The human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS). AIDS is no longer a disease of just homosexual men and IV drug users. The rate of HIV infection is increasing most rapidly among heterosexual women, to the point that it is the fifth leading cause of death among women 19–39 years of age. So HIV is no longer a disease of "other people. Everyone has to know how to protect themselves.
For more information, please see also http://www.womenshealth.gov/hiv/ and How to Prevent STDs by ACOG.
How does a person become infected?
The HIV virus is transmitted by blood or semen. Once HIV infects, the virus invades and kills cells of the immune system, making the body less able to fight disease.
HIV infection can happen during sex or by sharing needles used to inject drugs. An infected woman who is pregnant can pass the virus to her baby. Women with HIV who breastfeed also can pass the virus to their babies. Once someone is infected, he or she always will carry the virus and can pass it to others.
People may become infected with HIV if they are exposed to infected blood or blood transfusions during a medical procedure. This was not known until 1985, so persons who received blood transfusions before then could have been infected this way. Since that time, blood has been carefully screened prior to transfusions so now the risk is very low.
Health care workers exposed to blood and body fluids of an infected person may become infected that way.
HIV is NOT spread by: Hugging or kissing or touching, Sharing a hot tub, swimming pool, steambath or sauna, being exposed to a cough or sneeze of an infected person, or to their tears or sweat, touching their bedsheets, toilet seats that they've used, telephones or doorknobs, or sharing food or drink with them.
In short, HIV cannot be spread by casual contact with people and objects because the virus cannot get through skin that is not broken.
What are the symptoms of HIV infection?
Shortly after an infection with HIV, some people get a flu like illness. Then they may have no symptoms for months to even years. It often takes 3 months or so for antibodies to the virus to show up in their blood. As the HIV attacks the white blood cells of the immune system ("CD-4 cells") and it begins breaking down, people infected with HIV may have weight loss, fatigue, and fever from infections with other bacteria and viruses that they would normally be able to fight off.
HIV becomes AIDS when a person develops specific infections or symptoms that result from low or malfunctioning CD-4 cells, or when the CD-4 cell count drops to a certain low level. This is often a several years after the infection (on average 11 years). During this time the person appears healthy, might not know they have HIV, and can be spreading it to others during that time.
HIV results in severe problems over time, because it makes the body very prone to infections that it would otherwise be able to fight off. Sometimes these infections can be treated, but without a healthy immune system, they often come back.
Most women get the HIV virus by using IV drugs or having sex with men who use such drugs. However, the number of women infected by heterosexual activity has been increasing.
During sex, the virus is spread more easily from men to women than from women to men. The risk of spreading HIV from woman to woman during sex is not known, but it is thought to be low.
How do I get tested?
A simple blood test can tell you whether you have been infected with HIV. It looks for HIV antibodies in the blood.
Women's Health Connection offers a rapid screening test produces very quick results (in about 20 minutes). It often takes about 2 weeks to get results from other types of screening tests. No matter what type of test is taken, if the test result is positive, another test is used to confirm the results.
Women and men aged 19–64 years should be tested for HIV every year. You may have counseling before the test, after getting the results, or both. Pregnant women should be tested for HIV.
A negative test result means that HIV antibodies were not detected in your blood. These usually take 6-12 weeks to show up 6–12 weeks after a person is infected. Sometimes it may take longer. For this reason, you may want to take a second test after about 6 months to be sure to get an accurate result. Whether your results are positive or negative, you should still protect yourself by stopping any behavior that could pose a risk.
What if the results of my HIV test are positive?
A positive test result means that you are infected with HIV and can pass the virus on to others. You will need to get special health care and take precautions to prevent further spread of this virus. Your physician will help you arrange these.
Other important steps:
- Tell all sex partners, past and present
- Do not share needle to inject drugs (if you have, tell the people that you shared them with)
- Practice safer sex (hyperlink)
- Never arrange to be an organ donor.
- Do not share razors, toothbrushes, or other appliances that might have blood on them
- Tell every health care provider who treats you that you are HIV positive
- If you are pregnant, there are measures you can take to prevent your newborn from developing HIV/AIDS
How do I prevent HIV infection?
The best way to help prevent the spread of HIV infection during sex is by practicing safer sex (hyperlink "practicing safer sex".) This includes using barrier contraception (latex condoms) so that your partner doesn't get HIV from you, in addition to the oral contraceptive pill, or tubal ligation or any other form of birth control you have in place.
How is HIV treated?
There is no vaccine to prevent HIV infection, and there is no cure for AIDS. People are, however, now living many years with their disease. Medications are available that fight HIV–related infections and help protect the immune system. In most cases, many medications are used together. Your doctor will work with you to determine what medicines to take, when to take them, and how much to take of each. Taking these exactly as prescribed can improve the quality and quantity of your life.
A woman infected with HIV is more likely to get vaginitis, especially yeast infections and pelvic inflammatory disease (hyperlink). They can be harder to treat, occur more often and be more severe.
If you are infected with HIV, you should be tested for other STDs, and should be vaccinated against hepatitis B, influenza, HPV and pneumonia if you are not immune to these diseases. Some cancers, such as cervical cancer, are more common in women who are infected with HIV. So HIV infected women should have more regular PAP smears, at least yearly.
Any special concerns for pregnancy and childbirth?
During pregnancy, all women should be tested for HIV as early as possible. If you are pregnant and infected with HIV, you can infect your baby. Without treatment, this risk is 25%, with treatment, it is much lower. Also, cesarean delivery may be recommended for some women, and breastfeeding should be avoided. Special prenatal care is needed.
Take home message
HIV is no longer a disease of "other people". All women between ages 18 and 65 should be screened every year, and other women should, based on risk factors. Every woman needs to know how to prevent this disease and protect herself.
