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| 1. |
What
is HIV and how does it differ from other viruses which
infect human beings?
HIV stands for Human
Immunodeficiency Virus. As the name suggests it only
causes disease in humans, which leads to the depletion
of white blood cells leading to lowering of immunity.
Once the virus enters the body it lies dormant for many
years and hence is known as a 'slow virus'. Most other
viruses for example, those causing measles, mumps, chicken
pox, etc., manifest the disease in 14-21 days after
it enters the body. Hence the incubation period is short
(2-3 weeks) whereas in HIV infection it is very long
and runs into years. |
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| 2. |
How
does HIV attack the immune system?
Once HIV enters the body, it gets attached to
a type of white blood cell called T lymphocyte (which
is the T cell in the human body's protection against
infections). The RNA (genetic material) of the virus
then gets converted to DNA (genetic material) by an
enzyme that the virus produces. This viral DNA then
gets incorporated into the DNA of the human cell (T
lymphocyte), and remains there for the lifetime of that
cell. This infected cell now becomes a virus factory
producing more viruses (HIV) which bud out of the cell,
attack new T lymphocytes, and destroy them. Over a period
of years, the T cell count of the infected person drops
to a critical level and the individual develops many
opportunistic infection and hence is then said to have
AIDS. |
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| 3. |
What
is the difference between a person infected with HIV
and one who has AIDS?
A
person living with HIV (medically known as an HIV positive
person) is one who has virus in his/her body. Such a
person, remains infected and is presumed infective for
the rest of his/her life. However, s/he will appear
to be perfectly normal and healthy and asymptomatic
for many years. An asymptomatic HIV infected person
does not have Acquired Immunodeficiency Syndrome (AIDS).
But when an HIV positive person's T lymphocytes (which
are responsible for the immunity) count falls to 200
or less, s/he starts developing symptoms for eg. cough,
fever, diarrhoea, skin lesions, etc. They are due to
opportunistic infections (so called because they develop
when the body's immunity becomes deficient) like TB,
Thrush, Pneumonia, Cryptococcal meningitis, etc. All
persons with AIDS are infected with HIV, but not all
persons with HIV infection have AIDS. AIDS is only the
end stage of this infection. |
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| 4. |
How is HIV transmitted?
Anyone
can become infected with HIV. It is transmitted only
through unprotected penetrative sex (vaginal, anal,
oral) with an infected partner, transfusion of infected
blood and blood products, contaminat ed needles and
syringes, and from an infected mother to her baby before,
during delivery or through breast milk.
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But
since the sexual route accounts for almost 80 percent
of infections, the prevalence is much higher in the
sexually active age group of 15 years to 40 years. It
is not who you are or where you are, but what you do
that puts you at this risk of acquiring the HIV infection
and eventually developing AIDS. Therefore, there are
no "risk groups" but only "risk behaviours".
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| 5. |
How is HIV not transmitted?
HIV
cannot spread by casual contact such as touching, holding
hands, body contact in crowded public places, shaking
hands, working or playing together, sharing food, vessels
and clothes, eating food cooked by an infected person,
light kissing, mosquito and other insect bites, swimming
pools, and toilets. |
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| 6. |
Do mosquitoes transmit HIV?
There
is no evidence to show that mosquitoes transmit HIV.
Epidemiologically, the incidence of HIV infection is
the highest among the sexually active group of 15 years
to 40 years. However, mosquitoes bite persons of all
age groups and if they were a means of spreading HIV,
the incidence of infection would be uniformly high and
among all age groups. HIV does not survive or replicate
inside the intestine of the mosquito, which is another
reason to believe that mosquitoes cannot spread the
HIV infection. |
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| 7. |
Can HIV spread through kissing?
Kissing
such as on the cheek or lightly on the lips carries
no risk of transmitting HIV. In deep kissing there is
a small risk because the saliva of an infected person
contains few virus particles which by itself is not
sufficient to cause the infection. But there could be
bleeding gums or ulcers in the mouth and exchange of
infected saliva mixed with blood during kissing could
transmit the HIV. |
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| 8. |
How long can the virus live
outside the human body?
The
Human Immunodeficiency Virus is fragile. Once the virus
is outside the body in a dry form, it dies immediately.
Even in a wet state, it does not live long when exposed
to heat, detergents, or disinfectants. When stored in
blood banks at 4°C, it can live for about 3 weeks (or
longer), or till the white cell disintegrates, but in
a frozen state it can survive for years.
