Frequently Asked Questions:
1. What are HIV & AIDS?
Human Immunodeficiency Virus (HIV) is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). Being HIV-positive or having HIV disease is not the same as having AIDS. Many people are diagnosed with HIV but may not get sick for many years. Once in a person's system, HIV begins to attack the immune system and for many who are HIV-positive, over a period of time, they can become ill with a number of conditions.
AIDS is a technical term defined by the Centers for Disease Control and Prevention. An HIV-positive person is diagnosed with AIDS when that person has developed certain opportunistic infections or other medical conditions such as a T-cell or CD4 (the most basic element of the immune system) count of less than 200. Only a physician can officially make the diagnosis that a person with HIV now has "AIDS". Generally an AIDS diagnosis occurs many years after infection.
HIV is the virus, AIDS is the disease and "HIV disease" is the most appropriate way to describe the continuum of HIV to AIDS. It is important to note that an AIDS diagnosis does not mean that an individual will soon die. While severe illness can develop, there are many medications available to help treat these. With good medical care it is possible for a person to maintain good health even after an AIDS diagnosis.
2. Do I need to get tested? Where can I get tested?
Transmission of HIV almost always occurs through unprotected anal or vaginal sex, or by sharing needles. If people think they have been exposed to the HIV virus they should get an HIV test. Explore the other questions on this page to help assess if you are at risk for HIV or contact the Oregon HIV/STD Hotline and a trained volunteer will assess your risk.
The most commonly used test is a blood test that looks for antibodies to the virus. Antibodies are produced by the immune system to fight the virus. The "window period" is the time that it takes for the antibodies to develop after being exposed. Although many people develop antibodies within the first month of their infection, some people take a bit longer. Clinicians agree that testing at three months after exposure will give a conclusive result. All pregnant women should be tested for HIV so they can be treated prenatally and greatly reduce the risk of transmitting HIV to their baby.
People can get tested for HIV by their regular doctor, or they can go to a community clinic, a public health clinic, or a clinic that specializes in sexual health such as Planned Parenthood. There is now a rapid blood test for HIV that requires only a few drops of blood and gives same day results. It is especially important to practice abstinence or safe sex and to avoid sharing needles during the window period in order to get an accurate HIV test result, and to avoid the risk of infecting another person since newly infected people are especially infectious to others.
Call the Oregon HIV/STD Hotline at (503) 223-2437 or (800) 777-2437 to get information about testing and testing sites in Oregon.
3. Where did HIV come from?
Since scientists first became aware of HIV in the early 1980s, they have explored and debated how and where the disease originated. To this day, the debate continues and different theories exist. Despite these differing theories, all the experts still agree that HIV is the virus that weakens a person's immune system and can lead to either one or more physical conditions that a physician then diagnoses as "AIDS".
In February of 1999, an international team of scientists reported that they had traced the roots of the most common type of HIV (HIV-1) to a virus found in a subspecies of chimpanzees in Africa. It is now generally accepted that HIV is a descendant of this virus. It is believed that the virus was transferred to humans as a result of chimpanzees being killed and eaten or their blood getting into cuts or wounds of people during the hunting process .
While determining the origin of HIV was important to increase understanding of the virus, it is important to now focus on treatments for people living with HIV and education and prevention efforts to stop the spread of HIV.
4. Is there a cure for HIV?
There is no cure for HIV yet, but research continues daily. There are a variety of medications that can slow down the progression from HIV to AIDS and reduce damage to the immune system. Many of these drugs were not available until the mid-to-late 1990's. Other drugs can prevent or treat opportunistic infections that result from HIV infection.
5. What is the difference between HIV-1 and HIV-2?
There are two identified strains of HIV: HIV-1 is the retrovirus usually associated with the epidemic in most of the world, including the United States; HIV-2 is not as virulent as HIV-1 and is primarily epidemic in West Africa. Many HIV tests in the United States will detect either HIV-1 or HIV-2. Blood banks and plasma centers also screen for HIV-1 and HIV-2.
Due to the rare incidence of HIV-2 in the United States, testing for this specific strain of HIV is only recommended if a person has had a known risk with someone from a country where HIV-2 is prevalent.
