About HIV/AIDS
What is HIV/AIDS?
Human Immunodeficiency Virus (HIV) is the virus that causes AIDS. It attacks the human immune system. Over time (and without effective treatment), HIV gradually destroys the body's defenses against disease, leaving it vulnerable to many infections and cancers that would not normally develop.
Even without treatment, some people with HIV infection have no symptoms at all, others have mild health problems, and still others have severe health problems associated with AIDS.
Acquired Immune Deficiency Syndrome (AIDS) is a late stage of HIV infection. By the time a diagnosis of AIDS is made, HIV will already have seriously damaged the body's immune system. Often, a person with an AIDS diagnosis will already have a life-threatening infection or cancer.
Before the use of effective treatment, it commonly took 10 years or more from the time of initial HIV infection to a diagnosis of AIDS. On average, it would take another two to four years before death. However, new treatments are radically slowing the destruction of the immune system caused by HIV and lengthening life expectancy. Some people with HIV infection may never develop AIDS.
How is HIV Transmitted?
HIV is transmitted when infected blood, semen, vaginal fluids or breast milk enter another person's body. This most often occurs during unprotected sex or during injection drug use (when needles or other drug paraphernalia are shared).
HIV is spread in the following ways:
Unprotected sexual intercourse
HIV can enter the body during sex through the mucous membranes of the anus, vagina, penis (urethra) or mouth and through cuts, sores and abrasions on the skin. Unprotected anal and vaginal sex are the riskiest sexual activities. There are a small, but growing, number of reported cases of HIV transmission through oral sex; however, the risk of oral sex transmission is clearly lower than for anal or vaginal sex.
Injection drug use
Using shared, unsterile needles and syringes carries a high risk of HIV transmission. Sharing cookers, cottons and water for mixing/bleaching can also transmit HIV.
From an infected mother to her infant
HIV can be transmitted from mother to child during pregnancy, during birth or through breast-feeding. However, with effective treatment of HIV the risk of transmission from mother to child is greatly reduced. Consequently, all pregnant women should see their doctor, be tested for HIV and obtain recommended treatment.
HIV is rarely transmitted in the following ways:
Blood transfusions and organ transplants
The risk of acquiring HIV from a blood transfusion or organ transplantation today is estimated to be about 1 in every 600,000 transfusions. Blood and organ banks do extensive testing on specimens of blood, blood products and organs for HIV and other blood-borne germs.
The health care setting
There is a very small, but real, risk of health care workers getting HIV from patients as a result of needle stick accidents and other substantial blood exposures. The risk of patients getting infected from health care workers is also very small.
HIV is not transmitted by:
Casual contact
HIV is not spread by casual contact. It dies quickly outside the body and is easily killed by soap and by common disinfectants such as bleach. There is no risk of HIV infection from:
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donating blood
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mosquito bites
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toilet seats
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shaking hands
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hugging
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kissing
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sharing eating utensils
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food or objects handled by people with HIV or AIDS
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spending time in the same house, business, or public place with a person with HIV/AIDS
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Information courtesy Public Health – Seattle & King County.
How can I prevent HIV?
Protect yourself from infection.
The primary ways to contact HIV/AIDS is through unprotected sex with a person who is infected and using a needle that has been used by an individual with HIV/AIDS.
Sexual Contact
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Abstaining from sex with others is the surest method to preventing HIV infection through sexual transmission.
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Having sex with one HIV-negative partner who only has sex with you is the next surest method to preventing infection
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When used consistently and correctly, latex condoms used with silicon or water-based lubrication or polyurethane condoms used with silicon, oil or water-based lubrications are extremely effective at reducing the risk of HIV transmission.
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Touching, dry kissing, body rubbing and mutual masturbation are some examples of sexual activities that are extremely safe.
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When acquiring a new sex partner, abstain or use condoms for three months (or three months from your last HIV test or potential exposure to HIV) and then get tested for HIV. If both partners are HIV-negative and not engaging in other risk behaviors (e.g., sharing needles or having other sex partners), you do not have to worry about HIV infection.