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| 9. |
Can I get the HIV infection
if I donate blood?
No.
This is not possible as all materials used for collecting
blood are sterile. In fact, persons who are healthy
should come forward for voluntary blood donation.
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| 10. |
What is the risk of getting
HIV by going to a dentist?
The risk of getting
HIV from a dentist is low. However, there have been
stray reports linking the infection with dentists. Wherever
there is invasive procedures of skin or mucous membrane,
universal precautions should be practiced. |
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| 11. |
Is the breast milk of an HIV
positive woman infective?
HIV
is known to be present in the breast milk of an infected
woman. Hence, there is a possibility of acquiring the
infection via breast milk. However, in a country like
India where infant mortality is very high, the advantages
of breast feeding (prevention of other infections) outweigh
the risk of HIV infection through breast milk. Formula
feeding should be advocated on individual cases only
after proper counselling. |
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| 12. |
How would one know if a baby
born to an HIV positive woman has the HIV infection?
Most
children born to HIV positive mothers carry HIV antibodies
from the mother in their blood. These take about fifteen
months to disappear. Only after that will an HIV antibody
test show whether the baby is, in fact, infected with
the HIV, or not. In less developed countries, the chance
of a baby born to an HIV infected mother being infected
is about 40 percent. But today there are antiretroviral
drugs available which can be given to the pregnant woman
and babies to prevent the infection in the babies. As
an alternative to pregnancy, women living with HIV could
also be counselled to adopt a baby. |
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| 13. |
How
long does it take for an HIV infected person to develop
symptoms?
This
depends on the mode of the HIV transmission and the
lifestyle of the HIV positive person. Majority of persons
who are infected through blood transfusion develop symptoms
on an average from 3 years to 5 years. With the other
modes of transmission when the quantum of the virus
is low, the person can remain healthy for 8 to 12 years
or longer. If an HIV positive person improves his/her
quality of life by adopting safer sex methods, has good
nutrition, regular exercise, regular medical management,
emotional support, does yoga and meditation, avoids
stress and regularly treats other illnesses, continues
to be active, and has an optimistic outlook, s/he is
likely to live longer. |
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| 14. |
How does an HIV positive person
progress to AIDS?
A
few weeks after the virus enters the body, some people
have flu-like symptoms such as fever, body ache, and
headache, (every infected person may not experience
these). These symptoms disappear after a while, and
then there is a long phase of 3 years to 12 years which
is asymptomatic. After that, when the immune system
starts failing, AIDS sets in.
The major and minor signs classified by the World Health
Organization are: |
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Major Signs
- Weight loss greater
than 10% of body weight
- Fever for more than
one month, intermittent or continuous
- Chronic diarrhoea for more
than one month, intermittent or constant
Minor
Signs
- Persistent cough
for more than one month
- General itchy dermatitis
(skin irritation)
- Recurrent herpes
zoster (shingles)
- Oropharyngeal candidasis
(fungus infection in the throat/mouth)
- Chronic progressive
and dissipated herpes simplex infection
- Generalised lymphadenopathy
(swelling lymph glands)
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If
a person has two major and two minor signs he is diagnosed
as having AIDS. It is important to note that these symptoms
are fairly common in various non-AIDS conditions also.
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| 15. |
How would I know if any of the
people I meet everyday is HIV infected?
You
cannot. Individuals may identify their HIV status only
by doing an HIV test. |
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| 16. |
Is there any treatment for HIV/AIDS?
Almost
all opportunistic infections a person with AIDS develops
can be treated with appropriate drugs. Eg. TB, thrush,
diarrhoea, pneumonia can all be treated. They can also
be prevented by drugs - chemoprophylaxis.
When it comes to treatment of HIV itself, there are
many antiretroviral drugs available. These should be
given in combinations of 2 or 3 drugs for lifetime of
the patient. These drugs are expensive, have side effects
and need to be monitored using laboratory tests which
are very expensive. |
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| 17. |
What is 'safe sex'?
Sexual activity which completely
eliminates the risk of infection is safe sex.
For eg.
1.
any sexual activity between two uninfected people is
safe.
2.
any sexual activity which does not involve the entry
of body fluids such as blood, semen, vaginal fluids,
or other contaminated material into the body is safe.
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| 18. |
What is 'safer sex'?
Safer
sex is a way of adapting your sex life to minimize the
risk of giving or getting the HIV infection. It includes
those sexual practices which reduce the risk of acquiring
or transmitting HIV during sexual activity. Sex can
be made safer by using a condom consistently or by practicing
non-penetrative sex. |
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| 19. |
What can I do to protect myself
against getting the HIV infection?
