FAQ HIV and AIDS
What is AIDS?
In the final stages of HIV infection, patients develop AIDS syndrome. The abbreviation AIDS stands for “acquired immune deficiency syndrome”. This means “acquired immunodeficiency syndrome”.
At this stage, the immune defense is greatly weakened. The patient then suffers from infections that are otherwise rare, but can be dangerous to him. In addition, the patients develop a so-called Wasting syndrome with fever, diarrhea and severe weight loss.
How does HIV affect the immune system?
The HIV virus needs special immune cells, the CD4 cells, to multiply. The HIV particles in your blood look for those CD4 cells, which they can easily penetrate because they fit exactly. Once inside, the HIV virus uses the CD4 cell as a kind of copier to multiply itself. The HIV virus forces the healthy CD4 cell to make new virus particles. Eventually that CD4 cell opens up and is then so damaged that it dies. The released new virus particles enter the body and all seek a CD4 cell again. This way everything starts all over again and more and more immune cells break down.
Your body naturally tries to fight HIV infection. Your immune system has recognized the HIV cells and wants to attack and destroy them. But because the virus multiplies so quickly, mistakes are made and the copy always looks slightly different. That is called mutation. The immune cells no longer recognize the virus particle and do not destroy it immediately. This way the virus particle can continue to multiply undisturbed.
Every day billions of new virus particles are created and billions of CD4 cells die. Those CD4 cells, however, have a very important role in the immune system; they control all other immune cells so that every cell knows exactly what to do. When many CD4 cells die, the other immune cells do not know what to do anymore. Your immune system will not work properly anymore, so you can no longer defend against pathogens. You will then become more susceptible to ordinary, common viruses, bacteria or fungi. Eventually you can even get infections of viruses, bacteria or fungi that you would not even get sick of. We call that with a difficult word ‘opportunistic infections’. Opportunism means: acting according to the possibilities of that moment. An opportunistic infection is an infection that can occur at that time because someone has a reduced immune system.
First symptoms of an HIV infection
Shortly after the infection with HIV (usually 11-15 days) it comes to a rapid multiplication of the viruses. In more than half of those affected, the early phase of the disease has no or only a few uncharacteristic symptoms, about 25% of the newcomers are symptomatic of acute HIV infection. Common symptoms of disease are at this early stage of the disease:
- general fatigue
- night sweating
- loss of appetite
- skin rash
- inflammation of the oral and pharyngeal mucosa
- joint pain
The symptoms of an acute infection with the HI virus are similar to those of influenza or glandular fever (Epstein Barr virus infection). At this early stage of the disease, the HI viruses multiply explosively, so that the viral load of the affected persons can amount to several million viruses per milliliter of blood. At the same time, the number of certain immune cells, the so-called CD4 cells, decreases for a short time before being restored. Because the infected person has not yet formed any antibodies against the pathogen, the diagnosis of HIV infection by an HIV test is not yet possible. The diagnosis of acute HIV infection can only be made by the direct detection of the virus (PCR) to the occurrence of anti-HIV antibodies.
How does HIV infection develop?
The HIV virus is transmitted through direct contact with blood, semen, vaginal secretions and breast milk. Because the body has not yet formed antibodies (antibodies) to the virus immediately after infection, the amount of virus in the blood is extremely high. New infected people therefore run a high risk of infection.
Usually it is transmitted during unprotected sexual intercourse with an infected partner. 70% of new infections affect homosexual men, 20% of infections occur in heterosexual contacts. In case of unprotected sexual intercourse with an equally infected partner, HIV-infected persons can also be infected by another, possibly resistant, subtype of the HIV virus. A small risk of contamination can also not be ruled out during oral sex contact.
9% of all infected people are drug addicts who share their syringes or needles with others.
15-30% of HIV-infected mothers transfer the disease to their child during pregnancy or childbirth. Treatment with retroviral drugs and birth by caesarean section can reduce the transmission risk to 2%. Since transmission of HIV can also take place via breast milk, mothers with HIV infection should not breast-feed their child.
Infected blood or blood products may contain HIV viruses in such high concentrations that infection is possible. Since 1985, hospitals and blood banks in European countries have been testing blood and blood products, as well as blood donors that repeat HIV antibodies. That is why today the risk of getting infected in this way is negligible. In isolated cases, the HIV virus can be transmitted during tattoos with unclean utensils. According to current knowledge, the risk of infection due to saliva, sweat or tears is extremely low. However, if these fluids come into contact with open wounds, transfer cannot be completely ruled out. While some pathogens spread through the exhaled air, the HIV virus cannot skip coughing or sneezing in other people.
