18 HIV

What is HIV?

According to HIV.gov (2021a), the human immunodeficiency virus, otherwise known as HIV, is a virus that attacks the body’s cells that helps fight infection, making an individual more at risk for other diseases and infections. HIV spreads by having contact with certain bodily fluids such as blood, semen, or urine of an HIV-positive person. The most common forms of spreading HIV are participating in unprotected sex and sharing injection drug needles. If HIV is left untreated, it can lead to the development of AIDS, acquired immunodeficiency syndrome. Currently, there is no cure for HIV, so once someone tests positive, they will be dealing with the symptoms for life.

Symptoms of HIV

The Center for Disease Control and Prevention (CDC) (2020c) states that some individuals will have flu-like symptoms within two to four weeks after infection, otherwise known as acute HIV infection. These symptoms might last for a couple of days or several weeks. Potential symptoms include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and mouth ulcers. Some individuals, however, might not feel sick during the acute stage of HIV infection. It is important to note that these symptoms alone do not necessarily mean you have HIV. Multiple other illnesses can cause these same symptoms, and getting tested for HIV is the only sure way to know.

Stages of HIV

The CDC (2020c) describes the stage symptoms in the following manner. Stage one is the acute HIV infection period of two to four weeks after first exposure. Some individuals have flu-like symptoms as listed above, but individuals may not feel sick right away or at all. Stage 2 is the chronic HIV infection period after acute infection. Symptoms can range from mild to severe, depending on how advanced the infection is, including coughing or breathing difficulties, weight loss, diarrhea, fatigue, or high fever. Stage 3 is when a person’s white blood cell count is low, and they are diagnosed with AIDS, the final and most severe phase of HIV infection. People with AIDS have badly damaged immune systems and can often develop several severe illnesses at an increased rate. The survival rate without treatment is about three years; however, with the development and availability of current HIV medications, an individual’s progression into stage three is less common today than in the 1980s. In some cases, people with chronic HIV will have no symptoms, otherwise known as a latent infection, lasting up to ten years.

Who Is At Risk for HIV?

HIV can affect anyone regardless of age, gender, race, ethnicity, sexual orientation, or where they live. However, certain groups of people in the United States are more likely to get HIV than others because of certain factors, including what subpopulations they belong to and their risk behaviors. In 2018, men accounted for 81% of the 37,968 new HIV diagnoses in the United States (CDC, 2020g). Nearly one in seven men with HIV are unaware they have it (CDC, 2020g). According to CDC (2020a), gay and bisexual men accounted for 69% of new HIV diagnoses in 2018, making them the population most affected by HIV. The spread of HIV and other sexually transmitted infections among gay and bisexual men has become a syndemic. The specific health problems that have created the HIV syndemic include the number of infectious diseases regularly found among this particular population, the high rate of substance abuse problems and psychological disorders, and the significant percentage of gay and bisexual men who have experienced childhood sexual abuse and other negative events (O’Leary, 2014, p. 22).

HIV Prevention

On their website, the CDC (2021) outlines the many tools that can help prevent HIV. One of the most popular ways to prevent HIV when engaging in sex is wearing a condom. Most condoms are highly effective in preventing HIV as well as other sexually transmitted infections. There are two main types of condoms: external condoms and internal condoms. An external condom, also known as a male condom or just a condom, is worn over the penis during sex. Latex condoms provide the most protection against HIV. Natural membrane, such as lambskin, condoms have small holes in them and do not block HIV and other STI’s. Individuals should not use natural membrane condoms for HIV or STI prevention. An internal condom, also known as the female condom, is used in the vagina or anus during sex. A female condom is a thin pouch made from nitrile, which is a synthetic latex product. HIV can not travel through the nitrile barrier.

Another way to prevent HIV when engaging in sex or injection drug use is by taking pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP). PrEP is medicine for individuals at risk for HIV to prevent getting HIV. When taken as prescribed by healthcare providers, PrEP is about 99% for preventing the risk of contracting HIV from sex (CDC, 2020e). Although there is not as much information about how effective PrEP is among people who inject drugs, there is enough information to conclude that PrEP reduced the risk of getting HIV by at least 74% when taken as prescribed (CDC, 2020f). PEP is a medicine taken to prevent HIV after a possible exposure. The CDC (2020d) recommends that PEP should only be used for emergencies and needs to start within 72 hours after unprotected sex or infected blood from a needle.

