What is HIV?HIV stands for Human Immunodeficiency Virus. HIV is the virus that causes AIDS. While many viruses can be controlled by the immune system, HIV targets and infects the same immune system cells that are supposed to protect us from illnesses. These are a type of white blood cell called CD4 cells.

What is HIV? 

What is HIV?HIV stands for Human Immunodeficiency Virus. HIV is the virus that causes AIDS. While many viruses can be controlled by the immune system, HIV targets and infects the same immune system cells that are supposed to protect us from illnesses. These are a type of white blood cell called CD4 cells.

HIV takes over CD4 cells and turns them into virus factories that produce thousands of viral copies. As the virus grows, it damages or kills CD4 cells, weakening the immune system.  

What is AIDS?

AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is the most advanced stage of HIV infection.  HIV causes AIDS by attacking the immune system’s soldiers – the CD4 cells. When the immune system loses too many CD4 cells, you are less able to fight off infection and can develop serious, often deadly, infections. These are called opportunistic infections (OIs) because they take advantage of the body's weakened defenses.  When someone dies of AIDS, it is usually opportunistic infections or other long-term effects of HIV infection that cause death. AIDS refers to the body’s immune-compromised state that can no longer stop OIs from developing and becoming so deadly.  

What is the Difference Between HIV and AIDS?You don't have AIDS as soon as you are infected with HIV. You can be HIV+ for many years with no signs of disease, or only mild-to-moderate symptoms. But without treatment, HIV will eventually wear down the immune system in most people to the point that they develop more serious OIs.  The Centers for Disease Control and Prevention (CDC) defines someone as having AIDS if he or she is HIV+ and meets one or both of these conditions:

• Has had at least one of 21 AIDS-defining opportunistic infections
• Has had a CD4 cell count (T-cell count) of 200 cells or less (a normal CD4 count varies by laboratory, but usually is in the 600 to 1,500 range)

 How Do I Know if I Have HIV?Most people can not tell that they have been exposed or infected. It can take up to 12 weeks for an HIV test to come back positive. However most people respond much faster. Within two to four weeks of exposure to HIV, you might have flu-like symptoms such as fever, swollen glands, muscle aches, or rash.  The only way to know for sure if you are infected is take an HIV test. If you are infected, your immune system will make antibodies to fight the virus. The HIV test looks for these antibodies. If you have them in your blood, it means that you have HIV infection.  Do I Need to Get

Tested for HIV?The CDC estimates that more than 25% of HIV+ people are unaware of their HIV status. Many of these people look and feel healthy and do not think they are at risk. But the truth is that anyone of any age, gender, race, sexual orientation, or social or economic class can become infected. It is your actions (or the actions taken against you), that put you at risk. You should be tested if:

• You have had vaginal, anal, or oral sex without a condom
• You have shared needles or syringes to inject drugs (including steroids or hormones)
• You are uncertain of your partner’s status or your partner is HIV+
• You are pregnant or are considering becoming pregnant
• You have ever been diagnosed with a sexually transmitted disease
• You have hepatitis C

Why Should I Get Tested?If you test HIV+ there are effective medications to help you stay well. But you cannot get the health care and treatment you need if you do not know your HIV status. Being unaware of your status also makes it more likely to unknowingly pass HIV to others.  If you test HIV- you can take steps to stay that way. You can also spare yourself unnecessary worrying.  

What Tests are Available?The most common test for HIV is the antibody test (called ELISA). It can be done on blood, saliva, or urine. According to the CDC, it is more than 99% accurate. Results are generally available within two weeks. (There is a rapid ELISA test that gives results in less than half an hour.)  A positive result means your body has developed antibodies for HIV, so you are infected with the virus. To be completely certain, positive results are confirmed with a more sensitive test called the Western blot.  A negative result means your body has not developed antibodies and is probably not infected. To get truly accurate results, it's necessary to wait three to six months after your last possible exposure to the virus before being tested. That is because the immune system can take anywhere from three to twelve weeks to make antibodies. In this "window period," someone may get an unclear result or a false negative.  

