Did you know that some of the early symptoms are often mistaken for the flu?
Most people have a pretty good idea of what HIV is: an easily transmitted viral infection that attacks the body’s immune system. The virus is typically passed from one person to another by way of bodily fluids. So, any activity in which you come into direct contact with another person’s bodily fluids—such as sex (including oral and anal), sharing of intravenous needles for drug use, childbirth and breastfeeding, or contact with infected blood—puts you at high risk of acquiring the illness, especially if you don’t know if the other person is HIV-positive.
“HIV is principally spread by sexual contact, and anyone who has unprotected sexual intercourse could possibly be HIV-infected,” says John Bartlett, M.D., director of the AIDS Research and Treatment Center at the Duke University School of Medicine. “And once acquired, it is a lifelong infection.”
If left untreated, HIV can destroy so much of your immune system that your body can no longer fight off subsequent infections and cancer, eventually leading to acquired immune deficiency syndrome (AIDS) and death, he says. Although the HIV/AIDS infection and survival rates were bleak in the past, new advances have made it possible to keep the virus under tight control. Unfortunately, many people don’t know this information exists, and medical professionals all over the country are working to raise awareness of HIV in hopes of one day eradicating it altogether.
Because it’s only through a deeper understanding of the virus that you can truly protect yourself against infection, here are six HIV/AIDS facts that medical professionals want you to be informed about right now—whether you believe you’re at risk or not.
On a national scale, women’s numbers look pretty good: According to the CDC, only one-quarter of the people living with the virus in the U.S. are female. In 2015, women accounted for 19 percent of the 39,513 new HIV diagnoses in the United States. That’s about 7,402 women—a number that has actually been on the decline in the past few years.
When you take a step back and view the number of women affected by HIVAIDS from a global perspective, however, the statistics are staggeringly different. AIDS research foundation amfAR reports that in 2016, approximately 17.8 million women around the world were HIV-positive—that’s 51 percent of all adults in the whole world who are infected by the virus.
The main cause of transmission, globally speaking, is unprotected heterosexual intercourse. “Assuming a lack of prevention method, such as condoms or medicines to prevent HIV, women have a higher risk for getting HIV during vaginal sex than men do, and the riskiest behavior for getting HIV is receptive anal sex,” says Hilda Morales, N.P., a nurse practitioner in the HIV/AIDS Center at Montefiore Medical Center.
“In a behavioral survey of heterosexual women at increased risk of HIV infection, 92 percent of HIV-negative women reported having vaginal sex without a condom in the previous year, and 25 percent reported having anal sex without a condom,” she says.
Having protected sex is one of the most widely recommended ways to safeguard yourself against HIV, but it’s certainly not the only way. Thanks to the wonders of modern medicine, high-risk HIV-negative women now have the option to take TRUVADA, a type of prescribed medication called pre-exposure prophylaxis, or PrEP, which is more than 90 percent effective in preventing the virus when taken daily.
“It’s no longer just about how you should use condoms if you’re sexually active, or use clean needles if you inject drugs,” says Carlos Malvestutto, M.D., assistant professor in the division of diseases at The Ohio State University Wexner Medical Center. “There are new medications that are going to be coming out in the near future as well as TRUVADA, which is two drugs combined in one. Essentially somebody who’s at high risk can take this medication every day and they will be protected, even if they’re exposed to HIV, as long as they are taking the medication. So we’re trying to raise awareness about these prevention methods.”
If your partner is HIV-positive, if you or your partner use intravenous drugs, or if you have multiple sexual partners, being open and honest about HIV prevention with your partner(s) is another great way to ensure you’re not infected. “Talk with each new sexual partner about risks,” says Laurie Mortara, M.D., infectious disease specialist at MemorialCare Medical Center in Long Beach, Calif. “Agree to have both of you tested for HIV and sexually-transmitted diseases before becoming sexually active, and regularly if other partners are involved and/or IV drug use is involved. Also, control your use of condoms. Ask yourself: Is the night without a condom worth a lifetime of HIV infection and medications?”
Unlike other illnesses, HIV doesn’t always come with a set of easy-to-recognize red flags. “Many people with HIV cannot remember being ill at all prior to diagnosis, and in 2015 over 50 percent of those diagnosed with HIV were estimated to have had it for at least three to seven years,” says Mortara. As a matter of fact, the virus’ inconsistent, mild, and sometimes nonexistent symptoms can cause even the most meticulous doctors to misdiagnose HIV as something entirely different.
According to Kristin Englund, M.D., infectious disease specialist at the Cleveland Clinic, people infected with the virus may or may not experience minor flu-like symptoms—such as fever, malaise, body aches, night sweats, rash, and sore throat—which can first show face anywhere from two weeks after the virus is acquired up to late in the final stages of infection. At that point, which could be years down the road, the damage to the immune system is usually already done. “Night sweats, swollen lymph glands, weight loss, and chronic diarrhea can also indicate an HIV infection, though they can be caused by many other diseases,” says Englund.
