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FAQ, Facts and Myth about HIV-Aids

What is HIV?

Are HIV and AIDS the same thing?

No. When someone is described as living with HIV, they have the HIV virus in their body. A person is considered to have developed AIDS when the immune system is so weak it can no longer fight off a range of diseases with which it would normally cope.

Who has HIV in the UK?

Anyone can get HIV if they are sexually active, regardless of whether you’re gay or straight or where you come from — but HIV rates are higher among gay and bisexual men and African communities in the UK. Everyone should ensure they take steps to protect themselves and others from HIV infection by using a condom during sex.

Is HIV still a serious issue in the UK?

Although HIV is now a long-term, manageable condition and not a death sentence, it is still a serious issue in the UK. More people than ever before are living with HIV in the UK and 6,000-7,000 people are diagnosed every year.

Do young people learn about HIV and how to protect themselves at school?

Comprehensive sex and relationships education (SRE), which includes information about HIV, is not compulsory in all schools, so many young people are not being given the information they need to protect themselves from HIV infection and other STIs.

Getting HIV

How is HIV passed on?

HIV is passed on through infected bodily fluids such as semen, vaginal fluids, blood, breast milk and rectal secretions. The most common ways HIV is transmitted are through sex without a condom and through sharing infected needles, syringes or other injecting drug equipment. You cannot get HIV through casual or day-to-day contact, or kissing, spitting or sharing a cup or plate.

Can you get HIV from oral sex?

The risk of HIV transmission from performing oral sex is low but it can still happen. It is best to avoid giving oral sex if you have cuts or sores in your mouth or bleeding gums, as this increases the risk of HIV entering your body.

How can I protect myself and others from HIV infection?

Always use a condom when having vaginal or anal sex. You may also want to use a condom or dental dam during oral sex although the risk of transmission of HIV is much lower. You can get free condoms from a sexual health clinic, which you can locate via the FPA website. Never share needles, syringes or any other injecting equipment.

What do I do if I don’t like using condoms?

Condoms have come a long way in recent years and you can now get condoms in different sizes, flavours, and with added features to increase pleasure and heighten sensation. Condoms are still the best way to protect yourself and others from HIV infection, and other STIs, so if you think you don’t like using condoms, it’s worth trying out some different varieties.

If you find using condoms or negotiating condom use difficult, it is worth speaking to your local sexual health clinic or GP.

How do I know if I’ve put myself at risk of HIV infection?

Putting yourself at risk of HIV relates to both what you’re doing and who you’re doing it with. If you are having sex without a condom, you could be putting yourself at risk of HIV — but this risk increases if your partner is sleeping with more than one person, has HIV but doesn’t know it, or has any other STIs. Take our ‘Have you put yourself at risk?’ quiz.

If you have shared a needle or injecting drug equipment when injecting drugs, you have put yourself at risk of HIV (and other serious viruses) and should definitely have an HIV test (as well as getting tested for other infections such as hepatitis B and hepatitis C).

What should I do if I’ve put myself at risk of HIV?

If you think you have put yourself at risk of HIV infection, you should go and get a free and confidential test at your local sexual health clinic. If you know you have put yourself at risk and it is within 72 hours of possible exposure to HIV, you can ask for Post Exposure Prophylaxis (PEP) treatment from a sexual health clinic or A&E. PEP is not guaranteed to prevent HIV infection but the sooner it is taken the more effective it can be.

Can HIV be passed on through fingering or hand-jobs?

No – HIV is not passed on through fingering, hand-jobs, or any form of mutual masturbation.

Can HIV be passed on through saliva, sweat or urine?

No – HIV can not be passed on through saliva, sweat or urine, because these bodily fluids do not contain enough of the virus to infect another person.  The only bodily fluids which can transmit HIV are semen, vaginal fluids, blood, breast milk and rectal secretions.

Will HIV definitely be passed on during sex between an HIV positive and an HIV negative person?

