What is AIDS?

AIDS stands for Acquired Immune Deficiency Syndrome

Acquired: Because it is a disease that you catch from another person. It is called an infectious disease. Immune Deficiency: Because it is a disease that affects the body's immune system. The immune system gives the body its ability to fight off infectious diseases. When a person's immune system stops working properly, it is said that they have an immune deficiency. Syndrome: Because it is a disease that has a wide range of symptoms (a syndrome is a group of symptoms).

AIDS is caused by a virus. The virus which causes AIDS is called the human immunodeficiency virus, or HIV. Although HIV-infected people look and feel well the virus is slowly weakening their immune systems. They are infectious to people they have unprotected sex with and people they share needles with. HIV-infected people may remain well for many years before they develop AIDS. Sometimes people only find out that they are infected when they get sick. The only way a person can tell if they have HIV before they get sick is to have a blood test. The test is called an HIV antibody test. (See HIV Test)

What are the symptoms of HIV infection?

Once HIV has begun to kill large numbers of T-helper cells, people with HIV infection begin to get mild illnesses caused by this immune deficiency. This may take anything from two years to 20 years after the infection. These mild illnesses are sometimes called AIDS-related conditions or ARC. Some of the symptoms of this period of HIV illness include:

Sudden and severe loss of weight Fever that has no apparent cause and which comes and goes Heavy sweating at night Loss of appetite and constant tiredness Severe or persistent diarrhoea Swollen glands in the neck, armpits and groin

Of course, some or all of these symptoms can be caused by infections other than HIV. Only a doctor can tell if HIV is causing the symptoms, usually by having an antibody test done. If HIV is the cause, these symptoms may come and go, and they may last several years. Eventually, people with immune deficiency caused by HIV develop more serious illnesses. These are caused by organisms like viruses, parasites and bacteria which the healthy immune system finds and kills. HIV-infected people can also develop some kinds of cancer. Infection with HIV may also damage the nervous system and sometimes may cause brain disease. When these serious diseases appear, the HIV-infected person is diagnosed with AIDS. For a person to be diagnosed with AIDS, they must have one of the following illnesses:

A particular kind of pneumonia (pneumocystis carinii pneumonia or PCP) which rarely affects people without HIV infection. Cervical cancer combined with HIV infection. A rare kind of skin cancer (Kaposi's sarcoma or KS) HIV infection of the brain or nervous system One of a number of other rare infections (usually of the brain of digestive system) or other rare cancers.

Five years after infection, about 15% of infected people have AIDS. But by 10 years, this figure has reached 50%. At present, doctors think that nearly all HIV- infected people will have AIDS by 15 to 20 years after infection.

What are the ways in which HIV spreads?

HIV can pass from person to person only in very specific ways, unlike the virus that causes flu which can pass through the air (as when a person with flu coughs or sneezes). Scientific research has shown, that for infection to occur, HIV must:

Leave the body of an infected person in a body fluid Be in a sufficient quantity or 'dose' to cause infection Enter the bloodstream of another person.

HIV has been found in small amounts in saliva (spit) and is probably present in small amounts in all body fluids. But the amounts are not large enough to infect other people. Scientific studies of infected people have shown that the only 'dangerous' or infective body fluids are:

Blood Semen Vaginal Fluids

It is possible that breast milk may spread the virus to babies that are being fed in this way, but breast milk is not a dangerous body fluid for infecting others.

How is HIV NOT spread?

HIV cannot be spread through the air, for example by coughing HIV cannot be spread through food HIV cannot be spread on toilet seats or in swimming pools HIV cannot be spread through sharing eating or bathroom facilities with an infected person HIV cannot be spread by mosquitos or other insects HIV cannot be spread through kissing an infected person HIV is spread only when blood or other body fluids from an infected person enter the bloodstream of another person. HIV is a fragile virus and does not live long outside the body or fresh body fluids. It cannot live in temperatures above 70 degrees Centigrade. It can be killed with soap and hot water, and with bleach.

There are four distinct ways HIV can be passed from person to person. These are:

1.Through having anal and vaginal intercourse with an infected person without properly using condoms. 2.Through sharing drug-injecting equipment such as needles and syringes with an infected person. 3.Through the direct injection of blood or blood products from an infected person, such as in a blood transfusion, although this has virtually been eliminated in Australia today. 4.From an infected mother to her child before, during or immediately after birth.

1.Sexual Intercourse

HIV is found in the semen of infected men, and in the vaginal fluids and menstrual blood of infected women. HIV can be passed on during sexual intercourse if these fluids are exchanged.

In Australia, AIDS appeared first in homosexual (or gay) and bisexual men. Anal intercourse (whether between man or between men and women) can easily transmit HIV infection, because the lining of the rectum is fragile and allows the virus to get into the bloodstream.

HIV can also be transmitted through vaginal intercourse between men and women. In some countries, particularly in Africa, nearly all HIV-infected people were infected in this way. It is clear that vaginal intercourse passes on HIV, though not as easily as anal intercourse. Some people may be more open to infection than others. People who have sores or ulcers caused by other sexually transmissible diseases are more easily infected by HIV.

It is important that a condom is used every single time you have sexual intercourse; and that you think about other things that you can do that are sexually satisfying without being risky (for some ideas see Safe Sexy Sex ). 2.Sharing Injecting Equipment

People who use needles to inject drugs are easily infected with HIV. This is because needles and syringes which have been used by an HIV-infected person have blood on or in them. If they are passed to another person, this blood is injected into the new user, carrying HIV with it.