Where Can I Get Tested?You can get tested at your doctor’s office, a clinic, the local health department facilities, or at a hospital. In addition, many states offer anonymous HIV testing. You can also purchase a kit that allows you to collect your own blood sample, send it to a lab for testing, and receive the results anonymously. (Only the "Home Access" brand kit is approved by the Food and Drug Administration.)  It is important to get tested at a site that provides counseling. Counselors can answer questions about high-risk behavior and suggest ways you can protect yourself and others in the future. People who test HIV+ can receive support and referrals to health care and other services. The counselor can help you through the whole testing process – from start to finish.  The CDC's National AIDS Hotline can answer questions about HIV testing and refer you to testing sites in your area:  1-800-342-2437 (English) 1-800-344-7432 (Spanish)  Is There a Vaccine to Prevent HIV Infection?There is currently no vaccine available. The best way to prevent HIV is to use sterile needles and practice safer sex .   

HIV Transmission

How HIV SpreadsThere is still misunderstanding about how HIV is transmitted from one person to another. Knowing the basics helps you avoid getting the virus if you are HIV-, and avoid passing it on if you are HIV+. HIV is spread through the following body fluids: 

• Blood (including menstrual blood)
• Semen and other male sexual fluids ("pre-cum")
• Vaginal fluids
• Breast milk

HIV is not spread through these body fluids: 

• Sweat
• Tears
• Saliva (spit)

The spread of HIV can be prevented! There are ways to avoid, or at least,reduce contact with the bodily fluids that spread HIV (blood, sexual fluids, and breast milk). This info sheet will explain how. 

Methods of TransmissionIn the past, HIV was spread in blood products, such as whole blood or the "factor" used by hemophiliacs. Many people were infected this way. The blood supply is now much more strictly tested and controlled. The odds of being infected from receiving blood or factor in the U.S. are extremely low. You cannot get HIV from donating blood – a new clean needle is used for each donation. Some people, primarily healthcare workers, are occasionally infected through needle sticks with infected blood, or through other medical accidents. This is a very tiny percentage of overall infections. Today, the most common ways HIV is passed from one person to another are: 

• Re-using and sharing needles
• Unprotected/unsafe sex (no condoms or other barrier devices)
• Mother-to-child

Re-using and Sharing NeedlesMany HIV infections occur when people share needles to inject heroin, methamphetamine, or other drugs. This risk can be greatly reduced by cleaning needles with a bleach solution before re-using them. The risk can be eliminated by using fresh needles each time. Many cities now offer free needle exchange programs. When getting a tattoo or body piercing, always go to a licensed professional and make sure the equipment is autoclaved, not just "sterilized" with alcohol. 

Un-protected/unsafe SexEvery sexual act that involves sexual fluids of some kind has at least some risk. Barriers, such as condoms (male and female), dental dams, latex gloves, and even plastic food wrap (such as Saran Wrap), help reduce risk substantially. Unsafe sex (sex without condoms or barriers) puts you and your partner at risk for HIV or other sexually transmitted diseases (STDs). Safer sex (sex using condoms or other barriers correctly and consistently) protects you and your partner. Which common sexual activities are most likely to cause HIV transmission when safer sex isn't used? (Listed from most to least risky.) 

1.      Receptive anal sex ("bottoming") remains the most risky activity, due to the likelihood of direct semen-blood contact. But penetrative anal sex ("topping") with someone can result in HIV transmission, too.

2.      Vaginal intercourse puts both partners at risk, but HIV is transmitted from men to women much more easily than from women to men.

3.      Oral sex can be risky for the person performing it, particularly if he or she swallows semen, vaginal fluids, or menstrual fluids.

4.      Sharing sex toys without sterilizing them can be dangerous.

5.      Rimming (licking the anus) is very unlikely to result in HIV infection.

6.      Mutual masturbation (hand jobs) and fisting (using a hand to penetrate the anus or vagina) are relatively risk-free, as long as your hand has no open cuts or sores.

