UNSAFE ACTIVITIES

UNSAFE ACTIVITIES

Unsafe sex has a high risk of spreading HIV. The greatest risk is when blood or sexual fluid touches the soft, moist areas (mucous membrane) inside the rectum, vagina, mouth, nose, or at the tip of the penis. These can be damaged easily, which gives HIV a way to get into the body.

Vaginal or rectal intercourse without protection is very unsafe. Sexual fluids enter the body, and wherever a man’s penis is inserted, it can cause small tears that make HIV infection more likely. The receptive partner is more likely to be infected, although HIV might be able to enter the penis, especially if it has contact with HIV-infected blood or vaginal fluids for a long time or if it has any open sores.

SAFER ACTIVITIES

Most sexual activity carries some risk of spreading HIV. To reduce the risk, make it more difficult for blood or sexual fluid to get into your body.

Be aware of your body and your partner’s. Cuts, sores, or bleeding gums increase the risk of spreading HIV. Rough physical activity also increases the risk. Even small injuries give HIV a way to get into the body.

Use a barrier to prevent contact with blood or sexual fluid. Remember that the body’s natural barrier is the skin. If you don’t have any cuts or sores, your skin will protect you against infection. However, in rare cases HIV can get into the body through healthy mucous membranes. The risk of infection is much higher if the membranes are damaged.

The most common artificial barrier is a condom for men. You can also use a female condom to protect the vagina or rectum during intercourse. Fact Sheet 153 has more information on condoms.

Lubricants can increase sexual stimulation. They also reduce the chance that condoms or other barriers will break. Oil-based lubricants like Vaseline, oils, or creams can damage condoms and other latex barriers. Be sure to use water-based lubricants.

Oral sex has some risk of transmitting HIV, especially if sexual fluids get in the mouth and if there are bleeding gums or sores in the mouth. Pieces of latex or plastic wrap over the vagina, or condoms over the penis, can be used as barriers during oral sex. Condoms without lubricants are best for oral sex. Most lubricants taste awful.

SAFE ACTIVITIES

Safe activities have no risk for spreading HIV. Abstinence (never having sex) is totally safe. Sex with just one partner is safe as long as neither one of you is infected and if neither one of you ever has sex or shares needles (see Fact Sheet 154) with anyone else.

Fantasy, masturbation, or hand jobs (where you keep your fluids to yourself), sexy talk, and non-sexual massage are also safe. These activities avoid contact with blood or sexual fluids, so there is no risk of transmitting HIV.

To be safe, assume that your sex partners are infected with HIV. You can’t tell if people are infected by how they look. They could be lying if they tell you they are not infected, especially if they want to have sex with you. Some people got HIV from their steady partners who were unfaithful “just once”.

Even people who got a negative test result might be infected. They might have been infected after they got tested, or they might have gotten the test too soon after they were exposed to HIV.

Antiretroviral therapy (ART)

The current therapy for HIV infection is called HAART (Highly Active AntiRetroviral Therapy) and consists of a combination of at least three different active ingredients. There are more than 20 different drugs in use.

A successful HAART suppresses the viral load (concentration of HIV in the blood) below the detection threshold and indirectly increases the number of T-helper cells. Due to these drugs, an HIV infection changes from a fatal illness into a chronic illness. This way it is possible to prevent the appearance of symptoms, and also to significantly reduce the risk of infection.

The drugs all prevent replication of HIV via various mechanisms, by interrupting the replication cycle. However, these drugs can only work over the long term, if they are taken daily, 365 days a year.



Thanks to antiretroviral therapy (ART), people infected with HIV are living significantly longer and have a better quality of life. But ART cannot completely eliminate the HIV in a person and it is not a cure. The drugs must be taken for a lifetime, which is a heavy burden on the patient. As soon as the drugs are stopped, the viruses replicate again explosively. Sometimes the drugs are not tolerated or the HIVs are resistant to these drugs, which therefore do not work any longer. Despite ART, more than 100 people still die from Aids every year in Switzerlan

Course of HIV infection

The course of untreated HIV infection can be divided into three phases: the acute HIV disease, then the latency phase and finally the disease of Aids, ending in death.

The acute HIV disease lasts a few weeks. This period is also known as the window of vulnerability, and it is characterized by an explosive replication of the HIV. During this phase, the HIVs invade the organs of the defense system and other bodily organs and establish themselves there.

The latency phase lasts on average 10 years, during which the virus concentration is relatively low.

In the Aids phase the defense system is completely destroyed, as the result of which death occurs after 1-2 years.



Weakening and destruction of the immune system

The defense system (immune system) has two main jobs: as well as combating outside invaders such as bacteria, viruses, fungi etc., which give rise to so-called infectious diseases, it also prevents cancer by tracking down and destroying the body's own damaged or degenerate cells.

It takes several years before the human immune system is defeated by the HIV infection. A veritable war goes on between the immune system and the viruses, with many battles. We know now that as early as a few days after infection (during the acute infection stage) several thousand million (!) new viruses are formed and at the same time thousands of millions of helper cells are destroyed. Hence, 2-3 weeks following infection, the acute HIV infection (= primo-infection) can appear, which subsides again after about 6 weeks, when the human immune system has gained the upper hand in the first battle. Even during the symptom-free latency period, the viruses replicate with extraordinary vigour. The human immune system kills as many HIV as are produced, maintaining equilibrium year upon year. When AIDS itself occurs, the immune system becomes exhausted and the quantity of virus steadily increases. The weakening of the immune system through HIV infection makes people increasingly vulnerable, especially to infectious diseases and cancer.

What is AIDS & HIV?".

What is AIDS & HIV?".
AIDS (acquired immune deficiency syndrome) is a condition caused by HIV. This virus attacks the immune system, the body's "security force" that fights off infections. When the immune system breaks down, you lose this protection and can develop many serious, often deadly infections and cancers. These are called "opportunistic infections" (OIs) because they take advantage of the body's weakened defenses.

In the U.S., the Centers for Disease Control (CDC) is responsible for collecting data on the number of people with AIDS. This is not the same thing as the number of people living with HIV. Remember, AIDS includes the words "immune deficiency". Since people can live with HIV an average of 10 years—without effective treatment—before their immune systems become seriously impaired, AIDS is really just an advanced stage of an HIV infection.

The CDC uses specific criteria for determining when a person living with HIV progresses to AIDS. One thing they look at is CD4 cell counts: if a person's CD4 count falls below 200, then they have officially progressed to AIDS. Another thing they look for are OIs: if an HIV-positive individual is diagnosed with an opportunistic infection that's included on the CDC's list of over two dozen possible HIV-related OIs, then they are diagnosed with AIDS.

Many OIs can be prevented and/or treated. In fact, a lot of the AIDS research you hear about has been done to find treatments or cures for specific OIs, and not just looking for drugs to stop HIV.