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The Facts

 


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The facts

HIV is a global pandemic, which means the condition has been spread across the world. The World Health Organisation (WHO) estimates that 33.4 million people around the world are currently infected with HIV. There are about 2.7 million new HIV diagnoses each year.

The virus is particularly widespread in sub-Saharan Africa – the African countries that lie south of the Sahara Desert, such as South Africa, Zimbabwe and Mozambique.  HIV is also common in South and South-East Asia.

In the UK around 83,000 people were living with HIV in 2008.  More than 7,200 people are diagnosed each year – this number has not reduced since the beginning of the epidemic in the 1980’s.  Half of these people are diagnosed with late stage disease that means they will need to start treatment soon.  27% of people infected with HIV remain unaware of their infection (i.e. they have never tested).

In the UK the main risk groups for HIV are:

  • Gay and bisexual men (38% of new diagnoses in 2008)
  • Heterosexually acquired infection (58% of new diagnoses in 2008)
    • Black Africans (38%)
    • UK born or other ethnic groups (20%).
  •  Only 2% of HIV infections were acquired through intravenous drug use and sharing needles.

Although we commonly think of HIV as a condition predominantly affecting gay men, in the UK more than half of new infections are acquired heterosexually between men and women.  Highly effective treatment for HIV has been available for more than 12 years and is getting better all the time.  Starting treatment at the right time now means that people with HIV can expect to have a reasonably normal life expectancy.  Mothers diagnosed with HIV before or during the early stages of pregnancy can take advantage of treatment and reduce the risk of infecting their baby from 1 in 6 to less than 1 in 100.


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What is HIV?

HIV stands for Human Immunodeficiency Virus.  It is a retrovirus (contains RNA) and attacks the body’s immune system that provides natural defence against infection and disease.  In late stage HIV infection, also known as AIDS (Acquired Immunodeficiency Syndrome), the weakened immune system means the body is more vulnerable to life threatening infections such as severe pneumonia and certain types of cancer or lymphomas.  The time from infection to AIDS is highly variable but on average it is 8 to 10 years without treatment.


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How do you catch HIV?

The virus is passed on through exchanging body fluids such as semen, blood or vaginal secretions in the following ways:

  • Unprotected sex (sex without a condom). This is the most common form of transmission. Anal sex is the riskiest, then vaginal sex and rarely oral sex
  • Sharing needles or equipment (called ‘works’) to inject drugs.
  • From mother to baby during pregnancy, birth or breastfeeding – but this can be prevented with treatment and medication.

You can’t catch HIV from kissing, from being sneezed on by someone with HIV, from sharing baths, towels or cutlery with a HIV-infected person, from swimming in a pool or sitting on a toilet seat that someone with HIV has used, or from animals or insects such as mosquitoes.

All blood transfusion products in the UK have been tested for HIV since 1985 and there have been no HIV infections from blood products since then.  Blood transfusions received in third world countries may not be tested so rigorously so may pose a potential risk. 


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Early signs of HIV

There are few early signs and they are frequently dismissed or mistaken for other conditions.  The bottom line is that most people will only know if they have HIV by having a test.

The following section describes what someone may notice at different stages of infection.


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Seroconversion (primary infection)

Two to four weeks after infection with HIV up to 60 % of people may develop a transient flu-like illness.  Sometimes this is very mild, but sometimes it can be a severe illness requiring hospital admission. Other people may not notice anything at all. Things you may notice include:

  • Fever and sweats.
  • Sore throat.
  • Mouth ulcers.
  • Feeling very tired.
  • Headache.
  • Swollen glands in neck and armpits.
  • A rash – non itchy – all over the body including palms and soles of feet – but can be very mild.

These symptoms may last up to 2 weeks then get better. During this stage some HIV tests (particularly the rapid tests) will give false negative HIV results – you will need to repeat the HIV test using a sensitive test a few weeks later.  During this seroconversion period a person can be very infectious and more likely to pass HIV onto a partner as the level of virus in their body is very high. There is evidence to show that 20% of HIV infections in gay men are acquired this way.


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Asymptomatic phase

After seroconversion most people with HIV feel well for many years so will have no idea they have HIV. This is called the asymptomatic phase – but you can still pass HIV on.  For this reason if you think you have been at risk of HIV, or are worried, get tested – you can’t tell by looking at someone if they have HIV.


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Late stage HIV infection

After many years (2 – 10 years) HIV infection severely weakens the immune system so that someone may start to develop problem with their health.

Things you may notice include:

  • Tiredness.
  • Loss of appetite.
  • Weight loss.
  • Diarrhoea.
  • An outbreak of shingles.
  • Skin problems such as acne, psoriasis, itchy spots and rashes.
  • Recurrent warts or herpes.
  • Thrush (candida) in the mouth.
  • Fevers.
  • Tuberculosis.
  • Kaposi’s sarcoma – purple spots on the skin.

If your immune system becomes very weak you may develop very serious infections needing urgent hospital admission such as pneumonia.


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Getting a HIV test

You can have a HIV test at:

  • Any sexual health clinic or GUM clinic – such as the Wolverton. Testing is confidential and you can attend any clinic without a referral.
  • GP surgeries.
  • Some contraception and young people’s services – such as the Point clinics at the Wolverton, The Courtyard Clinic at St George’s Hospital and the Roehampton clinic at Queen Mary’s Hospital.
  • Antenatal clinics if you are pregnant.

Don’t assume that blood tests done in hospital or at your GP will have detected HIV. Blood is only tested for HIV if you specifically consent to it.


Treatment following HIV risk (PEPSE)