do not share sex toys (if you do, wash and cover them with a new condom before anyone else uses them).
- Do not share needles if you are a drug user
- Take PrEP (find out where to get PrEP in Bexley here)
Living with HIV
If you take your medication correctly, you can live a long, healthy life with a near-normal lifespan You will be referred to a specialist HIV service which may be in a sexual health clinic or hospital setting.
There are some things that people living with HIV are unable to do which include donating blood and organs, traveling to some countries, or purchasing certain life insurance policies. Your healthcare team will give you the most up-to-date information, but it is important to know that people living with HIV are protected under the Equality Act (2010) and there is no legal obligation to disclose your HIV status unless you are working in a frontline job in the armed forces, or a healthcare job where you perform invasive procedures.
HIV can also have a psychological impact, but support is available, and you will be in regular contact with your healthcare team who will monitor you on an ongoing basis. You may want to develop a good relationship with your healthcare team so they can provide you with the best possible support.
If you are a Bexley resident and want to get help, contact the Trafalgar Clinic team. Their details can be found here.
It may be difficult to tell your current and/or previous partner(s), but it is important to make them aware of your diagnosis. Speak to a member of your healthcare team if you require support with partner notification.
Complications of HIV
Untreated HIV infections can develop into AIDS (Acquired Immune Deficiency Syndrome). This is several potentially life-threatening infections due to the damage the HIV virus has caused within the body. The immune system is severely weakened, leaving you susceptible to opportunistic infections and some cancers. AIDS cannot be passed on, but someone living with AIDS can pass on the HIV virus.
Early detection via regular testing, and regular treatment can prevent the HIV virus developing into AIDS.
HIV in pregnancy
Transmission from parent to baby during pregnancy is possible, so you will be prescribed medication to prevent this. There is a 1 in 4 chance your baby will acquire the HIV virus without this medication, vs 1 in 100 (>1%) when taken correctly. There is no increased risk of passing on the virus via a vaginal delivery, however in some cases a caesarean may still be recommended.
The HIV virus can be passed on through breast milk, so formula feeding is recommended to avoid transmission to your baby. If your viral load is undetectable, it may be possible to breastfeed, a doctor or midwife will discuss breastfeeding with you.
Some HIV medications can be harmful to your baby, so your treatment plan may need to be reviewed if you become pregnant or are trying to conceive whilst living with HIV.