A wide range of symptoms is associated with HIV/AIDS. Many symptoms are not necessarily due to the breakdown of the immune system, but are the result of opportunistic diseases and infections and their manifestations. Two common manifestations are Pneumocystis Pneumonia (PCP) — a lung disease in which victims experience shortness of breath, a non-productive (dry) cough, anemia, and fever — and Kaposi’s Sarcoma (KS), a type of cancer that manifests itself as grayish-purple skin lesions, lesions on several internal organs, night sweats, and weight loss. Other symptoms associated with the various opportunistic diseases and conditions are chronic headaches, chronic and persistent diarrhea and vomiting, blindness, memory loss, rashes, sores, assorted aches and pains, neurological dysfunction and other manifestations.
HOW IS HIV TRANSMITTED?
Get the facts about how HIV is transmitted. Become more aware of how you might be putting yourself at risk.
HIV can live only in certain fluids of the human body. These fluids are blood, semen, vaginal secretions and breast milk. Saliva, sweat, urine and tears do not spread the virus because they do not have enough white blood cells for the virus to grow and survive.
HIV can be transmitted by any type of sexual contact (anal, penis-to-rectum; vaginal, penis-to-vagina; or oral, mouth-to-penis, -vagina, or -rectum), by blood-to-blood contact, including injecting drugs and sharing needles, or by a woman to her baby either before or during birth or through breastfeeding. HIV is not transmitted through any type of casual contact, nor by insects or animals. People are at risk of HIV infection when they participate in behaviors in which the exchange of bodily fluids is possible. Two examples of risky behaviors are having unprotected sex with an infected person and sharing needles.
Unprotected sex, or sex without latex or polyurethane condoms, can let HIV enter the blood. Vaginal, anal and oral sex each can transmit HIV. In an infected man, the semen (male sexual fluid) has a high amount of HIV. Semen can pass HIV from one person to another during unprotected vaginal, anal or oral sex. The virus can go through the lining of the vagina, anus or mouth into a person’s bloodstream. In women, vaginal fluids and menstrual blood can pass the virus to another person.
The most efficient means of HIV transmission is blood-to-blood transmission and injecting drugs and sharing needles is the behavior that accounts for the second highest number of reported AIDS cases (behind sexual contact) in the United States. If sufficient amounts of HIV-infected blood get into the body, infection may occur. It may take as little as a few drops for infection to occur. History has shown exposure of infected blood to intact skin (no open sores or lesions) does not transmit the virus.
If a person injects drugs either intravenously (into the vein) or intramuscularly (into the muscle) and shares needles, they are engaging in a behavior that puts them at great risk of transmitting or acquiring HIV.
Any type of needle sharing may transmit HIV. If an infected body builder injects anabolic steroids and shares the needle with someone else, the virus may be transmitted. Sharing tattoo needles or sharing needles for ear or body piercing could be a means of transmitting HIV. Intravenous infection could occur among seniors who are diabetic and share insulin needles.
The risk of transmission from mother to child through breastfeeding is present due to the high concentration of HIV in breast milk. Without treatment, an estimated one in every seven infants breast-fed by an HIV-positive mother becomes infected through breast milk.
Since 1985, all donated blood and blood products are screened for HIV. The risk of HIV infection through a blood transfusion is almost zero. Donating blood poses no risk because blood is drawn using sterile needles that have never been used.
The use of drugs and alcohol continues to be prevalent in many communities and is linked to risk factors for HIV infection and other STDs. Substance use can increase the risk for HIV transmission through the tendency toward risky sexual behaviors while under the influence and through sharing needles or other injection equipment.
WHO IS MOST AT RISK?
HIV risk factors are the same for everyone, but some populations are more affected than others (see the data here):
In Florida, African American and Hispanic populations are disproportionately affected. Social and economic factors including racism, poverty, lack of access to health care, and geographic region are barriers to receiving HIV prevention services. African American and Hispanic men are more likely than white men to be given a diagnosis of HIV infection in the late stages of infection, often when they already have AIDS, suggesting that they are not accessing testing or health care services through which HIV infection could be diagnosed at an earlier stage.
Men Who Have Sex With Men (MSM)
MSM are members of all communities, all races and ethnicities, and all strata of society. Social and economic factors, including racism, homophobia, poverty, geographic region and lack of access to health care, are barriers to receiving HIV prevention services, particularly for MSM of minority races or ethnicities. Sexual risk factors account for most HIV infections in MSM. Not using a condom during anal sex continues to be a significant threat to the health of MSM.
