HIV Infection and AIDS

U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, September 1994.

While it's almost certain that you've heard quite a bit about AIDS in the past few years, the term HIV might be new to you.

HIV and AIDS are closely related, and if you understand HIV infection, you can better understand AIDS.

WHAT IS AIDS?

AIDS stands for acquired immunodeficiency syndrome, a disease in which the body's immune system breaks down. Normally, the immune system fights off infections and certain other diseases. When the system fails, a person with AIDS can develop a variety of life- threatening illnesses.

AIDS IS CAUSED BY HIV

AIDS is caused by a virus called the human immunodeficiency virus, or HIV. A virus is one of the smallest "germs" that can cause disease.

If you have unprotected sex (sexual intercourse without consistent and correct condom use) or share needles or syringes with an infected person, you may become infected with HIV. Specific blood tests can show evidence of HIV infection. You can be infected with HIV and have no symptoms at all. You might feel perfectly healthy, but if you're infected, you can pass the virus to anyone with whom you have unprotected sex or share needles or syringes.

WILL YOU GET AIDS IF YOU ARE INFECTED WITH HIV?

About half of the people with HIV develop AIDS within 10 years, but the time between infection with HIV and the onset of AIDS can vary greatly. The severity of the HIV-related illness or illnesses will differ from person to person, according to many factors, including the overall health of the individual.

Today there are promising new medical treatments that can postpone many of the illnesses associated with AIDS. This is a step in the right direction, and scientists are becoming optimistic that HIV infection will someday be controllable. In the meantime, people who get medical care to monitor and treat their HIV infection can carry on with their lives, including their jobs, for longer than ever before.

You can become infected with HIV in two main ways:

• Having unprotected sexual intercourse - anal, vaginal, or oral - with an infected person.
• Sharing drug needles or syringes with an infected person.

Also, women infected with HIV can pass the virus to their babies during pregnancy or during birth. They can also pass it on when breast-feeding. Some people have become infected by receiving blood transfusions. Since 1985, however, when careful screening and laboratory testing of all blood donations began, this possibility has been greatly reduced.

You cannot be infected by giving blood at a blood bank.

YOU CAN GET HIV FROM SEXUAL INTERCOURSE

HIV can be spread through sexual intercourse, from male to male, male to female, female to male, and, in theory, from female to female.

HIV is sexually transmitted, and HIV is not the only infection that is passed through intimate sexual contact. Other sexually transmitted diseases (STDs), such as gonorrhea, syphilis, herpes, and chlamydia, can also be contracted through anal, vaginal, and oral intercourse. If you have one of these infections and engage in sexual behaviors that can transmit HIV, you are at greater risk of getting HIV.

HIV may be in an infected person's blood, semen, or vaginal secretions. HIV can enter the body through cuts or sores in the skin. HIV can also enter the body through the moist lining of the vagina, penis, rectum, or even the mouth. Some of these cuts or sores are so small you don't even know they're there. Anal intercourse with an infected person is one of the ways HIV has been most frequently transmitted. Other forms of sexual intercourse, including oral sex, can spread it as well. During oral sex, a person who takes semen, blood, or vaginal secretions into their mouth is at risk of becoming infected.

Many infected people have no symptoms and have not been tested. If you have sex with one of them, you put yourself in danger. Also, the more sexual partners you have, the greater your chances of encountering one or more who are infected and of becoming infected yourself. The only sure way to avoid infection through sex is to abstain from sexual intercourse or engage in sexual intercourse only with someone who is not infected and only has sex with you. Latex condoms have been shown to help prevent HIV infection and other sexually transmitted diseases. But you have to use condoms correctly every time you have sex - vaginal, anal, or oral. Condoms made of plastics such as polyurethane should also be highly effective. Condoms made of lambskin, however, do not offer good protection.

YOU CAN GET HIV FROM SHARING NEEDLES

Sharing needles or syringes, even once, is very risky. Many people have become infected with HIV and other germs this way. HIV from an infected person can remain in a needle or syringe and then be injected directly into the bloodstream of the next person who uses it. Sharing needles to inject IV drugs is the most dangerous form of needle sharing.

Sharing needles for other purposes may also transmit HIV and other germs. These types of needles include those used to inject steroids and those used for tattooing or ear-piercing.

If you plan to have your ears pierced or get a tattoo, make sure you go to a qualified person who uses brand-new or sterile equipment. Don't be shy about asking questions. Responsible technicians will explain the safety measures they follow.

