HIV 101

In medical terms HIV stands for Human Immunodeficiency Virus. This means that HIV is a virus that attacks the body’s immune system, decreasing the body’s ability to fight germs and ward off cancer. Germs can cause life threatening infections to a person whose immune system has been weakened by HIV. If left untreated, HIV can progress to AIDS. There is no cure for HIV, however medical treatment and care can help someone living with HIV stay healthy and improve quality of life. 

In medical terms AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is a very serious condition in which the immune system has been severely damaged by chronic HIV infection. An individual diagnosed with AIDS is susceptible to a variety of infections that are less common in people with a healthy immune system. Medical treatment and care can help someone living with HIV and diagnosed with AIDS manage and possibly improve immune system function and overall health.

HIV (Human Immunodeficiency Virus), the virus that causes AIDS, can be passed from an infected person to another person through blood, semen, vaginal fluids, and breast milk. HIV-infected fluids must get into the bloodstream in order for the person to become infected (seroconvert).

There is a high to moderate risk for transmitting HIV by:

1. Having unprotected vaginal or anal sex with someone who is infected with HIV.
2. Sharing needles with someone who is infected with HIV. This could include injecting drugs, steroids, or vitamins, or sharing tattooing and piercing equipment.
3. Having unprotected oral sex with someone who is infected with HIV.
4. Breast-feeding by a mother infected with HIV.

While there are no set symptoms that you are infected with HIV, sometimes individuals exposed to the virus will go through an acute stage of the infection. Also known as the Primary HIV Infection, the acute HIV infection is the time between when a person is exposed to the virus and when they produce an antibody response. The Primary HIV Infection stage may include flu-like symptoms such as fever, chills, night sweats, rashes, diarrhea, etc. However, these symptoms can also occur with a variety of other viral infections unrelated to HIV.

If you are concerned that you may have been exposed, contact a local agency as soon as possible to set up a testing appointment.

Concerned about a situation or potential exposure? Call or email Madeleine at 303.444.6121 or madeleine@bcap.org.

HIV antibody testing is the most common and most accessible form of HIV testing. Rapid HIV antibody testing, such as Uni-Gold and OraQuick, usually takes between 10-20 minutes. These tests use a small sample of either blood or saliva and are often conducted with the client present. This type of testing is most common type of HIV testing available, and is most likely to be available at sliding scale or reduced fees. Please refer to BCAP’s HIV Testing page for further details.

ELISA and Western Blot tests are most commonly used for confirmatory testing. An ELISA test is highly sensitive to any recent antibody activity. A Western Blot test looks specifically for HIV antibodies. The Eliza/Western Blot combination is often more costly due to the additional procedures needed to run the test. A blood draw is required and it usually takes 3-10 days to receive results. In order for a serum sample to be confirmed HIV-positive, it must receive a positive ELISA test and a positive Western Blot test.

Viral load testing actually tests for the virus itself, not HIV antibodies. This type of testing is commonly used on clients who have already tested HIV-positive to monitor their disease progression. This type of testing is costly and is not used to diagnose HIV due to the possibility of a false positive or a false negative.

Additionally, the FDA has approved 1 at-home HIV testing kit, Home Access. This test is performed by you providing your own blood serum sample from home and mailing the sample to a designated lab with an identifier code attached to it. You then call a 1-800 number after a number of days to receive your test results as well as counseling for a reactive or non-reactive result. Test kits usually cost $45-$60.

While HIV testing can come with a host of personal and social stigmatization,  BCAP does not recommend home testing due to the value of in-person counseling. Receiving a reactive test result should not be done without the support of a trained counselor to help you handle questions, emotions, and what should be done next.

A reactive HIV antibody test means that the test administered to you identified something in your serum (either blood or saliva) that looks like an HIV antibody. This antibody presence then caused the test to react. However, a rapid HIV antibody test alone does NOT ensure that you are either positive or negative. You will need to access confirmatory testing as soon as possible to confirm your HIV status. While rapid HIV antibody tests are highly accurate, they are not 100% full-proof.

While waiting for your confirmatory test results, make sure you take care of yourself-physically, emotionally, and mentally.

The following are a few suggestions to help take care of yourself during this stressful time.