Contrary to what is often thought, the HI virus is therefore not transmitted by:
- skin contact (hugs or kisses on the cheeks or mouth)
- swimming in swimming pools
- eat together and share knife and fork
- the amount of viruses in sweat, tears and saliva is too small to cause an infection.
- Insect bites
What are the symptoms of Aids
Most HIV patients who still have AIDS today do not know that they have HIV infection. If they are not treated, the gradual weakening of the immune system usually leads to the complete development of the AIDS status of the disease during HIV infection. These are mainly symptoms of certain AIDS-definition of opportunistic infections such as Pneumocystis pneumonia, a certain form of pneumonia, Kaposi’s sarcoma, a tumor that mainly affects the skin and mucous membranes, serious herpes infections, tuberculosis and some other diseases, At the same time, the number of helper cells often falls below 200 per microliter. This is often a life-threatening condition. In the past, survival after diagnosis was often only 3 years. Nowadays modern medicine often allows a survival of more than 10 years. However, it does not have to be that far with early diagnosis and consistent HIV therapy.
What are HIV symptoms specific to men / women?
Although men and women generally have similar warning signs for HIV, there are some symptoms that only affect women or men:
HIV symptoms specifically for men
An HIV symptom that only occurs in men is a stomach ulcer on the penis. HIV can lead to hypogonadism or poor production of sex hormones in both sexes. However, the effects of hypogonadism on men are easier to see than the effects on women. The symptoms of low testosterone, an aspect of hypogonadism, may include erectile dysfunction (erectile dysfunction).
HIV symptoms specifically for women
One of the symptoms women can get after HIV infection is changes in menstruation. A woman can bleed more easily or harder, periods can be absent or women can have severe PMS. Stress or other sexually transmitted diseases that are common in HIV can also cause these problems. But they can also affect the immune system and influence the hormones because of the effects of the virus. Another HIV symptom for women is fungal infections. Yeasts are microscopic fungi that naturally live in the vagina. However, if a woman is infected with HIV, the fungi can become uncontrollable and cause vaginal yeast infections several times a year. Sometimes they are the first sign that the body is infected with the HIV virus. A fungal infection can cause the following symptoms:
- Thick, white discharge from your vagina
- Pain during sex
- Pain when urinating
- Burning of the vagina or pain
Lower abdominal pain can also occur after HIV infection. They are among the signs of a pelvic inflammatory disease. This is the collective name for an infection of the uterus, ovaries and / or fallopian tubes. For some women, it is one of the first signs that they have HIV. Together with pelvic pain, pelvic inflammation can cause the following symptoms:
- Unusual vaginal discharge
- Irregular periods
- Pain during sex
- Pain in the upper abdomen
How can you become infected with HIV?
HIV, the human immunodeficiency virus, is the cause of the lethal immunodeficiency syndrome AIDS. In this country, the infection is usually in unprotected sexual intercourse. The virus is also transmitted when infected blood reaches mucous membranes or directly into the bloodstream, or when HIV infected mothers give birth and breastfeed a baby.
In the acute phase of infection (2-6 weeks after contact with the HI virus), flu-like symptoms such as fever, fatigue, malaise and headache usually occur. In the second phase of the infection, the so-called latency phase, one does not feel physical symptoms. In this latency phase, the virus multiplies and infects the cells of the immune system. On average, this phase lasts for 9-11 years. However, the duration of the latency phase varies greatly from patient to patient. In the third phase, the symptoms of “AIDS-related complex” appear, similar to those in the acute phase. However, these flu-like symptoms do not differ, in contrast to the acute phase.
What are the most important protective measures against the HI virus?
Although AIDS is a good medical treatment, it can be used to live for many years, but it can not be cured until today. That is what you always need to think about during sexual intercourse. Almost 80% of HIV infections in this country are based on unprotected sexual intercourse! HIV can be transmitted during vaginal and anal intercourse and in oral sex when sperm or menstrual blood enters the mouth. The only protection against this are condoms or the femidom (“condom for women”). Incidentally, these protect not only against HIV, but also against many extremely unpleasant or dangerous venereal diseases such as herpes, genital warts, chlamydia, syphilis or gonorrhea. Even with unprotected intercourse and the so-called coitus interruptus (“look out” or “retreat before the peak”) there is a risk of infection. Even if there was no ejaculation during sex, the HI virus can be transmitted! There is no danger of kissing, kissing, caressing and stroking. Shared use of toilets, cutlery, indoor swimming pools, saunas, etc. is also safe.
