HIV Treatment

HIV is caused by a virus known as a retrovirus. The combination of medications used to treat HIV is known as antiretroviral therapy (ART).

Although there remains no cure for HIV infection, ART enables people with HIV to live a normal, healthy and quality life. ART controls and reduces the amount of virus in a person’s body fluids and blood, hence, slows down the progression into AIDS and death.

ART is recommended to everyone with HIV, regardless of at what stage, and how healthy the person is. ART also reduces an infected person’s risk of spreading HIV to others.

ART usually comes in a combination of 3 or more drugs. With medical advancement, there are available options of 1 pill to combine multiple drugs together.

When should I start HIV treatment?

You should begin antiretroviral therapy (ART) as soon as possible after the diagnosis of HIV infection. Any delay of treatment will allow HIV virus to continue to destroy your immune system, putting yourself at higher risk of developing AIDS.

What do I expect when I consult my doctor on HIV treatment?

Your doctor will take into account your other concurrent medical conditions and any other medicines that you may be taking as there may be interactions with ART.

You will need more regular follow up with your doctor at the initial stage of starting of ART treatment. You will be offered regular blood tests to monitor whether you are responding well to the ART treatment. 

Two important blood tests are:

Most people who take HIV ART treatment daily are able to reach undetectable HIV viral load within 6 months of starting treatment. Following ART treatment, the CD4 lymphocyte cells count usually rise slowly. These 2 blood tests will determine whether HIV infection is well controlled.

Often, your doctor may recommend you to change your HIV medicine if notice your medication is not working as well as they should. You should let your doctor know if you or your partner is pregnant or planning for pregnancy.

What are the common side effects of HIV treatment ART?

Some common side effects that you may experience:

Do I still need to continue my HIV medication if my viral load is undetectable?

YES. When your HIV viral load has diminished and reached an undetectable level when you are on ART, it means your treatment is working, and you should continue your medication. If you stop your ART, the HIV virus will no longer be suppressed and it will multiply rapidly. It is important to keep your viral load at an undetectable level so that you can remain healthy, and this slows down the progression to AIDS. Also, an undetectable viral load places you at low risk of transmitting HIV to other people.

What are the perks of taking HIV medicine regularly?

What should I do if I miss my dose of HIV medicine?

It is important to reiterate the imperativeness of taking your HIV medicine regularly. This is the only way to keep your HIV viral load low and CD4 lymphocytes cell count high. A poor compliant of medicine will allow HIV virus to multiply fast, damage your immune system, and place you at higher risk for AIDS.

Understanding Human Immunodeficiency Virus (HIV)

AIDS (Acquired Immune Deficiency Syndrome) is used to describe a condition when a HIV person has a severely damaged immune system, leading to potentially life-threatening illness and infections.

Currently, unfortunately, there is no cure for HIV, but there are effective medications to help most people with HIV to control the virus and live a long and quality healthy life.

Early diagnosis and good control of HIV are important to prevent develop AIDS.

What are the symptoms of HIV infection?

Approximately 2-6 weeks after HIV infection, some people may experience transient, flu-like symptoms. 

80% of people who are infected with HIV may experience flu-like symptoms such as:

If you have several of these symptoms and you are at risk of HIV infection for the past few weeks, you should get yourself tested for HIV.

The symptoms will eventually disappear, and one may experience no symptoms for years. The HIV virus may silently damage your immune system until much later stage. When the immune system has become severely weakened, you may develop symptoms such as:

How is HIV transmitted from one person to another person?

Most cases of HIV are spread by having sex with another person with HIV without the use of a condom. A HIV infected person without symptoms can still transfer the disease to another person. A HIV infected person who is on HIV treatment can significantly reduce the risk of transmission of disease to others.

Sexual contact
As mentioned, most people acquire the HIV virus through unprotected vaginal or anal sex.
Although you can get HIV through unprotected oral sex, the risk is lower.

It is riskier if:

Other modes of transmission of HIV include:

Some categories of people are particularly high risk of acquiring HIV, this include:

HIV virus thrives in blood and some body fluids. To acquire HIV, one of these infected fluid need to get into your bloodstream.

Body fluids that may contain HIV to infect others include:

Interestingly, body fluids such as saliva, sweat, urine do not contain sufficient virus to infect other people. Hence HIV cannot be transmitted through:

How does HIV infect a body?

Once inside the bloodstream, the HIV virus can attach itself to an immune system cell known as CD4 lymphocyte cell. (CD4 lymphocytes protects the body from bacteria, germs and viruses). Once attached to the CD4 lymphocytes, the virus enters the cells, replicate and make thousands of copies of itself. In the midst of this, the viral copies will kill the CD4 lymphocytes. This process continues until eventually, the CD4 lymphocytes cells die, and the number of the cells (CD4 counts) will diminish to a dangerous level where the immune system stops working.

This can take up to 10 years, where an infected person can feel perfectly well.

