HIV: Misconceptions and Treatment

Human Immunodeficiency (HIV) and Acquired Immune Deficiency Syndrome (AIDS) are taboo subjects in many countries, and are often misperceived. As mentioned in a previous article, HIV and AIDS are not the same, but people often misuse the terms as it refers to the same disease. The progression of HIV may lead to AIDS in serious cases; but currently, with help from certain medications such as antiretrovirals, the level of HIV in the body can be suppressed. These drugs also help keep the body healthy and strong in order to reduce the risk of transmission and the progression to AIDS.


(Picture credits: European Aids and Treatment Group)


Misconceptions and Transmission


There are three main routes in which HIV can be transmitted: sexual contact, exposure to body fluids (such as seminal fluid), and from mother-to-child transmission (during the pregnancy, childbirth or breastfeeding). HIV can only survive outside the human body for a short period of time and requires a human host in order to reproduce; therefore, HIV is not transmitted via air or water, tears, sweat and saliva (as long as it is not mixed with the blood from an HIV positive person).


As stated by the National AIDS Trust, anyone who is sexually active can become infected by the virus regardless of their sexuality (although HIV cannot spread via sexual activities that do not include the exchange of body fluids); however, gay and bisexual men have the highest risk of contracting HIV, and according to AIDS.gov they account for 67% of all diagnoses due to anal sex. In addition, there is a low risk of contracting HIV from performing oral sex but it is best to avoid doing so when a person has mouth sores or any oral bleeding.


Another common misconception is that some HIV-positive people believe that they can have unprotected sex with their HIV-positive partners. This is a dangerous misunderstanding as there are various strains of HIV, and if a person is infected with more than one strain, it can intervene with their treatments and can lead to a deterioration in health.


Some also believe that HIV can be transmitted through blood-sucking insects. Although insects, such as mosquitoes, act as vectors which can carry HIV positive blood, HIV cannot replicate inside its gut and thus, is broken down. Also, when an insect bites, only the saliva is injected into the human body, not its blood.




Forms of Treatments


According to the World Health Organisation (WHO), as of 2015, around 36.7 million people are living with HIV and 18.2 million are on anti-retroviral treatment. Nowadays, many different types of treatments are available, which have been adapted for individual requirements. Treatments involve the daily intake of a combination of medications which help fight and suppress the infection. An example is the antiretroviral therapy, commonly known as ART. The combination of different medicines help prevent the HIV from making copies of itself (such as Nucleoside/ Nucleotide Reverse Transcriptase Inhibitors - NRTIs) and also reduces the levels of HIV in the body, which allows the immune system to recover and become strong enough to fight diseases. As stated by the WHO, there is a 96% reduction in the risk of transmitting HIV to the uninfected sexual partner as long as their HIV-positive partner comply with the ART regimen. However, despite the effectiveness of the ART, there is still no cure for HIV; therefore, the use of condoms and the safe disposal and sterilisation of injecting equipments should be used and practised in accordance with ART in order to reduce the risk of transmission as much as possible.


In addition, other antiretroviral drugs (ARV) play an instrumental part in the prevention of HIV. These include the Pre-exposure prophylaxis (PrEP) for HIV-negative partners, or those with occupational exposures to HIV. PrEP is an oral drug which is an anti-HIV medication taken by individuals prior to coming into contact with HIV. However, it is not to be confused with a sexually transmitted disease or pregnancy prevention and it does not completely remove the risk of infection. The effectiveness of PrEP depends on the amount an individual takes on a regular basis, and the continuous consumption of PrEP (seven per week) can have a 99% protection rate; however, side effects of the drug include weight loss, nausea and headaches.


Another ARV is the Post-exposure prophylaxis (PEP), which is an oral drug that should be consumed within 72 hours of (possible) exposure to HIV in order to prevent the risk of transmission. The earlier the intake of PEP, the more effective it is. PEP also includes a 28-days course of ARV drugs, medical counselling, HIV tests and follow-up care, but is not 100% effective.




What to do


Despite the effectiveness of ART and ARVs, the best way to reduce the risk of HIV transmission is to be careful when dealing with, or the potential exposure to, HIV-infected blood, since there is no 100% cure; bearing in mind that immune impairment can lead to AIDS. If an individual finds themselves in a situation where they feel like they might have been exposed to HIV, they should get tested immediately, either by an antibody test, combination test (antibody/ antigen test) or a nucleic acid test for clarity, and to control the virus as effectively as possible. In some countries, an HIV home-kit can be requested online and sent back to the clinic if an individual feels more comfortable in doing so.


For individuals who are HIV-positive, it is important to adhere to the ART regimen as it will improve the chances of survival, as well as their quality of life and health. There are also may types of support available for those who struggle to cope with an HIV diagnosis, such as mental health and financial help.


It is also important that individuals are not embarrassed or scared to seek advice and help, as HIV tests can either be confidential or anonymous, and are treated like any other private medical information.



Links:

AIDS.gov

Mint is from Bangkok but currently attends high school in the UK. She is interested in medicine and global health, and aspires to become a doctor. Over the summer, Mint visited both public and private hospitals, which led her to do some research on the corruption within the healthcare system in Thailand as well as the UK. She also started an HIV Awareness Project in conjunction with local hospitals and health centres, which aims to educate the youth about HIV, as it remains a taboo subject in many countries. In her free time, Mint also enjoys playing golf and tennis.

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