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:

Fever
Sore throat
Rashes over the body
Lethargy
Muscle and joint ache
Swollen glands

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:

Weight loss
Night sweat
Persistent diarrhoea
Recurrent infections
Skin rash
Serious life-threatening illnesses

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:

The person giving oral sex has mouth sores, ulcers, broken or bleeding gums
The person receiving oral sex has recently been infected with HIV and has a lot of virus in their body, or has another STI

Other modes of transmission of HIV include:

Sharing needles in injection drug users
Mother to baby transmission during delivery or breastfeeding
Sharing sex toys with someone who is infected with HIV
Needlestick injury in healthcare workers
Blood transfusion

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

Men having unprotected sex with men
People who have chemsex (the use of chemical drugs to increase the effect or sexual experience)
People who have unprotected sex with multiple sexual partners
Women who have unprotected sex with men who have sex with men
People who have unprotected sex with a person who has lived or travelled in Africa
People who inject drugs and share needle equipment
People who have unprotected sex with others who inject drugs or share equipment
People with another sexually transmitted infection
People who have received a blood transfusion in Africa, Eastern Europe, countries of previous Soviet Union, Asia, Central and Southern America

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:

Vaginal fluid
Menstrual blood
Semen
Blood
Mucous membrane/ lining of the anus (back passage)
Breast milk

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

Kissing (Closed-mouth or social kissing)
Biting
Contact with healthy intact skin of an infected person
Being spit and sneeze on
Sharing toilet, swimming pool
Sharing towel
Sharing cutleries
Mouth-to-mouth resuscitation
Animals, Insects, ticks or mosquitoes

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.