HIV AND BABIES

A woman infected with HIV can pass the virus on to her baby during pregnancy, while giving birth, or when breast-feeding. If a woman is infected before or during pregnancy, her child has about one chance in four of being born with HIV infection. Medical treatment with AZT during pregnancy and labor may reduce the risk of infecting the baby to about 1 in 12. There must be no breastfeeding by the infected mother and the baby must be given AZT for the first several weeks of life. Even then, the risk of infecting the child cannot be totally eliminated.

Any woman who is considering having a baby and who thinks she might have done something that could have caused her to become infected with HIV - even if this occurred years ago - should seek counseling and testing for HIV infection to help her make an informed choice about becoming pregnant. To find out where to go in your area for counseling and testing, call your local health department or the CDC National AIDS Hotline (1-800-342-AIDS).

BLOOD TRANSFUSIONS AND HIV

In the past some people became infected with HIV from receiving blood transfusions. This risk has been practically eliminated. Since a 1983 Public Health Service recommendation, potential blood donors at risk of HIV infection have been asked not to donate blood. Since 1985 all donated blood has been tested for evidence for HIV. All blood found to contain evidence of HIV infection is discarded. Currently in the United States, there is only a very small chance of infection with HIV through a blood transfusion.

You cannot get HIV from giving blood at a blood bank or other blood collection center. The needles used for blood donations are sterile. They are used once, then destroyed.

HOW YOU CANNOT GET HIV

HIV infection doesn't "just happen." You can't "catch" it like a cold or flu. Unlike cold or flu viruses, HIV is not spread by coughs or sneezes. Again, you get HIV by coming in contact with infected blood, semen, or vaginal fluids from another person.

• You won't get HIV through everyday contact with infected people at school, work, home, or anywhere else.
• You won't get HIV from clothes, phones, or toilet seats. It can't be passed on by things like forks, cups, or other objects that someone who is infected with the virus has used.
• You won't get HIV from eating food prepared by an infected person.
• You won't get HIV from a mosquito bite. HIV does not live in a mosquito, and it is not transmitted through a mosquito's bite like other germs, such as the ones that cause malaria. You won't get it from bedbugs, lice, flies, or other insects, either.
• You won't get HIV from sweat, saliva, or tears.
• You won't get HIV from a simple kiss. Most scientists agree that although transmission of HIV through deep or prolonged kissing may be possible because of potential blood contact, it would be unlikely.

WHO IS REALLY AT RISK FOR HIV INFECTION?

There is evidence that HIV, the virus that causes AIDS, has been in the U.S. at least since 1978. The following are known risk factors for HIV. You may be at increased risk of infection if any of the following have applied to you since 1978.

• Have you shared needles or syringes to inject drugs or steroids?
• If you are a male, have you had sex with other males?
• Have you had sex with someone who you believe may have been infected with HIV?
• Have you had a sexually transmitted disease (STD)?
• Have you received blood transfusions or blood products between 1978 and 1985?
• Have you had unprotected sex with someone who would answer yes to any of the above questions?

If you answered yes to any of the above questions, you should discuss your need for testing with a trained counselor. If you are a woman in any of the above categories and you plan to become pregnant, counseling and testing are even more important.

If you had unprotected sex with someone and you didn't know their risk behavior, or you have had many sexual partners in the last 10 years, then you have increased the chances that you might be HIV-infected.

WHAT ABOUT THE HIV TEST?

The only way to tell if you have been infected with HIV is by taking an HIV-antibody blood test. This test should be done through a testing site, doctor's office, or clinic familiar with the test. It is important that you discuss what the test may mean with a qualified health professional, both before and after the test is done.

DO YOU NEED MORE INFORMATION ABOUT HIV OR HIV COUNSELING AND TESTING?

You can receive free publications from the Centers for Disease Control and Prevention. To receive brochures, or to ask any questions about HIV infection or AIDS, call the CDC National AIDS Hotline at 1-800-342-AIDS. (Spanish: 1-800-344-7432; deaf access: 1-800-243-7889 [TDD]). The Hotline is staffed with information specialists who can offer a wide variety of written materials or answer your questions about HIV infection and AIDS in a prompt, confidential manner. There are also local groups that can help you find the information you need. Contact your State or local health department, AIDS service organization, or other community- based organization dealing with HIV and AIDS. The CDC National AIDS Hotline can tell you how to contact all of these. --