HIV Stigma and Discrimination

HIV stigma refers to the negative beliefs and attitudes directed at people living with HIV and AIDS. It is the bias that comes from identifying a person as part of a group that is understood to be socially unacceptable. Examples from the CDC (2020b) include:

• Thinking that only certain groups of people can get HIV.
• Making judgments about people who take action to prevent HIV transmission.
• Feeling that individuals deserve to get HIV because of their actions.

While stigma pertains to a belief or attitude, discrimination is the conduct that comes from those beliefs or attitudes. HIV discrimination is treating individuals living with HIV differently than those without HIV. Examples include a health care professional refusing to provide care to a person living with HIV, socially cutting off a community member because they are HIV positive, and referring to people as Positives or HIVers (CDC, 2020b).

HIV stigma today comes from the many negative beliefs about HIV when HIV first appeared in the early 1980s. Yet, there are still many misunderstandings today about how HIV is transmitted and what it means to live with HIV. The lack of awareness and information linked with out-of-date ideas leads individuals to fear HIV (CDC, 2020b).

HIV affects the body not only physically but also mentally. Individuals with HIV often internalize the stigma they face and begin to grow a poor self-image. These individuals may worry about their HIV status being shared because they may be judged or face prejudice. HIV internalized stigma can bring on feelings of shame, isolation, fear of sharing, and hopelessness. Stigma and discrimination can keep individuals from getting tested and treated for HIV (CDC, 2020b).

Life After an HIV Positive Diagnosis

Being HIV-positive can be an overwhelming and lonely experience. However, many organizations and resources, such as the Joint United Nations Programme on HIV/AIDS and the Kaiser Family Foundation, are available to help the more than one million HIV-positive people living in the United States today (HIV.gov, 2020). Also, remember that being HIV-positive is not the death sentence it once was. HIV can lead to AIDS, but being HIV-positive does not necessarily mean that an individual has AIDS. New treatments have allowed HIV to develop into a more stable condition. With the proper medical care and a healthy lifestyle, many HIV-positive individuals can live full lasting lives (WebMD, 2007).

References

Centers for Disease Control and Prevention. (2020a, September 16). HIV and Gay and Bisexual Men. https://www.cdc.gov/hiv/group/msm/index.html

Centers for Disease Control and Prevention. (2020b, October 22). HIV Stigma. https://www.cdc.gov/hiv/basics/hiv-stigma/index.html

Centers for Disease Control and Prevention. (2020c, November 3). About HIV/AIDS. https://www.cdc.gov/hiv/basics/whatishiv.html

Centers for Disease Control and Prevention. (2020d, November 3). About PEP. https://www.cdc.gov/hiv/basics/pep/about-pep.html

Centers for Disease Control and Prevention. (2020e, November 3). PrEP. https://www.cdc.gov/hiv/basics/prep.html

Centers for Disease Control and Prevention. (2020f, November 3). PrEP Effectiveness. https://www.cdc.gov/hiv/basics/prep/prep-effectiveness.html

Centers for Disease Control and Prevention. (2020g, November 5). HIV and Men. https://www.cdc.gov/hiv/group/gender/men/index.html

Centers for Disease Control and Prevention. (2021, February 11). Condoms. https://www.cdc.gov/hiv/basics/hiv-prevention/condoms.html

HIV.gov. (2020, November 5). Global HIV/AIDS organizations.  https://www.hiv.gov/federal-response/pepfar-global-aids/global-hiv-aids-organizations

HIV.gov. (2021a, January 26). What are HIV and AIDS? https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids

HIV.gov. (2021b, January 26). Who should get tested? https://www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/who-should-get-tested

O’Leary, D. (2014). The syndemic of AIDS and STDS among MSM. The Linacre Quarterly, 81(1), 12–37. https://doi.org/10.1179/2050854913y.0000000015

WebMD. (2007, February 1). What to Do After Being Diagnosed As HIV-Positive. https://www.webmd.com/hiv-aids/hiv-positive-what-now