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Facts
Facts about HIV
by Lotte Ø. Rodkjær and Tinne Laursen
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HIV stands for Human Immunodeficiency Virus. The virus makes humans sick not animals. The HIV virus destroys the body’s immune system. The immune system protects the body and fights off various diseases.
There are two main types of HIV: HIV-1 and HIV-2. HIV-2 is more prevalent in West Africa and less widespread, whereas HIV-1 has spread to the whole world since the beginning in the early 1980s. Recent research indicates that both viruses originate from Africa.
Once HIV gets into the human body, it slowly starts to destroy the immune system. HIV attacks living cells and uses their metabolism - especially the white blood cells that play an important role in the normal immune system. These are called helper T-cells or CD4 cells.
It often takes many years before the number of helper T-cells is so low that the immune system no longer functions properly. The immune system cannot carry out its central task of protecting the body from all other types of viruses and bacteria that surround us. When the capacity of your immune system is reduced, you fall ill more easily.
The period of time from a person has been infected with HIV to the weakening of the immune system varies. In some persons, it only takes a couple of years – in others it may take up to 15-20 years. If you do not receive medical treatment, it will take 7 to 9 years on average to the time of infection to the first serious iinfection appears. These infections are caused by the malfunctioning of the immune system.
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Viruses are small organisms - much smaller than bacteria. Viruses are so small that you cannot see them in ordinary microscopes – only in specific microscopes that magnify more than 100,000 times the normal size.
Viruses can only live inside other living organisms such as plants, animals and humans, and can only survive outside these organisms for a short period of time.
There are many types of viruses. Some viruses only infect certain types of animals or plants, while others only infect humans.
These different types of viruses cause different types of diseases. Several of the most common diseases are caused by viral infections, such as colds, the flu and chickenpox. These are infections where you most often are cured by yourself.
Viruses infect in different ways. The flu virus is spread very easily when you cough or sneeze – and in this way, many people quickly fall ill. Other types of viruses may be transmitted, if the blood of an infected person gets into the bloodstream of another person.
HIV can only be transmitted to another person, if the blood, semen or vaginal fluid get into another person’s body.
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AIDS stands for Acquired Immunodeficiency Syndrome. A person is diagnosed with AIDS when certain infections occur. These infections include a certain type of pneumonia that only occurs when the immune system is weakened.
In this condition, HIV has destroyed so many helper T-cells that the immune system no longer responds properly to the frequent small and major attacks the immune system is constantly faced with.
At some point, an HIV positive person may get infected with diseases that people with normal immune systems hardly ever get. This is due to the very weakened immune system. These diseases are called AIDS-related diseases or complications.
Today, many conditions can be avoided, if the HIV diagnosis is detected in time. It is possible to receive medical treatment, before the immune system is weakened. Through this medical treatment, the immune system is strengthened and the complications can be avoided.
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Today, HIV is a global epidemic, and very few places remain unaffected by the virus. However, some places are more affected than others. This is especially true for sub-Saharan Africa. By the end of 2000, 36 million people worldwide were diagnosed with HIV or AIDS, hereof 25 million live in Africa.
HIV spreads fast in Asia and in the former USSR, but in many years to come, Africa will remain the continent most affected by the disease.
In Denmark, about 300 new persons are diagnosed with HIV each year. approximately 5000 are HIV positive, of these 80-100 are young people between 15 and 25 years of age.
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HIV is only transmitted in three ways.
You get infected if you get an HIV-infected person's blood, semen or vaginal fluid into your own body.
If you get one of these three fluids on your skin, i.e. outside your body, you cannot get infected. It can only infect you if it gets into your body.
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Through blood. If the blood of an HIV positive person gets into another person’s bloodstream, for instance by sharing syringes and needles.
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Through sex. HIV is present in the male semen and in the female vaginal fluid. HIV can be transmitted during sex. When having sexual intercourse it is important to use a condom. By using a condom you are protected from pregnancy, sexually transmitted diseases and HIV. It is important to use the condom correctly so it does not burst and to wear it during the whole intercourse.
