HIV 101

When I speak to friends, loved ones, and internet trolls about HIV, there's a lot of missing facts and outdated information. Whether I'm explaining the difference between HIV and AIDS, or, why the stigma is doing more damage than the virus itself, people have no idea what I'm talking about.

I was on the verge of defriending anyone I thought would never get it, until I remembered what this blog is all about; Helping Ignorant Victims. Victims to their own ignorance, living in a world with no idea that the same virus that changed life as we know it is making a resurgence, and we can stop it. Taking away the one smart friend they have isn't going to help things. This is an important time to educate and be educated. It's time to smarten up!

 

HIV

Human immunodeficiency virus attacks important cells that fight infection and disease, destroying the immune system in the process. There's no cure (yet), but, due to the advancement of medicine, research, and treatment, HIV is treated as a chronic disease (like diabetes) and not a terminal illness. There are three stages of possible progression.

 

Acute HIV Infection - This refers to the first 1-4 weeks of contracting the virus, when seroconversion takes place. During this time, there may be physical symptoms attributed to HIV (of the 7 people in my life who are positive, three were diagnosed after seeking treatment for flu-like symptoms. Three friends found out after routine check-ups. Only two of my friends found out by getting tested). Symptoms include - but are NOT limited to: swollen glands, persistent fever, headache, and rash. It is also during this time that the person with the virus is highly infectious, making them vulnerable to transmitting HIV to others. This is why it is SO IMPORTANT to GET TESTED REGULARLY! CDC suggests annual testing (more frequent testing is suggested for those in high-risk categories).

 

Clinical Latency Stage - During this stage the virus appears dormant. It slows down producing copies of itself, and leaves few - if any, physical symptoms of its presence. However, HIV will continue to multiply in the system. When left untreated, the virus can remain dormant in the system for as long as ten years and as little as two.

 
According to a 2014 report from UNAIDS, 36.9 million people were living with HIV worldwide, with 2 million people infected across the world (50,000 new cases here in the states).

*For more information on HIV testing and treatment, go to aids.gov


 

AIDS

Acquired Immunodeficiency Syndrome is the most advanced,
progressive stage of HIV (often referred to as late-stage HIV). Depending on which report you read (I'm going with AVERTing HIV and AIDS ), studies show that individuals can live roughly 10 to 15 years with untreated HIV before the virus progresses to AIDS. By this time, the immune system has suffered extensive damage, and the body is vulnerable to different infections and illnesses.

People living with AIDS are vulnerable to tuberculosis, pneumonia, and other opportunistic infections. The CDC classifies an AIDS diagnosis as any HIV+ patient who develops one or more OI, regardless of their viral load or CD4 count.

Thanks to groundbreaking antiretroviral treatment (more on that in a bit), AIDS is not nearly as prevalent as it used to be in America. However, in many third world countries AIDS is a major issue. Here are a few quick facts (provided by dosomething.org) about how HIV/AIDS is affecting Africa:

 

·         Out of the 34 million HIV-positive people worldwide, 69% live in sub-Saharan Africa.

·         There are roughly 23.8 million infected persons in all of Africa.

·         91% of the world’s HIV+ children live in Africa.

·         More than one million adults and children die every year from HIV/AIDS in Africa alone.

·         In 2011, 1.7 million people worldwide died from AIDS.

·         Since the epidemic of HIV/AIDS, more than 75 million people have contracted the illness, and over 36 million have died from an HIV-related cause. 71% of the HIV/AIDS-related deaths in 2011 were people living in Africa.

 

*For more information on the plight of Africans fighting the war against AIDS, check out the AIDS Foundation of South Africa or UNAIDS.org

 

Viral Load

According to AIDS.gov, the term viral load refers to the amount of HIV in a sample of blood. A viral load test is a lab test that measures the number of HIV virus copies (particles) in a milliliter of your blood. A viral load test helps provide information on your health status and how well antiretroviral therapy is controlling the virus. A high viral load means that there's a high level of HIV present in the body; a low viral load means that the HIV is being controlled and suppressed.

In other words, there is a degree as to how much of the virus is in the blood stream. The higher the degree, the higher the risk of contracting an infection or illness, spreading the virus, and getting AIDS. In addition to reducing the amount of HIV in the body, HIV medicines greatly reduce the risk of transmitting to others. 

 

 

Undetectable Viral Load

 

“... When an HIV-infected person takes antiretroviral therapy that keeps the virus suppressed, the treatment is highly effective at preventing sexual transmission of HIV to an uninfected heterosexual partner.” Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases

This is a moment when every poz patient should give themselves a gold star. Celebration need be had when your doctor tells you that your viral load test came back undetectable. So long as you take care of yourself and take your medicine, you stand a good chance of living a full and healthy life.

The correlation between preventing those who are negative from contracting the disease, and keeping those who test positive undetected cannot be overstated. Keep the patient healthy and undetected. This way, they live long, productive lives with unlikely risk of transmitting HIV. Keep negative patients negative with regular testing and proper prevention. It’s that simple! Or, so it would seem…

 Only about 25 percent of people living with HIV in the U.S. have achieved viral suppression. African Americans are least likely to have controlled HIV in this manner, with 21 percent achieving viral suppression, compared to 26 percent of Hispanics and 30 percent of whites.

data retrieved from Illinois HCC 

 

Undetectable means that after a series of tests, results show that a person living with HIV no longer shows traces of the virus. However, ven though ART's and a healthy lifestyle have suppressed the virus to untraceable levels, it's still there. Without ART's, copies of the virus will most likely resurface and multiply in the blood. No drug holiday's for poz patients.

