Tuesday, September 27, 2011

HIV 101


Because of the research projects I am currently interning for, I have been thinking/reading about HIV-related topics for the past 5 months. I think it would be negligent of me to not make a HIV 101 post. Conducting and listening to interviews of study participants has made me cognizant of how little people still know about HIV, how it is transmitted, how they can protect themselves and what is available (in NYC) to those who become HIV positive. So I am going to start with a basic HIV 101 post and in the future, I will post more in-depth analyses of HIV-related topics.

Note: For this post, I am going to list the links I used at the end instead of sprinkling them throughout the post like I usually do. This is to ensure a more fluid post.

What is HIV and What Does It Do?

HIV stands for Human Immunodeficiency Virus. HIV attacks the CD4 cells aka T-cells in the immune system. These cells usually assist the body in fighting off infections and diseases and without them, the body is defenseless against opportunistic infections. An opportunistic infection is an infection that the body is usually able to fight without a problem, but because HIV has weakened the immune system, the infection seizes this opportunity and attacks the body. At this point, HIV turns into AIDS, which stands for Acquired Immunodeficiency Syndrome. With AIDS, the immune system is seriously damaged and the individual dies from opportunistic infections. For the record, HIV does not have to progress into AIDS. In this day and age, an individual can take medication and live a long and otherwise healthy life with HIV without it progressing into AIDS.

How can HIV Be Transmitted?

The fluids that have a high risk for transmitting HIV are blood, semen (cum), breast milk and vaginal fluid. Pre-seminal fluid (precum) that is released during sexual intercourse can also transmit HIV. To clear things up, HIV CANNOT be transmitting from the following: saliva, tears, sharing food, utensils, cups and bathrooms with a HIV-positive person, hugging, breathing, coughing and sneezing. HIV cannot be transmitted through the air and HIV cannot survive for long outside of the body. HIV is a virus and, like a parasite, desperately needs a living host in order to survive. The only way for HIV to be successfully transmitted is if the infected fluid comes directly in contact with wounds, tears and lesions.

Risky Behaviors

Unprotected Receptive Anal Sex (Bottoming) – The anus is not made for sexual intercourse the way the vagina is. The lining of the anus is very thin and prone to tearing and infected semen can get into the broken skin. Receptive Anal Sex is inherently riskier than insertive anal sex because the bottom is receiving the potentially infected semen from the top.

Unprotected Insertive Anal Sex (Topping) – Infected blood from tears in the bottom’s anus can get into the urethra and into any tears/open sores on the penis.

Unprotected Vaginal Sex – The vaginal wall can also tear and HIV can be absorbed through the mucous membranes of the vagina and cervix. And infected blood and vaginal fluid can get into the urethra and any tears/open sores on the penis.

Unprotected Oral Sex – This is the least common way to transmit HIV. Risk increases if the person has cuts in their mouth. It is recommended that a person does not brush their teeth or floss right before or after unprotected oral sex. Bleeding gums could ease the transmission of HIV.

Having another STI (sexually transmitted infection), like herpes, could increase the risk of HIV transmission because of the possibility of having open sores or the effect that the STI may have on the immune system.

Sharing needles and other injecting drug equipment – Residual blood left on drug paraphernalia can spread HIV.

Prevention

Obviously abstinence is the best prevention of HIV and other STIs, but let’s be realistic. Most people aren’t just going to stop having sex so here are other ways to prevent HIV transmission.