To make matters even more complicated, these issues often disappear quickly, allowing HIV to fly under the radar—and blinding doctors and patients to the fact that there’s something seriously wrong. Meanwhile, the viral infection is still brewing under the surface, gradually breaking down your immune system.
“These HIV symptoms are usually self-limited, so they resolve within a week or so,” says Malvestutto. “It’s actually very difficult for people to identify the symptoms, which is why by the time an infected person gets concerned enough to show up to the emergency room, most medical providers just say let’s see how things go in the next few weeks. And when the symptoms go away within another week, there’s no thought that this was an HIV infection at all.”
And it’s when someone who is HIV-positive doesn’t feel or look sick that the risk of passing along the virus to someone else is greatest. Because getting tested by a medical professional is the only surefire way to know if you have HIV, Malvestutto strongly recommends not relying on HIV symptoms alone—and not waiting for a doctor to ask you if you want to get tested—in order to request an HIV exam. “It’s important for women to really take charge and have that conversation about risk factors for HIV with their medical provider, and just get tested,” says Malvestutto.
Early detection is the key to getting life-saving treatment when you need it and preventing the spread of infections—and the only way to know for sure if you have HIV is to get tested regularly. In fact, the CDC recommendation is that everyone between the ages of 13 and 64 get tested at least once, regardless of how at-risk they are of acquiring an infection.
“About 15 percent of people living with HIV in the U.S. are unaware of their diagnosis,” says Malvestutto. “So nothing is driving them to request an HIV test, and they may be having unprotected sex. That’s why about 40 percent of new infections actually come from people who are unaware of their own HIV.”
If you’re avoiding getting tested because you think the process will take too long or cost you big bucks, then you should reconsider. The HIV test, which involves a simple blood drawing, is a lot more turn-key than you might expect.
“The test is actually very easy, very quick, and very sensitive,” says Malvestutto. “It can detect HIV infection in as early as two weeks after exposure to HIV, and you have a result within 40 minutes. It’s also widely available: All health departments offer it for free, but you can get it from primary-care providers and emergency departments as well.”
Another option for detecting a possible HIV infection is to pick up an over-the-counter screening kit that you can use at home. The test—which is usually done with mouth swabs—can be helpful if you want to get tested but are hesitant about seeing a medical professional; however, be aware that it’s not a replacement for getting help at your physician’s office. “If the at-home test turns positive, go to the doctor for a confirming blood test and effective treatment,” says Mortara.
Let’s say you had a wild night out and either intentionally or accidentally had unprotected sex with a new partner. Well, just like you can take emergency contraception if you’re worried about getting pregnant, you can now also take a similar pill for prevention of HIV infection if you believe you were exposed to the virus. This treatment is what the medical experts call post-exposure prophylaxis, or PEP.
“You’re essentially given a cocktail of medications, and you have to take them for 28 days,” says Malvestutto. “The earlier you start taking it, the better; but it really has to be taken within 72 hours [of possible exposure] to greatly reduce the risk of acquiring HIV. Go any later than that, and it will not work. It’s important to act quickly and not wait to go see your primary-care physician or your closest emergency department.”
All emergency rooms can provide PEP upon request. Once you ask for it, the medical provider will test you to make sure you don’t already have HIV. If you don’t, they’ll simply start you on the preventive course right away. This is yet another weapon ladies have in their arsenal in the fight against HIV, but may not know about. “For women, it’s particularly important to know that this exists as an option, and we need to raise awareness about it,” says Malvestutto.
The days when an HIV diagnosis meant that your lifespan and quality of life were on the chopping block are a thing of the past. There is no cure for HIV/AIDS yet, but with the help of effective and consistent treatment, the life expectancy for those who are HIV-positive is now almost completely normal.
“It’s not at all the way it used to be in the ’80s and ’90s,” says Malvestutto. “Now we have very effective medications that are very potent and very easy to take. In the old days, treatment of HIV required taking multiple pills with lots of side effects like diarrhea, abdominal pain, nausea, headaches, and vivid dreams. Now we have treatments that are extremely well-tolerated, and the drugs are combined in a single tablet.”
“By going on treatment, the virus becomes suppressed and undetectable in the blood, and at that point it can no longer be transmitted to an uninfected partner during unprotected sex,” continues Malvestutto. “Even in the cases with advanced HIV, we are able to suppress the virus and rebuild the immune system. It’s changed so much that at this point the life expectancy for patients with HIV is almost the same as somebody without HIV. In fact, it’s now getting to a point where more than half of patients living with HIVare over 50 years old—that’s just a result of how effective these treatments are. When your virus is controlled, you can lead a perfectly normal life and do all the things you want to do, like have a family and be safe with your partner. The key is to start treatment right away.”
And these medications are only expected to get better: Doctors are now testing bi-monthly treatment injections that can be used to treat HIV instead of daily pills, and Malvestutto even believes that a cure could be found within his lifetime.