HIV has been around for some time and the majority of people are now aware of it. The fact that this virus causes a variety of health issues is well known.
But there are a lot of myths out there pertaining to infection with the virus. Yet, correct information and good understanding are critical to your ability to stay protected.
The aim of this article, therefore, is to furnish you with facts that can help you avoid or be in effective control of this scary virus. We provide answers to most questions that people typically have about HIV.
What is HIV?
HIV stands for human immunodeficiency virus. This submicroscopic organism is known to attack the immune system of a host. It effectively breaks down your body’s defense against diseases and infections.
The virus destroys many key immunity cells, particularly CD4 or T cells. It is the destruction of these cells that eventually allows the infection to progress to acquired immune deficiency syndrome (AIDS).
Infection with HIV is life-long, which means that it has no cure. The virus typically shortens the lifespan of those infected considerably.
More than a million people are estimated to be living with HIV in the United States. According to the CDC, 38,739 people in the U.S. and six dependent areas were diagnosed with the virus in 2017.
Yet, many of those affected don’t realize they have the virus because it is not always immediately symptomatic.
However, advanced medical treatments have now helped to improve the survival rate drastically. It is now possible to prevent HIV infection from progressing to AIDS.
New cases of AIDS in the U.S. are estimated at about 18,000 per year.
Brief History of HIV
Not much was known about this virus until the late years of the 20th century. It was not until 1981 before AIDS, caused by the virus, was clinically observed in America. The disease was first reported among gay men and drug users.
Different research groups soon observed that a particular retrovirus may have been responsible for reported AIDS cases.
The virus was initially known by different names, including human T-lymphotropic virus III (HTLV-III) and lymphadenopathy-associated virus (LAV). Its name became HIV in 1986.
The origin of the virus has been traced to non-human primates of West-Central Africa, specifically chimpanzees and Old World monkeys.
A theory has it that simian immunodeficiency virus (SIV), the variant of this retrovirus seen in chimpanzees, was probably transmitted to humans through blood contact or consumption of the primate’s meat. This version then mutated into HIV in humans.
It is thought that humans may have had the virus since the late 19th century. Medical experts believe that HIV has been in the US, at least, since the 1970s.
HIV Types and Groups
HIV actually describes more than just a single virus. It mainly refers to two species in the Lentivirus subgroup of a retrovirus. This kind of virus is known for causing prolonged illnesses and having a long incubation period.
The two types or species of the virus are HIV-1 and HIV-2.
This is the more common of the two classes of the virus. HIV-1 is also highly virulent and more infective than the other species.
It is the type that’s believed to have originated from the common chimpanzee. This was the species that researchers first observed in AIDS patients.
Most HIV infections in countries around the world are linked to HIV-1. It is responsible for an estimated 95 percent of cases.
Traced to sooty mangabey, this species causes suppression of the immune system more slowly and is less virulent, compared to HIV-1.
HIV-2 is also less infective. What this means is that you are less likely to contract the virus when exposed to it than you would with the first type.
This particular species is endemic to certain countries. It mainly affects people in West Africa, according to medical researchers. Occurrence in other parts of the world is insignificant.
HIV groups and subtypes
The immunodeficiency virus has groups and strains. The potential for faster transmission or progression differs between these groups and their subtypes.
Specifically, four groups of HIV-1 have been identified, based on the region of their envelope. They are groups M, N, O, and P.
Group M is the most common. It has at least about nine different subtypes, including A, B, C, D, F, G, H, J, and K. The most prevalent of these subtypes in North America, Europe, Asia, and Australia is subtype B.
The other three groups are less common. Group O is believed to account for up to 5 percent of infection cases in West and Central Africa. Groups N and P are even rarer.
How Can You Acquire HIV?
The virus is transmitted between individuals through bodily fluids. These include:
- Breast milk
- Vaginal secretions
- Anal mucus
Sexual contact is arguably the most common means by which people contract HIV infections. You can have it through vaginal or anal intercourse, especially when you have unprotected sex.
It is also possible to get the infection by sharing sharp objects, such as needles and razor blades, with anyone who has the virus.
Blood transfusion is, obviously, another means a person can acquire this virus. But this is not much of a risk in places where blood is usually properly screened before transfusions.
A pregnant or nursing woman who has HIV could transmit it to her child.
The infection develops when bodily fluids with a huge load of the virus enter a person’s body through sores or cuts in the skin. The virus then infects the T cells of the immune system. Infected T cells can also, in turn, spread the infection to other T cells.
Symptoms of HIV
The symptoms a person will notice when infected with this retrovirus aren’t really due to it per se, at least not directly. They occur as a result of other infections and disorders that it creates room for.
People with HIV, especially those that do not seek prompt treatment, go through three main stages. The symptoms that you can observe in each of these stages are typically different.
Primary infection stage
This refers to the period following a contraction of the virus – specifically two weeks or over a month after the infection. During the primary or acute HIV infection phase, infected individuals experience flu-like symptoms. This is a sign of the body trying to deal with the infection.
