HIV: Information, Testing and Support

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Understanding HIV

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HIV stands for Human Immunodeficiency Virus. It is a virus that attacks the body's immune system, specifically CD4 cells, which help protect us from infections and illness.

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Without treatment, HIV can gradually weaken the immune system. However, with modern treatment, people living with HIV can live long, healthy lives and may never experience serious HIV-related illness.

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What is AIDS?

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AIDS stands for Acquired Immune Deficiency Syndrome.

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AIDS is not a virus and it is not something that can be passed from one person to another. It is the term used to describe the most advanced stage of HIV infection, when the immune system has been severely damaged and certain serious illnesses develop.

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Before effective HIV treatment became widely available, many people diagnosed with HIV eventually developed AIDS. Today, this is uncommon in the UK because HIV can be successfully managed with antiretroviral treatment (ART).

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Healthcare professionals now often use the terms "advanced HIV" or "late-stage HIV" rather than AIDS.

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How is HIV Transmitted?

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HIV can only be transmitted through specific body fluids from a person living with HIV who has a detectable viral load.

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These body fluids are:

• Blood

• Semen (including pre-ejaculatory fluid or "pre-cum")

• Vaginal fluids

• Rectal (anal) fluids

• Breast milk

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HIV must enter another person's bloodstream or come into contact with a mucous membrane, such as the lining of the vagina, rectum, penis, mouth or eyes, for transmission to occur.

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HIV is NOT transmitted through:

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• Kissing

• Hugging

• Shaking hands

• Sharing food, cups or cutlery

• Using toilets

• Coughing or sneezing

• Saliva, tears or sweat

• Touching unbroken skin

• Mutual masturbation

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Blood Transmission

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HIV transmission can occur if blood containing HIV enters another person's bloodstream through:

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• Needlestick injuries

• Cuts or wounds

• Contact with mucous membranes

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There is no risk from contact with intact, unbroken skin.

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Needlestick injuries in healthcare settings carry a very low risk of HIV transmission. Emergency medication called Post-Exposure Prophylaxis (PEP) may be recommended following a potential exposure.

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Sexual Transmission

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HIV can be transmitted through condomless vaginal or anal sex if one partner has HIV and is not virally suppressed.

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The risk of HIV transmission can be prevented through:

• Effective HIV treatment (U=U)

• PrEP (Pre-Exposure Prophylaxis)

• Condoms

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The risk of HIV transmission through oral sex is extremely low.

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HIV and Pregnancy

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A person living with HIV can pass HIV to their baby during pregnancy, birth or breastfeeding.

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In the UK, all pregnant women are routinely offered an HIV test. When HIV is diagnosed and treated during pregnancy, the risk of transmission to the baby is extremely low.

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CD4 Count

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CD4 cells are an important part of the immune system.

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A CD4 count measures the number of CD4 cells in a sample of blood and helps healthcare professionals monitor the health of the immune system.

Without treatment, HIV can reduce the number of CD4 cells. In general, a higher CD4 count indicates a stronger immune system.

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Viral Load

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A viral load test measures the amount of HIV in the blood.

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The lower the viral load, the less HIV is present in the body. Effective HIV treatment reduces the viral load and protects the immune system from damage.

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The aim of HIV treatment is to achieve and maintain an undetectable viral load.

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What Does Undetectable Mean?

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HIV treatment, known as antiretroviral therapy (ART), can reduce the amount of HIV in the blood to an undetectable level.

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An undetectable viral load means the amount of HIV in the blood is so low that standard tests cannot detect it.

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People who maintain an undetectable viral load cannot pass HIV on through sex. This is known as:

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U = U

Undetectable = Untransmittable

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U=U is supported by extensive scientific evidence and is recognised by HIV organisations and healthcare professionals worldwide.

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Most people who start HIV treatment achieve an undetectable viral load within a few months, although this can take longer for some individuals.

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HIV Testing

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The only way to know your HIV status is to take an HIV test.

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Testing is quick, simple and confidential. HIV testing is available from:

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• Sexual health clinics

• Some GP surgeries

• Some pharmacies

• Community organisations and charities

• Home testing and home sampling services

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Rapid HIV tests can provide results within minutes, while laboratory-based tests and some home sampling kits may take several days.

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Early diagnosis means treatment can begin promptly, helping people stay healthy and preventing onward transmission.

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Post-Exposure Prophylaxis (PEP)

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PEP is emergency medication that can prevent HIV after a possible exposure.

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PEP should be started as soon as possible, ideally within 24 hours and no later than 72 hours after exposure.

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PEP may be recommended following:

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• Condom failure during sex

• Sexual assault

• Needlestick injuries

• Other high-risk exposures

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PEP does not protect against other sexually transmitted infections (STIs) and does not prevent pregnancy.

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Pre-Exposure Prophylaxis (PrEP)

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PrEP is medication taken by HIV-negative people to reduce their risk of acquiring HIV.

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When taken correctly, PrEP is highly effective at preventing HIV transmission through sex.

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PrEP is available free of charge through NHS sexual health services.

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Living Well with HIV

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HIV is now a manageable long-term health condition.

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With effective treatment, people living with HIV can expect to live long, healthy lives. They can work, study, have relationships, have children and enjoy the same opportunities as anyone else.

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Mental Health and Wellbeing

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Looking after your emotional wellbeing is just as important as looking after your physical health.

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Some people living with HIV experience challenges related to stigma, diagnosis, relationships, disclosure or other life circumstances. Others may experience mental health difficulties that are unrelated to HIV.

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If you are struggling with your mental health, speak to your HIV clinic, GP or another healthcare professional. Support is available, and seeking help is an important step towards maintaining your wellbeing.

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Local HIV Services

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For information about local HIV testing, treatment and support services, please contact your local sexual health clinic or GP surgery.

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For Cambridgeshire and Peterborough:

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• Contact your local sexual health clinic such as iCaSH (integrated contraception and sexual health clinic) on 0300 300 3030 or visit https://www.icash.nhs.uk/contraception-sexual-health/hiv

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• HIV Clinic at Addenbrookes Hospital

   Clinic 1a – HIV Clinic, Outpatient Department

   Addenbrooke’s Hospital, Hills Road

   Cambridge CB2 0QQ

   Tel: 01223 217766

 

General enquiries (not appointments): cuh.hiv@nhs.net

https://www.cuh.nhs.uk/clinics/clinic-1a-hiv-and-infectious-diseases/

 

You can also speak to your healthcare team if you have questions about HIV, treatment, testing, PrEP, PEP or living well with HIV.

 

Dhiverse can help with signposting and we offer training for professionals.