The three safe sex rules:
- Sleep together – always with a condom (or femidom).
- No semen, no menstrual blood in the mouth, no semen or blood swallowing.
- If itching, burning or discharge to the doctor.
HIV and drug addicts
AIDS is still today as a disease of drug addicts. This is because there is a high risk of infection if non-sterile syringes are used or even used together, because then possibly infected blood residues can end up directly in the bloodstream of the next user.
At the doctor or in the hospital, the hygiene standards in this country are so high that there is no risk of infection. B. with tattoo or piercing. Blood donations are screened for HIV, so the chance of a blood transfusion infection is negligible – again based on the situation in the developed world.
HIV-infected women who have a baby.
If they are unaware of their infection or have no way to treat the virus (as is usually the case in developing countries), the risk of infection for the baby during pregnancy, childbirth and breastfeeding is high. If, however, appropriate medical measures are taken (treatment with medication, abstinence, etc.), chances are that the HI virus will not be transferred from the mother to the child.
When should you test yourself with the INSTI HIV self-test?
If you notice any of the above symptoms and come into contact with HIV, we recommend an HIV self-test. We recommend that you test yourself if you are sexually active, have multiple sexual partners, use intravenous drugs, or have sex with someone who has HIV. Testing is quick and easy and requires only a small amount of blood. You can have HIV tests carried out with your doctor or the health organization of the government. If you prefer to test yourself at home in a familiar environment without anyone else, order an HIV self-test; For example, the INSTI self-test. You can order this on our website.
How do you prevent HIV infection?
The most effective way to prevent HIV infection is to always use condoms during vaginal, anal and oral sex. When used correctly, a condom acts as a barrier and prevents the mixing of body fluids from an HIV-infected person who enters the body of their sexual partner. Needles, syringes or other injection devices for drug use should not be shared.
Is there a cure for HIV?
At the moment there is no cure for HIV or AIDS. However, treatment with antiretroviral therapy (ART) can keep HIV under control and give people a long and healthy life. The only way to prevent HIV infection is to refrain from sexual activity or practice safe sex by always using a condom.
What is antiretroviral therapy (ART)?
Antiretroviral therapy (ART) is the name of the drug taken by a seropositive person. ART is usually a combination of at least three antiretroviral drugs that are now taken in a single pill and inhibit the growth of the virus by preventing it from multiplying in the body (multiple copies of itself). The combination of medication is better at treating HIV than with just one drug alone. An HIV-infected person can lead a long, happy and satisfying life. With proper treatment and support it is possible to live as long as the average person.
What is PrEP?
HIV-negative persons who are at high risk of becoming infected can prevent so-called pre-exposure prophylaxis. Patients are taking a drug that is also used to treat HIV and contains the active substances emtricitabine and tenofovir disoproxil fumarate. The efficacy is proven in homosexual men with risky sex life and similar to the use of condoms. However, the drug does not protect against other sexually transmitted diseases.
The prophylaxis is usually well tolerated, but can damage the kidneys. Users need to have their kidney function checked regularly and have an HIV test done every three months to prevent infection. Taking PrEP daily reduces the risk of HIV infection from sex with more than 90% and 70% of people injecting drugs. The risk of HIV infection can be further reduced by using PrEP and condoms.
How many people are infected with HIV Worldwide
- 36.9 million people worldwide live with HIV (as of 2017).
- Of these, 21.7 million people have access to antiretroviral therapy. This is 2.3 million more than in 2016 and almost 14 million more than in 2010.
- 940.000 people died of AIDS in 2017, compared to 1.5 million in 2010.
- In 2017, around 1.8 million people around the world were newly infected with HIV, the same number as in the previous year.
- In eastern and southern Africa, where more than 50% of people are living with HIV, the number of adult new infections has fallen the most in the world, by a total of 30% since 2010.
- In Eastern Europe and Central Asia, by contrast, the number of new infections has risen by 30% in the last six years.
- In terms of the UNAIDS * 90-90-90 targets, in 2017, 75% of people living with HIV worldwide knew about their status, 79% of whom had access to treatment, and 81% of those had a suppressed viral load.