A Slice of range V o l u m e
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The truth about HIV
FEBRUARY IS THE TIME OF THE YEAR TO SPREAD LOVE – NOT SEXUALLY TRANSMITTED DISEASES SUCH AS HIV. SO MUCH HAS CHANGED SINCE THE VIRUS WAS DISCOVERED ALMOST 30 YEARS AGO. IN FEBRUARY 2010, LET’S FACE HIV WITH COURAGE, NOT HELPLESSNESS.
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erhaps no health topic elicits such intense reactions as HIV, short for the human immunodeficiency virus. It has replaced leprosy and tuberculosis (TB) as the disease enveloped by the most stigma. And as in the case with leprosy and TB, HIV research has made several breakthroughs, changing the landscape of this once-invincible virus.
HIV in the Philippines is low, but this is no reason to let our guards down.
A Slice of Orange is a newsletter designed to help clarify basic health information and offer juicy tips on uplifting your health.
Editorial team Alvin Delfin Christine Llenes-Delfin Ivan Olegario, MD
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HIV? AIDS? HIV is the virus that causes Acquired Immunodeficiency Syndrome (AIDS), a condition when the immune system begins to fail. This leaves the person defenseless against lifethreatening infections.
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sex work (prostitution) Increasing rate of casual sex, unsafe sex, and injecting drug use Stigma and discrimination regarding HIV/AIDS, leading people infected with HIV to hide their true condition
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Get yourself tested
People with HIV usually do not know that they are infected. This is because:
How HIV gets around
HIV is popularly known as a sexually transmitted disease. However, As soon as the virus infects someone, the intercourse is not its person usually goes through four stages of sole route. Transmisinfection: sion can happen with • Incubation period (2-4 weeks of the transfer of blood, semen, vaginal fluid, no symptoms) pre-ejaculate, or breast milk. HIV has been • Acute infection (around one month found at low concentrations in saliva, tears of any one or a combination of the and urine, but the potential risk of transmis following symptoms: fever, swollen lymph nodes, sore throat, rash, muscle sion from these is negligible. It is not pos pain, malaise, and mouth sores. This is sible for mosquitoes to transmit HIV. usually mistaken as a common flu) The three major routes of transmission are • Latency stage (Two weeks to 20 (1) unsafe sex; (2) contaminated needles; years of no symptoms. The person’s (3) transmission from mother to baby. immune system attempts to fight off the virus. The virus may in turn hide Unsafe sex within lymphoid organs, evading Most infections are attack and continuing to multiply) transmitted this way. It • AIDS (the person’s immune system can occur when infect is depleted, leading to life-threatening ed secretions of one infections in nearly every organ partner come into con system of the body. Cancers may also tact with the genital, occur. Survival after developing AIDS oral, or rectal mucous membranes of an is only 9.2 months on average) other. Males are more likely to transmit to In the Philippines, the prevalence is cur- their partner than women. The correct and rently low, with less than 0.1 percent of consistent use of latex condoms reduces the adult population estimated to be HIV- the risk of transmission of HIV. Spermicide positive. However, this is no reason to let may actually increase the transmission rate when condoms are not used. our guards down. Several factors make the Philippines an HIV epidemic in the brewing: • Increased mobility within the Philippines, and to other countries • A conservative culture that prevents open discussions regarding sexually transmitted diseases • High prevalence of commercial
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Contaminated needles Most blood products are meticulously screened for HIV. Therefore, transmission through contaminated needles is mostly among drug users who share needles.
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Their sexual partners do not disclose their sexual history Their sexual partners do not disclose to them about being infected, or are also unaware that they are infected The active infection stage is often mistaken as a simple flu episode Many people have the wrong knowledge about HIV transmission
Since treatment works best when taken early, and personal knowledge may lead to more careful behavior to prevent transmission, it is a good idea to get tested. Modern HIV testing is extremely accurate. HIV testing is usually performed in 2 stages. The first is a screening test using ELISA. This test detects antibodies against HIV. A negative screening result indicates that the person is not infected, unless he or she is still within the window period. A positive screening result still needs to be confirmed by a test called the Western blot. This test detects HIV proteins in the blood. If the Western blot turns out positive, only then will the person be considered HIV positive.
For mothers Transmission of the virus from the mother to the child can occur during pregnancy, during delivery, and during breast feeding. Risk of transmission can be lowered with
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drug treatment, birth via Cesarean section, and complete avoidance of breast feeding. Sadly, not breastfeeding a child also has its dangers. Sometimes breast feeding may be done when the mother takes antiviral drugs for an extended period.
HIV: A treatable disease There is no available vaccine or cure yet for HIV. However, treatments are available--highly active antiretroviral therapy, or HAART. This is a combination of at least three anti-retroviral drugs belonging to at least two drug classes.
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Another approach is a course of antiretrovirals immediately after exposure. This technique, called post-exposure prophylaxis, reduces the risk of infection, although not completely. Visit a doctor immediately after you suspect you have been exposed.
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The Window Period
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his is the period wherein the body still has not produced enough antibodies against the virus to be detected by the ELISA test. This usually takes between 3 weeks to 6 months from the time of infection. During this time, the patient is already infected and can even transmit the virus. However, their ELISA test will still turn up negative. Take another screening test after 6 months if you think you could still be within this window period.
Considering the limitations of antiviral drug therapy, avoidance of exposure to the virus remains the best way to fight HIV.
Know your rights
HAART does not cure the patient; it only suppresses replication of the virus. Despite this, many HIV-infected people experience remarkable improvements in general health and quality of life, and an average life expectancy of 32 years from the time of infection.
The WHO policy on HIV Testing states that people undergoing HIV testing must be protected for:
• Confidentiality. However there is much debate on whether test results should be disclosed to sexual partners. In the Philippines, this is not required. • Access to counseling for those who test positive • Informed consent. No patient can be tested (using blood specimens drawn for other purposes) without his knowledge.
But HAART is not cheap. In the Philippines, treatment easily reaches Php 2,000 daily, which is taken for practically a lifetime – or Php 700,000+ a year. The virus becomes resistant if treatment is stopped.
R A C E 03.07.10 • UP DILIMAN
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