Behaviors that may accompany drug use can put people at risk for HIV. For example, trading sex for drugs or for money to buy drugs increases the number of sexual partners and the risk of infection. Similarly, heavy alcohol consumption may cause a person to lose inhibitions and engage in unprotected sexual contact with an infected person and transmission could occur. Judgment is often impaired during inebriation and any measures to prevent the transmission of HIV by the individual may be compromised.
HOW CAN I REDUCE MY RISK?
Protect yourself from HIV infection. Find out how you can make changes in your lifestyle to reduce your risk.
Abstinence from sexual activity is the only sure way to not become infected through sexual contact. If a person is not sexually active (through oral, anal or vaginal contact), there is virtually no chance of contracting HIV or any STD through sexual activity.
Having sex with only one uninfected partner is a way to be sexually active and not risk infection with HIV. Mutual monogamy means that both partners in a relationship are only having sex with each other.
Condoms are an important tool in preventing the spread of HIV. When used properly, condoms create a barrier that prevents the virus from spreading from an infected individual to someone else. Latex condoms are approximately 90 percent effective at preventing pregnancy and the passage of almost all STDs, including HIV. Most often, human error causes condoms to fail. This figure would be about 98-99 percent if everyone who used condoms used them correctly. Polyurethane condoms and female condoms are also highly effective.
Condoms may be obtained free of charge at any county health department in the state of Florida. Local AIDS services organizations and other community-based organizations also distribute free condoms. To find the nearest location where free condoms are available, call the Florida HIV/AIDS Hotline.
If an injecting drug user is sharing needles, needles and syringes must be cleaned. Ordinary household bleach drawn into the needle and syringe will inactivate HIV. The bleach must be drawn into the syringe, shaken, and squirted out. This process must be completed three times. Then, water must be drawn in, shaken, and squirted to thoroughly rinse out the bleach. This process should also be completed three times since injecting bleach into the veins can be more deadly than HIV.
PrEP and PEP
PrEP (Pre-Exposure Prophylaxis) is a comprehensive HIV prevention strategy that involves the daily use of antiretroviral medications to reduce the risk of HIV infection in HIV-negative individuals. In July 2012, the US Food and Drug Administration approved the use of Truvada (TDF/FTC) for use as PrEP in HIV prevention in sexually active HIV–negative individuals. PrEP is used in conjunction with other prevention methods to reduce the risk of infection. Learn more about PrEP by clicking here.
Post Exposure Prophylaxis (PEP) involves taking antiretroviral medications as soon as possible after a potential exposure to HIV to reduce the likelihood of HIV infection. There are two types of PEP: 1) occupational PEP, or an exposure that happens in the workplace (such as a needle stick in a healthcare setting), and 2) non-occupational PEP (nPEP), or when someone is potentially exposed to HIV through sexual intercourse or injection drug use.
To be effective, PEP must begin with 72 hours of exposure and consists of 2-3 antiretroviral medications that must be taken for 28 days. A physician must determine what treatment is appropriate based on the nature of the exposure. Starting PEP after a potential exposure does not guarantee that someone exposed to HIV will not become infected. Learn more about PEP by clicking here.
Avoid Breast Feeding
Because there are documented cases showing that HIV can be transmitted from mother to infant through breastfeeding, HIV-positive women are counseled to avoid breastfeeding. If the mother does not want to feed her baby formula, another option is locating a milk bank (an organization that collects donated breast milk and distributes it). For more information on this option, look for the Human Milk Banking Association of North America, Inc.
The observation of universal precautions involves the assumption that any patient could be infected with HIV and/or hepatitis and the responsibility to take appropriate precautions. Universal precautions include such practices as hand washing, the use of protective barriers, proper disposal of needles, and cleaning and disinfecting spills. Health care workers must take precautions when working with the body fluids of others. Hands should be washed properly and frequently.
Latex or plastic gloves, goggles, masks, and protective aprons should be worn during appropriate times and procedures to reduce the risk of exposure of skin and mucous membranes. Needles used for the injection of medicines or the drawing of blood should never be recapped or manipulated by hand in any way.
All needles should be disposed of properly in puncture-proof containers. Some healthcare workers have reported contracting HIV through accidental needle sticks from recapping used needles. When cleaning and disinfecting spills, visible material should be removed with disposable towels and the area decontaminated with a 1:10 solution of bleach and water. If universal precautions are followed at all times, infections are not likely to be transmitted in the health care setting.
Avoid Substance Use
Substance use does not necessarily put people at risk for HIV directly; however, judgment is often impaired during inebriation and any measures to prevent the transmission of HIV by the individual may be compromised.