During sex, it is not an automatic consequence that HIV will transmitted. Compared with some other infectious diseases, risk of HIV infection from a single act of sex is usually low. But of course repeated acts of sex increase probability of transmission which is why it is important to have safer sex. Condoms are highly effective at preventing HIV from being passed on so condoms should always be used during sex to avoid HIV and other STIs.

There are other factors which can increase and reduce the risk of having sex with someone with HIV, but a condom is the safest and easiest way to prevent transmission and stay safe.

Is the risk of HIV transmission always the same during sex?

There are varying degrees of risk in relation to HIV transmission, depending on the sexual activity and how much HIV is in the body of the person with HIV (the ‘viral load’).

If a person is recently infected with HIV, or has HIV and doesn’t know it,  the level of HIV in their body will be high and the chances of passing HIV on to another person are therefore higher.

If a person is diagnosed with HIV and is on treatment, the levek of HIV in their body will be greatly reduced and in most cases will reach what is clinically referred to as an ‘undetectable viral load’.  This means the chances of passing on HIV to another person are very unlikely.  However, HIV treatment should not necessarily be viewed as a replacement for condoms and there are a range of factors to consider. A person with HIV can discuss these with their doctor for further information.

Is anal sex more risky than vaginal sex when it comes to HIV transmission?

HIV can be transmitted through both anal and vaginal sex, but in some circumstances there is greater risk involved in anal sex. This is because anal sex carries a greater risk of trauma (such as tearing of the skin and bleeding) which makes it easier for the HIV infection to get through.

Can having another STI increase the risk of HIV transmission?

If you have an STI this may make you more vulnerable to HIV transmission since STIs can cause ulceration and other harms to bodily tissue – which make it easier for HIV to be passed on.

If someone with HIV also has an STI this can increase the amount of virus in their body. The more virus there is, the greater the risk of transmission to another person, so it is a good idea for sexually active people to get regular sexual health check-ups for both HIV and other STIs.

If a man is circumcised, will it prevent HIV transmission?

There is research showing male circumcision can reduce risk of HIV transmission to the circumcised male during heterosexual sex. In countries with high rates of HIV and heterosexual epidemics, such as Sub-Saharan African countries, male circumcision is recommended at a population level as an HIV prevention tool, as part of wider prevention strategies (education, promotion of safer sex practices, correct and consistent condom use). However, in the UK, male circumcision is not recommended to individuals as a method of HIV prevention as there is better access to condoms, testing and treatment, and sexual health information. There is also no evidence to suggest male circumcision prevents HIV transmission during anal sex. The best way to prevent HIV transmission during any penetrative sex is to use a condom.

Only gay men get HIV

It is true that gay men are particularly affected by HIV as a group (over 37,000 gay men in the UK have HIV) but HIV can still affect anyone and there are many heterosexuals living with HIV in the UK. The majority of new HIV diagnoses in 2010 were acquired heterosexually, while approximately a third of people with HIV in the UK are women. Anyone who has sex without a condom or shares needles when injecting drugs is at risk of HIV.

You can get HIV from someone who spits at you or bites you

There is no risk of HIV infection from spitting and the risk of infection from biting is negligible. With over 60 million people infected with HIV worldwide over 25 years, there have only ever been four possible reports of HIV being transmitted through biting, all of which occurred in extremely specific and unusual circumstances.

You can get HIV if you stand on or pick up a used needle

There has never been a case of HIV infection from picking up or standing on a used needle in the UK. There have only ever been five cases of HIV infection from being pricked with a needle, and these all occurred in healthcare settings and there have been none since 1999. HIV is a very fragile virus that does not survive for long when exposed to the environment.

It’s very easy for me to catch HIV from someone who is infected

You can only become infected with HIV if you have sex without a condom or share a needle or injecting equipment with someone living with HIV. HIV is not spread through day-to-day contact, touching, kissing or sharing utensils. In addition, being on HIV treatment makes people with HIV far less likely to pass it on.