Sexual assault can result in infection if the assailant is HIV+. The risk increases when rape involves anal penetration, force, and/or multiple assailants. Some forced sexual acts involving wounds can place a victim at very high risk. In major cities, PEP (post-exposure prophylaxis) is often offered to victims of sexual assault. This month-long treatment reduces the likelihood of HIV infection substantially. It is currently only used on a regular basis for victims of sexual assault and for healthcare workers who have been exposed to HIV on the job. PEP must be started as quickly as possible, always within 72 hours of the exposure. 

Mother-to-Child TransmissionHIV+ mothers can pass the virus to their babies while pregnant, during birth, or by breastfeeding. New medical techniques have almost eliminated the risk of a baby getting HIV from its mother when precautions are taken. HIV+ mothers should not breastfeed their babies. 

Freak TransmissionsThere are a few isolated cases of people infected from using a razor that had just been used by an HIV+ man or in other off-beat ways. To be safe, always avoid direct contact with blood and sexual fluids in any context. Don't worry too much about freak cases. For instance, there is a documented case of transmission from deep or "French" kissing – in two people who had terrible dental problems. The odds of getting HIV from kissing, even when one person is HIV+, are less than the odds of being struck by lightning. 

True versus False Risk of Transmission HIV cannot be transmitted except when certain bodily fluids are exchanged. You can greatly reduce the risk of transmission by:

• Avoiding contact with sexual fluids by always practicing safer sex
• Abstaining from sex unless you and your partner are both HIV- and in a long-term, monogamous relationship
• Not using injection drugs, or if you do, always using new or clean needles
• Finding our your HIV status if you are planning to get pregnant and working with a knowledgeable doctor and obstetrician if you are HIV+

If you

protect yourself in these ways, you do not need to be afraid of getting or passing HIV by casual contact. Remember, HIV is not transmitted by:

• Hugs
• Dancing
• Sharing food or drinks
• Using a shower, bath, or bed used by an HIV+ person
• Kissing (between people with no significant dental problems)
• Sharing exercise equipment

Women and HIV 

A Look at the NumbersOver two and a half decades have passed since the first diagnosis of AIDS in America. While there were a handful of women among the first cases, AIDS was thought to primarily affect gay men. As the years passed, women began to emerge as the changing face of AIDS. The proportion of HIV and AIDS cases among women has more than tripled from 7 percent in 1985 to an alarming 30% in 2005.  The United States Centers for Disease Control and Prevention (CDC) estimates that there were 127,150 women  living with HIV/AIDS in the US in 2005. However, women remain undiagnosed, or not in care, and The World Health Organization (WHO) estimates a much higher prevalence of between 300,000 and 500,000 HIV+ women in the U.S. in 2005.  WHO estimates that there were between 15.1 -20.9 million HIV+ women worldwide, accounting for almost half of the estimated 39.5 million HIV+ adults in 2006. HIV has hit the African-American and Hispanic communities particularly hard. Women in these communities account for over 78 percent of all female AIDS cases in the U.S. There has also been an increase in HIV diagnoses in older women (45 and older.) For women in America, high-risk heterosexual contact is clearly the most prevalent mode of transmission: 72% of new HIV infections are by heterosexual contact. A further 26% have been exposed through injection drug use. 

 Is HIV Different for Men and Women?Until recently, very little research had been done on women and HIV. While many questions remain unanswered, there is some information about how HIV-related illnesses affect men and women differently:

• Men are eight times more likely than women to develop Kaposi's sarcoma or KS (a cancer-like disease caused by a herpes virus)
• Women are more likely than men to develop bacterial pneumonia
• Women may have higher rates of herpes simplex infections than men
• When women are first diagnosed, they tend to have lower concentrations of HIV in their blood (lower viral loads) compared to men. In addition, women tend to have lower CD4 cell counts than men with equal viral loads. Yet women seem to progress to AIDS at the same rate

 Trials are currently underway to determine how certain HIV drugs affect women differently than men.  If you are thinking about starting treatment, it is important to watch your lab results and talk to your doctor about the best treatment plan for you. 

