HIV: Some Plain Talk

What is HIV?

The human immunodeficiency virus (HIV) is the virus that causes AIDS (acquired immune deficiency syndrome), by attaching to the cells of the immune system and interfering with defense of the body against disease.

How does a person become infected?

HIV can be found in the blood, semen, or vaginal fluids of infected people. The HIV-infected person can infect others, even if no symptoms of illness are present. HIV is not spread by pets, touching, eating or drinking, coughing or sneezing, or mosquitoes.

HIV is passed from person to person most often in these ways: 1. Having sex -- anal, oral, or vaginal intercourse -- with a person who is infected with the virus. 2. Using a needle or syringe that has been used by or for an HIV-infected person. It is unlikely, but possible, for a person to become infected with the HIV virus in the following ways: - Women who are HIV-infected can pass the virus to their babies through the birth process or through breast-feeding. - Persons who receive blood transfusions are at slight risk of becoming infected, especially those who received transfusions before 1985 when testing for HIV in donated blood became widespread. (There is no risk involved in donating blood, because new equipment is used with every blood donor.)

Health-care workers who are exposed to body fluids of HIV-infected patients could possibly become infected through body fluid contact. Health-care workers practice precautions to limit contact with HIV and other bacteria or viruses.

Other factors that increase the chances of infection if exposure to HIV occurs:

- Anal sex, which is more risky than vaginal or oral sex;

- Open lesions or sores;

Recipient of sexual fluids is more at risk than is the donor.

What happens if I become infected with HIV?

Being infected means that the virus is in your body for the rest of your life. Therefore, you can always infect others, even if you feel fine and have no symptoms. The HIV weakens the immune system and, over time, makes the body more and more vulnerable to unusual opportunistic illnesses and infections. Rare types of cancer, pneumonia, and tuberculosis; extreme weight loss; and damage to the brain and nervous system can signal the beginning of AIDS. In some people, AIDS-related illnesses develop within a few years. Many HIV-infected people will develop AIDS within 10 years after becoming infected.

Normally, the immune system has many ways to resist infections and diseases. The T-cell, one part of the immune system, is a type of cell produced in the body to help fight infections and diseases. The average healthy person has 800 to 1,200 T-cells. Doctors say that an HIV-infected person has AIDS when there are less than 200 T-cells or when the person develops a rare infection or cancer.

There is no cure for the HIV infection, but some treatments are helping to slow the disease or prevent some of the serious infections that are life-threatening.

The AIDS Clinical Trials Information Service can be reached Monday through Friday, 8 a.m. to 6 p.m., CDT, at 1-800-TRIALS-A, or 1-800-874-2572. A local medical society or public health clinic may also direct you to an HIV counselor, doctor, or other source of help.

How do I know if I am infected with HIV?

Most people who have HIV infection do not know it. The HIV-antibody test is the only way to tell if you are infected. When a virus enters the body, the immune system makes proteins called antibodies. The HIV antibodies can be found in the blood of HIV-infected people with a blood test, the Enzyme-Linked Immunosorbant Assay (ELISA). If the HIV test is positive, the ELISA is repeated on the same blood sample. If the ELISA is positive two times, it is confirmed with a different test called the Western blot. Together, these tests are 99.9 percent accurate in identifying HIV antibodies.

A negative result means that no antibodies are found in the blood. Even if a test is negative, there is a small chance that you may be infected. It takes time for the body to develop antibodies after becoming infected with HIV. Almost all people develop HIV antibodies within 2 to 12 weeks after infection, but it can take up to 6 months. To be sure, you must be retested at least 6 months after you last engaged in a behavior that could expose you to HIV. A sexual or drug-using partner may have a negative test, but that does not tell whether both partners are negative.

How do I know if my partner is infected with HIV?

You usually won't know for sure. That is why condoms are recommended for use, unless you are in a long-term relationship where you and your partner are having sex only with each other and both of you are not infected. If there is any question of the exclusive nature of the relationship, or of drug use, the use of a latex condom is strongly advised. Even when a new relationship is monogamous (only one sexual partner at a time), the use of a latex condom is advised until a blood test shows that both partners are free of the HIV infection.

How do condoms prevent HIV infection?

Only abstinence from sex is 100 percent safe where AIDS is concerned. The latex condom, when used correctly, can provide fairly good protection from pregnancy and sexually transmitted diseases, including HIV. Some health-care professionals recommend that female partners use nonoxynol-9 contraceptive vaginal foam, in addition to a latex condom, for added protection should the condom break or tear.

Correct use of a condom means:
- A new latex condom is used every time sexual intercourse occurs. Do not use lambskin or "natural" condoms, which have pores large enough for viruses to pass through.

- The condom is put on at the moment of male erection and carefully removed immediately after ejaculation.

- The condom has been stored properly (not in a wallet or in the car) to prevent damage from heat or cold.

- The condom has not passed its expiration date.

To find out about treatments, call toll-free the National AIDS Hotline:

1-800-342-AIDS;
in Spanish, 1-800-344-7432;
Deaf Access, 1-800-243-7889 (TTY).