Condoms aren’t effective in preventing HIV transmission

The most common way to be infected with HIV is through unprotected sex without a condom. When used properly and appropriately, condoms are extremely effective at protecting against HIV transmission. It is important to ensure you always use a condom when having sex, particularly if you have more than one partner or if you haven’t had a sexual health check up recently. If you are using a lubricant as well as a condom (which is particularly recommended for anal sex) ensure it is water-based. Find out more about how to use a condom here.

You can get HIV by having a fish pedicure

It was recently reported that Garra Rufa fish pedicures posed a risk of HIV transmission. This is inaccurate and there is no risk of HIV transmission from visiting a fish pedicure spa.

HIV can be passed on through sharing razors or toothbrushes

HIV cannot be passed on by sharing razors or toothbrushes, even if you are sharing with an HIV positive person. However, for general hygiene purposes it is advisable not to share these personal items as they do carry general bacteria.

You can get HIV from a mosquito or flea bite

HIV cannot be passed on by insect bites. Firstly the HIV virus can’t survive in or on an insect. Secondly these insects only suck blood up, they do not inject blood back in.

There is no HIV risk from pre-cum

A small amount of HIV can be found in a man’s pre-cum (pre-ejaculation), though less than there is in semen. Because it is harder to transmit HIV through the membranes in the mouth and throat pre-cum carries no HIV risk during oral sex.

However, as it is easier to transmit HIV through vaginal and anal membranes, there is more of a risk of HIV transmission from pre-cum in these types of sex. In fact a number of incidents of HIV transmission have been attributed to the delay in applying a condom during sex.

HIV symptoms

What are the symptoms of early HIV infection?

The most common symptoms of early HIV infection, usually occurring around ten days after infection, are fever, rash and severe sore throat all occurring together. This combination of symptoms is unusual in healthy people and indicates the need for an HIV test.  70-90% of people experience symptoms of early HIV infection but some do not experience any. After two-three weeks these symptoms disappear, and someone with HIV may then live for many years without any further symptoms or indicators that they are HIV positive.

What should I do if I experience symptoms of early HIV infection?

If you experience the symptoms of early HIV infection — fever, rash and severe sore throat occurring at the same time — then you should get an HIV test as soon as possible. It could be just a bad case of flu, but there is also a risk it could it be the early signs of HIV infection so it always best to know for sure by getting tested.

Are there any other symptoms of HIV infection?

There are four stages of HIV infection. The first stage is the when the infection enters the body and takes hold, sometimes referred to as ‘seroconversion’, and possible symptoms of this include a severe flu-like illness along with a rash. This may disappear after a few weeks and even if you see a doctor they may fail to recognise the signs of HIV infection, so an HIV test is always recommended if you’ve put yourself at risk (had sex without a condom or shared injecting drug equipment).

The second stage of HIV infection is the ‘asymptomatic’ stage, and as the name suggests there are generally no symptoms in this stage, often for as long as ten years.

The third stage of HIV infection is the symptomatic stage, where the body’s immune system has become so damaged that it becomes susceptible to a range of ‘opportunistic’ infections that would normally be prevented by the body’s natural defences (‘opportunistic’ means the infections take advantage of the weakened immune system in a way they wouldn’t normally be able to in an otherwise healthy person). These infections include bacterial diseases such as tuberculosis, pneumonia and blood poisoning, fungal diseases such as oral thrush, and viral diseases.

The final stage of HIV infection is when the immune system has been so weakened that it can no longer fight off a range of increasingly severe illnesses, eventually leading to an AIDS diagnosis.

After the first stage of HIV infection, the following stages can be halted and slowed down by highly effective HIV medication which will prevent the HIV infection from damaging the immune system so severely and can stop stages three and four from taking place.

Testing for HIV

Where can I get an HIV test?

The most common place to go to for an HIV test is a local sexual health clinic but you can also get tested in a range of other locations, such as at your GP or private doctor’s surgery, in hospital or in a local community setting.  HIV tests are also now available by post and over the counter at some pharmacies but will you have to pay for these.

Will I have to pay for an HIV test?

Generally no – all NHS services are free of charge and this includes HIV tests in a sexual health clinic or GP surgery.

