What is HIV?
The Human Immunodeficiency Virus (HIV) is a virus which can gradually damage the immune system. Without treatment and over a number of years, the virus can reduce the body’s ability to combat infections and illnesses. However, people who are HIV-positive but receive treatment on time are likely to remain healthy with normal life expectancy.
What is AIDS?
AIDS stands for 'Acquired Immune Deficiency Syndrome'. It is a term used when a person’s immune system begins to weaken due to the damage caused by HIV. This can lead to the development of a number of infections and illnesses. However, this progression to developing AIDS can be successfully stopped if HIV treatment is begun (WHO, 2015).
HIV in Ireland
Around 350 people in Ireland contract HIV each year (Health Protection Surveillance Centre). Around half of them are MSM (men who have sex with men). Just under half of new infections are people aged 25 to 34.
The good news is that most people living with HIV who know that they are infected are taking effective medication. Taking this treatment means that the levels of HIV in the body are kept at very low or ‘undetectable’ levels. This also means that the person will live longer, stay healthier and be much less likely to pass on the virus.
There are a large number of people in Ireland who have HIV, but are not aware of their status. We need to do everything we can to increase the number of people who know that they have HIV to ensure that treatment starts at the right time and these individuals can continue to lead a normal, healthy life. Successful treatment also prevents the virus being passed on to others.
Did you know? …
The faster you start the right treatment, the higher the quality and the longer the length of life you will have.
How can I get HIV?
HIV is transmitted by body fluid to body fluid. The body fluids that can transmit HIV are:
- Semen and pre-seminal fluid (pre-cum)
- Vaginal secretions
- Breast milk
The body fluids that cannot transmit HIV are:
The virus can be transmitted from one person to another sexually (such as through unprotected sex) or non-sexually (such as through sharing needles).
- Vaginal Sex
- Anal Sex
- Oral Sex
If an infected man has unprotected (no condom) vaginal sex with a woman, he can pass on the virus to her through the lining of the cervix, uterus and womb. If she has any cuts or sores (which may not be visible) then the risk of transmission is higher as it makes it easier for the virus to get into the bloodstream. If an infected woman has unprotected sex with a man, she can transmit the virus to him through either a sore or cut on his penis, his urethra or the inside of his foreskin.
Anal sex is riskier than vaginal sex, as the membrane (lining) of the anus is thinner and more delicate than the vagina and therefore more prone to tearing. For both vaginal and anal sex, the receptive partner ("the bottom") is at a higher risk of contracting any STI, than the giving partner.
Oral sex is considered very low risk for contracting and transmitting HIV. This is because saliva has enzymes which break down the virus and because the lining of the mouth is tougher than the vagina or anus. There is a hypothetical risk of transmission if sexual fluids come into contact with sores or ulcers in the mouth or if blood from the mouth comes into contact with any genital sores. This risk is considered extremely small.
The risk of getting the virus through sex is increased if there is any blood present (such as during a woman's period or due to any cuts) or if any partner has another STI or STIs.
- Sharing needles
- Mother to child
- Blood transfusions and products
- Healthcare workers
- Tattoos or piercings
- Needle stick injuries
Sharing needles is a very high risk activity for many blood borne diseases as needles are an efficient way for one person's blood to enter another person's blood stream.
Mothers can transmit many STIs to their newborns either during pregnancy, during delivery or by breastfeeding. There are drugs which can reduce the risk of transmission of these STIs significantly if a mother knows her status early enough in the pregnancy.
It is extremely rare to contract the virus through a blood transfusion carried out in a developed country these days, as all blood donations are routinely screened. However, in countries where blood supplies are not routinely screened, blood transfusion poses a high risk for transmission.
What are the signs and symptoms of HIV?
Many people who become newly infected with the Human Immunodeficiency Virus (HIV) experience symptoms which are very much flu like in nature during the first few weeks. This is a sign that your immune system has noticed something is wrong and is putting up a fight against the new infection. Having these symptoms do not mean that you do have HIV. The only way to know for sure is to get tested.
These symptoms usually occur two to six weeks after transmission. They can last for up to four weeks. Research carried out by the National Aids Trust suggests that 70% - 90% of people who become infected with HIV develop these early symptoms.
Not everyone has symptoms, but when these do occur, most commonly they include:
- Sore throat
- Body rash
Other symptoms can include:
- Joint and muscle pain
- Swollen glands
These symptoms are very common to many illnesses. The only real way to know if you have HIV is to get tested.
Symptoms of HIV over longer periods
After the first stage, there follows a long period where there are fewer symptoms. This is known as the 'asymptomatic stage'. An untreated HIV positive person can look and feel well for the first few years of an infection. They may slowly find that it takes longer to get over colds and other infections. This period can last around 8 to 10 years (without treatment, but much longer if the appropriate treatment is followed). It is during this time that the virus attacks the immune system causing a drop in the CD4 count.
CD4 is a protein found on the surface of a type of white blood cell (T cells) that play an important role in fighting off infections. It is these CD4 cells that send a signal to other cells in the body that an infection is present and needs to be destroyed. As the CD4 count drops and the immune system is weakened, the person may begin to experience signs of other illnesses.
As the CD4 count drops, the person may have entered the third stage: the 'symptomatic stage' during which Infections such as pneumonia and TB are more likely as the immune system is weakened and it can be harder to fight off new infections. Signs of other illnesses can include sudden weight loss, night sweats, an increase in frequency of cold sore outbreaks, swollen glands, tiredness and diarrhoea.
