The Human Immunodeficiency Virus (HIV) is the virus that can lead to Acquired Immune Deficiency Syndrome (AIDS). People who are infected with the virus are said to be HIV positive. Over time (usually many years) HIV affects a person’s immune system, which means the body is less able to protect itself from disease. When the immune system has been badly damaged by HIV infection, people can get sick from infection or cancers. At this stage of HIV infection, a person is said to have AIDS.
How do you get HIV?
HIV may be transmitted:
§When blood, semen or vaginal fluid from an infected person enters the body of an uninfected person. This can happen through:
§unsafe sex – rectal, oral and vaginal
§sharing needles and injecting equipment contaminated with blood
§Mothers who are HIV positive can transmit the virus to their babies:
§during (a vaginal) birth
§Through donated blood and blood products. However all blood, organs, tissues and semen donated in Australia are screened for HIV. The risk of getting HIV from these products in Australia is very low.
Donating blood or body parts does NOT put you at risk of HIV infection.
How common is it? Who is at risk?
Since 1984 (when testing for HIV became available) to June 2000, 17,500 people in Australia have been found to be HIV positive. The majority of these cases have been identified amongst men who have sex with men. About 6,000 of those people have died from AIDS.
Anyone who has unsafe sex or shares a needle and syringe with someone infected with HIV is at risk of HIV infection.
What is unsafe sex?
Unsafe sex is any sexual activity that allows blood, semen or vaginal fluids to pass from one person to another. This includes:
§Unprotected vaginal sex (no condom)
§Semen can enter a woman’s body through breaks in the fine lining of the vagina. Vaginal fluids can enter a man’s body through the head of the penis.
§Unprotected anal sex (no condom)
§The risks for anal sex are greater than for vaginal sex because of the potential for the lining of the anus or rectum to tear. Semen can enter the body through these tears. Blood or secretions can enter through the head of the penis.
§Unprotected oral sex (no condom or dental dam)
§There have been a few cases of infection through oral sex, although the risk of HIV transmission is much lower than for unprotected vaginal or anal sex. Semen or vaginal fluids can enter the body through small cuts or scrapes in the mouth. Even small abrasions caused by brushing teeth can allow HIV to enter the body.
These risks can be reduced by:
§using a condom, dental dam or other latex barrier;
§not allowing semen, vaginal fluids and menstrual blood to enter the mouth; and
§not having oral sex whilst you have conditions such as ulcers or bleeding gums in the mouth, or if you have just cleaned your teeth.
Do not have sex if you or your sexual partner has a genital sore or ulcer or a sexually transmissible infection. Other STIs enable HIV to spread more easily from person to person.
You can’t contract HIV through:
Kissing, hugging, swimming in public pools, sharing crockery and cutlery, bites from insects including mosquitoes, toilet seats, shaking hands or any everyday social contact.
What about injecting equipment?
If a person injects any substance, new equipment should be used on every occasion. You should not share any equipment, including spoons for mixing or your tourniquet.
Cleaning needles and syringes and other injection equipment is not an effective means of destroying HIV and other blood borne infections such as hepatitis C.
Reusing one’s own needles should be avoided where possible. However, where new equipment is not available, ensure the injecting equipment is thoroughly cleaned (see Drug Using below).
How can you test for HIV?
§A blood test is the only way of detecting HIV.
§Most people with HIV look and feel well for many years and they may not even know they are infected.
If you think you or your partner has been at risk of infection, you can have a blood test through your local doctor or sexual health clinic. You have the right to a confidential coded test.
The window period
§Using current medical equipment, it can take up to three months before evidence of HIV infection can be detected in the blood. This is called the window period
§This means that if you have had unsafe sex or may have been exposed to HIV through sharing needles or intravenous equipment, you will need to wait three months before you can be sure of a negative test result. During this time be sure you always practise safe sex. Do not donate blood during this time.
How is HIV/AIDS treated?