How long do I have to wait for an HIV test result?

Anywhere from 20 minutes to two weeks, depending on the type of test you have.

Is a blood test the only way you can test for HIV?

A blood sample – either through a needle or finger-prick – is the most common way to test for HIV but you can also now test for HIV through saliva.

Are HIV test results accurate?

HIV tests are extremely accurate and ‘false positives’ are very rare (although slightly more common in rapid tests — where results are almost immediate). But all HIV positive test samples are sent for a second, lab-based test for confirmation — so a person would never incorrectly be diagnosed with HIV.

HIV will also not be detected during the ‘window period’, the small window of time (around four weeks) straight after infection where signs of HIV cannot be picked up during screening.

If you think you have put yourself at risk, do not hang around waiting for the window period to pass — speak to your local sexual health clinic as soon as possible to discuss the best course of action.

Are there any health benefits to getting tested early if you think you have HIV?

Finding out early if you have HIV has two vital benefits. Firstly, you will be able to start treatment as soon as you need it, which makes it more effective in helping you live a long, healthy and active life. Secondly, if you know you have HIV you can take the right steps to prevent passing it on to others by practicing safer sex.

How come you can test for HIV via saliva but you can’t pass it on via saliva?

There are traces of HIV in saliva which can be picked up in an HIV test, but there is not enough of the virus present to infect another person.

It takes months before you can have a test and get the results to find out if you have HIV

Testing for HIV has rapidly advanced in recent years but you often read incorrectly that you have to wait 3, 6 or even 12 months to get a reliable HIV test result. In fact, you can now get an HIV test with accurate results from 4 weeks after potential infection. Results can be returned between 20 minutes and 2 weeks, depending on the test type. If you think you have exposed yourself to risk of HIV, don’t wait or do nothing – it’s important to seek advice from your local sexual health clinic as soon as possible.

My HIV test results won’t be kept confidential

Most HIV testing in the UK is done in a sexual health or genitourinary medicine (GUM) clinic. These clinics are legally bound not to reveal personal details and test results. GPs and private doctors also perform HIV tests, which means your HIV test and results would appear on your medical records – but these would still not be discussed with anyone else unless relevant to your treatment. If you are concerned about who else your HIV test results will be shared with, speak to your doctor about this.

I have had an HIV test because my blood was taken and tested in hospital/my GP surgery

If you have a blood test at a hospital or in a GP surgery they will not automatically test for HIV.  You will be explicitly told if HIV is one of the conditions they plan to test for when they look at your blood.  If HIV testing is not mentioned, you should not assume you have had an HIV test and it could still possibly be the case that you have undiagnosed HIV.

HIV treatment

Do I not need to worry about getting HIV now that treatment is so good?

It is true there are extremely effective treatments for HIV which enable people to live a long life, but there is still no cure and HIV is a condition you have to live with every day for the rest of your life. Whilst HIV needn’t be feared the way it was decades ago, it remains a serious, long-term condition with life-limiting consequences. Treatment must be taken everyday and can cause side-effects and sadly there is still a lot of stigma and discrimination around the condition. Everybody should take all the steps possible to avoid HIV transmission, such as using a condom during sex.

Is HIV treatment free to everyone in the UK who needs it?

The Government has announced that from October 2012, HIV treatment will be provided for free on the NHS to everyone who needs it.  Until this time, some migrants face extensive bills for the HIV treatment they access.  No one with HIV should ever be denied treatment, even though they may be charged for it.

What are the benefits of HIV treatment?

HIV treatment has become extremely effective in the last 15 years and an HIV positive person on treatment can now lead a full and active life and live a near normal lifespan.

There may be some side effects from treatment, but these are less severe than in the past and are increasingly well managed. Many people living with HIV also experience problems which can’t be helped by their HIV treatment (such as emotional and pychological difficulties) but the benefits of being on treatment are huge and ultimately HIV treatment is the difference between staying well and becoming extremely ill and possibly dying early. This is why it’s always best to know your HIV status and get tested if you’ve put yourself at risk.

