HIV (AIDS)

Symptoms of HIV can vary from person to person and may not always be noticeable in the early stages of the infection. Often people develop a flu-like illness which can be caused by many different viruses including HIV.

Symptoms of HIV include:

Fever
Fatigue
Swollen glands
Sore throat
Headache
Muscle aches
Joint pain
Skin rash
Night sweats and/or drenching sweats
Weight loss
Diarrhoea

Most individuals may experience a short, flu-like, illness, usually within 2 to 4 weeks after acquiring a HIV infection (sometimes earlier or later). This is often referred to as ‘primary HIV infection’ or ‘seroconversion illness’. Many patients do not experience any symptoms or signs of HIV but can still pass on the infection to their partners. Having no symptoms never rules HIV out.

After these initial symptoms have passed, it is possible for HIV to remain without symptoms even though the virus will continue to damage and weaken your immune system.

It is essential to get tested if you are concerned about having HIV or you think you have been exposed to it.

HIV infection produces complications in two ways:

The direct effect of the virus, for example, brain causing dementia or HAND (HIV-associated Neurocognitive Disorder).
The consequences of damage to the immune system by the virus, for example, opportunistic infections and opportunistic cancers.

If left untreated, HIV can lead to several health complications, including the development of AIDS (Acquired Immunodeficiency Syndrome) which is the most advanced stage of HIV infection. Having HIV doesn’t mean someone has AIDS, and most people who are diagnosed early and take effective treatment will not develop it.

Individuals with HIV may experience other health issues, such as wasting and diarrhoea, which may be a result of advanced HIV infection or an opportunistic infection. There is also an increased risk of developing bone disease, such as osteoporosis, and cardiovascular disease.

Neurological problems such as HIV-associated dementia may occur as a direct result of HIV or as a side effect of taking antiretroviral therapy (ART). Mental health problems, such as depression and anxiety, are also common among individuals with HIV.

Although HIV can lead to several health complications, with early diagnosis and appropriate treatment many people living with HIV can manage their infection and prevent these complications from occurring.

Most patients who have been exposed to HIV will experience flu-like symptoms, usually within 2-4 weeks after infection occurs, though sometimes earlier or later. After this, HIV may not cause any noticeable symptoms for many years. It is essential to get tested as soon as possible if you have been exposed to HIV.

HIV can be transmitted through infected body fluids such as semen, vaginal fluid, rectal fluid, blood and breast milk. HIV can occur If these fluids come into contact with:

The penis, vagina, mouth and rectum.
Damaged tissue that has been cut or scraped.
The blood stream.

HIV cannot be transmitted through non-sexual contact such as hugging, kissing, holding hands, sharing household items such as bedding, towels, plates or utensils.

Your risk for HIV can be increased by:

Having unprotected anal sex (highest risk) or vaginal sex (second highest risk) with someone who is living with HIV and is not on appropriate treatment, or has a high-viral load.
The risk of contracting HIV from unprotected oral sex is low, however, it can be increased if the person performing oral sex has mouth ulcers, sores, or bleeding gums.
Having unprotected sex with a current or previous partner who has HIV and is not on medication.
Not using condoms when having sex with new partners who have not been recently tested for HIV.
Engaging in chem-sex.
Using intravenous drugs or sharing needles.
Having other STI’s such as Syphilis, Herpes, Chlamydia, Gonorrhoea, and Bacterial vaginosis.
Receiving unsterile body piercings
Receiving a blood transfusion which is infected with HIV but has not been properly screened before use.
Sharps or needle-stick injury.

Condoms are very effective in preventing HIV transmission if they are used correctly. However, condoms can sometimes split or come off during sex. The risk of condoms splitting is increased when using certain creams or vaginal pessaries, such as thrush treatment.
Furthermore, being under the influence of alcohol or having sexual contact in dark can compromise your recollection of proper condoms use. Therefore, It is important to get tested if you think you have been exposed to HIV or any other STI.

HIV can be prevented by:

Wearing a condom during anal, vaginal, and oral sex with all new partners.
Using a water-based or silicone-based lubricant can help to prevent condom splitting. Condoms are up to 98% effective if they are used correctly. However, some creams and vaginal pessaries, such as thrush treatment can make condoms less effective.
Circumcision may lower the risk of getting HIV through heterosexual sex in men, by around 50 to 60% in studies, but it only gives partial protection.
Taking PrEP (pre-exposure prophylaxis) to prevent HIV transmission from injectable drugs or sex.
Taking PEP (post-exposure prophylaxis) to prevent HIV infection after possible exposure. PEP should be taken as soon as possible after exposure but certainly within 72 hours after being exposed to be effective.
Not sharing or using shared equipment when injecting or taking drugs.

If your HIV-positive partner is not on effective treatment, it is highly possible that they will pass HIV onto you.

