HIV Debunked

Chapter One:
Transmission & Risk

How Is HIV Passed From One Person To Another?

No, you cannot get HIV from things like sharing utensils or drinks or anything like that so let’s be sensible here. The most common ways that someone can get HIV are as follows:

A) Having sex (anal, vaginal, or oral) with a person who has HIV

B) Sharing drug needles with someone who has HIV

C) Women with HIV can pass it to their babies before or during birth, and through breastfeeding

What Fluids Are HIV Transmitted Through?

HIV is transmitted through the following body fluids:

Rectal fluids
Vaginal fluids
Breast milk

What is HIV?

HIV stands for human immunodeficiency virus. HIV is a virus, like the flu or cold. A virus is nothing than a set of instructions for making new viruses, wrapped up in some fat, protein and sugar.

Without living cells, a virus can’t do anything—it’s like a brain with no body. In order to make more viruses (and to do all of the other nasty things that viruses do), a virus has to infect a cell. HIV mostly infects CD4 cells, also known as T cells, or T-helper cells. These are white blood cells that coordinate the immune system to fight disease.

Once inside the cell, HIV starts producing millions of little viruses, which eventually kill the cell and then go out to infect other cells. All of the drugs marketed to treat HIV work by interfering with this process.Hiv debunked

What is AIDS?

AIDS (acquired immune deficiency syndrome) is a condition caused by HIV. This virus attacks the immune system, the body’s “security force” that fights off infections. When the immune system breaks down, you lose this protection and can develop many serious, often deadly infections and cancers.

These are called “opportunistic infections (OIs)” because they take advantage of the body’s weakened defenses. You have heard it said that someone “died of AIDS.” This is not entirely accurate, since it is the opportunistic infections that cause death. AIDS is the condition that lets the OIs take hold.

Can Someone Please Tell Me WTF Is U=U

Haha, calm down. It’s actually quite simple.Hiv debunked
U=U is an informational campaign about how effective HIV medications are in preventing sexual transmission of HIV.

U=U means “Undetectable = Untransmittable,” indicating that if an HIV-positive person is on HIV meds (antiretroviral therapy, or ART) with a consistently undetectable HIV viral load, the HIV virus cannot be transmitted to a sex partner. As a prevention strategy, this is often referred to as Treatment as Prevention, or TasP.

U=U and TasP are based on substantial scientific data. In fact, the U.S. Centers for Disease Control and Prevention has said that, “People who take ART daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.” 

So for HIV-positive persons: take your HIV meds every day! Double down on this both for your personal health and, with confidence, to prevent HIV transmission.

Why should you bother using condoms to prevent transmission when HIV is treatable?

For real? If i, or anyone really were given a choice, I would rather find out that I was HIV infected today, rather than 20 years ago. For people fortunate enough to be able to access treatment, combination antiretroviral therapy has changed the nature of HIV infection from a terminal condition to a treatable, chronic illness. Even though there is no cure for HIV infection, daily treatment has emptied the HIV wards of hospitals and has allowed people with HIV to feel well and move on with their lives.

Each time researchers recalculate the average life expectancy of HIV-infected persons taking antiretroviral therapy, they arrive at a higher figure.

Nevertheless, would I rather have a chronic illness, or not?

I’d rather not. 

I’d rather not take pills every day. I’d rather not worry that the medication will stop working. I’d rather not run the risk of experiencing side effects that some people get from the medications. I’d rather not worry about infecting my sex partners. I’d rather not increase my risk of getting other diseases such as lymphoma, coronary artery disease, and lung cancer that seem to be more common among HIV-infected individuals.

As with any life-changing experience, becoming infected with HIV has given some of my patients a valuable perspective on certain aspects of their existence. Nevertheless, almost all of them do whatever they can to avoid infecting others–they don’t want others to go through what they have gone through.

I am very, very glad that HIV is treatable, both for my patients who are living with HIV and for anyone who becomes infected in the future. I’m also glad that antiretroviral therapy can not only keep people with HIV healthy but can prevent sexual transmission of HIV to negative partners. And I’m glad that we have condoms and PrEP (pre-exposure prophylaxis), which are very effective at preventing the sexual transmission of HIV when used correctly, so that all of us, whether HIV infected or uninfected, can help to reduce the number of people infected with or affected by HIV.Hiv debunked

Can you reduce the risk of getting HIV after having unprotected sex with someone who has HIV?

Let’s say you had sex with someone who has HIV infection and the condom broke, or you found out only after condomless sex that your partner had HIV.

Can you reduce your risk of getting HIV from sex–or from a needlestick–by taking medications afterward?

Yes. This is called postexposure prophylaxis, or PEP. 

