HIV/AIDS

An estimated 40 million people in the world are infected with HIV (are HIV-positive). HIV progresses to AIDS and can be slowed but not cured. Learn how to protect yourself from this disease that attacks the immune system.

What is HIV/AIDS?

The human immunodeficiency virus (HIV) is a virus that causes a disease called acquired immune deficiency syndrome (AIDS). HIV attacks and destroys white blood cells, whose role is to defend the body against external threats such as infections. 

People infected with HIV are called HIV-positive. At the beginning of the disease, two thirds of people don’t have symptoms. Approximately 3 to 4 weeks after contact with the virus, the other third will get symptoms similar to the flu or mononucleosis: muscle or joint pain, fatigue, fever, sore throat, headaches, and rash. These symptoms will last for 1 to 4 weeks. 

Even when the symptoms go away, the disease will continue to slowly progress. In the long term, which can be many years, people can get HIV symptoms such as:

• persistent fatigue
• swelling of the lymph nodes in the neck, underarms or groin
• fever
• chronic cough
• night sweats
• significant and unexplained weight loss
• persistent diarrhea

AIDS is the last stage of HIV infection. In this stage, the body's defence system has broken down so much that the person develops serious infections or certain cancers. It can take several years (5 to 7 years on average) from the initial HIV infection for someone to develop AIDS. Current treatments can slow the progression of the disease.

HIV transmission

Anyone can get HIV. HIV is transmitted through infected blood, semen, vaginal secretions and breast milk. In most cases, HIV is contracted from:

• Unprotected sex (without a condom) with someone who has HIV.
• Sharing needles or syringes contaminated by the virus.
• Sharing sex toys with someone who has HIV.
• Coming into contact with infected blood.
• Mother to child during childbirth. Among pregnant women who are infected with HIV but who are untreated, 1 out of 3 will spread the infection to their babies during childbirth. This risk has been reduced to an estimated 1 out of 100 cases thanks to medical advances and medications administered during pregnancy and childbirth.
• Breastfeeding through breast milk.

Having a sexually transmitted infection such as gonorrhea, chlamydia, syphilis or genital herpes increases the risk of contracting HIV. Don’t hesitate to talk to your doctor to get screened and reduce the risk of transmission.

HIV tests have been done on all blood donations in Canada since 1985. Although testing can  generally only detect the virus starting from the third month of infection, the risk of contracting HIV from a blood transfusion is still extremely low, and it is impossible to contract the virus by giving blood. All equipment used by Héma-Québec and the Canadian Red Cross is sterile, and each needle is used only once.

Even if they don’t have symptoms, someone who is HIV-positive can give HIV to someone else. The risk of giving it to someone else varies depending on the amount of virus in the blood (viral load): the higher the load, the greater the risk of transmission. Medication can greatly reduce the risk of transmission by reducing the viral load.

If you think you may have come into contact with HIV, go to the emergency room or see your family doctor right away. You can get medication that may prevent the virus from developing, depending on the situation and how much time has elapsed since you came into contact with the virus.

Most people will be diagnosed with HIV with a blood test within 3 months of coming into contact with the virus.

How to prevent the spread of HIV

The best way to prevent HIV and AIDS is to avoid at-risk behaviour.

• Use a female or male condom made of polyurethane or latex for all types of sexual intercourse (genital, anal or oral). For effective protection, the condom must be used properly and fit correctly. If you use sex toys, you must also cover them with a condom. To prevent transmission during oral sex, cover the vulva or anus with a dental dam to avoid direct contact between the mouth and genitals. You can get a dental dam at a pharmacy or make one by cutting a condom into a square. Before you stop using condoms when in a stable and exclusive relationship, both you and your partner need to get tested for HIV and other STIs.
• Don’t share syringes or needles, particularly those used for intravenous drugs. The Public Health Agency of Canada estimates that injection drug use is responsible for 1 in 10 cases of HIV around the world.
• Don’t share any personal items that can have traces of blood, such as toothbrushes, razors or nail files.
• The virus can also be spread from ear piercings, tattoos, dental care or acupuncture treatments: make sure that all instruments used for these services are sterile.
• If you travel to developing countries, such as a number of regions in Africa, refuse all blood transfusions unless your life depends on one. If you need to get an injection, make sure the needle is sterile.

If you are infected with HIV, you must contact anyone with whom you’ve had unprotected sex or shared injectable drugs and let them know. These people must also get screened and treated, if necessary. This will prevent the virus from spreading to other people.

How HIV is not spread

You can’t become infected by HIV:

• From masturbating (unless a mucous membrane comes into contact with semen or vaginal secretions).
• By touching or kissing (with or without saliva) or eating food prepared by someone who is HIV-positive.
• By sharing dishes or utensils.
• By taking a bath or swimming with the person. 
• Through mosquito bites or pet bites.

How to disinfect a contaminated object

If fabric becomes contaminated with biological fluids infected by HIV, wash it for 30 minutes in water above 59 °C and a detergent to kill the virus. If you wash with cold water, you’ll need to add a disinfectant such as bleach.

On hard surfaces, a blend of 1 part bleach and 9 parts water applied for 15 to 20 minutes will kill the virus. You can also use 70% isopropyl alcohol.

HIV /AIDS treatment

There is currently no cure for HIV or AIDS. If you get the virus, you will have it for the rest of your life. However, medication can prevent the virus from reproducing. The amount of reproduced HIV virus is expressed as a viral load. The goal of prescribed medications is to reduce the viral load in the body. The less the virus reproduces, the better the body’s immune system can fight infections. Triple therapy is a combination of 3 drugs that act on different parts of the virus’s reproduction cycle. This is currently the best approach to prevent or slow the progression of HIV to AIDS and limit the spread to other people. 

You need to take your prescribed medication regularly and remember every single dose. If you often forget to take your medication, the virus could change and become resistant to the drugs. This means you will have fewer treatment options to keep the virus from reproducing. Over the long term, it may be difficult to reduce the viral load, which may in turn cause HIV to progress to AIDS and its related complications.

The higher the viral load, the more white blood cells are destroyed. You then become more vulnerable to infection and certain cancers. This is why someone with HIV must take drugs at a certain stage of the disease to prevent infection. HIV is not fatal on its own: the destruction of the immune system is what is fatal. People usually die of infections that someone without HIV and with an intact immune system could fight off.

Although the quality of life of people with HIV has improved a great deal and their life expectancy is similar to that of someone with a healthy immune system, AIDS is still a deadly disease. A lot of research is being done to find a cure , but no one has discovered it yet. Prevention is therefore essential.

If you have concerns or questions about HIV infection or screening, you can speak confidentially with your doctor, a CLSC health care professional, or your pharmacist.


Resources: 
Coalition des organismes communautaires québécois de lutte contre le sida: http://www.cocqsida.com
Clinique L’Actuel: http://cliniquelactuel.com/ 
Portail santé mieux-être Québec: http://sante.gouv.qc.ca/problemes-de-sante/vih-sida/ 
Government of Canada: http://canadiensensante.gc.ca/diseases-conditions-maladies-affections/disease-maladie/hiv-aids-vih-sida/index-fra.php
World Health Organization: http://www.who.int/features/factfiles/hiv/fr/