Sexual health questions: HIV

What is HIV?
Human Immunodeficiency Virus (HIV) is a virus that attacks the immune system of an infected individual.

If untreated, HIV infection can result in acquired immune deficiency syndrome (AIDS). This is the term used to describe the reduced ability of the immune system to fight infections and illnesses, leading to life-threatening complications. However, people who are HIV-positive but receive treatment on time are likely to remain healthy with normal life expectancy.

Public Health England estimates that there are over 100,000 people with HIV in the UK. 92% know their status, however, around 1 in 12 people who are HIV positive in the UK do not know that they are infected, emphasising the importance of regular testing.

How can I catch HIV?
HIV can be transmitted sexually and non-sexually through the exchange of bodily fluids.

These include:

• Semen
• Pre-cum (the fluid that the penis produces for lubrication before ejaculation)
• Vaginal fluids, including menstrual fluids (period blood)
• Breast milk
• Blood
• The mucus found in the rectum

Unprotected sexual intercourse with an infected person could also transfer to virus, including vaginal, anal or oral contact. Acquiring or passing on HIV through oral sex is possible but rare.

HIV cannot be transmitted by air, water, insect bites, saliva, tears or sweat. The virus also cannot be passed through healthy, unbroken skin.

What are the symptoms and signs of HIV?
Signs of an HIV infection may not always be present in the early stages after exposure. If symptoms are present, they can occur in the first four to six weeks following infection and include flu-like illnesses, sore throat and swollen glands. This is usually when your body has begun the ‘seroconversion process’. Seroconversion is where your body tries to counteract the virus by producing antibodies.

Following this phase, symptoms can clear for up to 15 years. However, during this time you are still infectious, and the virus is still causing harm to your system. If the infection remains untreated, you will become more susceptible to other infections including bacterial, viral or fungal diseases.
As HIV advances in the body, symptoms of a weakened immune system start to appear.

Common symptoms include:

• Unintentional weight loss
• Chronic diarrhoea
• Recurrent infections, such as chest infections
• Skin rashes, especially on the face, genitals or anus
• Increased Herpes ulcers or thrush infections on and around the mouth and genitals
• Sweats, especially at night
• Unusual tiredness
• Nausea or loss of appetite
• Swollen lymph glands in the neck, groin or armpits.

If you have these symptoms and think that you may have been at risk of HIV at any time, then it is advisable to get tested. You may have been at risk of HIV if you have had any unprotected sex with different partners, shared injecting equipment when using recreational drugs or steroids, or if you have taken a blood transfusion outside of the UK.

How can HIV be tested/checked?
Knowing that you are HIV positive is much better for your long-term health because you can start treatment early. A blood sample is collected from the arm using or with a finger stick using a lancet.

You may also choose to have an instant test, which would allow you to get your results after about 20 minutes.

What are the risks associated with HIV?
If an HIV infection is left untreated, the reduction of CD4 cells affects the immune system. This means it will be harder to fight infections and other diseases. Eventually, the development of an AIDS-defining illness, leading to a diagnosis of AIDS, can be fatal.

It is possible for an HIV-positive female to pass the infection to her baby; this can occur during pregnancy, at birth or through breastfeeding. In the UK, this possibility is considered as a rare occurrence because pregnant women are routinely tested for HIV and given appropriate treatment if found HIV-positive, which would prevent transmission of the virus to the foetus.

What if I test positive for HIV?
With access to effective treatment, HIV is no longer life-threatening. Medication can help to control the virus to prevent it from causing further harm to the immune system. You can choose whether to continue your treatment privately or through your own GP.

Early detection and treatment are highly important to protect your long-term health. You should start to monitor the effects of the virus as soon as possible. HIV can be detected from as early as ten days after any exposure.

Tocolo will refer you back to your own GP or to an appropriate specialist, such as the Terrence Higgins Trust (THT), to help you get the support and advice you need. THT has 37 centres nationwide that are there to support you. With over 30 years of experience, they will help you decide whom to tell about your HIV status and how. Having helped thousands of newly diagnosed people, THT are the UK’s experts in this area.

Their dedicated website enables the HIV positive community to share their thoughts and feelings. The THT will also help you to seek medical support and answer your questions about what this means for you and your future relationships.

There are also apps and webpages which can help you to monitor your condition, allowing you to manage the virus whilst maintaining your health and lifestyle.

It is important to notify recent sexual partners if you test positive for HIV. This prevents further transmission and enables earlier treatment if they have been infected.