It is sharing needles and syringes, not the drug itself, that carries the risk.

This means that not only people who are regular users of drugs can get HIV infection. People who inject drugs only occasionally can also get infected.

Safe Needle Use

The safest way to inject drugs is to use a clean syringe every single time.

Never share injecting equipment

Cleaning is not a guarantee of protection against HIV, and Hep B and C, but if you must share, it is best to clean according to this three step procedure: 1.Fill syringe with clean cold water. Shake to remove blood and clots. Squirt down the drain. Do this twice. 2.Fill the syringe with bleach. Shake for 30 seconds. Squirt down the drain. Do this twice. 3.To rinse away the bleach, fill syringe with clean cold water. Squirt down the drain. Do this twice. see Needle And Syringe Exchanges, Direct Line 3.Direct Injection of Blood

In the early years of the AIDS epidemic, a number of people were infected with HIV through blood transfusions or through using blood products for treating other illnesses. Some people with haemophilia, who need regular blood products to prevent bleeding, were infected at that time.

The blood that infected these people came from blood donors who were HIV-infected without knowing it. Because AIDS was not seen before 1981, and HIV was not discovered until 1984, some HIV-infected people donated blood before the risk was known.

In May 1985, all Australian blood banks began testing all blood donated for HIV. As well, Blood Banks legally require that people whose behaviours make them likely to be at risk of HIV infection do not donate blood. Australia's blood transfusion system is now among the safest in the world.

The other way in which people can be directly injected with blood that has HIV in it is through accidents in hospitals. Worldwide by mid 1990, about 30 health-care workers had become infected with HIV after accidents with needles or sharp instruments that had HIV infected blood on them.

In Australia, all hospitals have brought in strict rules for handling needles and sharp instruments, to try to stop accidents that might spread infection in this way. Anyone who is doing first aid that may bring them into contact with another person's blood should follow these rules:

Blood must not contact cuts, sores, broken skin or skin conditions like acne or dermatitis.

Latex gloves should be used when handling injuries or blood. Blood must not be allowed near the eyes or mouth.

Blood should be cleaned up promptly and the area sterilised with dilute bleach. Bleach kills HIV effectively and quickly. People who have handled blood or things with blood on them should wash their hands promptly.

It is important to be careful with needles or other sharp objects which may be found in parks or the street. These may have blood in or on them. They should picked up carefully and be disposed of in a puncture-proof container.

4.Infection of Babies

Like other infections, HIV can pass to an unborn child while it is in the womb. Babies can also be affected if they come into contact with their mother's blood while they are being born. About a third of children born to HIV-infected mothers have the HIV infection themselves. It is also possible that babies of some HIV-infected women can be infected during breast feeding.

Infection of unborn and newborn children can be prevented. Women who may have been exposed to HIV infection should seek counselling and information about testing before they decide to become pregnant. Regardless of the risk of exposure and the result of testing, the decision to have a child or to proceed with a pregnancy is one which a woman must make for herself.

Can AIDS Be Treated?

Until 1987, there was no effective treatment for AIDS or HIV infection. Although some of the illnesses that people with AIDS got could be treated for a while, the immune deficiency that caused the illnesses could not be treated.

In 1987 an American drug company discovered that a drug called zidovudine, (known as AZT for short) was able to block HIV's ability to make new copies of itself in the cells of infected people.

AZT is not a cure for AIDS, because it only slows down, but does not stop, the progress of HIV infection. But it has helped people with AIDS to live longer and to have a better quality of life.

AZT is now also being used by people who have HIV infection but who have not developed AIDS. It is hoped that the drug will slow down the process of infection and prevent then from developing AIDS. Other treatments are now also being used to prevent people with HIV getting pneumonia.

In 1990 two other new drugs, dideoxyinosine, or DDI, and dideoxycytodine, or DDC, became available in Australia. DDI and DDC help some people who have not benefited from AZT treatment. Other new treatments are being tested, but there is still no cure for AIDS likely to be available soon.

Early knowledge of HIV infection gives the best chance of early treatment, and also enables the infected person to avoid the possibility of unintentionally infecting others.

THE HIV TEST

The HIV test is a blood test which looks for HIV antibodies, which the body's immune system forms when HIV infection happens.

If the antibody test result is positive (that is, if it finds HIV antibodies in the person's blood), then the person is infected with HIV. They are said to be antibody-positive.

If the test results are negative, then the person has not been infected with HIV. They are said to be antibody- negative.

During the early stage of HIV infection, however, the body's immune system will not have had the time to make antibodies. This happens with all infectious diseases and is called the window period. For HIV this window period usually lasts for two to twelve weeks after infection. Because of this fact, further antibody tests should be done to be certain of a negative test result.

Any doctor or clinic can provide a HIV test, so choosing the one which best suits you is the priority. Not all clinics are able to provide this test free of charge, so you might like to enquire about this when you make the appointment. All results are confidential and in Victoria positive results will be notified to the Department of Health and Community Services by code rather than by name.

When you go for a test you should have counselling before testing and after you get your result. This is required by law in Victoria and is designed to ensure people understand how to prevent themselves being at risk of HIV, and to offer support if they are positive.

If you are unsure about whether or not you need an antibody test, your doctor is the best person to advise you.

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