Frequently Asked Questions

What is HIV and how does it affect us?

HIV/AIDS is different from other illnesses because:

• HIV/AIDS affects people at the most productive age (15-49 yrs.)
• AIDS is incurable at the moment, particularly killing younger people.
• There are no specific symptoms in the initial years. So, the HIV infection goes unnoticed for several years. That is why AIDS is called a silent killer.
• HIV infection is preventable.
• Stigma and discrimination associated with HIV/AIDS hinders with the prevention as well as care and support efforts.
• It predominantly spreads through sexual contact. Sexual behaviour being in private domain, people don't want to talk about it. Discussion on sex is a taboo in most of societies. Hence, correct information does not reach people.

We all need to know about HIV/AIDS as it can happen to any one. Everyone can play a role in prevention of this infection.

HIV stands for:

H= Human
I  = Immuno-deficiency
V = Virus.

• HIV, after entering the human body, gradually destroys the immune system, i.e. the ability to fight infections/diseases .
• As it is a human virus. It is found only in human beings.

There are no immediate and specific symptoms of HIV infection, generally. HIV infection does not mean that a person has AIDS

AIDS stands for:

A = Acquired
I   = Immune
D = Deficiency
S = Syndrome.

• AIDS is the later stage of infection with HIV. It is a condition in which a group of symptoms appear as the immune system becomes very weak.
• It may take around 10-12 years from the stage of HIV infection to the stage of AIDS. This time varies from person to person, based on health status, life styles and ability to afford the treatment.
• With the introduction of Anti Retroviral Treatment (ART), this duration can be further increased.

HIV infected people can live productive lives for years. Life span of HIV positive people can be extended with the ART.

HIV can be transmitted through:

• Unprotected sex with an infected person;
• Transfusion of infected blood or blood products;
• Sharing of infected needles or syringes; and
• Infected mother to her child - during pregnancy, during birth or after delivery through breast milk.

These are the only four known routes of HIV transmission. This is because HIV is found in high concentration in blood, semen, vaginal secretions and breast milk.

HIV does not spread through social contacts like: shaking hands, sharing equipment, eating from the same utensils, sharing toilets etc.

• No. Mosquito does not inject its own or previously bitten person's blood into the next person. Mosquito injects saliva, which acts as a lubricant so the insect can feed efficiently. HIV is not found in the saliva of mosquitoes.
• Diseases such as yellow fever and malaria are transmitted through the saliva of specific species of mosquitoes but not HIV.

In simple terms, mosquito does not become a carrier of HIV after biting an infected person. Therefore, mosquito does not transmit the HIV infection from person to person.

• There may be a possibility of a risk in any situation in which skin piercing instruments are used, like in a barber's shop, beauty saloons, tattooing, nose and ear piercing etc.

Centre for Disease Control, Atlanta, recommends that instruments that are used to penetrate the skin should be used once then disposed off or thoroughly cleaned and sterilized.

A person can avoid being infected by HIV through sex by:

• By abstaining from sex; or
• By having a faithful relationship with one partner (mutual faithfulness); or
• By using condoms correctly and consistently

Casual sex and sex with multiple partners is a high-risk behaviour. Anal penetrative sex has a higher risk. Oral sex can also be risky Looking at a person you cannot know whether he/she is infected or not. So, better avoid casual sex or use condom consistently and correctly avoid sex under the influence of alcohol and drugs.

• Open mouth kissing is a low-risk activity, as the concentration of HIV is very low in saliva.
• HIV is not casually transmitted, so kissing on the cheek is very safe. Even if the other person has the virus, unbroken skin is a good barrier. No one has become infected from social contact such as dry kisses, hugs, and handshakes.
• Prolonged open-mouth kissing could damage the mouth or lips and allow HIV to pass from an infected person to his/her partner(s).

Kissing in presence of bleeding gums or ulcers in mouth can be risky.

• Presence of Sexually Transmitted Infection (STI) can increase a person's risk of becoming infected with HIV, about 3 to 10 times, depending upon the nature of STI.
• STI’s may cause discharge from the genitals or sores/ulcers on the genital areas. These conditions provide easy entry point to the HIV.

STI’s can be cured while HIV infection can not be. So, timely treatment of STIs is essential.

People have several myths about STI’s. They need to know the symptoms of STI’s and take treatment from registered medic al practitioner.

Use of condoms protects from both STIs as well as HIV infection.

STI symptoms in men:

• Discharge or pus from the penis.
• Sores, blisters, rashes or boils on the penis.
• Swelling in the genital area
• Pain or burning during urination.
• Itching in and around the genital area.

