What is HIV? HIV is a virus that attacks the immune system. Immune system is our body’s natural defense against sickness. The virus slowly destroys a type of white blood cell in the immune system called a T-helper cell, and makes copies of it inside these cells. T-helper cells are also referred to as CD4 cells in medical parlance.

Since HIV destroys more CD4 cells and makes more copies of it, it gradually breaks down a person’s immune system. This means someone living with HIV, who is not receiving treatment, will find it harder and harder to fight off infections and diseases.

However, the speed at which HIV progresses normally varies depending on age, health, ethnicity, race,area and background.

Key points about HIV

  • Acronym, HIV stands for Human Immunodeficiency Virus.
  • The earlier HIV is diagnosed; the better it will be. A treatment can start immediately – leading to an assured and better long term health.
  • HIV is found in semen, blood, vaginal and anal fluids, and breast milk.
  • HIV cannot be transmitted through sweat, saliva or urine. Saliva is highly anti-inflammatory
  • Using male condoms or female condoms during copulation is the best way to prevent HIV and other sexually transmitted infections.
  • If anyone injects drugs, always use a brand new, sterilized, factory sealed, clean needle and syringe, and discard it immediately in a safe manner. Never share the syringe and other equipment.
  • If anyone is pregnant and living with HIV, the virus in the mothers’ blood can pass into baby’s body through placenta, or after giving birth or through breastfeeding. Taking HIV treatment nearly negate this risk to a great extent.
  • There is effective antiretroviral treatment available so people with HIV can live a normal, healthy life spanning to 25 to 40 years.

What is AIDS?

When the HIV virus keeps on slowly progressing in the body, it gives birth to a number of symptoms (or syndrome),that stage is called AIDS. So AIDS is not a virus though it is an advanced stage caused by the HIV virus. A person is said to have AIDS when their immune system being too weak fail to fight off infection, and they develop certain defining symptoms and illnesses. Normally, it is the last stage of HIV, when the infection is very advanced, and if left untreated will lead to death.

Key points aboutAIDS [Acquired Immune deficiency Syndrome]

  • AIDS is a set of symptoms and illnesses that develop as a result of advanced HIV infection which destroythe immune system at a snail’s pace.
  • AIDS is also referred to as advanced HIV infection or latestage HIV we can say colloquially.
  • Now with treatment in time, people are living over 25 years with the help of medications called Haart Therapy.

Although there is currently no cure for HIV with the right treatment and support, people with HIV can live long and healthy lives. To do this, it is especially important to take treatment with devotion and deal with any possible sideeffectsvaliently. Risk factors that herald the coming of HIV in a person?

HIV is carried through the following bodily fluids of an infected person:

  • Blood
  • Semen and pre-cum
  • Rectal fluids/anal mucous
  • Vaginal fluids
  • Breast milk.

To get infected, these bodily fluids need to get into the blood through an injured mucous membrane of the susceptible host i.e. the lining of the vagina, rectum, the opening of the penis, or the mouth, breaks in the skin (like cuts), or be injected directly into one’s bloodstream.

A person living with HIV can pass the virus to others whether they have symptoms or not. People with HIV are most infectious in the first few weeks after infection.

Precautionary measures to be taken without fail.

  • Do not indulge in coitus without a protection: Having sex without protection with someone who has HIV is asking for too much trouble.

Do not share the injection kit: Sharing needles, syringes or other equipment used to prepare and inject drugs with someone who has HIV is indeed suicidal.

  • HIV can be transferred from mother-to-baby during pregnancy, childbirth and breastfeeding.A mother infected with HIV can pass the virus to her baby via her blood through placenta during pregnancy. And after birth, through her breast milk when breastfeeding. A mother must not breastfeed in such a situation. Bottle feed is the remedy.
  • Contaminated blood transfusions and organ/tissue transplants: Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV is deadly. This risk is extremely small because all countries test blood products for HIV first.
  • Healthcare workers can also be at risk of HIV: If proper safety practices are not in place, healthcare workers can also be at risk of HIV from cuts made by a needle or sharp object (needlestick injury) with infected blood on it. However, the risk of ‘occupational exposure’ is very low in most countries.Needless to add that deaths have happened to few medical and Para-medical staff, particularly in an operation theatre where blood is handled.If any staff thinks he has puthimself at risk of HIV, the only way to find out if one have HIV is to have an HIV test.

Unprotected Sex and HIV During unprotected sex, HIV virus in the bodily fluids of an infected person namely blood, semen, vaginal fluid, pre-cum or anal mucus can pass into the body of their sexual partner through the mucous membranes, if broken, of the penis, vagina, rectum and sometimes the mouth and throat even. Are some types of sex riskier than others?