HIV treatment also has preventive benefits. HIV treatment works by reducing the level of HIV in the body (clinically referred to as an ‘undetectable viral load’) and when this happens, the chances of passing HIV on to a partner are significantly reduced. This does not mean that HIV treatment is a replacement for condoms, but it does give HIV positive people more options for safer sex and reduces overall risk of onward tranmission.

The reduction of infectiousness as a result of HIV treatment is also how mother-to-child HIV tranmission is prevented – in the UK today, most women with HIV will give birth to HIV negative babies because of interventions of HIV treatment.

What is PEP?

PEP or Post Exposure Prophylaxis is a medical treatment that can prevent HIV infection after the virus has entered the body.

If you have put yourself at risk of HIV infection you can go to a sexual health clinic or hospital A&E department and they can usually prescribe a course of PEP drugs. You need to start PEP ideally within 24 hours of the risk occurring and no later than 72 hours. The longer you wait the less chance of PEP working.

The treatment involves taking anti-HIV drugs for four weeks. The drugs can have side-effects, including diarrhoea, headaches, nausea and vomiting – these stop once you stop taking PEP.

It is not guaranteed you will get PEP if you ask for it. The doctor you see will advise you whether they recommend it based on the level of risk involved. They will also ask you to have a HIV test before and after taking PEP. PEP won’t be offered if you refuse to be tested.

Have people been cured of HIV?

In the past few years there have been significant steps towards learning how we might one day cure HIV.

When talking about a possible cure, scientists distinguish between a ‘functional’ cure or a ‘sterilisation’ cure. ‘Sterilisation’ would mean that someone who previously had HIV no longer has any trace of the virus in their body. A ‘functional’ cure would be where someone diagnosed with HIV would remain non-infectious and be able to maintain a good immune function without taking daily medication.

The closest we have come to the sterlisation cure is the Berlin Patient. The Berlin Patient had been living with HIV for many years. In 2007-2008 he had bone marrow transplants to treat leukemia. The transplant came from someone who had a rare genetic immunity to HIV and this appeared to have eradicated the Berlin Patient’s HIV infection. Subsequent research has suggested he may still have some of the virus present in his body, so we can not yet definitively call this a successful ‘sterilisation cure’. The treatment undergone by the Berlin Patient was made necessary by a severe illness and would not be recommended as a cure approach for otherwise healthy people living with HIV. This is why the ‘functional cure’ is a key focus of interest.
The reason people living with HIV currently have to take their treatment everyday is a key piece in the cure puzzle. Even if medication can stop HIV replicating in immune cells that are currently active, our body holds reservoirs of ‘sleeping’ immune cells, which wake up unpredictably. If someone is living with HIV, they will have HIV-infected immune cells sleeping in their reservoir. If these wake up, the HIV will return.

In 2013 it was reported that the ‘Mississippi Baby’ had been functionally cured of her HIV infection, however in 2014 we learned that her HIV had returned. The baby acquired HIV from her mother, who was not diagnosed prior to the delivery. In an attempt to prevent infection, the baby was given antiretroviral treatment, which she continued to take after she was diagnosed as HIV positive. The treating clinic lost contact with the Mississippi Baby at 18months of age. Yet even without taking medication, her HIV did not re-emerge for more than two years.

There is also a lot of interest in the VISCONTI cohort of adults living with HIV. This was a group who were given treatment very early in their infection. They then had this treatment stopped, but still managed to control their viral load without medication for at least four years.

Each of these studies takes us closer to a cure, but we are still some years off the final solution.

You can’t have a baby if you or your partner is HIV positive

If someone living with HIV decides to have a baby, there are options available and steps they can take to ensure HIV is not passed on to their partner during conception (if the partner is HIV negative) or to their child. In the UK today there is less than a 1% chance of an HIV positive mother passing HIV on to her child if the right steps are taken.