Injection Drug Use
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Abstaining from injection drug use is the most effective way to prevent HIV transmission through drug use.
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If you are injecting drugs, use a brand new syringe every time you inject.
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If new syringes are unavailable, properly bleaching a used syringe may effectively reduce HIV transmission.
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Do not share drug injection equipment (including cookers, cottons, and water used for mixing/bleaching) with others.
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Information courtesy Public Health – Seattle & King County
What is PrEP & PEP?
Helping people who are HIV-negative stay negative
According to AIDS.gov, "pre-exposure prophylaxis, or PrEP, is a new HIV prevention method in which people who do not have HIV infection take a pill daily to reduce their risk of becoming infected."
A message from the WA State Director of Health Education, Prevention, Advocacy, Public Policy and Communications:
"In order to End AIDS, we must bring the same ferocity, passion, and collaboration that brought protease inhibitors and legal protections for HIV-positive men and women. Pre-Exposure Prophylaxis (PrEP) is a game changer that, when used properly just like any other medication, prevents HIV infection. Making all proven treatments to prevent HIV infection available to all those who may benefit is the next step to making AIDS history. We will not stop until we end AIDS once and for all."
Take a pill a day to prevent HIV infection. Studies have shown that taking medications used to treat people living with HIV can also prevent infection in those who are HIV-negative. PrEP must be taken every day in order to be effective. Please consult with your medical provider.
For the Pre-Exposure Prophylaxis Drug Assistance Program (PrEP DAP) and a list of providers by county, click here.
Helping people who are HIV-negative stay negative
According to AIDS.gov, "pre-exposure prophylaxis, or PrEP, is a new HIV prevention method in which people who do not have HIV infection take a pill daily to reduce their risk of becoming infected."
Truvada is currently the only antiretroviral (ARV) medication approved for use as PrEP. When taking Truvada, a person has a 95-99% protection against HIV infection if adherent (meaning, they take the pill at same time every day). Individuals who wish to start taking PrEP must not have HIV (determined through initial antibody/RNA tests), and must also get tested for HIV every three months while they are on PrEP. Studies on other ARVs are being done, including a newer drug, maraviroc (brand name Selzentry).
As Truvada is commonly used in treating HIV infection, there is some concern that those using it as PrEP may develop resistance should they happen to become infected while on PrEP. Therefore, using Selzentry as PrEP would eliminate some of the resistance concerns associated with Truvada.
While PrEP is to be taken orally, studies are underway on injectable ARVs (for treatment and prevention). If approved, individuals can receive an injection every two or three months to treat or prevent HIV, rather than taking a daily pill. This is similar to Norplant as a long-acting contraception.
PrEP costs roughly $14,000 per year, however, cost should not deter use. Financial assistance will be available for most individuals seeking coverage. Below is an overview on how PrEP is covered:
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Insurance: PrEP is covered by insurance plans, including Medicaid. No reports of insurance not covering PrEP.
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WA Department of Health PrEP Drug Assistance Program (PrEP DAP): PrEP is available for qualified individuals – including those in a sexual/drug-sharing relationship with someone who has HIV; or gay/bi/trans* men who have been diagnosed with a bacterial sexually transmitted infection (STI) like syphilis or gonorrhea, exposed to STI, have had ten or more sexual partners, used methamphetamine, or had unprotected anal sex with partner of unknown HIV status within last year. More info here.
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Gilead Compassionate Use Program: Based on specific critera, individuals can receive full coverage or receive co-pay assistance up to $200/mo. Click HERE for more info.
PrEP is one more tool in the HIV prevention toolbox. SAN supports the use of PrEP for individuals who feel that they are at risk for HIV infection, and who are able to adhere to the recommended use of Truvada (once-a-day pill) and to a three-month testing schedule. When used along with latex or polyurethane condoms, lubes, and other safer sex and harm reduction strategies, PrEP can greatly reduce the risk of HIV transmission in HIV-negative individuals.
Wondering how to talk to your doctor about PrEP? Click here to learn more..
Check out My PrEP Experience, a website devoted to sharing real stories of people who use PrEP as an HIV prevention tool.
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