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Mother to foetus or child transmission. When an HIV positive woman is pregnant and gives birth she risks passing on the infection to her child. The child can be infected during pregnancy, birth or breast-feeding. By treating both mother and child with medicine and by advicing against breast-feeding, the risk of transmission is very low.
It is very important to know that HIV is not transmitted in other ways. It is not dangerous to hug, kiss or fondle someone who is HIV positive, and you can easily share a glass and use the same toilet.
An HIV positive person cannot infect others with the AIDS related diseases, and the risk of getting infected with other, "normal" infections, such as inflammation of the throat, is not higher in HIV positive persons than in others.
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| Treatment options for HIV |
Everybody who is told they are infected by HIV attend control visits due to their disease. Most go to control visits at an outpatient clinic at a department of infectious diseases every third or fourth month. At these visits they keep an eye on the status of the immune system through blood samples.
At each visit you talk to a doctor and a nurse how you are doing and you get the results of the blood tests. In this way the doctors can follow the development of the HIV disease and offer treatment when necessary.
The doctors in the outpatient clinic are responsible for initiating treatment. The outpatient clinic is also the place where you receive counseling and help to tackle the problems that can occur when you are HIV positive.
Today the treatment options for HIV are really good!
It is not all HIV positives who need medicine. At the hospital they take blood samples that i.a. show the amount of virus in the blood. In this way they find out if you need medicine. If your immune system is well-functioning you do not need medicine right away.
Up until 1996 there was not much medicine for HIV. Most HIV positives thus developed AIDS and died 8-10 years after contracting the HIV virus.
If you forget to take your pills repeatedly, there is a considerable risk that the medicine will stop working. To follow the treatment requires discipline and due care.
You always have to take different types of medicine at the same time to get the optimal result. This is called combination treatment.
The medicine cannot cure, make the HIV virus disappear, but it can make HIV “sleep” to prevent it from damaging the immune system.
When you have started the treatment you have to take the medicine for the rest of your life like patients with e.g. diabetes. Almost all the medicine is available as tablets or mixture.
Most HIV positives tolerate the treatment and have a good effect of the treatment. Some experience uncomfortable side-effects in the first period after starting treatment, but they usually disappear again. The doctor and the nurse will explain this to you.
When you get the medicine at the outpatient clinic where you go for control visits you do not have to pay for it yourself.
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Thoughts right after having a positive HIV test
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When you have just been told you have HIV in your body, most feel different than other young people. Most are scared and sad when they have just been told they are infected with HIV. Some young people tell it is as if the carpet is pulled away from under their feet and others experience that they have to been grown up and responsible all of a sudden – as if all the innocent and funny have been taken away from them. Most young people with HIV are scared and worried in the beginning about being ill and dying.
After a while you feel different again. It is as if you need time to learn about HIV and find out what it means to your life. There are many new things to learn about the virus.
To most young people is it not usual to have to relate to a disease. It is therefore difficult in the beginning. Most that are told they have HIV do not know about the new treatment options for HIV in our part of the world. That is why some think the disease will develop rapidly and that you die from HIV. As mentioned previously it does not have to be like that today. Depending on the status of your immune system, you will at some point be offered medical treatment.
Some feel different because they suddenly think differently and have other feelings than other young people. Thoughts about disease, treatment options, boy or girlfriends and sexuality can be quite pressing in the beginning.
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| Living as others when you have HIV |
In many ways you can live like other young people. With the treatment options available today it is expected that young people will live a long life similar to other young people. That is why young HIV positives should continue to realize the plans you have made concerning school, studies, education and job. Here HIV positive young people are not different from other young people.