 It may seem like a drag for *serodiscordant couples to rely on condoms as a sole mean of protection. Especially since there is no 100% guarantee against contracting HIV or any other STD/STI when it comes to shared-needle usage or sexual contact. However, there are ways to further protect and intervene HIV transmission.

 *Serodiscordant is a term used to describe couples with differing HIV status; one partner is HIV+ and the other is negative. Such couples are also referred to as magnetic or mixed-status. In the event that both partners are HIV+, they are then in a seroconcordant relationship.


Antiretroviral Treatment (or therapy)

HIV/AIDS-related deaths has dropped dramatically since it's inception in 1981. The reason is ART. This form of treatment has been a key factor in viral suppression, as well as increased lifespan of HIV+ patients.

ART is a combination of medicines used to fight HIV. The combination, dosage, and amount differs for each person. Some people have to take a few pills in the morning and a few pills at night. Others take much more (I have a few friends who take a single pill once a day). There's a variety of contributing factors; prescriptions, dosage, existing medical condition, cost, etc.


For more information on antiretroviral treatment, go to advent.com 
 

 

PEP

 Post-exposure prophylaxis is the usage of ART's to prevent HIV from making copies of itself and spreading in an HIV negative body after a single high-risk event. PEP must be started as soon as possible to be effective, and always within 3 days of possible exposure.

 

You read it right. The same drugs used to suppress HIV can prevent you from getting it. While its inception is news to most, PEP has been around for well over a decade, used to prevent seroconversion in rape victims and many in the medical field who've been exposed to HIV.

 When you think PEP, think the morning-after pill. The only exception is that PEP requires 28 days of continuous use to work, and has little affect if taken improperly or outside the 3-day window of exposure.

 

 PrEP

 PrEP (re-exposure prophylaxis) is the controversial practice of using antiretroviral drugs to prevent HIV infection before exposure. When used correctly, *PrEP can build up to a 92% immunity against HIV.

Condomless sex outside of primary relationships or marriage happens with regularity. While an undetectable status reduces risk of transmission - dramatically, because of the virus' presence, it still poses a miniscule risk. For that reason, doctors will always advice PrEP users to proceed with condoms.

 

Truvada is currently the only medication available for PrEP use. It's only been on the market since 2012, but there is much hype, stigma, and gossip surrounding the prophylaxis.

When you think of Prep, think the birth control pill. It doesn't work right if you don't take it every day, and it's not necessary to take it if you're not active or no longer fall in the high-risk category. However, if you find yourself involved with someone who's positive, PrEP is an amazing option that would allow you and your partner to engage in the safest sex possible.

 

*Depending on which source you go by, the effectiveness of using Truvada for PrEP will vary. prepfacts.org gives it a 92-99% rating in effectiveness. Other sources give it approximate percentage rates - all ranging past 90%. However, there are those in the medical field, as well as the HIV/AIDS community who both question the effectiveness of prophylaxis as well as the intention of it. There will be a more detailed post on PrEP to come.

 

The Virus vs. The Stigma

I've yet to publish a post that doesn't make mention of the nasty stigma. A cluster-fuck of dated information, myths, shaming, and even heavier consequences (such as incarceration), prevent many from getting both tested and treated. Fear of the backlash drives them to put any relation of them and the virus in the far-back of their brains. Even those at high-risk can convince themselves they have unlikely chances of contracting HIV. Besides that, the humiliation and shame associated with the virus sends many into a mean depression and downward spiral.

When we talk about people living with HIV, we are NOT talking about a threat to society. We are talking about a human being with a medical condition. Just like hepatitis. Just like herpes. Just like that nasty ass flu that was floating around New York City a few winter's ago. When it comes to medical conditions, they should always be treated with care and compassion.

The stigma is so threaded into our social dialogue, many rarely even notice its existence. Yet, every time someone treats AIDS as a punch line, insinuates that someone has it, shames someone living with AIDS for carrying the disease, or a person in the media mistakes HIV with AIDS (I know you hear me Howard Stern), the stigma is being perpetuated and allowed. It's going to a lot of acknowledgement, and a lot of conversations like this in order to get our way around the stigma.

 

The Virus vs. The Future 

This is when the people who nod off during HIV talks need to wake up.

With a steady combination of HIV treatment, prevention, and information, we have more power than ever. This might seem far-fetched at first read, but keep in mind that San Fransisco's last annual report of newly infected HIV patients was only 350. New York, not to be outdone has pulled together an aggressive Ending The Epidemic Task Force. The task force, along with governor Cuomo has pulled together an impressive 5 year plan to get newly infected HIV diagnoses down to three digits. The plan incorporates treatment as prevention, along with outpatient programs, and prophylaxis.

Despite the hurtles that stigma and lack of information have created, there's much to be optimistic about when it comes to HIV treatment and prevention.




Thanks to the following sources:

Centers for Disease Control and Prevention
spectator.com                         avert.org
aids.gov                                   dosomething.org
unaids.org                               Illinois HCC
advent.com                             Poz    
Ending The Epidemic Task Force