What is the connection between HIV and other STIs?

Having other STIs are a risk factor of getting and transmitting HIV.

If you are HIV negative but have another STI, you are 3 times likely to acquire HIV if you have unprotected sex with someone with HIV. If the STI causes skin irritation, skin breaks or sores, this will allow HIV virus easier to enter the body during sexual contact. In STIs that does not cause breaks or open wounds in a person, you still have a higher risk of acquiring HIV as STIs can cause body inflammation leading to increase the number of immune cells to be used as target cells for HIV.

If you are HIV positive and have another STI, you are about 3 times likely to transmit HIV through sexual contact. This is because you have increased concentration of HIV in the semen and genital fluid in comparison to an HIV person without STI.

Are lesbians or women who have sex with women at risk of HIV?

Case reports of female-to-female transmission of HIV are sparse. Having said that, vaginal fluid and menstrual blood can contain HIV and exposure to these fluids with vagina or mouth can still possibly spread HIV.

Living with HIV

Despite the association of HIV with fear, stigma, discrimination, and other repercussions, it is a condition that many are able to live a normal and quality life with the proper taking of HIV medication.

Healthy Living

Aside from taking your HIV medication regularly, you should lead a healthy general lifestyle such as:

You should ensure your flu vaccination up to date yearly, and you are recommended pneumococcal vaccination.

Get Support for your mental well-being

Being diagnosed with HIV can be a life-changing event. It can cause tremendous emotional distress. One may commonly feel anger, hopeless, depress and anxious. You are not alone. Seek help, speak to your doctor. Your doctor will address your concerns and expectations. You may be linked up with trained counsellor or psychologist to give you further emotional support.

Some people find it helpful to speak to others who have HIV via support groups or internet chatroom.

Tell my partner or former partners about my HIV

It is common to feel angry, upset, or even embarrassed about disclosing HIV health status to your current or former partners. Having said that, it is important to inform your current sexual partner or any sexual partners regarding your HIV status, so that they will get tested and treated. Untreated HIV can lead to serious illness (AIDS) and death.

If you have any concerns, you may speak to your doctor for further advice. Your doctor will advise you to disclose your status to your future partners and how you can reduce the risk of transmitting the virus to others.

Do I need to tell my employer?

No, there is no legal obligation to inform your employer of your HIV status, unless you are at a frontline job that performs invasive procedures.

HIV and Pregnancy

If you are pregnant:

If you are planning a pregnancy:

Opportunistic Infections

If your immune system is damaged by HIV virus, you are at risk of developing certain infections that a person with an intact immune system will not. The name opportunistic infections are termed to infections that occur when your immune system is very weakened.

The four main types of opportunistic infections are:

People with HIV are also at risk of certain cancer such as cancer of the lymphatic system (Lymphoma), Kaposi’s sarcoma.

Regular follow up with your doctor and compliant to your HIV medicine is important to maintain your immune system and prevent opportunistic infections.

Take care, stay well.

Parasitic Infections: Scabies & Public Lice

Sexually Transmitted Infections: Parasitic Infections - Scabies & Pubic Lice

This article mainly highlights both Scabies and Pubic Lice as other types of STIs. Further discussion on both individual parasites may be shared in more detail in other articles. 

Scabies Infection

Scabies infection is caused by parasite Sarcoptes scabiei. In adult, Scabies is often transmitted through sexual contact. This is not the case in children with scabies.

When a person is infected with Sarcoptes scabiei parasite, it takes a few weeks for the body to be sensitized towards it, then only one will experience the classical symptoms of intense itch. Interestingly, in subsequent re-infestation of Scabies, one can develop itch symptoms within 24hours. This is because the body has already been sensitized by the Scabies parasite. 

What are the Symptoms and Signs of Scabies?

People with poor immune systems, elderly or the young can acquire scabies rash affecting the head. This is termed Crusted Scabies also known as Norwegian Scabies. 

What are the Treatment Options for Scabies Infections?

 Speak to your doctor if you have a poor immune system or other medical conditions such as HIV that may place you at risk of developing widespread Scabies, known as Crusted Scabies. 

Why Should I treat Scabies?

Apart from the discussed discomfort symptoms from Scabies, Scabies can cause outbreaks in Institutional settings such as residential places, nursing homes, hospitals. It is important to prevent and contain the infectious Scabies infection before it turns into an epidemic by treating the affected population. 

Pubic Lice Infection

Pubic Lice also medically termed pediculosis pubis or also colloquially known as ‘crabs’ are tiny parasites that thrive on pubic hair.

The lice can also be found in other areas such as

Pubic lice can be spread by sexual contact by close body contact with an infected person. It is unrelated to poor personal hygiene. Pubic lice crawl from hair to hair, but they are not able to fly or jump. They feed on human blood for survival. 

What are the Symptoms and Signs of Pubic Lice?

What are the Treatment Options for Pubic Lice?