HIV/AIDS : stay informed

Health

GENERAL

1) What is HIV?
The abbreviation HIV stands for human immunodeficiency virus. It is a retrovirus which infects the cells of the human immune system (in particular the CD4+ T lymphocytes and the macrophage cells essential to the cell immune system). It destroys or disrupts their functioning. The virus acts by progressively weakening the immune system to the stage of immunodeficiency.

2) What is AIDS?
The abbreviation AIDS stands for Acquired Immune Deficiency Syndrome. It describes all the symptoms and infections linked to an acquired deficiency of the immune system. It has been proven that AIDS is the final phase of HIV infection. Indicators such as the level of immunodeficiency or the appearance of certain infections are used to determine the transition of the infection from the HIV stage to that of AIDS.

3) What are the symptoms of HIV?
Most infected people do not know they have been infected. Immediately after infection, during seroconversion, some of them contract infectious mononucleosis (accompanied by fever, rashes, painful joints and swelling of the lymph nodes). Seroconversion corresponds to the production of antibodies against HIV and generally appears one or two months after infection.
Performing a screening (or HIV test) is the only way for a person to know if they are infected or not.

4) When does a person have AIDS?
The term “AIDS” corresponds to the final stages of HIV infection.
In the event of absence of treatment, the majority of people carrying HIV develop the signs of AIDS 8 to 10 years after their contamination.

5) How long does it take for a person infected with HIV to develop AIDS?
The duration varies greatly from person to person. It can take 10 to 15 years, sometimes more, sometimes less, between HIV infection and symptoms of AIDS. Antiretroviral therapy can also prevent progression to AIDS by reducing the viral load in an infected person.

TRANSMISSION

6) Where is HIV found in the body?
HIV is found in bodily fluids such as blood, semen, vaginal fluids, and breast milk.

HIV is transmitted by penetration (anal or vaginal) during sexual intercourse, by blood transfusion, by sharing contaminated needles in healthcare establishments and among drug addicts, but also from mother to child during pregnancy, childbirth and breastfeeding.

Sexual transmission
HIV is transmitted through penetration during sexual intercourse. The risk of contamination is low during vaginal penetration, because the transmission of HIV is not very frequent in this case. Studies show that the rate of transmission during anal sex is 10 times higher than for vaginal intercourse. A person carrying an untreated sexually transmitted infection, in particular causing ulcers or secretions, is 10 times more exposed to HIV transmission or contamination by the virus during sexual intercourse.
Oral sex is considered a low-risk sexual practice for HIV transmission.

Transmission due to sharing needles and syringes
The risk of HIV transmission is very high when reusing and sharing needles or syringes. People who inject drugs can significantly reduce this risk by always using new disposable needles and syringes or by properly sterilizing reusable needles and syringes before use.

Transmission from mother to child
A mother can transmit HIV to her child during pregnancy, childbirth and breastfeeding. The risk of transmission from mother to child is generally 15% to 30% before and during childbirth. It depends on several factors, in particular the viral load of the mother at the time of birth (the risk increases with the load). The mother can also transmit the virus to her child after childbirth, during breastfeeding. The rate of transmission of HIV to the child is extremely low if the mother is on antiretroviral therapy during pregnancy and breastfeeding.

Transmission during blood transfusion
The risk is extremely high (greater than 90%) of contracting HIV during a transfusion of contaminated blood and blood products. Blood safety involves screening all blood donations for HIV and other blood-borne pathogens, as well as properly screening donors.

7) What is the risk of HIV transmission by kissing on the mouth or with the tongue?
A kiss on the mouth does not present any risk and no study reveals a transmission of the virus through saliva by kissing.
 
8) What is the risk of HIV transmission by getting a piercing or tattoo?
A risk of HIV transmission exists if contaminated instruments are not sterilized or are shared between several people. Instruments designed to penetrate the skin should be used only once and then discarded or properly cleaned and sterilized.
 
9) What is the risk of HIV transmission by sharing a razor with an infected person?
Any cut involving an unsterilized object, such as a razor or knife, can transmit HIV. It is not advisable to share a razor unless it is properly sterilized after each use.
 
10) Is having sex with a person living with HIV safe?
It is safe to have sex with someone living with HIV if their viral load is made undetectable by treatment. It is also safe if you use a condom correctly or take pre-exposure prophylaxis as advised by your doctor.
 
