How is HIV transmitted?
HIV 101: For NZ Schools What’s HIV? What’s AIDS? What’s the difference? HIV is a virus that slowly destroys a person’s immune system. HIV causes AIDS, an advanced form of HIV infection but with modern treatment HIV usually doesn’t progress to AIDS. We say a person has AIDS when HIV has weakened their immune system so much that it can no longer fight off specific infections and cancers. There is no vaccine or cure for HIV or AIDS.
HIV stands for Human Immunodeficiency Virus AIDS stands for Acquired Immune Deficiency Syndrome Useful Websites www.nzaf.org.nz www.positivewomen.org.nz www.avert.org/children.htm www.womenchildrenhiv.org
There are only a few ways to transmit HIV. In New Zealand, almost all HIV transmission is through unprotected sexual contact. There are very low rates of HIV transmission from direct contact with blood, and from mother to baby. HIV can be transmitted through: • blood to blood contact • sexual contact with semen, anal mucous and vaginal fluid • breast feeding HIV cannot be transmitted through contact with: • tears • saliva • sweat • urine • faeces
HIV cannot be transmitted by biting, kissing, hugging, sharing toys, swimming pools, toilets and eating utensils with a person who is living with HIV. There is also zero risk of acquiring HIV from insect bites or animals.
Who has HIV in NZ? How many kids are living with HIV? HIV is a global problem. At present, there are 33.2 million people in the world living with HIV. NZ has around 2000 people living with HIV which is a very low number compared with most other countries. The AIDS Epidemiology Group at the University of Otago reports that 2% of people who are living with HIV in NZ are children under the age of 15. This is approximately 40 children in total. In NZ, the groups of people with the highest rates of HIV are gay and bisexual men, and people from NZ’s African communities.
Treatment for HIV
Eve van Grafthorst
These days, there are excellent drugs for HIV called antiretroviral treatments, or ARVs. ARVs decrease the amount of virus in a person’s body and they can usually live healthy, long lives. For some people, ARVs will lower the level of HIV in their blood to the point where it cannot be detected by modern testing equipment. This is called ‘undectable viral load’ and means HIV can only be transmitted through very high risk activities like sharing needles or unsafe sexual activities.
HIV in NZ kindergartens and schools The risk of HIV transmission in a kindergarten, childcare centre or school is so incredibly low that there has never been a reported case in the 30 year history of the HIV pandemic. Why is this when children sustain injuries in education facilities that result in bleeding?
Cuts, grazes and bites Cuts and grazes: For HIV to be transmitted, infectious blood must be moved very rapidly from the bloodstream of a person living with HIV directly into the bloodstream of an HIV negative person. This is why sharing hypodermic needles carries a very high risk of HIV transmission. It is extremely difficult to get blood into a body through a cut or graze because blood flows outwards. This is also the reason that dirt and debris from a graze may sit on the top few layers of a graze but they do not get absorbed into the bloodstream. Bites: Saliva does not transmit HIV. In fact, there is an enzyme in saliva that damages HIV and protects against transmission. In the history of the HIV pandemic there have been only a handful of cases (out of more than 30 million) where it is suspected that HIV was transmitted through biting. The person with HIV would have to have a high amount of HIV in their bloodstream and bleeding sores in their mouth and the bite would have to cause severe trauma with extensive tissue damage for there to be any risk. This has never happened in an educational facility anywhere in the world.
Can I find out who has HIV? No. This information is completely confidential and private in the same way that information about any other medical condition is. People living with HIV can choose to tell their employers, schools or service providers when they feel comfortable and safe enough to do so but they do not have a legal obligation to do so.
So, if I don’t know who has HIV how can I protect myself and my kids from from it? The Ministry of Education developed a set of guidelines about HIV transmission for education providers in 1991 that will prevent HIV transmission in educational facilities:
Ministry of Education Guidelines for infection control of HIV/AIDS and other blood-borne viruses in schools • Before treating a child who is bleeding, make sure you cover any cuts or abrasions with a water-proof dressing. • Wear gloves for all procedures. • Don’t delay treatment of a child who is bleeding, under any circumstances because gloves are not immediately available. Use an absorbent barrier such as a towel, paper towel, handkerchief etc. for an actively bleeding child. • Dispose of used gloves, soiled dressings, sanitary towels, tissues, etc, in a place where they will not be handled, e.g. in bags which are burnt or buried. • Wipe clean and then sterilise all surfaces and instruments contaminated with blood. Make sure you use an effective disinfectant, e.g. (one volume of household bleach to nine volumes of cold water). • Soak surfaces for 20 minutes and then wipe dry. Prepare a fresh solution immediately before you want to use it. • Wash hands thoroughly when you have finished. Hand washing is usually adequate for non-blood secretions, but the above precautions (i.e. gloves, etc) can also be used. • Make sure that first-aid kits include disposable gloves, disposable wipes or towels, plastic bags for contaminated waste, a skin disinfectant and a bleach solution (or hypochlorite solution/or granules) with instructions for use.
How can I help look after a person who’s living with HIV? With effective ARV treatment, people living with HIV do not require HIV-specific plans or special treatment. NZ educational facilities are required to have policies on infection control that manage risk (e.g. letting the school know if your child has mumps or chicken pox). The single, biggest issue that people with HIV in NZ face is stigma and discrimination. Learning about HIV and sharing information with your whanau and friends is the best thing you can do to support the people in your life who are living with HIV. www.nzaf.org.nz