• Avoid high stress situations.
• Make time in your day to relax and breathe, get a massage after work, or attend a yoga class on the weekend.
• Be aware of possible influences that could impair your decision-making ability, such as drug use or heavy alcohol drinking.
• Eat healthy foods, including lots of fruits and vegetables.
• Avoid surfing the internet for answers until you’ve confirmed your HIV status. It is easy to psych yourself out with inaccurate information from websites, which could be mentally harmful during this time.
• Take an evening to enjoy your favorite movie or book, or treat yourself to a night at a local theater.
• Use both a condom and lubricant during all sexual activity to avoid a potential exposure to someone else.

Concerned about a test result?

Call or email Madeleine at 303.444.6121 or madeleine@bcap.org.  Boulder County Public Health Department also provides confirmatory testing at 303.413.7500.

Realizing that you did not use protection, or that the protection you did use broke, can be both scary and overwhelming. First, take a deep breath, remain calm about the situation, and think through your situation.

Assess the sexual activity that caused the condom to break and whether or not any fluids were exchanged. Remember that unprotected anal and vaginal sex with ejaculation (including pre-cum) is a high risk behavior for HIV exposure, especially for the receptive partner. If there is a possibility that you have potentially been exposed to HIV, you will want to access Post-Exposure Prophylactics (PEP).

PEP is HIV medication that is taken daily for 1 month to reduce the likelihood of HIV connecting with your cells; (remember that HIV must connect with one of your CD4 immune cells in order to survive). This treatment is most effective if taken as soon as possible, usually within 4-48 hours after potential exposure. Cost of the prescription is often upwards of $1,200. PEP can be accessed at Boulder Community Hospital’s Emergency Room. A female may also want to access emergency contraception if there is a possibility of an unwanted pregnancy.

The decision to take PEP should not be taken lightly, and PEP should not be used in exchange for condoms as regular sexual protection. PEP treatment often has a host of side effects that impact your ability to conduct everyday work and social activities, and can be quite expensive if insurance does not assist in paying for it. Additionally, a doctor will have to assess your true risk for infection and may determine there is not a high enough risk to prescribe the medication-leaving you empty-handed with an ER bill to pay. However, in the event that you are at risk for a possible exposure, access PEP as quickly as you can.

Concerned about whether or not you should take PEP or need to assess a situation? Call or email Madeleine or Frank at 303.444.6121, madeleine@bcap.org or frank@bcap.org.

Regardless of whether you are HIV positive or negative, there is important information you should know about being sexually active with someone else who is positive.

Anal and Vaginal Sex:

• Remember that protection, such as a male condom and lubricant, should be used with all sexual acts, including anal, vaginal, and oral sex. While the receptive partner is at higher risk for HIV infection due to the increased exposure of mucus membranes, the insertive partner is also at significant risk for infection (cuts/sores along the penis, the urethral opening, etc.).
• Likewise, while a female’s vaginal wall creates a significantly larger exposed area for cuts/sores, the male is also at risk with penile cuts/sores and the urethral opening.

 Oral Sex

• While HIV is not transmitted through saliva, partners should use protection (such as a latex barrier or a flavored male condom) with oral sex due to possible cold sores, bleeding gums, chapped lips, or cuts/sores along the genitals that could provide an opening to the bloodstream.
• Do not allow one partner to ejaculate semen or vaginal fluids into another partner’s mouth (including pre-cum). If this does happen, do not swallow the body fluids or pass them back and forth (otherwise sometimes referred to as “snowballing”).
• Also, it is recommended to not brush or floss right before or right after oral sex due to the potential creation of a cut/sore in the mouth. Wait ½ hour and then brush away!

All partners should be aware of Post-Exposure Prophylactics (PEP), and where they can access it in their community. PEP can be administered to decrease the possibility of sero-conversion (the development of antibodies to HIV once the virus has entered your body) after an exposure to HIV. PEP can be accessed at Boulder Community Hospital’s Emergency Room. Please see more information under the”I think I might have been exposed to HIV last night.  What should I do now?” section.

Additionally, remember that there are different strains of HIV, and it cannot be assumed that 2 people have the same strain. An HIV-infected person can become re-infected with another strain or even with the same strain again (commonly called a super-infection). This super-infection could cause current medications to not work or a host of other health problems.

You can almost never tell if someone is infected with HIV by just looking at them. It’s important to ask all of your sexual and/needle sharing partners if they have been tested and what their status is.

However, sometimes asking someone their status is not enough. This is why it is equally important to always protect yourself. Always have male and/or female condoms and lubrication available and within easy reach during sexual activity. Remember to never share syringes or works with others and always use new clean equipment with each injection.

Concerned about a situation or potential exposure? Call or email Madeleine at 303.444.6121 or madeleine@bcap.org.