Differences in Care and TreatmentWomen tend to be diagnosed with HIV later in the disease than men. In addition, once they know their status, up to 25 percent of women postpone medical care due to several barriers including:

• Limited access to health care due to lack of insurance
• Unstable housing
• Fear of partner violence
• Other responsibilities such as child care or caring for a sick partner
• The stigma associated with HIV
• Active substance abuse
• Depression

If women do receive adequate care and treatment in a timely manner, they appear to benefit from HIV therapy as much as men. However, side effects from some HIV drugs are more significant in women than men. Gender differences in side effects may be due to an interaction between HIV therapy and female hormones. It may also be the result of women's smaller physical size. Standard doses of drugs are usually based upon research done predominantly in men. This means a woman, who will generally weigh less than a man, may get a higher amount of the drug in her body than is needed to be effective. If you are experiencing side effects, be sure to ask your doctor for help. Do not change your dose or stop your drugs without speaking to your doctor first! 

Gynecological Issues with HIV+ WomenCertain gynecological conditions are more common, more serious and/or more difficult to treat in HIV+ women than HIV-negative women:

• Some vaginal infections (including yeast infections)
• Bacterial vaginosis
• Common sexually transmitted diseases (such as gonorrhea, Chlamydia, and trichomoniasis)
• Herpes simplex virus outbreaks
• Pelvic inflammatory disease (PID)

Although there is little conclusive research regarding HIV+ women and menstruation, many HIV+ women report menstrual irregularities. Some have excessive bleeding while others stop menstruating altogether. Dysplasia, a pre-cancerous condition in the female reproductive system, is more common in HIV+ women, especially in women with advanced HIV disease. It is often more severe and difficult to treat than in HIV-negative women. Untreated dysplasia often leads to cervical cancer, a life-threatening illness. It is very important for HIV+ women to have regular Pap smears. A Pap smear is a screening test your doctor does to check for changes in the cervix. An abnormal Pap smear can indicate inflammation, infection, dysplasia, or cancer. HIV+ women are 10 times more likely to have abnormal Pap smears than HIV-negative women. These abnormal Paps are usually associated with low CD4 cell countsand human papilloma virus (HPV), a sexually transmitted disease that can also cause genital warts. 

The Centers for Disease Control (CDC) recommends that:

• HIV+ women have a complete gynecological examination, including a Pap smear, when they are first diagnosed or when they first seek prenatal care
• HIV+ women have another Pap six months later
• If both tests are negative, yearly screening is recommended
• Women who have symptomatic HIV infection or who have had dysplasia in the past should receive a Pap smear every 6 months

In Conclusion More research is clearly needed to determine how HIV progresses in women and how HIV drugs affect women’s bodies. However, it does seem that the HIV drugs can benefit women as much as men if women access care and treatment in a timely fashion. It is important to get tested for HIV on a regular basis. If the results are positive, it is even more important to seek on-going medical and gynecological care. By taking advantage of good health care and treatment, you increase your chances of living a longer and healthier life for you and your loved ones. 

Youth and HIV/aids  

AIDS was first discovered over 25 years ago. Yet today, 6,800 people will be infected with HIV. Of the 2.5 million people infected yearly, young people ages 15-24 account for 40 percent of new infections. Poverty, unemployment, a lack of education, sexual violence and gender inequality increase the vulnerability of young people to HIV infection.

11.4 million Children and adolescents have been orphaned by AIDS and are now heads of households, as we lose an entire generation of parents, teachers, workers and doctors in many regions. Although world leaders committed that by 2005, 90% of young people would know how to protect themselves from infection, currently in the hardest hit countries, less than half of youth can correctly identify modes of HIV transmission.

Despite the debilitating effects of AIDS, young leaders are taking action in their communities to prevent the spread of the disease and to address the devastating consequences of the pandemic. In fact, evidence shows that young people are most effective at changing the risk behaviors of their peers and at shaping a better future for themselves and their families