If you get HIV you’ll die soon

Although there isn’t a cure for HIV, treatment is so advanced that it is no longer considered a death sentence. People diagnosed with HIV in the UK today can have a near-normal life expectancy and live healthy and active lives. Early diagnosis is particularly important as the longer HIV goes undiagnosed the more damage it can do to the body.

My partner would automatically tell me if they had HIV

It is not always easy to tell someone you have HIV. In addition, over a quarter of people with HIV are undiagnosed. It is dangerous to assume that your partner would automatically tell you if they had HIV – either because they may struggle to confide in you or because they don’t know they have it! Your sexual health is your responsibility — always using a condom is the safest way to protect against HIV transmission.

Lots of people come to the UK to get free HIV treatment

Despite sometimes being talked about in the media, there is no evidence for this myth – commonly referred to as HIV-related ‘health-tourism’. In fact, the evidence shows that most migrants with HIV who come to the UK do not know they have it before they arrive (and are not diagnosed for a number of years) so are definitely not coming over here seeking treatment.

Living with HIV

Am I likely to know anyone living with HIV?

Today there are more people than ever before living with HIV in the UK, but fewer people report knowing someone with HIV. As a result of improved treatment, people with HIV generally look healthy and a quarter of people with HIV are unaware they have it. Many HIV positive people do not find it easy to tell other people about their condition, so you may not realise if someone you know is HIV positive.

Why do some people find it difficult to tell others they have HIV?

Unfortunately in today’s society there is still a lot of stigma around HIV and many people hold myths and misconceptions about HIV and how it is transmitted. Some people also hold prejudicial views about people living with HIV. This means many HIV positive people find it difficult to tell others about their HIV because they have fears about how people will react and think it will be easier if they kept it to themselves.

Can people with HIV still work?

Effective HIV treatment means most people diagnosed nowadays with HIV are able to work just like everyone else. In a recent NAT survey among people living with HIV in employment, 70% of respondents had taken no HIV-related sick days in the last 12 months.

Do some people deliberately infect others with HIV and get sent to prison?

It is true that in the UK a person can go to prison for recklessly or intentionally passing on HIV to another person. There has never been a case of anyone being convicted for intentionally passing on HIV but there have been several convictions for reckless HIV transmission, which involves a person knowing they were HIV positive but not taking the necessary steps to protect their sexual partner. Find out more about criminal prosecutions for HIV transmission here.

Are HIV positive people likely to get any other medical conditions?

Because HIV affects the immune system, people living with HIV can be susceptible to certain illnesses – particularly if they haven’t yet been diagnosed. These include bacterial diseases such as tuberculosis (TB), pneumonia and blood poisoning, fungal diseases such as oral thrush, and viral diseases.

There are also certain illnesses which HIV positive people are prone to being co-infected with, and these include hepatitis B and C. There is a vaccination against hepatitis B which all HIV positive people should receive but there is no vaccination against hepatitis C. Having both conditions at the same time can have severe health implications, with liver disease caused by hepatitis B and/or C is a leading cause of serious illness and death in people with HIV.

How should I respond when someone tells me they are HIV positive?

Unfortunately even in today’s society some people hold prejudiced views about HIV, this often stems from people not understanding the facts.

This means people living with HIV can find it difficult to tell others about their status because they have fears about how people will react. If they tell you they are placing a huge amount of trust in you and it is important not to abuse that trust.

Firstly it is important you keep the information to yourself and try to handle the situation as sensitively as you can. Put yourself in their shoes and think about what you would like someone to say and do. Often people living with HIV find questions about how they acquired their status difficult. Wait to see what level of information they want to share.

You could also try to gauge how the person is coping with their diagnosis. For some people, particularly if they have been living with HIV for a while, it may not be something they particularly struggle with, however for some, especially if they are recently diagnosed, they may be upset and be looking for support. Maybe ask them how they feel about it.

And most importantly try not to worry if somebody you care about has HIV. In most cases, and with the right support, people living with HIV can lead a normal life, be able to work, have relationships and children. And if they are diagnosed early and on effective treatment they are also likely to have a normal lifespan.


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