Most people get HIV by having unprotected vaginal or anal sex with a partner who is HIV positive. Anal sex is the most risky, because the lining of the anus is more delicate than the lining of the vagina and is more easily broken. Having multiple sexual partners and/or STIs also increases the risk of HIV infection via unprotected sex.

Pre-exposure prophylaxis (PrEP) precaution PrEP is Antiretroviral drugs taken daily by people at high risk of HIV infection. To prevent sexual transmission of HIV, PrEP is sometimes recommended for:

  • Those in an ongoing relationship /living with an HIVpositive partner
  • Those who are sexually active with more than one person, even if they are tested negative for HIV recently.
  • Heterosexual men or women who don’t use condoms with partners whose HIV status is unclear and are at high risk of HIV infection (e.g. they inject drugs or have bisexual male partners). PrEP can provide a high level of protection against HIV, but is most effective when used with condoms. If anyone thinks they are at high risk of HIV infection via unprotected sex, they should talk to a healthcare professional about whether PrEP is right for them.

Post-exposure prophylaxis (PEP)

PEP is the use of antiretroviral drugs after an event that puts you at risk of HIV – such as unprotected sex – to stop HIV from spreading in the body. It must be started within 72 hours

of possible exposure. However, PEP is not 100% effective, and should not be viewed as an alternative to condoms. Your doctor or healthcare worker will advise you on whether you could take PEP.

If you are having a tattoo or piercing,

make sure that a clean, sterilized needle is used. It is always better to buy a sterilized needle yourself and make sure that only this one is used on your body. It is always better to have a friend or relative with you as an extra pair of eyes has its own benefits.

How is HIV transmitted from mother-to-baby

? In case of a pregnant woman being HIV positive, HIV can pass into the baby’s body. This is most likely to occur in the last few weeks of pregnancy, during labour, or delivery. Breastfeeding your baby can also transmit HIV, because HIV is found in a woman’s breastmilk. There is a 15-45% chance of passing HIV to a baby if neither of you take HIV treatment. Protecting your baby during childbirth If the HIV+ve mother –to- be had taken treatment correctly, it will lower the amount of HIV in her body so much that it is said to be ‘undetectable’ (undetectable viral load). In such a situation a normal, vaginal delivery can happen as the risk of passing HIV to the baby during childbirth will be very less.If you don’t have an undetectable viral load, you may be offered a caesarean section, as this carries a smaller risk of passing HIV to your baby against a vaginal delivery

Protecting your baby during breastfeeding

Breast milk contains HIV. Then bottle feed is the best remedy. If you do not have access to formula and clean, boiled water all of the time, you may be advised by your physician to breastfeed while both you and your baby are taking antiretroviral treatment.

Can the baby have HIV after birth?

Attending doctors’ will be checking/testing the babyfor HIV at birth, and again after six months and then after 18 months.

How is HIV passed on by blood transfusions and transplants?

A person who is Hive cannot donate blood or blood products, such as an organ or tissue, because the person who receives this blood product is likely to develop an HIV infection too.To prevent this, blood products are tested for HIV before they are given to anyone around the globe.

How I can check the blood transfusion/transplant I’m receiving is safe?

To be vigilant and on the safer side,always ensure that the blood product is checked and is HIV free. It is your right to ask the healthcare professional if it has been tested for HIV or not.

Can I get HIV from donating blood?

No. New, disposable and sterile needles will be used to collect your blood, meaning there will be no blood from an HIV-positive person on the needle.If you suspect that the needle your healthcare worker is using is not new or sterile then ask them to change the needle before agreeing to give blood.

Conclusion

It’s now 35 years since HIV was finally discovered in USA and research for cure started… The virus is treated and managed with acombination of medications — termed ‘highly active antiretroviral therapy’ or Haart. Haart have resulted in being able to maintain the infected person’s immune system and therefore prevent the opportunistic infections that resulted in the development of AIDS and led to death. High-risk groups of this disease are sex workers and drug addicts. Doctors now categorize this as a chronic disease, though social stigma is attached to it. Due to its fear affect,depression in those with HIV is nearly ten times higher than among the general public.

According to 2014 National HIV estimates, an estimated 75,500 Canadians were livingwith HIV at the end of 2014. The Supreme Court of Canada, in the year 1998, formalized the ruling –in a case known as R v. Cuerrier- that an HIV +ve person has to declare his status to his life/sexual

partner or client beforeengaging in behaviors that could put someone else at “significant risk of serious bodily harm.” Some people wrongly believe that HIV can be spread by the air. The HIV virus can’t survive outside the body after 72 hrs. And other ways such as by touching toilet seats or from mosquito bites it does not happen. There is no need to panic while dealing with these persons, though properand cudgels are life sustaining

 

Prof. Surinder
Shaun Kochhar
LPN, FCN, M.Com, CAIIB, DIM
(A freelance writer w