Medical research has made great progress in reducing the impact of HIV infection on the immune system and managing the illnesses associated with HIV.
§Currently there is no cure for HIV and AIDS.
§There is no vaccine to prevent infection.
§There are antiviral treatments which keep the virus under control for long periods of time.
§If you are HIV positive the outlook is constantly improving. HIV positive people should consult an HIV specialist to ensure they have access to the latest treatment and advice.
§If you find out that you do have HIV, anyone you have practised unsafe behaviours with should also be offered a test. If your feel uncomfortable or embarrassed about telling your current or ex-partners, the doctor and nurse will assist by contacting them – your name is not mentioned – it is a confidential process. Remember, it is very important for your partner’s health and the health of other people they have sex with.
How do you avoid getting HIV/AIDS?
§PRACTISE SAFE SEX. Always using condoms when you have vaginal or anal sex is the best way to reduce your risk of getting HIV through sexual contact. Using water-based lubricant with condoms is recommended. This reduces the risk of the condom breaking and increases both partners’ enjoyment of sex. Oil based lubricants (such as Vaseline) should NOT be used. They weaken the condom and may cause it to break.
§Oral sex represents only a small risk for the transmission of HIV/AIDS but may still represent a risk for the transmission of other sexually transmissible infections (STIs). To avoid the risk of transmission of HIV or STIs if you are giving a man oral sex (his penis in your mouth) he should wear a condom. Whether you are male or female, if you put your mouth in contact with your partner’s anus or vulva while having sex you should use a dental dam.
§If you choose not to use a condom or dam, to reduce the risk of the transmission of HIV avoid oral sex if you have bleeding gums or ulcers and immediately after cleaning your teeth.
§If you are having unprotected sex, talk to your sexual partner about the risks involved. From a good discussion with your partner you may be able to come to a clear agreement about using condoms.
§There are lots of ways to enjoy physical intimacy with your partner. Explore other ways to be intimate, which do not put you at risk of sexually transmitted infections or an unintended pregnancy.
§If you tend not to use condoms after drinking alcohol or taking other drugs it may be time to have a think about this and the risks involved. While for some it may be unrealistic to think of not enjoying a drink, there are many ways of cutting down so that you stay in control and can make more rational choices about your sexual contact.
§Remember that using condoms not only protects you from STIs, it also is an effective form of contraception. If you do use other forms of contraception (like the pill, diaphragm and IUCD etc), use condoms as well.
§If sharing sex aids, use condoms to cover the toy, changing the condom and washing the toy after use by each partner
If you or your partner have more than one sexual partner and do not use condoms, have regular sexual health checkups.
§Skin acts as an effective barrier for most daily risks. However, special care must be taken around blood products because of the potential risk of transmission or HIV, or other blood borne infections through open cuts. Ensure gloves are used to clean up any spilled blood and disinfect thoroughly with bleach.
§Use new injecting equipment every time you inject. You can buy supplies of needles and syringes from most pharmacies, or get them free through needle exchange services.
§If new injecting equipment is not available, reduce the risks of infection by reusing your own needle and syringe rather than sharing.
If there seems to be no alternative to sharing:
1.Rinse the needle and syringe with cold water to remove any blood. Do not use hot water, as this will cause the blood to clot.
2.Rinse the needle and syringe with undiluted bleach (use fresh high strength bleach) or with a detergent/water solution. The bleach needs to be in contact with the needle and syringe for at least two minutes.
3.Rinse with clean cold water.
Cleaning a used needle and syringe is NOT guaranteed to kill HIV, hepatitis B or hepatitis C.
People with HIV must not donate blood, semen, or organs.
Who can I talk to?
If you would like more information on HIV, you can talk to:
§Your local doctor
§Your local sexual health clinic (See the local phone book under Government Services Section in the white pages. Look under the entry ‘Sexual’)
§Your local family planning clinic
§Your public hospital should be able to give you the phone numbers of your nearest family planning or sexual health clinic