There
is a lot you can do to keep yourself protected from
getting the HIV infection:
- Learn the facts about HIV and AIDS.
- Assess your own risk behaviours (unsafe sex,
sharing needles, etc.)
- Postpone, as much as possible, sex until marriage,
or else practice safe or safer sex
- Do not feel shy to talk about your doubts and
fears. Get these clarified.
- Verify that any blood product you receive has
been screened for HIV.
- Verify that any needles/ syringes or invasive
equipment being used on you is sterile.
- If you are going for procedures such as tattooing,
ear piercing, or acupuncture, verify that the equipment
to be used on you is sterile.
- Avoid alcohol and drugs as they affect your
judgement, and can induce you to take risks you would
not otherwise take, like having unsafe sex, sharing
needles, or driving rashly.
- Do not let peer pressure force you into unsafe
activities |
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| 20. |
What is the role of HIV/AIDS
awareness programmes in preventing the spread of HIV/AIDS?
The
objective of AIDS awareness programmes is to create
awareness about the problem, to give accurate and reliable
information about HIV/AIDS, to clear existing myths
and misconceptions, and to provide practical skills
that can be implemented at the individual's level so
as to lead to behaviour change that minimize the risk
of HIV infection. |
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| 21. |
How safe are condoms in the
prevention of HIV infection?
Condoms
make sex safer when used properly but they are not 100
percent safe. Safety factors to check on when buying
and using condoms are,
- Expiry date of the condom - do not use one
which has expired.
- Storage - condoms should be kept away from
the heat (for example, from car glove compartments,
direct sunlight), and pressure (for example, sitting
on a wallet containing condoms).
- Making sure that sharp objects do not tear
a condom during use
- Making sure that the air is expelled from the
teat of the condom while wearing, so as to prevent it
from bursting during intercourse. |
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| 22. |
Does the use of a condom reduce
sexual pleasure?
Condoms
do not reduce sexual pleasure, as sexual pleasure is
a perceived pleasure. Psychologically, some people perceive
a loss of pleasure when using a condom. Whereas, ribbed
condoms, for example, are known to increase sexual pleasure.
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| 23. |
Do contraceptives like 'Today',
diaphragm, and the pill protect a woman from getting
the HIV infection?
No,
they do not. These contraceptives only prevent a woman
from getting pregnant but do not prevent the potentially
infected semen from coming into contact with the lining
of the vagina or cervix. If the HIV or organisms causing
STD are present in the semen, they can still get into
a woman's body and infect her. |
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| 24. |
What are the different tests
to detect HIV?
There
are a number of tests to detect the HIV. Blood tests
are done to look for specific antibodies produced by
the HIV. These include,
Screening tests:
ELISA
(Enzyme Linked Immunosorbent Assay - the most commonly
followed procedure).
Spot
test or Rapid Test
These
may give false positive results and hence should be
confirmed.
Confirmatory Tests:
Western
Blot, the most commonly used procedure.
There are other tests that are done to detect the virus
or its protein or genetic material. These are however,
expensive, complicated or may take long and hence, are
used only for research and academic purposes.
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| 25. |
Why are consent and confidentiality
important during voluntary testing?
HIV
positive persons are discriminated against by family,
friends, neighbours, colleagues, employers, and the
society in general. Unless an individual is assured
confidentiality, s/he will not come forward for testing
for fear of such discrimination and stigma. Testing
for HIV without consent violates human rights and should
not be done. Only consented testing with pre- and post-test
counselling should be encouraged. |
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| 26. |
How can I know the HIV status
of the person I am going to marry?
Marriages
are based on mutual trust. It is important that any
concerns about HIV are communicated to the prospective
spouse in a sensitive and sensible manner. The HIV status
of a person cannot be determined without a HIV test.
A fully informed voluntary consent is a pre-requisite
before a HIV test can be performed on someone. Please
be prepared to likewise undergo a test should your prospective
spouse so requests. In some states of USA, HIV and VDRL
testing are mandated by law as pre-requisite to marriage
registration. In India, there is no such law.
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| 27. |
Should premarital HIV
testing be done?
This
cannot be made mandatory as it would undermine confidentiality
as a pre-requisite for testing. But if individuals request
consented voluntary testing, it should be encouraged.
Unfortunately in India, given the lack of code of conduct
in reporting test results, it may be possible to "purchase"
a negative result. |
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