Contraception

Condoms stop the spread of fluids by creating a protective barrier. Dental dams, like condoms, provide a protective barrier when performing oral sex on a vulva and/or rimming (licking someone’s anus). Also latex gloves can be used if a person has cuts on their fingers or long nails and wants to finger another person’s vagina or anus. Lube decreases the likelihood of tears in the vagina and anus, reducing the likelihood of fluid transmission. Proper lube use is also important. DO NOT use oil-based lubes!!! Oil breaks down the latex in condoms and gloves, making them useless and ineffective. Examples of oil-based lubes are: lotion, cooking oils (i.e. Crisco), and baby oil. Again, DO NOT USE THESE!!! Water-based and silicone-based lubes are perfect for sex and do not break down latex. These lubes are usually sold as sex lubes and can be found at your nearest drugstore/pharmacy/sex shop. Two quick notes: If you are susceptible to yeast infections, avoid water-based lubes that contain glycerin. And do not use silicone-based lube with silicone sex toys, it will eat away at your toy, rendering your expensive sex toy useless. Speaking of sex toys, be sure to clean your sex toys after every use, especially if you use your toys on multiple people.

PrEP

PrEP stands for Pre-Exposure Prophylaxis. It is another form of HIV prevention in which HIV negative people, who are at high risk for contracting the virus, take a low dose of antiretroviral medication (A type of HIV medicine.) every day in order to try to decrease their chances of becoming infected. According to the CDC, PrEP has been shown to be effective with men who have sex with men (MSM) and heterosexual men and women.

Statistics From the Center for Disease Control  (Who Is Most At Risk?)

In future blog posts, I will go into why these populations are more susceptible than others, but this is a HIV 101 post so I want to give basic information.

MSM

“Gay, bisexual, and other men who have sex with men (MSM) represent approximately 2% of the US population, yet are the population most severely affected by HIV and are the only risk group in which new HIV infections have been increasing steadily since the early 1990s. In 2006, MSM accounted for more than half (53%) of all new HIV infections in the United States, and MSM with a history of injection drug use (MSM-IDU) accounted for an additional 4% of new infections. ”

Women

“In 2009, there were an estimated 11,200 new HIV infections among women in the United States. That year, women comprised 51% of the US population and 23% of those newly infected with HIV.”

“For women living with a diagnosis of HIV infection, the most common methods of transmission were high-risk heterosexual contact and injection drug use.”

“In 2009, the rate of new HIV infections among black women was 15 times that of white women, and over 3 times the rate among Hispanic/Latina women.”

African-Americans

By race/ethnicity, African Americans face the most severe burden of HIV in the United States (US). At the end of 2007, blacks accounted for almost half (46%) of people living with a diagnosis of HIV infection in the 37 states

Hispanics

While Hispanics/ Latinos represented approximately 15% of the United States (US) population in 2006, they accounted for 17% of new HIV infections in the 50 states and the District of Columbia during that same year.

Youth

An estimated 8,300 young people aged 13–24 years in the 40 states reporting to CDC had HIV infection in 2009.”

“Nearly half of the 19 million new STDs each year are among young people aged 15–24 years.”

I Just Seroconverted. Now What?

To seroconvert is to become HIV positive. With the introduction of better HIV medications and a greater understanding of the virus, individuals who are HIV positive are now able to live full relatively healthy lives. There’s no cure for HIV, but there are treatments to decrease likelihood of transmission and to deal with complications resulting from opportunistic infections. There are public health services that cater to HIV positive individuals, like ADAP (AIDS drug assistance program that provides health insurance), psychological therapy, housing assistance, and substance abuse services. New York State, especially, is well known for its services. Two NYC centers that I have personally heard amazing things about are GMHC and Harlem United. Also check the Department of Health for more information. You are not alone.

Important Phone Numbers:

  • NYS HIV/AIDS Hotline - 1-800-541-AIDS
  • NYS TTY/TTD HIV/AIDS Information Hotline - 1-212-925-9560
  • NYS HIV/AIDS Counseling Hotline - 1-800-872-2777
  • NYCDOHMH HIV/AIDS Hotline - 1-800-TALK-HIV
  • Confidentiality - 1-800-926-5065
  • Legal Action Center - 1-212-243-1313; 1-800-223-4044
  • NYS Division of Human Rights - 1-800-523-2437; 1-212-306-7500



Reference Links:

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