It is during this stage where an immune system cannot cope and other infections occur, that someone may be diagnosed with AIDS (an AIDS defining illness will occur). These days, with appropriate medication, most people with HIV who take the appropriate treatment early and regularly enough will not go on to develop AIDS.
Any of these symptoms can occur in people without HIV, so even at this stage the only way to know is to get tested. You should take a test if you are at risk, even if you have no symptoms. An early diagnosis is important for successful treatment.
Research has also shown that early diagnosis is important as it allows HIV to be monitored and managed so that the person receives the most appropriate care to them. With correct management HIV is no longer the life-threatening illness it once was. Better2Know offers HIV tests that can detect the virus from just ten days after any potential exposure.
Most people do not have signs or symptoms to tell them that they are infected with HIV. However, if they do, the first symptoms can appear within two to four weeks of infection (e.g. Flu-like illnesses, sore throat, swollen glands, rash). This is called a ‘seroconversion illness’. This soon settles down and then most people will have no symptoms until years later.
As HIV becomes more advanced, the symptoms of a weakened immune system start to appear. Common symptoms include:
- Unintentional weight loss
- Chronic diarrhoea
- Recurrent infections e.g. chest infections
- Skin rashes, especially on your face, genitals or anus
- An increase in Herpes ulcers or thrush infections in your mouth/genitals
- Sweats, especially at night
- Unusual tiredness
- Nausea or loss of appetite
- Swollen lymph glands in the neck, groin or armpits.
These symptoms can all be caused by many other common conditions so do not necessarily mean that you have HIV. However, if you experience all or some of these symptoms and you think that you may have been at risk of HIV at any time, it is a good idea to get a test.
You may have been at risk of HIV if you have had any unprotected sex or have taken part in high-risk behaviours. This includes having unprotected sex with different partners, having unprotected sex with someone who is HIV positive, sharing injecting equipment when using recreational drugs or steroids or if you have been given a blood transfusion outside of the UK.
How do you test for HIV?
HIV testing can be tested for either by taking a sample of blood from your arm or by using a finger prick blood test on the end of your finger. Better2Know offers testing from as early as ten days after potential exposure to the virus. Learn more about our testing options here.
HIV Testing Options
Better2Know has a number of HIV Testing options. Which test you choose depends on how long ago you may have been exposed, as well as your own personal preference. The decision is always yours.
HIV takes time before it can be accurately detected. This time between infection and accurate detection is known as the "window" or "incubation" period. It is important you know your incubation period to choose the right test for you.
Better2Know offers four types of HIV test, which can detect the virus at different window periods:
- Instant HIV Test (tests start at 26 days after exposure) a fourth generation test
- 10 Day HIV RNA PCR Test (for exposures that occurred more than 10 days ago)
- 28 Day HIV DUO Test (for exposures that occurred more than 28 days ago), a fourth generation HIV test
We also offer HIV Medical Certificates if you need a certificate for a visa or work.
You may have heard of a third generation, 90 day HIV Test or antibody only test. This is the usual HIV antibody test which many sexual health clinics offer. It is a third generation test.
An antibody is the immune system's response to disease. If you have been infected with HIV, your body will produce antibodies which are typically detectable through testing after three months. Better2Know no longer offers the 90 day HIV test. This is because it is no longer the best test we can offer you. We offer the HIV Duo 28 day test which tests for everything which included in this 90 day test as well as the p24 antigen. Therefore the Duo test is a more accurate test, If you have been advised to retest in three months time, then Better2Know suggests our 28 day HIV test as the most appropriate test for you.
Please visit the individual test pages to find out more about each option.
What if I test positive for HIV?
With early intervention and access to effective medication, HIV is no longer a life-threatening condition. Treatment helps to prevent the virus from causing further harm to the immune system. There are also lifestyle changes you can make to help you to manage the infection.
Should you test positive for HIV, we can arrange an appointment with an HIV doctor for you who will do further tests to confirm your status, look at your CD4 levels and monitor your viral load. Your doctor will use the results from these tests to prescribe the most appropriate medication for you. You will have regular consultations and blood tests to monitor the effectiveness of the medication.
There are many organisations, groups, apps and webpages that can help you to manage your HIV whilst maintaining your wellbeing and lifestyle. If you do test positive for HIV, we can help you to find a support group near you.
It is important to notify your recent sexual partner(s) if you test positive for HIV, to prevent further transmission and enable earlier treatment. You can do so through the Better2Know anonymous partner notification system.
All HIV testing and referral with Better2Know is completely confidential. We will not share your results with anyone without your permission.
If you want to learn more before getting tested, please look at our pre-HIV Test counselling.
Why test for HIV?
Knowing that you are HIV positive is so much better for your long term health as you can start treatment early. This means that you will stay healthy and well for longer, living as long as most people who do not have HIV.
- Treatment is extremely effective and easy to take. There are so many different options now, so it is worth knowing if you have HIV.
- With effective treatment, you are much less likely to pass on HIV. This means that as well as protecting your own health, testing can also improve the wellbeing of others, too.
- The longer someone goes untested and untreated, the higher the likelihood that treatment will not work as well as it would have if it had been started sooner.
- Not having a test does not make the virus go away.
For more help and support, please contact Better2Know or your Doctor.