FAQ ?

HIV stands for “human immunodeficiency virus” and AIDS stands for “acquired immune deficiency syndrome”. In simple terms: HIV is a “virus” that makes the human body’s immune system weak or deficient, while AIDS is an “outcome of HIV infection”. However, being infected with HIV is not the same as having AIDS. AIDS is actually a late stage of HIV infection and comes about only when HIV has made your body’s immunity (defence system) too weak to fight off other infections. It may take several years for AIDS to develop. The healthier your body and the better you take care of it, the longer it will take for AIDS to develop.

• You can get infected with HIV if certain body fluids from an HIV infected person’s body enter your body. By body fluids we mean blood, seminal fluids (semen, pre-cum) and vaginal fluids, which can host HIV and carry it from one person to another. In almost 80% of cases, HIV is passed through unprotected penetrative sex – anal, vaginal or oral – with an infected person and body fluids from that person can enter your body. Different sexual acts have different risks. Unprotected anal sex and vaginal sex are considered to be more risky than unprotected oral sex.
• You can get infected with HIV if you receive blood or blood products from an HIV infected person.
• HIV can enter your body if you share syringes or other sharp injecting instruments with an HIV infected person because these instruments can lead to exchange of blood from the infected person to you.

• HIV can also be transmitted from an HIV infected mother to her child during pregnancy (through blood across the placenta), during delivery (through vaginal fluids or blood) or during breastfeeding (through milk). HIV has also been detected in other body fluids like saliva, tears and sweat, but the concentration of the virus in these fluids is too little for transmission of the virus to take place. Viral concentration is much higher in blood, vaginal fluids, seminal fluids and breast milk.

By having a mutually faithful and monogamous sexual relationship with an uninfected partner. If such a relationship is not possible or preferable, then by practising safer sex with every sexual partner, which involves:

• Using condoms properly and every time you practice certain penetrative sexual acts, specifically anal sex, vaginal sex and oral sex – Condoms and other latex barriers prevent exchange of infected blood, vaginal fluids and seminal fluids during these sexual acts.

A wide range of other sexual acts where chances of exchange of infected blood, vaginal fluids or seminal fluids are minimal and condoms need not be used. For example: Dry kissing, deep or wet kissing, petting and fondling, hugging, body rubbing, massage, licking erogenous zones of the body like ears, neck and thighs, sucking fingers or nipples, thigh sex and mutual masturbation.

A person infected with HIV may look and feel healthy for many years, but can still pass on the virus to others. You cannot tell whether a person is infected with HIV just by looking at the person. The only way to find out for sure is through a blood test. If HIV is detected through the test, the result is said to be “HIV positive”. If not, the result is “HIV negative”. There are several types of blood tests for HIV;

• Enzyme Linked Immuno Sorbent Assay (ELISA) test is the most common and cost effective test. It detects the presence of anti-bodies to HIV in the body. But it takes approximately 6-12 weeks from the time of the infection for the anti-bodies to show up in the body. So the ELISA test is effective only if it is conducted after this time period.
• Western Blot test is also an anti-body based test. It is more accurate than the ELISA test in detecting HIV, but is much more expensive than the ELISA test. Thus in India it is often used only to confirm the results of ELISA tests.
• Spot test is another most commonly used HIV test in India with a high degree of accuracy. It also tests for anti-bodies to HIV.
• Polymerase Chain Reaction (PCR) test is a direct test that looks for viral particles rather than anti-bodies to the virus in the blood. This test is capable of detecting HIV in the blood even within a few hours since the time of infection. But it is an expensive test and is available only in selected laboratories.

A cure for HIV/AIDS has not yet been discovered and prevention remains a crucial weapon against HIV/AIDS. However, the days when AIDS was considered invariably fatal are on their way out. It is increasingly becoming possible to treat HIV/AIDS. HIV/AIDS treatment has broadly two components:

• Treatment for HIV infection through anti-retroviral therapy (ART). If started at the right time and taken regularly, ART can reduce the viral load in the body to negligible levels. However, ART needs to be life-long. If it is stopped, HIV can regain its strength in the infected person’s body.

Early and complete treatment for the opportunistic infections (OI) that invade the body when a person infected with HIV. In India, two of the commonest opportunistic infections are tuberculosis and diarrhoea.

Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) is a Programme to prevent HIV infection to newborns from infected parents and provide treatment and care to all children infected by HIV.

The Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) programme was launched in India in the year 2002.  HIV testing for all pregnant women, initiation of ART for all infected pregnant women, promotion of institutional delivery for all pregnant women and paediatric care and support for all infected new-borns are the main components of the programme.

