What is HIV and how is it transmitted?
There is a lot of information available about HIV, particularly on the Internet, and at times this can be conflicting, overwhelming and confusing.
HIV is a virus which attacks and weakens the immune system. The immune system is the body’s natural defence that protects it against disease and ill health. HIV stands for human immunodeficiency virus. If left undiagnosed and untreated HIV can really weaken the immune system and as a result the body is unable to fight off infections.
Untreated HIV can make a person very ill and because the immune system becomes so weakened that it’s unable to protect the body effectively. It can then be more difficult to treat the HIV, but if diagnosed and treated in time for the immune system to recover, then the person can usually recover to some extent. Early diagnosis and treatment is the key to avoid this happening.
What is AIDS?
AIDS stands for acquired immune deficiency syndrome, and it is not the same as HIV. The term AIDS is very rarely used these days, particularly in healthcare. These days, if someone does become very ill with HIV we’re more likely to refer to advanced or late-stage HIV, as described above.
How is HIV transmitted?
Contrary to what many people think, HIV is not an easy virus to catch or pass on. HIV can only be passed on through certain body fluids, when a route into the body is available. Only certain body fluids contain HIV in high enough quantities to cause transmission. These are: sexual fluids (semen, pre-ejaculatory fluid, vaginal fluids and anal mucus); blood and breast milk.
- Sexual transmission
Different kinds of sex have different risks attached. Anal sex is the most risky, followed by vaginal sex. There is also a risk with oral sex, but the risk is greatly reduced. Whether HIV is transmitted is dependent on a number of factors, and these can be quite complex. However the viral load impacts on likelihood of transmission. Viral load tells you how much HIV is in your bloodstream i.e. the higher the viral load, the higher the risk of transmission.
- Blood to blood transmission
For example, the sharing of needles and injecting equipment provides a direct blood to blood route.
- Mother to baby transmission
A pregnant woman living with HIV can pass HIV on to her child through pregnancy, during childbirth or breast milk. All pregnant women in the UK are offered an HIV test, and if you are HIV positive you can reduce the risk of passing on HIV to your baby through taking anti-viral drugs, and avoiding breast feeding. In the UK it is very unusual for HIV to be passed from mother to baby. Less than 1% of babies born to women living with HIV in the UK are born with HIV themselves.
For more information on HIV and HIV Transmission you can talk to Grant, our Health Promotion Manager. T: 01223 508805 or grant@dhiverse.org.uk
What do we mean by CD4 count?
This measure is an indication of the strength of the immune system. CD4 count is an indication of the strength of the immune system. In general, the higher your CD4 figure is, then the stronger your immune system is. It is now recommended that anti-viral treatment is offered to you as soon as you are diagnosed. Monitoring your CD4 count will help determine whether the treatment is working properly or not. If your CD4 count has dropped to abnormally low levels due to HIV infection it should start to rise to more normal levels after the treatments begin to take effect. Because CD4 counts can vary between individuals, a single CD4 count doesn’t tell you very much. Several CD4 counts are needed in order to see if there are any trends.
This measure is an indication of the strength of the immune system. CD4 count is an indication of the strength of the immune system. In general, the higher your CD4 figure is, then the stronger your immune system is. It is now recommended that anti-viral treatment is offered to you as soon as you are diagnosed. Monitoring your CD4 count will help determine whether the treatment is working properly or not. If your CD4 count has dropped to abnormally low levels due to HIV infection it should start to rise to more normal levels after the treatments begin to take effect. Because CD4 counts can vary between individuals, a single CD4 count doesn’t tell you very much. Several CD4 counts are needed in order to see if there are any trends.
CD4 count is an indication of the strength of the immune system. In general, the higher your CD4 figure is, then the stronger your immune system is. It is now recommended that anti-viral treatment is offered to you as soon as you are diagnosed. Monitoring your CD4 count will help determine whether the treatment is working properly or not. If your CD4 count has dropped to abnormally low levels due to HIV infection it should start to rise to more normal levels after the treatments begin to take effect. Because CD4 counts can vary between individuals, a single CD4 count doesn’t tell you very much. Several CD4 counts are needed in order to see if there are any trends.
CD4 counts fluctuate throughout the day. They are generally lower in the morning and increase throughout the day. They are generally higher immediately after exercise and can be affected by diet, stress and other infections. It is important to acknowledge that your CD4 count will have natural variations and these do not mean that you necessarily have a stronger or weaker immune system.
What is viral load?
This measure indicates how much HIV there is per cubic millilitre of blood. The lower this number, the less HIV is in the system and the less damage it can cause. The aim of putting people on treatment is to get the viral load count to undetectable levels. This means that the amount of HIV in the system is at such low levels that ill-health is unlikely due to the HIV and the risk of passing on HIV is in effect close to zero.