The situation where young HIV positives have to live differently concerns the fact that they have to relate to living with a disease. On top of that it is an infectious disease that is unknown to many people. The people who are not directly affected by or has knowledge of HIV might not know the progress that has happened concerning treatment and maybe they do not know quite how it is transmitted. When you lack knowledge you get more worried and concerned even though there is no need to be afraid of an HIV infected person.
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Living with HIV concealed or in the open
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Many choose to live with HIV as a secret or something they do tell anybody about. Most tell they choose to live like this because many people do not have knowledge of HIV and because it is often connected with the disease being sexually transmitted.
Some young people have told about their HIV status to family and friends but do not wish that others should know about it. What is important is to find out what would be best on a long-term basis.
It is the infected person who chooses who should know!
It is important to find someone to talk with about the HIV. Especially in the beginning you have many thoughts about HIV, disease and the future and it is important to share these thoughts with someone. To carry such a big secret can be a huge burden.
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| Who can you talk to about HIV? |
Most young people who have been infected by HIV spent some days or weeks considering who should know about their disease. Often it is the nurse or counselor at the hospital they talk to about this – the importance of talking to someone. Luckily most have good families or friends and it is not difficult to find someone to talk with. A few uses the hospital staff in the beginning while others find a good friend to talk with. The hospital staff is used to help HIV positives find out who should know about the disease.
In addition to the closest relatives and the hospital staff it is also possible to use educated counselors who have extensive experience in talking to young people about HIV.
HIV-Danmark is a patient association which has counselors employed all over Denmark. You can get a referral from the hospital staff and you can call them yourself for advice, counseling and consultations (+45 70 22 58 68)
Sikker6-info is an anonymous telephone service with educated counselors answering questions about HIV on the phone; you can also talk to them about HIV-related subjects (+45 33 91 11 19)
At www.sundhed.dk you can click at Aarhus University Hospital, Skejby, the Department of Infectious Diseases to see the offers for HIV positives at hospitals and ongoing research projects within HIV. Here you can read about the experiences of other HIV positives
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| What can you do yourself? |
Most young people ask if there is anything they can do themselves to maintain a good health or if there are things in their everyday life they need to change. Often they think about food, smoking, alcohol, exercise and dietary supplements.
There is no evidence of major changes influencing the development of HIV. As for everybody else, it is of course good for your health to get exercise and eat healthy and varied food every day.
Whether you choose to take dietary supplements depends on how health you live.
Research shows that smoking is damaging. There are many ways to stop smoking at pharmacies and smoking cessation courses. You can discuss your lifestyle with your contact nurse.
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Sexuality and HIV
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For the majority it is habits of a sexual nature that demand the biggest change. When you are HIV positive you have to be careful not to infect others and not to be infected yourself with other sexually transmitted diseases or HIV once again. That is why you have to use a condom during sexual intercourse.
In Denmark there is a law that says you are not allowed to infect others with HIV. You do not do that if you use a condom. This law does not apply if you use a condom during sexual intercourse or if the HIV infected person tells his partner about his HIV status prior to the sexual intercourse.
If the condom bursts the partner should be informed about HIV as there is an option today to offer the non-infected a treatment called a PEP-treatment (Post Exposure Prophylaxis).
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Condom burst |
If an HIV positive has vaginal or anal intercourse with a male or female and the condom bursts it is important (as soon as possible) to go to the toilet and try to pee or pass stools. Let the semen run out itself if possible.
If an HIV positive woman has intercourse with a male and the condom bursts the male must try to pee and then thoroughly wash the glans and foreskin with water.
After this you contact a doctor at an infectious diseases department to discuss the condom burst. The attending doctor decides whether to initiate PEP-treatment.
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PEP-treatment |
In some cases prophylactic treatment can be offered after sexual mishaps with an HIV positive person, often when the condom bursts.
To get this treatment it is necessary to contact a department of infectious diseases right after and no later than 24 hours after the accident.
The doctor will decide if it is relevant to offer the treatment and it is therefore important to immediately contact the attending doctor by phone.
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Questions
If you have questions, we refer to the Mailbox.
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