11) Two people living with HIV want to have exclusive unprotected sex. Is it safe?
It is strongly recommended that a person living with HIV not be infected with another strain of the virus, except for pre-exposure prophylaxis, which never applies to people living with HIV.

PREVENTION

12) How to avoid HIV infection?
Here are ways to protect yourself from sexual transmission of HIV:
- abstinence
- Monogamous relationships between healthy partners.
- Sexual intercourse without penetration.
- Systematic and correct use of a male or female condom.
- Sex between two people, one of whom is living with HIV but is on antiretroviral therapy and has an undetectable viral load.
- Pre-exposure prophylaxis taken by people who are not infected with HIV.
- Voluntary medical male circumcision. Reduces the chances of HIV transmission from woman to man.

Other ways to avoid infection:

- If you inject drugs, always use new, single-use or properly sterilized needles and syringes before use or seek other preventive measures such as opioid substitution therapy.
- Ensure that blood and blood products are tested for HIV and blood safety standards are in place.

13) Are condoms effective against HIV?
Quality-certified condoms are the only products currently available that protect against sexual infection of HIV and other sexually transmitted infections. When used correctly, condoms are an effective way to prevent HIV infections in women and men.
For optimal protection, condoms must be used correctly and consistently. They can slip or break if used incorrectly, diminishing their protective effect.

14) What is the female condom?
A female condom is a woman-controlled method of contraception. It forms a barrier. The female condom is a strong, flexible and transparent polyurethane sheath. It is inserted into the vagina before intercourse. It completely hugs the vagina. Combined with correct and systematic use, it protects both against the risk of pregnancy and against sexually transmitted infections such as HIV. The female condom has no known side effects or risks. It is available without a prescription and does not require the intervention of healthcare personnel.

15) What is post-exposure preventive treatment?
Post-exposure preventive treatment (PEP) combines medication, laboratory tests and counselling. PEP treatment should begin a few hours after a potential exposure to HIV and lasts about four weeks. A priori, given the current state of research, taking medication quickly after potential exposure to HIV (ideally within two hours and less than 72 hours after this exposure) can prevent HIV infection. HIV.

16) How to avoid transmission from mother to child?
Transmission of HIV from a mother living with HIV to her baby can take place during pregnancy, childbirth or after birth during breastfeeding. In the absence of any intervention, it is estimated that a mother living with HIV will transmit the infection in 15 to 30% of cases during pregnancy and childbirth. Breastfeeding increases the risk of transmission by 10 to 15%. This risk depends on clinical factors and may vary according to the rate and duration of breastfeeding.
Significant progress has been made in reducing the number of children born with HIV. The risk for a woman living with HIV of transmitting the virus to her child can be reduced to 5% or less thanks to effective antiretroviral treatment during pregnancy, during childbirth and during the breastfeeding period.

17) What procedures should health personnel follow to prevent transmission in a health setting?
Healthcare personnel are advised to adopt universal precautions. Universal precautions refer to infection control rules developed to protect staff and patients from exposure to transmissible diseases through blood and certain bodily fluids.
Universal precautions involve:
- handle and properly dispose of sharp instruments (tools that can cause cuts or punctures, including needles, hypodermic needles, scalpels and other blades, knives, infusion sets, saws, glass shards and nails).
- Wash hands with soap and water before and after each intervention.
- Use protective equipment such as gloves, gown, apron, mask and goggles, in case of direct contact with blood and body fluids.
- Properly dispose of waste contaminated with blood or body fluids.
- Properly disinfect instruments and other contaminated equipment.
- Properly handle soiled fabrics.

In addition, it is recommended that all healthcare personnel take care to avoid injuries from needles, scalpels and other sharp instruments and devices. In accordance with Universal Precautions, everyone's blood and body fluids are considered infected with HIV and other potential viruses, regardless of known or suspected status.

18) Can HIV be cured?
It is not possible to cure HIV. There is, however, an effective treatment, which, if started early and taken regularly, allows a person living with HIV to have a quality and life expectancy similar to that of healthy people.
 
19) What treatment is available?
Antiretroviral drugs are used to treat HIV infection. They block the proliferation of HIV in the body. When a person living with HIV is on effective antiretroviral therapy, they are no longer infectious.
 