Some of the early signs of acute HIV infection are:
- Muscle aches
- Joint pain
- Sore throat
- Involuntary weight loss
The virus spreads faster during this stage of infection progression. The infected individual can easily pass it on to others due to a high viral load.
Clinical latent infection stage
Also known as the chronic or asymptomatic HIV infection stage, this phase can last for up to a decade. A person may not exhibit worrisome symptoms during this time, but the virus remains active.
HIV reproduces slowly and so the infected individual may not feel weak. The virus continues to do damage to the immune system and organs in the body, however.
Proper treatment can help to prolong this stage such that an infected person doesn’t progress beyond it for decades.
This phase, also called stage 3 HIV, is the last. The immune system becomes so weak that an infected person becomes easily susceptible to severe disorders.
Common symptoms that are seen in this final stage include:
- Swollen lymph glands
- Recurring fever (lasting for weeks at a time)
- Dry cough
- Unexplained, constant tiredness
- Shortness of breath
- Persistent diarrhea
- Blurred vision
Late-stage HIV leaves you open to what are called opportunistic infections and disorders. These include:
- Herpes simplex
- Persistent pneumonia
- HIV-related encephalopathy
- Kaposi’s sarcoma
- Invasive cervical cancer
People who progress to this last stage may not live beyond three years without adequate treatment.
Groups at Risk
We already mentioned how AIDS was first reported among gay men. It was initially thought to be restricted to such people that gay-related immune deficiency (GRID) was initially used to describe infection with the virus.
But it has since been known that all groups of people – young and old, male and female – can have HIV. It cuts across racial divisions.
You are at risk of having the virus if you fall into any of the following groups:
- Those having unprotected sex
- People engaged in intravenous drug use in an environment that often involves sharing of needles and syringes
- Persons having multiple sex partners
- Individuals having sexually transmitted infections (STIs) that give rise to open sores in the genital area
Researchers have also observed that a man not being circumcised may increase his risk of contracting and transmitting HIV.
How to Know Your HIV Status
A lot of people who have this virus do not even know they have it. This appears to be especially truer in Africa, where only less than one percent of sexually active people in the urban areas are believed to have been tested in 2001.
Even in America, the CDC says an estimated 1 in every 7 persons who have the virus do not know it.
Observed symptoms aren’t enough to determine whether a person has HIV. Blood tests are usually required to detect the virus.
There are three main types of tests for detecting the presence of HIV:
Antibody test – The aim of this test is to check for antibodies to the virus in your bodily fluid. It typically involves testing either blood or oral fluid. You can have your results in less than 30 minutes, but they can also take days to be ready.
Antigen/antibody test – While antibodies are produced when harmful agents enter the body, antigens are what prompts your immune system into action. The p24 antigen is present in people with HIV. This test is intended to detect both antigens and antibodies linked to the virus.
Nucleic acid test – The target with this one is not to test for antibodies or antigens, but for the real virus. Nucleic acid tests are usually great for early detection. But they are also very expensive.
A positive result suggests the virus is present in a person. The specimen is usually tested again before disclosing a positive result.
It is very vital to know your HIV status. The CDC recommends testing at least once for persons whose age falls within the 13-64 range. Those who fall within the risk groups should do this more often.
Early detection of the virus can drastically enhance the survival rate. It could also help to keep other people from getting infected.
How Soon After an Infection Can HIV be Detected?
It is not yet possible to detect the presence of this virus immediately after exposure to it.
The nucleic acid tests that help to detect it earlier require almost two weeks to more than a month after exposure. You may have to wait up to three months for detection to be possible with the antibody tests.
STDCheck offers what appears to be the fastest means of detecting the virus with its FDA-approved HIV RNA Early Detection Test. This newer method is not only faster but also provides accurate results.
Anonymous vs. Confidential Testing
In the United States, HIV test results are protected by both federal and state privacy laws. But the level of privacy you enjoy depends on the option you choose for testing.
You can select between anonymous and confidential testing. They might sound like the same thing, but they are slightly different.
When you go for this option, there is no way your results can be traced to you. You don’t need to provide very specific identifying information.
With anonymous testing, you get a unique identifier – not personal information. This is all you need to get your results.
You also enjoy significant privacy with confidential testing, only that it is not on the same level as anonymous. Your results will only be released to people you approve.
What you might not feel so great about here is that your result will be filed in your medical records. In other words, your health care provider and the insurance company may have access to it.
Your test result along with identifying information will also be provided to you’re local or state health department, which will pass the same on to the CDC for data purposes after your personal identifying information has been removed.
The confidential testing that STDCheck offers seem to be different from the usual. Your test result will not be put in your medical records or reported to your health insurer.
Treatment of HIV
There is no cure for this immunodeficiency virus. A person who has it will have to live with it for the rest of his or her life.
But there are now advanced treatments that can enable people to live longer with the virus. These assist in ensuring the infection doesn’t progress to AIDS. They obviously explain why many people in developed countries, such as the U.S., don’t develop the latter after exposure to HIV.
