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Immune system
What is HIV?
HIV stands for Human Immunodefiency Virus. HIV is a virus that attacks the body's immune system - the body's defence against diseases. A person infected with HIV may not have symptoms to start with but, eventually without effective treatment, the immune system will become very weak and the person will no longer be able to fight off HIV or other infections.
How do you become infected with HIV?
HIV can be passed on through infected body fluids such as blood, semen, vaginal fluids or breast milk. The most common ways HIV is passed on in the UK are:
  • Sex without a condom with someone already infected with HIV
  • Sharing needles, syringes or other injecting equipment with someone infected with HIV
  • From an HIV positive mother to her child during pregnancy, childbirth or breastfeeding. However, there are steps mothers can take to reduce very significantly the possibility of their unborn or breast-feeding child contracting HIV.

Oral sex carries a much lower risk than penetrative sex, but HIV can still be passed on through cuts, gum problems or ulcers in the mouth if they come into contact with infected body fluids. HIV cannot be passed on through kissing or touching, spitting, coughing or sneezing, toilet seats, swimming pools, or shared facilities or utensils.
How can I protect myself from HIV?
Always use a condom when having vaginal or anal sex. You may also want to use a condom during oral sex although the risk of transmission is much lower. Never share needles or other injecting equipment.
What if I think I might have been exposed to HIV infection?
If you are still within 72 hours of an incident of possible exposure to HIV you can ask for post-exposure prophylaxis (known as 'PEP') from a sexual health clinic or at your nearest Accident & Emergency Department. The sooner treatment is begun the higher the probability the treatment will be effective and prevent HIV infection. Find out more about PEP at www.tht.org.uk/pep
How can I know whether I have been infected with HIV?
Someone can be living with HIV for many years without any symptom or obvious sign of infection. Therefore the only way you can know whether or not you have been infected is by taking an HIV test.
How do I get an HIV test?
HIV tests in the UK are free and the result is confidential. The HIV test involves the taking of a small sample of blood which is then analysed for the presence of HIV antibodies (the body's defensive response to the HIV virus). Some GP surgeries offer HIV tests and the result will be included in your medical records. Sexual health clinics (also known as Genito-Urinary or GU clinics) also provide HIV tests on a confidential basis and these records are separate from those of your GP. To find your nearest sexual health clinic go to www.fpa.org.uk/finder. If your exposure to HIV has been in the previous three months then an HIV test may not yet indicate that you are HIV positive - it will be important to go back at the end of this 'window period' to have a second confirmatory test. This is because it takes time for HIV antibodies to develop. If you have been infected with HIV, it is extremely important to be diagnosed as HIV positive as early as possible to benefit from the extremely effective treatments which are now available. Every year 200 people infected with HIV die in the UK because they were tested too late for the treatment to work.
Symptoms of HIV infection
Though you can live for years without symptoms of HIV infection, as the body's immune system weakens there may well be infections and illnesses which result. There are a number of such illnesses which are often found in people infected with HIV. These include: pneumocystis pneumonia (PCP), tuberculosis (TB), lymphoma, Kaposi's sarcoma, Particularly severe or hard to treat skin conditions and conditions affecting the mouth (e.g oral candidiasis (thrush), gingivitis, dental abscesses).
Treatment
There are now very effective treatments for HIV which can ensure an active and long life - the treatment is known as Anti-Retroviral Therapy (ART). Not all people diagnosed with HIV are on ART - treatment commences when a key indicator of the strength of the body's immune system, known as 'the CD4 count', declines to a certain level. Once treatment commences it is extremely important that the drugs are taken exactly as prescribed (at least daily) if they are to remain effective (this is known as 'concordance'). ART frequently produces side effects, for example nausea, tiredness, diarrhoea and changes in body shape.
Living with HIV
Those diagnosed with HIV should receive specialist care from their local HIV clinic where they are regularly monitored and where treatment is decided and prescribed. There are many ways someone diagnosed with HIV can look after themselves and manage their condition to make sure they keep well, including eating well, exercise, reducing stress and not smoking. Find out more information on 'Living with HIV' from www.aidsmap.com
What is the difference between HIV and AIDS?
AIDS stands for Acquired Immunodefiency Syndrome. A person is considered to have AIDS when their immune system is so weak it can no longer fight off a range of diseases against which it would normally cope. AIDS is a result of HIV infection which remains untreated for a long period but with timely diagnosis and effective medication it is no longer an inevitable result of being infected with HIV. For more information on AIDS see the AIDS sheet in Medical Chest.
The future
There is currently no cure for HIV so those who start ART will need to be on treatment for the rest of their lives. Treatment continues to improve, with reductions in the number of pills most people need to take and continuing research and development to minimise side-effects. There is also research taking place into additional effective ways to prevent HIV transmission, either a vaccine or a 'microbicide' (which is a gel/cream which could be applied internally to reduce the risk of transmission), but no effective vaccine or microbicide is currently available.



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