The medications that are given for PEP are the same types that are used to treat HIV (antiretrovirals, or ARVs), and they usually are given as a combination of 3 medicines for 1 month. To work best, these ARVs should be taken as soon as possible after the exposure, and ideally not later than 72 hours after the exposure. To be evaluated for PEP, the exposed individual should contact his/her clinician or an emergency room promptly after the exposure. 

Exposed persons do not have to know the HIV status of the person with whom they had contact in order to be offered PEP–providers will evaluate the risk level of the exposure and, if possible, offer testing to the source individual. The exposed person should be tested to see if they already (without knowing it) have HIV or other sexually transmitted diseases such as hepatitis B, gonorrhea, chlamydia, and syphilis, but the first dose of PEP should not be delayed in order to complete that testing. The sooner after the exposure PEP medicines are started, the more likely they are to be effective. People on PEP should be monitored for side effects from the PEP medicines and tested again for HIV after the treatment is completed.

If you have a partner who is HIV-positive, or if you have had to take PEP more than once, you might want to consider taking pre-exposure prophylaxis (PrEP). PrEP is an ARV pill that people who are at risk of getting HIV can take every day to prevent HIV infection.Hiv debunked

Can you get HIV through oral sex?

The risk of getting HIV through receiving oral sex (that is, a partner’s mouth on your genitals) is very, very low.

We can’t say that there’s zero risk, because there are a few cases of HIV infection in people who have no other known risk factors for HIV.

Also, we can imagine a scenario where an HIV-infected person’s mouth is bleeding when he or she is giving oral sex. This could increase the risk of infecting the partner. But, in general, becoming infected with HIV by receiving oral sex is probably a very rare occurrence. 

The risk of getting HIV through giving oral sex (that is, your mouth on a partner’s genitals) is low compared with unprotected vaginal or anal sex, but there is some risk. The risk appears to be higher if you have cuts or sores in your mouth. Risk also appears to increase with the amount of your partner’s fluids that contact your mouth and throat. If there is blood in these fluids, that probably increases the risk as well. 

Of course, if your partner is not HIV infected, there is no risk of getting HIV. But if your partner is HIV positive, or you are not sure, it makes sense to use a condom or other barrier (a latex sheet, for example) for oral sex, or to take PrEP (pre-exposure prophylaxis). 

Is it safe for an HIV-positive person to have unprotected sex with another HIV-positive person?

We assume you are referring whether you can be “re-infected” or “superinfected” with another strain of HIV. While the research on this question is not 100% clear, there are only rare reports of someone who already has HIV getting another HIV infection that damages their health.

It is true that a person who’s been infected with one strain can become infected with a second strain when exposed to it (such as through unprotected sex), but this appears to be quite uncommon. A person whose first HIV infection is relatively recent may be more susceptible to infection with a second strain. Someone may become sicker once the second strain of the virus enters the system. This happens because the new strain may be more difficult for the immune system to control, or because the new strain is resistant to the HIV medications the person is taking. But, as we said, this rarely happens. 

For a person with HIV who is taking antiretroviral medicine and has an undetectable viral load, the risk of infecting someone else (or becoming re-infected) through sex is much extremely low. If you have (or your partner has) a viral load that is not fully suppressed with HIV meds and a virus that has resistance mutations, it would be a good idea to use condoms to prevent transmission of a difficult-to-treat HIV infection.

There are more reasons for two HIV-positive people to use condoms. Correct condom use can prevent the transmission of other sexually transmitted infections (STIs), such as gonorrhea, chlamydia, syphilis, hepatitis B, and hepatitis C. And, condom use can prevent unintended pregnancy.Hiv debunked

Will cleaning IV-drug needles and syringes with bleach before using them prevent you from getting HIV?

You can be infected with HIV if you use needles and syringes contaminated with blood from a person who is HIV positive. One way to avoid getting HIV from IV drug use is to stop injecting drugs. Another effective way is to always use new, sterile syringes and needles and also to be sure not to use any shared injecting equipment (cookers, spoons, cottons, etc.). But what if you can’t get into a drug treatment program, it hasn’t worked for you, or you can’t get your hands on sterile equipment?

There is some evidence that cleaning your needles and syringes with laundry bleach can lower your risk of getting HIV. In laboratory studies, HIV in syringes was killed after contact with undiluted bleach for at least 30 seconds. Watered-down bleach did not work, and neither did contact with bleach for less than 30 seconds.

Does this process work outside the lab? It’s hard to know, because this is very difficult to study. But it’s probably a lot better than not doing anything at all to kill the HIV in drug-injecting equipment. 

Note: It is important to rinse the syringes and needles with water after cleaning them with bleach, so that you won’t inject the bleach into your body. And how do you know when 30 seconds are up? Use a watch or a clock, or hum the song “Happy Birthday to You,” all the way through, three times over.

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