6. How is HIV transmitted?
A person must be infected with HIV in order to infect others. There are no uninfected "carriers" of the disease. The virus is transmitted only by the blood, semen, vaginal fluid or breast milk of an HIV-infected person. It is not transmitted by sweat, tears, urine, saliva or casual contact. In order for transmission to occur, the virus must enter an uninfected person's bloodstream. The virus can enter the bloodstream through contact with mucus membranes or through open cuts or by injection. Transmission almost always occurs through unprotected anal or vaginal sex (mucous membranes), or by sharing needles. In very rare cases, HIV transmission has occurred through oral sex. HIV can be transmitted from an HIV-positive woman to an infant through breast milk. It should be noted that HIV is not very concentrated in breast milk and it is only through repeated feedings of large quantities of breast milk that transmission may occur.
Transmission is most likely when a person is exposed to high concentrations of the virus. When a person is newly infected with HIV, the virus multiplies very rapidly within that person. A newly infected person is especially infectious to others in the first few weeks and months immediately following infection. This is why anyone who has had a risk of HIV infection should be especially careful to practice abstinence or safe sex or not share needles until they get a definitive HIV test.
7. Can I get HIV from casual contact?
No, HIV is a fragile virus and dies within seconds when exposed to light and air (oxygen). Therefore HIV can only be transmitted when an HIV-negative person comes into contact with one of these four bodily fluids: blood, semen, vaginal fluid or breast milk. HIV is most often transmitted through unprotected sex and sharing needles. HIV can NOT be transmitted from hugging, kissing, shaking hands, sharing towels, sharing eating utensils, swimming in public pools, or using public restrooms.
8. Is the blood supply safe?
Yes. The blood supply in the U.S. is one of the safest in the world. Since 1985, all blood in the U.S. has been tested for HIV, hepatitis and other infectious agents. Even in high prevalence areas where many people with HIV live, the risk of transmission through a blood or blood produced transfusion is infinitesimal.
9. Can mosquitoes transmit HIV?
No. Numerous studies by the CDC and other programs have shown no evidence of HIV transmission through mosquitoes. These studies showed that transmission via mosquitoes is not possible because:
- Mosquitoes do not ingest enough HIV-infected blood to transmit HIV to another person. The small amount of the virus ingested by mosquitoes is not substantial enough to cause HIV infection in another person.
- Mosquitoes digest HIV. The virus cannot survive inside the insect and it cannot be passed on to the mosquito's next host.
- Mosquitoes are not flying hypodermic needles. A mosquito's complex feeding apparatus does not involve any exchange of blood between the mosquito and host.
10. Can I get HIV from my doctor or dentist?
In the U.S., there has only been one documented case of HIV transmission from a health care provider to a patient. This case was reported in 1989 and involved a Florida dentist and the controversy about its reliability continues.
Health care workers are mandated by federal law to follow certain infection control guidelines to prevent infections from being passed from health care worker to patient and from patient to health care worker.
11. Are condoms effective in preventing HIV transmission?
The Centers for Disease Control and Prevention (CDC) state that correct and consistent use of a latex barrier for protection during sex greatly reduces the risk of transmitting HIV. Condoms can protect the mouth, vagina or rectum from HIV-infected semen. Male condoms protect the penis from HIV-infected vaginal fluids and blood in the mouth, vagina, or rectum. Female condoms can be inserted into the vagina or rectum to prevent HIV transmission. They also reduce the risk of spreading other sexually transmitted diseases.
Latex is the most common material for condoms. Viruses cannot get through it. Never use oil-based lubricants like Vasoline, salad oil or hand or body lotion. These can cause tears and leaks in the latex causing it to break. Instead, use a water-based lubricant such as K-Y Jelly. Polyurethane is an option for people who are allergic to latex. Lambskin or natural condoms have pores small enough for HIV to pass through; they do NOT prevent the spread of HIV.
Condoms must be stored, used and disposed of correctly. Also, observe the expiration date on the package and tear it open carefully. Avoid opening by tearing the package with your teeth or using a scissors as tiny cuts may be made in the condom. Never use a product that has been previously used or exposed to extreme temperatures.
Nonoxynol-9 is a chemical that kills sperm and is used in the vagina along with condoms or other birth control methods to help prevent pregnancy. It should not be used as a way to prevent HIV infection because many people are allergic to it. For some, their sexual organs can become irritated from Nonoxynol-9 and develop small sores that actually make it easier for HIV, if present in the other partner, to enter their system.
12. Is abstinence the only way to prevent the sexual transmission of HIV?
Abstaining from sexual activity with others can eliminate the risk of becoming infected with HIV. Be aware that using drugs or alcohol can impair judgment and make it difficult to maintain abstinence or ultimately practice safer sex. Learn about sexual activities that can reduce the risk of HIV transmission by avoiding exposure to semen or vaginal fluid. For many abstinence is a practical and useful choice, however for others it is not an option so learning about the correct and consistent usage of condoms and latex barriers during sex greatly reduces the risk of contracting HIV.