Treatment mostly consists of the use of antiretroviral medications. The drugs help to bring down the viral load in an infected person. Among them are:
Integrase inhibitors – These medications inhibit the enzyme integrase, which the virus requires to infect T cells of the immune system. They are typically the first-line intervention. Examples include Vitekta and Isentress.
Protease inhibitors – This kind of drugs blocks protease. HIV depends on this enzyme to create copies of itself in the body. Examples include Kaletra and Evotaz.
NRTIs – Fully known as nucleoside/nucleotide reverse transcriptase inhibitors, these drugs make it hard for the virus to replicate itself. Combivir and Ziagen are examples.
Among the other classes of drugs that are often used are non-nucleoside reverse transcriptase inhibitors and chemokine receptor antagonists.
Doctors often recommend a combination of antiretroviral medications. This is more effective for keeping the virus in check.
The efficacy of these drugs is so great that progression to AIDS is becoming rarer and rarer. They help suppress the viral loads to the extent that they become undetectable. That’s usually when the load drops to less than 50 copies per ml.
When this happens, it is practically impossible for such an individual to transmit the virus to another person. But this doesn’t mean they can now stop taking their medications. There’s still a need for treatment to continue suppressing HIV.
PrEP and PEP
Apart from drugs that are used to treat HIV, there are also those that are intended to prevent infection. They mainly fall into two categories: pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).
PrEP medications are for people who are at high risk of contracting HIV. These can reduce the risk of infection by up to 90 percent with these drugs. But it is important that you take them daily to improve efficacy.
On the other hand, PEPs are anti-HIV medicines a person takes when they suspect possible exposure to the virus. They are basically antiretroviral drugs.
The main difference between PEP and regular antiretrovirals is that they need to be taken within 72 hours of exposure. Hence, you’d often hear them described as emergency HIV pills.
PEP treatment lasts for four weeks. You will need to take 1-2 pills per day during this time.
PrEP offers probably a better means of protecting against infection in that prevention is always best. It gets better when you combine it with standard protection measures.
Prevention and Outlook
PrEP and PEP are just two of the ways you can prevent an infection. They are actually newer.
It is important to still stick to standard guidelines on how to reduce your risk of contracting HIV. You should:
- Use a condom correctly and always when you are not sure of the HIV status of your partner. The efficacy of this in preventing an infection rises dramatically when combined with PrEP.
- Avoid sharing needles and sharp objects, such as razor blades. This might also mean getting help for a drug abuse problem. If you take medicines by injection, ensure the needles you use are clean and unused.
- Guard against body fluid exposure. If you regularly have to come in contact with the body fluids of other people, make sure you protect yourself always. This is especially vital if you are a health worker.
- Get proper medical care when pregnant. Don’t just use antiretrovirals if you have HIV. You may put your baby at risk by so doing. It is advisable to work with your doctor for proper infection management to prevent mother-to-child transmission.
Men may also consider circumcision. Research has shown this could help to cut risk.
You can as well help to prevent the spread of the virus by informing your sexual partners if you are positive to it. This may give them a reason to get tested and also know their own status.
You need to remember, however, that having HIV is not the end of the world. With proper treatment, people who have it may even live longer than those who don’t.
The important thing will just be to stick to treatment religiously. Certain lifestyle adjustments will also help. You need to be closer to your doctor, if you have the virus, to better ensure it doesn’t adversely impact your health and lifespan significantly.
Frequently Asked Questions
Can I have the virus through sneezing, hugging, or kissing?
No. HIV is not transmitted through this means. Medical experts even say you cannot have it through contact with the saliva, feces, urine, or tears of an infected person.
Do I need to get tested even though I don’t think I am at risk?
It is still advisable to get tested, especially if you are sexually active. The CDC recommends that every individual between the ages of 13 and 64 should undergo testing at least once as part of a routine checkup. You could, for instance, think about the remote possibility of your “faithful” partner having sex with other people.
What can I expect during testing?
A health care worker takes a sample of your blood or oral fluid. You may then be asked to wait for your result if it’s a rapid test. Otherwise, you’d be told when to come for it.
A negative result usually means you are free, especially if there has been no exposure in at least three months. You may need to undergo repeat testing if the result is positive.
There is often a counselor on the ground to help allay your fears and address your concerns.
Does a negative result mean you are free of the virus?
Yes, but not always. The virus might not be detected if you are still in the window period. This time varies between tests, so you should ask your provider about the specific testing method. You should have the same test again at the end of the window period, if it has yet to elapse, to confirm.
Does my negative result mean my partner doesn’t have HIV?
Not really. Your result applies only to you. You should also ask your sexual partner to go for testing to be completely sure he or she is also negative.
Does being HIV positive mean I have or will have AIDS?
You may not yet have AIDS by testing positive for HIV. But you could eventually have that dreaded syndrome without proper treatment. The earlier your commencement of antiretroviral drug use, the better your chances of preventing that.
Who pays for the test?
In the U.S., health insurance covers the cost, without a co-pay. You may even be able to access testing for free in some places.
However, who pays matters for anonymity. You should be ready out-of-pocket if you desire utmost anonymity. It’s for this same reason that the confidential testing service STDCheck doesn’t accept payment through insurance.