Your partner cannot pass HIV onto you if they have an undetectable HIV viral load and are on effective treatment. It is important that your partner strictly follows their treatment plan as laid out by their clinician in order for their HIV viral load to remain undetectable. If your partner does not follow their treatment plan, it is possible for their virus level to become detectable again and put you at risk of getting HIV.

Determining the exact source of HIV transmission becomes challenging unless you have only had one sexual partner in your lifetime. Since HIV can persist in the body for an extended period without presenting significant symptoms, individuals may remain unaware of their HIV status until they receive a positive test result. Regular STI testing is crucial to ensure early detection and appropriate management.

No, the only way to definitively diagnose HIV is through a blood test for HIV.

It is important to get tested for HIV if there is a potential risk of exposure, even if there are no noticeable symptoms. Testing is crucial for early diagnosis and timely treatment, as well as for preventing the transmission of the virus to others.

While there are no alternative methods or indicators to diagnose HIV without testing, it is important to be aware of the potential risk factors and to take proactive steps to protect oneself and others from HIV infection. This includes practising safe sex, using condoms, getting regularly tested for sexually transmitted infections, and avoiding sharing needles or other drug paraphernalia.

With access to a new generation of HIV drugs and proper medical care, patients with HIV can live a normal life in terms of both quality of life and life span. There are few restrictions patients with HIV currently face like not being accepted for blood and organ donation. Other than this, patients with HIV can virtually do anything they wish including marry, have children and grandchildren.

Without treatment, HIV will progress into AIDS (Acquired Immunodeficiency Syndrome) within 10 to 15 years, though it may advance much faster in some people.

The symptoms of opportunistic infections associated with AIDS include:
Coma
Coughing or shortness of breath
Difficult or painful swallowing
Extreme fatigue
Fever
Confusion and forgetfulness
Nausea, abdominal cramps and vomiting
Seizure and lack of coordination
Severe, persistent diarrhoea
Severe headaches
Vision and weight loss

HIV is primarily transmitted through specific routes such as unprotected sexual intercourse, sharing needles or syringes, and mother-to-child transmission during pregnancy, childbirth, or breastfeeding. It is not transmitted through casual contact such as hugging, kissing, or sharing household items such as bed linen, towels, or utensils.

ART (antiretroviral therapy) is recommended for individuals living with HIV to suppress the virus and reduce the viral load. When the viral load becomes undetectable through regular monitoring, the risk of transmitting HIV to partners through sexual intercourse is extremely low. This concept is known as "Undetectable = Untransmittable" (U=U). Consistent adherence to ART is crucial for maintaining an undetectable viral load.

Additionally, your partners may consider using pre-exposure prophylaxis (PrEP), which is a medication taken by HIV-negative individuals to prevent HIV transmission. PrEP has been shown to be highly effective in reducing the risk of acquiring HIV when taken consistently and correctly.

It is essential to consult with a healthcare professional who specialises in HIV management to receive personalised guidance based on your specific situation. They can provide accurate information, answer any further questions, and ensure you have the necessary support and resources to make informed decisions regarding HIV transmission and prevention.

While a cure for HIV is currently unavailable, significant progress has been made in managing the virus. Effective treatment options exist that allow individuals living with HIV to lead fulfilling and vibrant lives without having to worry about their HIV infection.

Occasionally you may have come across news reports of HIV infection being cured. These are the cases where patients had certain types of blood cancers whose treatment required wiping out their native immune system and replacing their immune system from other individuals with in-built resistance to HIV. Such treatment to treat blood cancer is very specialised and risky, and eradication of HIV in these patients is an additional benefit rather than main reason for the treatment.

5-10% of the population has a mutation called Delta 32 mutation. People with single Delta 32 mutation get partial protection against HIV whilst those with double Delta 32 mutation get almost complete protection from HIV. The test to identify one's Delta 32 mutation is currently not available in the UK.

Being HIV positive does not mean you cannot have children. There is a risk of passing HIV onto your children but there are effective ways to lower this risk.

It is essential to speak to your clinician if you are planning to become pregnant as you can pass HIV onto your baby through the placenta, during birth, and through breastfeeding if you are not on an effective HIV treatment. The risk of mother to child transmission of HIV in the absence of medical care is 30-50%. In the early years of the HIV epidemic, caesarean section was routinely undertaken and this reduced the risk of transmission to 1-2%. The availability of effective HIV drugs leads to undetectable HIV viral load, which dramatically reduces the risk of transmission of HIV to the newborn baby, thus making the option of being able to give birth to their baby by vaginal delivery possible for HIV positive mothers. You can read more about HIV during pregnancy here.

If you acquire HIV after all your children have been born and breastfed, you will not pass on HIV to them.

Unfortunately, you will no longer be able to donate blood if you have HIV.

If you are a former or current partner of someone living with HIV you may not be able to donate blood until 3 months have passed since the last sexual contact and you have tested negative for HIV.