Even for those who have chosen abstinence as their prevention technique, at some point most adults will enter into a sexual relationship with someone else, thus learning about safer sex prior to that encounter will aid in understanding how to remain HIV-free.
13. Can I get HIV from unprotected oral sex?
There have been very few documented cases of transmission through solely oral sex thus the risk is extremely low.
HIV is not transmitted through saliva. Sexual transmission of HIV requires the presence of HIV infected blood, semen or vaginal fluid. The risk of transmission is increased by the presence of open cuts or sores in the mouth or on the genitals. Having other sexually transmitted diseases (STDs) can also increase the risk of HIV transmission. Specifically, the sores associated with syphilis and herpes can assist with HIV transmission.
Reduce the risk of HIV during oral sex by using a latex or polyurethane barrier such as a condom or dental dam.
It is important to remember that some other STDs, unlike HIV, can be easily transmitted during oral sex. The barriers above can also reduce this risk.
14. What if I have another Sexually Transmitted Disease (STD)?
Research has shown that HIV transmission is 2-5 times more likely to occur when another sexually transmitted disease is present. If the STD causes sores or irritation in the skin it can be easier for HIV to enter the body. Even if the STD does not cause open sores or irritation it can stimulate an immune response that can make HIV transmission more likely. Most STDs can be detected by testing within a few weeks after exposure, and many are treatable or curable.
15. How is HIV transmitted through injecting drug use?
Sharing needles is a high risk behavior for HIV since a contaminated syringe can pass blood directly from one person's bloodstream to another. Blood can enter a syringe when it is placed into the vein. Some of this blood remains in the syringe after use and can enter to bloodstream of others if the needle is shared. Sharing needles is also a high risk for hepatitis transmission.
An injection drug user who has never shared syringes or other drug paraphernalia cannot become infected with HIV from clean (sterile) syringes regardless of his or her drug use. The exchange of blood from sharing contaminated syringes causes transmission, not the drug use itself.
16. How can the risk of HIV infection from injecting drug use be reduced?
Injecting drug users can reduce HIV transmission by not sharing syringes or any other injection supplies. Sharing needles with anyone is a risk for HIV and other blood-borne diseases. People who inject drugs should use their own "works" to best protect themselves against potential exposure to HIV. Using a sterile syringe significantly reduces the risk of contracting HIV and hepatitis.
17. Are clean syringes available in Oregon?
Clean syringes can be purchased in quantities of ten or fewer from pharmacies throughout the state and it is legal to possess up to ten clean syringes. Some organizations in Oregon such as Outside In (http://www.outsidein.org/index.htm) offer syringe exchange programs.
18. We all know how HIV is spread, so why continue to spend money on prevention?
HIV is like many other social and public health issues involving behavior, such as smoking, eating health foods, seatbelt use and speeding; people need to be continually reminded. HIV prevention education doesn't always reach those who need the information and for many young people, they may only receive the information once while in high school. Later in life they may have many questions and that's why we need to make sure the message of HIV transmission is broadly placed. HIV has impacted certain communities disproportionately due to ongoing stigma and fear. Focused prevention efforts can help to engage these communities to slow the spread of HIV.
As of the end of 2006, 5,000 people were known to be living with HIV in Oregon. There are several thousand others who are also HIV-positive, but have not been tested and thus don't know their status. Advances in treatment have allowed people with HIV to live longer, more healthy lives. That also means that there is a growing percentage of the population which is living with HIV. This trend will continue as long as there is not a viable vaccine for HIV.
HIV is a preventable disease but, to achieve this, everyone needs complete, accurate information in order to reduce their risk surrounding HIV. Ongoing, age-appropriate education is necessary to raise awareness in the public and reduce new infections.
If you have additional questions or would like clarification on the items above, please contact the Oregon HIV/STD Hotline. The Oregon HIV/STD Hotline is the statewide toll-free information and referral service that can answer your questions about HIV and connect you to resources that can help. You can contact the Oregon HIV/STD Hotline through our phone line, e-mail, or online chat service. Oregon HIV/STD Hotline staff are available to answer questions Monday through Friday, 9 am-6 pm, and Saturday from 12pm - 6pm. Calls, emails and online chat services are confidential.
Last Updated: Tuesday, November 11, 2008
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We thank the Minnesota AIDS Project AIDSLine for furnishing these questions and answers.