HIV

HIV/AIDS

What is AIDS?
AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is a serious disease caused by infection with the human
immunodeficiency virus (HIV). HIV attacks the body's immune system. The healthy immune system produces white blood cells
and antibodies which attack infectious agents such as viruses and bacteria that enter the body and cause disease. In a person
with AIDS, HIV has entered the blood's infection fighting white blood cells and over several years has destroyed the cells. HIV
can live in an infected person's body for years before any signs of illness appears. Yet, as the number of white blood cells
declines, the immune system becomes less and less able to protect itself against a variety of illnesses. The infected person
becomes more susceptible to opportunistic infections or cancers that attack the body and can cause death.
How common is HIV infection?
The epidemic's impact on our nation's health was highlighted during 1995, when the cumulative number of reported AIDS cases
surpassed one-half million. By 2000 the World Health Organization (WHO) projects a cumulative total of 30-40 million HIV
infected men, women, and children.
Worldwide, the vast majority of people infected with HIV/AIDS are heterosexual. The demographics of the epidemic in the
U.S. seem to be slowly shifting to women, blacks, and young people. A woman with an HIV infected male partner is 10 times
more likely to get the virus than is a man with an infected female partner.
AIDS is the leading cause of death for men 25-44 and the third leading cause of death among women. A 1990 study of blood
samples drawn from 20,000 students at 19 public and private universities found 1 student in 500 tested positive for HIV.
We have no way of knowing how many students at Duke are infected with HIV. We do know that former students have died
of AIDS and that currently there are students on campus infected with HIV. AIDS is not just something that happens to other
people.
How do people become infected with HIV?
HIV is a blood-borne virus in that it is transmitted through body fluids containing blood or plasma. Transmission of HIV can
occur sexually or non-sexually through the exchange of body fluids infected with a high concentration of the virus, mainly blood,
semen, or vaginal/cervical secretions. Transmission is especially effective during activities that involve "sealed penetration," i.e.,
anal or vaginal intercourse, and needle sharing.
HIV is transmitted through:
1.Sexual Contact
Unprotected anal, vaginal, oral intercourse with an infected partner.
Artificial insemination with semen from an infected person.
2.Blood
Needle sharing with an infected person for any reason (IV drug needles, steroid needles, ear piercing).
Receiving a blood transfusion with infected blood. (Since 1985 blood donations in the U.S. has been screened for
HIV.)
Accidents in health care (i.e., needle stick)
3.Perinatal
Intrauterine (during pregnancy)
Peripartum (during birth)
Breast feeding
There is no chance of transmitting HIV through sexual activities that do not involve direct contact of semen, vaginal secretions,
or blood with mucous membranes.
The AIDS virus is NOT spread through the air, in food, or by casual social contact. You cannot become infected with HIV by
someone coughing or sneezing on you, by sharing cups or pencils, by swimming in a pool with an infected person, or by shaking
hands, hugging or probably even kissing an infected person. Although small amounts of HIV have been found in body fluids like
saliva, feces, urine, tears, and sweat, there is little scientific evidence that HIV can spread through these body fluids.
Some people become infected with HIV the first time they get infected fluid in their bodies. Others are exposed and not
infected. However, even if you are not infected by the virus after one exposure, you may become infected by a subsequent
exposure. The more times you are exposed to HIV, the greater your chance of getting the infection. If you do not have HIV,
you have everything to gain by protecting yourself now. If you have been infected, subsequent exposures to the virus can
negatively impact your health.
How can I tell if I have HIV infection?
Many people do not know they have the virus and may unknowingly pass it on to others. They may look and feel fine for many
years after HIV infection occurs.
You cannot tell if you are infected by how good you feel. You cannot tell if your partner is infected by how good they look.
While talking to your partner is sensible, you cannot completely rely on what your partner tells you about his or her HIV status.
A major national study has revealed that 40% of college men and 20% of college women will lie about their sexual histories in
order to get sex. The only way to know if you (or your partner) have the virus is by taking a blood test called the "HIV Antibody Test."
What is the HIV antibody test?
What many people call the "AIDS" test is not a test for AIDS at all, but for the antibodies of the HIV which causes AIDS.
Once infected with HIV, the immune system produces antibodies in an attempt to defend itself against HIV. The test identifies
these antibodies. Therefore the test is accurately called the "HIV antibody test."
Should I be tested?
Have you:
had unprotected sex?
shared needles?
had sex with someone who may have been exposed to HIV?
had more than one sex partner?
failed to use condoms correctly for every sex act or with every partner?
If you answered yes to any of these questions, there is a chance you could be infected with HIV. You should get tested six
months after your last unsafe experience.
You also might want to get tested if you are in a committed, mutually monogamous relationship in which you and your partner
want to safely engage in unprotected sex. Because of the time it takes to develop detectable levels of antibodies, the test results
will only be reliable if neither of you has engaged in risky behaviors within the past six months. In addition, as has been
discussed, this is only as safe as the honesty between you and your partner.
What kind of test will I have?
Accurate testing for HIV antibodies may require two different tests, the ELISA (Enzyme linked immunoabsorbent assay) and
the Western Blot. Only a small amount of blood is needed for these tests.
The ELISA detects almost all persons infected with the HIV virus within the first six months of infection. To be reported as
HIV antibody positive by ELISA screening, at least 2 tests on the same blood specimen must react positively. In a small
number of cases the test may show the presence of infection when the test result is caused by something other than HIV ("false
positive"). Therefore repeatedly positive ELISA screening tests are confirmed by the more specific Western Blot test before a
blood specimen is considered HIV positive.
What level of confidentiality do I want when I get tested?
State laws vary on the protection and reporting requirements of your test results. If you are not being tested in North Carolina,
be sure that you know these requirements before submitting to being tested.
Confidential Testing:
In a confidential test the result is protected information like other parts of your medical record. Your result may be disclosed to
others only with your permission; for instance, for insurance or employment screening. The results of testing negative or positive
will be entered in your medical record. Positive results are reported to the Department of Public Health as required by state law.
What do the test results mean?
A negative test result means you do not have detectable levels of antibodies to the HIV virus. However the immune system
often takes three months and sometimes as many as six months after infection to develop detectable antibodies to HIV. If you
have engaged in any risky behavior during the six months prior to your test, a negative result may not be accurate.
A negative test result does NOT mean that you are immune to AIDS or HIV, or that you cannot become infected with HIV in the future. A positive test result means that you have been infected with HIV and you can transmit the virus.
What is the incubation period for AIDS symptoms?
The incubation period is the time between infection and the onset of symptoms of disease. The incubation period between HIV
infection and the onset of AIDS can vary anywhere from six months to an unknown period of time. Some people who are HIV
antibody positive may never develop AIDS. CDC has stated that the average length of incubation at this time is seven years or
more, however, this number continues to change due to various factors.

