Basic Health

S.T.I. Information:

Sexually transmitted infections (STIs) are infections you can get by having sex with someone who has an infection. These infections are usually passed from person to person through vaginal intercourse, but they can also be passed through anal sex, oral sex or skin-to-skin contact. STIs can be caused by viruses or bacteria. STIs caused by viruses include hepatitis B, herpes, HIV, and the human papilloma virus (HPV). STIs caused by bacteria include chlamydia, gonorrhea, and syphilis.

The Human Immunodeficiency Virus (HIV) targets the immune system and weakens people’s defence systems against infections and some types of cancer. As the virus destroys and impairs the function of immune cells, infected individuals gradually become immunodeficient. Immune function is typically measured by CD4 cell count.

Immunodeficiency results in increased susceptibility to a wide range of infections, cancers, and other diseases that people with healthy immune systems can fight off.

The most advanced stage of HIV infection is Acquired Immunodeficiency Syndrome (AIDS), which can take from 2 to 15 years to develop, depending on the individual. AIDS is defined by the development of certain cancers, infections, or other severe clinical manifestations.

Signs and symptoms:

The symptoms of HIV vary depending on the stage of infection. Though people living with HIV tend to be most infectious in the first few months, many are unaware of their status until later stages. The first few weeks after initial infection, individuals may experience no symptoms or an influenza-like illness including fever, headache, rash, or sore throat.

As the infection progressively weakens the immune system, an individual can develop other signs and symptoms, such as swollen lymph nodes, weight loss, fever, diarrhoea and cough. Without treatment, they could also develop severe illnesses such as tuberculosis, cryptococcal meningitis, severe bacterial infections and cancers such as lymphomas and Kaposi’s sarcoma, among others.

Diagnosis:

No single HIV test can provide an HIV-positive diagnosis. It is important that these tests are used in combination and in a specific order that has been validated and is based on HIV prevalence of the population being tested. HIV infection can be detected with great accuracy, using WHO prequalified tests within a validated approach.

It is important to note that serological tests detect antibodies produced by an individual as part of their immune system to fight off foreign pathogens, rather than direct detection of HIV itself.

Most individuals develop antibodies to HIV within 28 days of infection and therefore antibodies may not be detectable early, during the so-called window period. This early period of infection represents the time of greatest infectivity; however HIV transmission can occur during all stages of the infection.

It is best practice to also re-test all people initially diagnosed as HIV-positive before they enroll in care and/or treatment to rule out any potential testing or reporting error. Notably, once a person diagnosed with HIV and has started treatment they should not be re-tested.
HIV is spread only in certain body fluids from a person who has HIV. These fluids are blood, semen, pre-seminal fluids, rectal fluids, vaginal fluids, and breast milk. To reduce your risk of HIV infection, use condoms every time you have sex. Don’t inject drugs or if you do, use only sterile injection equipment and water, and never share your equipment with others. If you don’t have HIV but are at high risk of becoming infected with HIV, talk to your health care provider about pre-exposure prophylaxis (PrEP). PrEP involves taking a specific HIV medicine every day to reduce the risk of HIV infection.

How is HIV spread?

The person-to-person spread of HIV is called HIV transmission. HIV is transmitted (spread) only in certain body fluids from a person who has HIV:
  • Blood
  • Semen
  • Pre-seminal fluids
  • Rectal fluids
  • Vaginal fluids
  • Breast milk
HIV transmission is only possible if these fluids come in contact with a mucous membrane or damaged tissue or are directly injected into the bloodstream (from a needle or syringe). Mucous membranes are found inside the rectum, the vagina, the opening of the penis, and the mouth.

How can I reduce my risk of getting HIV?

  1. Get tested and know your partner’s HIV status. Talk to your partner about HIV testing and get tested before you have sex.
  2. Have less risky sex. HIV is mainly spread by having anal or vaginal sex without a condom or without taking medicines to prevent or treat HIV.
  3. Use condoms. Use a condom correctly every time you have sex. Read this fact sheet from CDC on how to use condoms correctly.
  4. Limit your number of sexual partners. The more partners you have, the more likely you are to have a partner with HIV whose HIV is not well controlled or to have a partner with a STD. Both of these factors can increase the risk of HIV transmission. If you have more than one sexual partner, get tested for HIV regularly.
  5. Get tested and treated for STDs. Insist that your partners get tested and treated too. Having an STD can increase your risk of becoming infected with HIV or spreading it to others. Talk to your health care provider about pre-exposure prophylaxis (PrEP). PrEP is an HIV prevention option for people who don’t have HIV but who are at high risk of becoming infected with HIV. PrEP involves taking a specific HIV medicine every day. For more information, read the AIDS fact sheet on Pre-Exposure Prophylaxis (PrEP).
  6. Don’t inject drugs. But if you do, use only sterile drug injection equipment and water and never share your equipment with others.

I am HIV positive but my partner is HIV negative. How can I protect my partner from HIV?

Take HIV medicines daily. Treatment with HIV medicines (called antiretroviral therapy or ART) helps people with HIV live longer, healthier lives. ART can’t cure HIV infection, but it can reduce the amount of HIV in the body (also called the viral load). Having less HIV in your body will reduce your risk of transmitting HIV to your partner. However, even someone who is taking HIV medicines and has an undetectable viral load can still potentially transmit HIV to a partner. To further lower your risk of transmitting HIV to your partner, you can use condoms correctly every time you have sex and talk to your partner about taking PrEP. If you inject drugs, don’t share your needles, syringes, or other drug equipment with your partner.

Are HIV medicines used in other situations to prevent HIV infection?

Yes, HIV medicines are also used for post-exposure prophylaxis (PEP): PEP is the use of HIV medicines to reduce the risk of HIV infection soon after a possible exposure to HIV. PEP may be used, for example, after a person has sex without a condom with a person who has HIV or after a health care worker is accidentally exposed to HIV in the workplace. To be effective, PEP must be started within 3 days after the possible exposure to HIV. PEP involves taking HIV medicines each day for 28 days. For more information, read Post-Exposure Prophylaxis (PEP).

How can I learn more about preventing HIV?

Browse through the following information. This fact sheet is based on this information.
HIV can be suppressed by combination ART consisting of 3 or more ARV drugs. ART does not cure HIV infection but suppresses viral replication within a person's body and allows an individual's immune system to strengthen and regain the capacity to fight off infections. In 2016, WHO released the second edition of the consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. These guidelines recommend to provide lifelong ART to all people living with HIV, including children, adolescents, and adults, pregnant and breastfeeding women, regardless of clinical status or CD4 cell count. By July 2017, 122 countries already have adopted this recommendation by mid-2017, which covers more than 90% of all PLHIV globally.

The 2016 guidelines include new alternative ARV options with better tolerability, higher efficacy, and lower rates of treatment discontinuation when compared with medicines being used currently: dolutegravir and low-dose efavirenz for first-line therapy, and raltegravir and darunavir/ritonavir for second-line therapy.

Courtesy of the World Health Organization