20) How do antiretrovirals work?
HIV produces copies of itself inside an infected cell, which then allows it to infect other healthy cells in the body. The more cells the virus infects, the greater its impact on the immune system (immunodeficiency). Antiretrovirals slow down the proliferation and therefore the spread of the virus in the body. They interfere in this process in different ways.
Nucleoside reverse transcriptase inhibitors: HIV needs an enzyme called reverse transcriptase to make new copies of itself. This type of medication inhibits reverse transcriptase by preventing the process of duplication of the virus's genetic material.
Non-nucleoside reverse transcriptase inhibitors: This type of drug also interferes with HIV duplication by binding to the transcriptase enzyme itself. The enzyme can no longer function properly and stops producing new virus particles in infected cells.
Protease inhibitors: Protease is a digestive enzyme. It is essential for the duplication of HIV to generate new particles of the virus. It breaks down proteins and enzymes in infected cells which then infect other cells. These inhibitors prevent the protease from breaking protein bonds and thus slow down the production of new virus particles.
Clinical trials are currently being carried out on other drugs that inhibit other stages of the virus cycle (such as the virus entering a cell and fusing with it).

21) How long should I wait before taking an HIV test following a potential exposure?
It is generally advisable to wait three months after possible exposure before getting tested. Even if the screening tests for anti-HIV antibodies are very effective, it takes up to two months depending on the test used. This corresponds to the period between HIV infection and the appearance of detectable antibodies. This period is reduced to about three weeks for the most effective HIV tests currently recommended.
 
22) Why get tested?
Knowing your HIV status has two advantages. On the one hand, if you are infected, you can immediately start a treatment that can prolong your life by several years (see question 36). On the other hand, if you know you are infected, you can take all necessary precautions to avoid transmitting HIV. If you are not infected, you can learn how to protect yourself from HIV in the future.
 
23) Where to get tested?
You can get tested at different places: at a doctor's office, at health services near you, at hospitals, family planning clinics and dedicated HIV testing sites. Always try to get tested at a place where you can get HIV counseling. You can also test yourself for HIV using a self-test kit.

24) Are my test results confidential?
Anyone taking an HIV test must give their informed consent before testing. The results must remain completely confidential.
Here are the different types of tests available:
Confidential HIV testing: healthcare professionals handling the HIV test guarantee the confidentiality of the results contained in their archives. The results may not be communicated to third parties without the written consent of the person concerned.
Anonymous HIV test: the name of the person concerned is not used for the purposes of the test. This person receives the results thanks to a code assigned to the test. No trace that could establish a link between this person and the test is kept.

Shared confidentiality is strongly recommended. It concerns the following people: family members, life partners, caregivers, people you trust, etc. However, care must be taken in communicating the results, in order to avoid discrimination within the social, professional and health services environment. Only the person tested can decide on confidentiality. Although the HIV test result should be kept confidential, counsellors, healthcare professionals or social workers may also need to know the status of an infected person in order to provide appropriate solutions.

25) What if I have HIV?
Thanks to new treatments, people infected with HIV can now live long and healthy lives. Make sure your doctor knows about HIV treatments. Health professionals or specialists in advising on the virus can advise you and help you find the right doctor.
 
26) My HIV test is negative. What does this mean?
A negative test means that no HIV antibodies were detected in your blood during screening. If your HIV status is negative, make sure it remains negative: learn about the modes of HIV transmission and avoid risky behaviour.
However, the risk of infection cannot yet be ruled out, because your immune system needs a maximum of three months to produce enough antibodies that can be seen in a blood test. It is recommended to repeat the test later and to take the necessary precautions in the meantime. During this period, a person is particularly infectious and must take appropriate measures to avoid any transmission.

STEREOTYPES

27) Can I get HIV from a mosquito bite?
A mosquito or any other insect cannot transmit HIV by biting. Even if the virus enters a mosquito or other blood-feeding or biting insect, it cannot reproduce there. Since insects cannot be infected with HIV, they cannot pass it on to the next human they bite.

28) Should I be afraid of HIV infection while playing sports?
There is no evidence of HIV transmission through exercise.

29) Can I have several sexually transmitted infections at the same time?
Yes, you can have more than one sexually transmitted infection (STI) at the same time. Each requires its own treatment. You cannot immunize yourself against STIs, so you can get the same infection more than once. Often, men and women do not notice any warning signs immediately after contamination, but can still infect their sexual partner.

30) If I am on antiretroviral therapy, can I transmit HIV?
You cannot transmit HIV if your antiretroviral therapy is effective and the virus is undetectable. It is also recommended to monitor the viral load as part of the treatment of people living with HIV.