What are the symptoms of HIV infection?
The symptoms of HIV infection are the symptoms of the diseases that attack the body because of a weakened immune system.
Most of the following symptoms are not specific to HIV infection. However, if you have any of these symptoms for long
periods of time without the presence of another disease or condition you should consult a medical provider.
fever that lasts from a few days to longer than a month
periods of excessive sweating, especially at night
loss of appetite
chronic or long lasting fatigue
weight loss of more than 10% of body weight
muscle and joint pain
unexplained long lasting sore throat
unexplained swollen lymph glands
diarrhea lasting longer than a month with no other disease
lingering infections
As the immune system becomes more compromised the HIV infected person may acquire opportunistic diseases such as
Kaposi's sarcoma, Pneumocystis carinii pneumonia, tuberculosis, neurological disorders such as meningitis, and herpes simplex
infections. At this point, the HIV infected person is diagnosed with AIDS.
How is HIV infection (AIDS) treated?
The full disease state of AIDS is associated with life-threatening infectious diseases and cancers. Treatment usually depends on
the particular disease. It is important to seek treatment as soon as you know you are infected with the virus and before you
have any visible signs of the disease. The full effects of HIV infection (AIDS) may appear 5-10 years after the original infection
with the virus. As advances are made in the treatments of HIV-associated illness and immune disorders it becomes increasingly
beneficial for people infected with HIV to know early whether or not they have the disease. Early detection will allow your
health care provider to advise you about health practices which may prolong your life.
If I am positive, how can I prevent transmitting the virus to others?
Law requires you to inform all sexual partners of your positive HIV status.
practice Safer Sex
avoid "sharing" semen, blood, or vaginal secretions in any way
tell sexual partners to be screened for HIV
avoid sharing needles
avoid donating blood, plasma, semen, or body parts (tissue organ donor)
tell your health care provider avoid pregnancy