STI symptoms in women:

• Unusual and foul smelling discharge from the vagina.
• Sores, blisters, rashes or boils around the genitals.
• Pain in the lower abdomen.
• Lumps on or near the genital area.
• Pain or burning during sexual intercourse.
• Itching in and around the genital area.

It is important to know these symptoms and take immediate treatment. Self medication needs to be avoided.

It is important to take the full course of prescribed treatment, even if the symptoms disappear.

As sexual partner(s) may also have the same infection, it is important get the partner(s) treated as well.

• In case of injury requiring blood transfusion, blood should be taken from a licensed blood bank.
• All blood collected for donation is now tested for HIV also;
• Hospitals/ nursing homes, doctors and paramedical staff need to make sure that the equipment for injections and operation is properly sterilized. Unnecessary blood transfusion needs to be avoided.
• People should also insist on use of sterilized syringes/ disposable syringe for injections.
• Injecting drug users should avoid sharing of needles/syringes.

To prevent HIV infection through this route, both individuals as well as health care providers must take precautions. There is no risk in donating blood.

• There is 25-40% chance that an infected pregnant mother would pass on the infection to her child.
• If the couple knows their status, they could decide whether or not to have the child.
• In case, couple wants to have the child or it is a very late discovery of mother's status, the couple should receive information and counseling, and explore the following options:
• Mother could take the available treatment, both for herself and the new born child.
• Couple could opt for the caesarian delivery instead of the normal delivery.
• Couple could decide not to breast feed, if it is affordable and discuss options available in consultation with the doctor/counselor.

Mother to child transmission of HIV can also be prevented. The couple needs to know the available options and act upon them.

AIDS is a condition of weakened immune system. In this symptoms of various opportunistic infections appear causing certain cancers, tumors, tuberculosis, pneumonia, brain and skin related problems.

According to WHO, main signs/symptoms are:

(A) Major Signs:

• Weight loss (> 10% of body weight)
• Persistent fever for longer than a month
• Chronic diarrhea for longer than a month

(B) Minor Signs:

• Persistent cough
• General itchy skin diseases
• Thrush in mouth and throat
• Recurring shingles (herpes zoster)
• Long lasting swelling of the lymph glands

Only on the basis of symptoms, HIV/AIDS cannot be confirmed. A blood test is necessary.

• Our immune system produces antibodies to fight any infection. Window period is the time taken by the human body to produce antibodies in the quantity that it can be detected through blood test.
• It takes about 3-12 weeks (upto 6 months in some cases) after HIV infection to form antibodies in detectable quantity.
• In simple terms, window period it is the period in which a person is infected but his/her test result does not show it.

During window period the HIV status does not show in the test but the person can infect others.

• There is no cure available for HIV/AIDS at the moment.
• However, Anti Retroviral Therapy (ART) can prolong the life of a HIV positive person.
• Once started, these drugs have to be taken life long.
• These drugs are expensive and may have severe adverse reactions.
• The ARTs need to be administered under supervision of doctors who are trained in HIV case management.

With the advent of ART, HIV/AIDS has become a medically manageable Problem.

• It is safe to work with a HIV positive person as HIV does not spread through social contacts like shaking hands, sharing equipment, traveling in the same bus, eating together, using the same toilets etc.
• Mosquitoes and insects do not spread HIV nor is it spread through water or air.
• Even workers, who come in contact with the body fluids more like the doctors or para-medical persons, need not panic. They should follow universal precautions and infection control measures like gloves, masks, etc.

HIV positive people pose no risk to their co-workers.

• HIV status of a person should not be a criterion for either employing people or keeping them in employment.
• There should be no discrimination of People Living with HIV/AIDS (PLHA).
• HIV status of people should be kept confidential.
• Workplace should have HIV prevention, care and support programme.
• As women are more vulnerable and HIV affects women more adversely, the gender dimension should be suitably addressed.

The ILO Code of Practice on HIV/AIDS and the world of work provides guidelines for developing policy and programmes against HIV/AIDS in the world of work. The ILO Code can be seen at www.ilo.org/aids

• We should not isolate the infected person, as he/she does not provide any risk to us through social contacts. We can work, eat as well as live with the person.
• We should not pass moral judgments on the person.
• We should work for reducing stigma and discrimination related to HIV/AIDS by spreading correct information, dispelling myths and having a positive attitude towards the infected person(s).
• Supporting the person in staying active and economically productive.
• Providing the necessary care and affection and support to the family.

Non-discriminatory attitude towards PLHA helps in HIV prevention efforts. People can live with HIV infection for years. They need care and support, not isolation.