Viral loads will vary between individuals, but the vast majority of people will quickly achieve an undetectable viral load once treatment has started.
What is an undetectable viral load?
This is mainly only achieved when taking HIV medication. The term undetectable viral load can be misleading to some people. Although it is called undetectable, there is still HIV present in the body. It is called undetectable as the devices used to determine the viral load cannot detect HIV if there are fewer than 40 to 50 copies of HIV per cubic millilitre of blood. Having an undetectable viral load is the aim of treatments and means that the treatments you are taking are working i.e. HIV is present in very low levels, HIV is causing less damage to your body and the likelihood of passing on HIV is in effect close to zero
Treatment guidelines
Current UK guidelines state that anyone living with HIV can start treatment when they feel that the time is right. However, if you’re not on treatment, the viral load and the CD4 count may be factors that determine when your doctors think it is appropriate for you to start treatment. You can talk to your HIV consultant about this.
For more information on CD4 or Viral Load you can talk to Grant, our Health Promotion Manager. T: 01223 508805 or grant@dhiverse.org.uk
What is PEP?
PEP stands for post exposure prophylaxis. PEP is HIV medication you take after you have had an exposure. It’s a combination of HIV drugs which can be used to reduce the likelihood of a HIV negative person getting HIV after they have been exposed to the virus. PEP needs to be prescribed, and can be obtained from A&E departments or sexual health clinics. PEP needs to be taken as soon after exposure as possible to increase its chances of working effectively. In the UK, PEP can be taken up to 72 hours after exposure. However, it is much less likely to be effective when used this late. PEP is not a single tablet. It is a combination of three HIV drugs which need to be taken for 28 days. The principle behind PEP is that the very early use of HIV drugs may stop HIV from establishing itself in the body. You will be asked to take a HIV test before being prescribed PEP to ensure that you are not already HIV positive; the result will not tell you anything about your most recent exposure to HIV.
What is PrEP?
PrEP stands for Pre-exposure Prophylaxis. PrEP is anti HIV medication in the form of a pill which can be taken daily or before sex, in order to prevent HIV from being able to take hold in someone’s body if they are exposed to it. This is an exciting development in HIV prevention and studies undertaken so far do indicate that PrEP is successful in preventing HIV infection in most settings. PrEP is not currently available in the UK outside of a clinical trial setting, but work is ongoing and this may change. You can purchase PrEP online from reputable companies.
For more information on PEP or PrEP you can talk to Grant, our Health Promotion Manager. T: 01223 508805 or grant@dhiverse.org.uk
HIV Testing
A HIV test is used to determine if someone is HIV positive and taking a HIV test has never been simpler.
Knowing your HIV status puts you in control of your health and means you can access the medical treatment and support you need to stay well. With early diagnosis, treatment and healthcare, people living with HIV can expect a normal life expectancy. You can only know your HIV status by taking a HIV test.
Although a HIV test can determine if someone is HIV positive, they are subjected to a ‘window period’. If a test is taken too early, it may give a false negative result. A false negative result means that the test states that you are HIV negative when in fact you may actually be HIV positive. Many sexual health clinics use a window period of 12 weeks. This means that you may need to wait up to 12 weeks after your perceived risk, before taking a test. Different tests are more sensitive than others, and therefore the window period may not be 12 weeks, but it will depend on the test. The service providing your test will be able to give you more information about this.
HIV Insti Testing at Dhiverse
At Dhiverse we offer free and confidential instant HIV tests in a confidential, friendly and relaxed environment. You can have a chat with us before deciding to test and we offer follow up support. The test is a finger prick blood test and you get the result there and then in around a minute.
Insti tests are 99.9% accurate but if your test is reactive (indicates that you are HIV+) then we will refer you to a sexual health clinic for a confirmatory test. We can usually get you an appointment at a sexual health clinic on the same day.
Times: At Dhiverse we offer tests at the following times:
Monday to Thursday 10am to 5pm each day and Friday 10am to 2pm
For more information or to book a test with Dhiverse contact Grant on 01223 508805 or email enquiries@dhiverse.org.uk
Testing at a Sexual Health Clinic
Many people choose to go to a sexual health clinic to have an HIV test. Again, the test is free and completely confidential, and will not be passed on to any other part of the NHS without your permission (it will not go on your GP’s medical records). You can access any sexual health clinic; you do not need to go to the closest. Dhiverse can support you both with your visit to a sexual health clinic and once you receive your results. Different places offer different tests e.g. instant tests and tests where results are in a couple of days or longer.
For details of sexual health clinics that provide HIV testing in Cambridgeshire, Peterborough and other parts of East Anglia please click here https://www.icash.nhs.uk/where-to-go/icash-cambridgeshire