With effect from 1st January 2014, pregnant women who have found HIV positive being initiated on lifelong ART irrespective of CD4 count and WHO clinical Staging; their newborn (HIV exposed) babies have initiated on 6 weeks of Syrup Nevirapine immediately after the birth which prevent the transmission of HIV from mother to child. The regimen is extended to 12 weeks of Syrup Nevirapine if the duration of the ART of mother is less than 24 weeks.

The HIV exposed baby is initiated on Cotrimoxazole prophylaxis at 6 weeks and tested for HIV DNA PCR at 6 weeks by DBS (Dry Blood Spot) collection. If the DBS sample is positive for HIV DNA PCR, then a repeat DBS sample will tested for HIV DNA PCR. The HIV exposed baby is then initiated on lifelong ART at the earliest if confirmed HIV positive through 2 DNA PCR test.

What PLHIV need is not just treatment, but also self-care, care from their close ones and larger social support. A combination of care, support and treatment can remarkably improve the quality of life of PLHIV

So what constitutes care, support and treatment for PLWHA?

• Antiretroviral Treatment (ART)
• Treatment for  opportunistic infections
• Provision of emotional, social and economic support – not only to PLHIV but also to their families, particularly children.
• Maintenance of general health and well-being through nutritious food, exercise and rest, and stress reduction and management.

Prevention of opportunistic infections through general hygiene, safe food and drinking water, and safeguarding against air-borne infections and diseases like malaria.

As the name suggests, STIs are infections that are transmitted through sexual contact. Like HIV, many STIs are transmitted through unprotected penetrative sex (anal, vaginal or oral). Therefore these STIs can also be prevented in the same way as HIV – mutually faithful and monogamous sexual relationship with an uninfected partner or practising safer sex with each and every sexual partner Limiting the number of sexual partners and maintaining overall personal hygiene (including oral hygiene) are some of the ways to reduce possibility of transmission STIs. There are a large number of STIs known to medical science. Some of the common ones are: Chlamydia, genital warts, gonorrhoea, hepatitis A, hepatitis B, hepatitis C, herpes simplex virus, pubic lice, syphilis and trichomoniasis.

Yes, like HIV, many STIs can be transmitted non-sexually as well. STIs like Hepatitis B and C, herpes simplex virus, syphilis, gonorrhoea and many others can be transmitted through sharing of infected injecting instruments and infected blood and blood products. Some of these can also be passed on by an infected pregnant woman to her child during pregnancy or delivery. STIs like pubic lice can be transmitted through sharing of towels and underwear. Not sharing clothes and maintaining personal hygiene prevents non-sexual transmission of STIs.

Some generic symptoms of common STIs in men:

• Discharge or pus from the penis or anus
• Sores, blisters, rashes or boils on the penis or testicles
• Sores, blisters, rashes or boils in or around the anus or mouth
• Lumps on or near the penis, testicles, anus
• Swelling on the penis or testicles
• Pain or burning during urination
• Itching in and around the genital areas – penis, testicles, thighs, anus

Some generic symptoms of common STIs in women:

• Pain in the lower abdomen
• Unusual and foul smelling discharge from the vagina
• Lumps on or near the vagina or anus
• Pain or burning during penetrative sex (vaginal)
• Itching in and around the genital areas – vagina, thighs, anus
• Sores, blisters, rashes or boils in or around vagina, anus or mouth

Some STIs, particularly in women, can have symptoms inside the body, which cannot be seen. If left untreated, these STIs can cause serious complications like infertility.

As soon as any symptoms that can be associated with STIs appear, or if you suspect that you may have been exposed to an STI, you should immediately consult a dermatologist (skin specialist). The doctor may prescribe some tests, which should be carried out at the earliest. It is also important to complete the entire course of medicines prescribed by the doctor and keep your follow-up appointments. If you don’t complete the treatment, many STIs can recur – more painfully so and cause serious complications!  The key to dealing with STIs is early detection and complete treatment to prevent reinfection. It is also important to treat your sexual partner also to prevent reinfection.

The predominant mode of transmission of both HIV and STIs is sexual (in that sense, HIV is also an STI). The presence of certain STIs in a person is often considered as a marker for potential HIV infection as well. Many of the measures for preventing the sexual and non-sexual transmission of HIV and STIs are also the same. In addition: Many STIs cause ulcers, blisters, sores and boils and most of these are located in / on / around the mouth, penis, vagina or anus. During unprotected penetrative sexual acts, HIV transmission can take place more easily through these openings in the skin or mucous membrane present in these organs. Early and complete treatment of STIs is therefore desirable not only to reduce or prevent the harmful effects of STIs themselves, but also to prevent HIV infection. In people already infected with HIV, STIs tend to compromise the immunity further, making it easier for HIV infection to progress in the body.