HIV/AIDS Questions & Answers
What is HIV?
HIV (Human immunodeficiency virus) is the virus that causes AIDS (Acquired immune deficiency syndrome). It is a retrovirus that infects several kinds of cells in the body, the most important of which is a type of white blood cell called the CD4 lymphocyte (also know as the T-Cell.)
The CD4 cell is a major component of the human immune system that helps protect you from many infections and some cancers. HIV can effectively disable your body's immune system and destroys its ability to fight diseases.
Two major types of HIV have been identified: HIV-1 is the cause of the worldwide epidemic, HIV-2 is found mostly in Africa. At least ten different sub-types of HIV-1 have also been found. Most people infected with HIV eventually develop AIDS as a result of their infection.
How is HIV transmitted?
HIV is a blood borne pathogen, which means that when the virus is present in a person's blood it may be transmitted through exposure to that blood.
The most common means of exposure are semen and vaginal fluid (including menstrual blood) from unprotected sex or through exposure to blood from injection drug use (via contaminated needles or syringes).
HIV can also be transmitted from mother to child through birth or by breast feeding.
What are the symptoms of HIV?
Some people who contract HIV initially experience very strong symptoms, but others experience none at all. Symptoms can occur within days or weeks of exposure to the virus and are often referred to as "flu-like".
When symptoms do occur they may include recurring fever or profuse night sweats, swollen lymph glands in the armpits, groin or neck, dry cough, diarrhea or fatigue.
What will HIV do to me?
HIV damages your immune system and, when left to it's own, will eventually destroy it's ability to protect your body.
When HIV enters the bloodstream it primarily infects white blood cells called T4 lymphocyte cells (helper cells). In a healthy person, the normal range of these T4 cells is usually between 600 and 1200 per cubic millimeter.
People who are infected with HIV and not experiencing symptoms usually have a lower than normal T4 cell count. People diagnosed with AIDS generally have between 0 and 350 T4 cells per cubic millimeter.
HIV not only reduces the number of T4 cells, it also impairs their functioning. HIV-infected individuals with low T4 cell counts tend to have more serious infections.
How do I know if I'm infected?
You can't rely on symptoms to know if you're infected with HIV. Many people who contract the virus don't experience noticeable symptoms for many years.
The only way to know if you are infected with HIV is to be tested. HIV tests are easily available and often free at various locations.
What are the tests for HIV?
There are different types of tests for HIV. The standard text is EIA (enzyme immunoassay), often referred to as "ELISA". EIA is a standard screening test used to detect the presence of HIV antibodies through either a blood test or oral swab.
The EIA should never be used alone to diagnose an HIV infection. The reason is because EIA produces true negatives (which means that a negative test result is accurate), but it can also produce false positives (which means that a positive test result may be caused by something other than HIV).
Positive EIA tests should be used in conjunction with a confirmatory test such as Western Blot (WB). A positive EIA result plus a negative WB result is an "negative" test. A positive EIA result plus a positive WB result is an "positive" test.
Where can I get tested?
A lot of places provide testing for HIV infection. Common sites include local health departments, free clinics, offices of private doctors, hospitals, and sites specifically established to provide HIV testing.
It is important to locate a test site that has the ability to answer your questions and provide counseling about HIV and AIDS. Counselors can not only answer questions you might have about the virus as well as ways you can protect yourself and others, but they can also help you understand the meaning of your test results and describe what HIV/AIDS-related resources are available in your local area.
How long should I wait to get tested?
The most common HIV test (EIA) detects antibodies that your body produces to fight the virus. Most people develop enough antibodies to be detected within 3 months after infection (the average is 25 days, but in rare cases can take up to 6 months).
If you may have recently been exposed to HIV, don't wait to be tested. When contacting a test site, inquire if they offer the PCR (polymerase chain reaction) test. A PCR can detect more recent infections. If not, the EIA will provide your HIV status as of 3 months prior to the test date.
If your EIA test results are negative, repeat the test 3 months after the possible exposure. If the results of your second test are negative, you can be confident that you were not infected.
What's the difference between confidential and anonymous tests?
There is an important difference between "confidential" and "anonymous" HIV tests. It is not determined by the type of test, but rather policies of the test site and/or laws governing your area.
With confidential testing you must provide your identity and the test result becomes part of your medical record which, by law, can only be released with your written permission. Confidential testing is a good option for people who need an official copy of their test result with their name on it.
Anonymous testing leaves no paper trail. When you have an anonymous test you are known only by a number and the only person who learns the results is you. Anonymous HIV tests are not available in all states.
What are rapid tests?
Rapid HIV tests produce quick results, usually in about 20 minutes. In comparison, results from screening tests with private physicians are normally available in 1 to 3 days, and with public health clinics in 1 to 3 weeks.
The rapid test may be performed by swabbing the gum for oral fluid, a finger stick or whole blood and is considered as accurate as the EIA. Both the rapid test and EIA look for the presence of antibodies to HIV.
As is true with all screening tests, a reactive rapid HIV test result must be confirmed before a diagnosis of infection can be given.
What's the difference between HIV and AIDS?
HIV is a retrovirus that is passed from person to person. It can effectively disable the body's immune system and destroy its ability to fight diseases. If a person is infected with HIV, they do not necessarily have AIDS.
AIDS is a condition of a person's immune system. An HIV-infected person receives an AIDS diagnosis after developing one of the Center for Disease Control and Prevention (CDC) defined AIDS indicators.
An AIDS diagnosis can be given on the basis of certain blood tests such as CD4 counts. A CD4 count of less than 200 or less than 15% indicates a severely damaged immune system and an AIDS diagnosis.
Also, the presence of an Opportunistic Infection, regardless of the CD4 count, results in an AIDS diagnosis. A diagnosis of AIDS can only be made by a physician.
What is an opportunistic infection?
An Opportunistic Infection is one of a group of illnesses that occurs in people with damaged immune systems. The infection essentially takes advantage of weakened immunity, hence the term "opportunistic".
People with HIV that develop ordinary infections, like colds or the flu, do not necessarily have an Opportunistic Infection. If a germ is powerful enough to infect healthy people, then it isn't considered "opportunistic". People with healthy immune systems do not develop Opportunistic Infections.
Can I be tested for AIDS?
People sometimes erroneously refer to an HIV test as an "AIDS test". These are different tests that provide different diagnosis. An HIV test only determines if the person has been infected with the virus. It cannot provide an AIDS diagnosis.
If a person is infected with HIV, they can (and should) be tested regularly to check the status of their immune system. One such test is a "CD4 count". If their CD4 count falls below 200 or 15% per cubic millimeter, they receive an AIDS diagnosis. For that reason, the CD4 count might be referred to as an AIDS test.
A person who is not infected with HIV cannot be tested for AIDS.
Is treatment available for HIV/AIDS?
The good news is there are increasingly effective treatments that slow the progress of HIV and prevent or control the loss of cellular immunity that leads to many of the opportunistic diseases.
Even for persons who have lost much of their immune system, there are medications that can prevent or forestall complications. For example, the chances of getting Pneumocystis carinii pneumonia (PCP), a potentially life-threatening lung infection, can be nearly eliminated even for people diagnosed with AIDS by PCP-prevention treatment.
The key is knowing your HIV status. You cannot fight HIV if you don't know you're infected.