HIV

What is it?

HIV is the Human Immunodeficiency Virus that causes failure of part of the immune system. The immune system is important because it defends the body from infection and disease.

Acquired Immune Deficiency Syndrome (AIDS) refers to a range of specific illnesses that people with HIV may get when their immune system is badly damaged. These illnesses include infections and cancers.

The presence of HIV in the body is not an AIDS diagnosis. It is possible for people to have HIV for many years but show no symptoms that define AIDS.

How do you get it?

HIV is only infectious in blood, cum (semen), pre-cum, anal mucus, vaginal fluids and breast milk. A person can only become infected with HIV if one of these body fluids containing HIV gets into their body and passes into their bloodstream. For gay men, the main ways in which this occurs is through unprotected sex (fucking or being fucked without using condoms) or sharing injecting equipment.

For HIV-positive men, having an ‘undetectable’ HIV viral load does not mean that you can’t pass on HIV during unprotected sex. The presence of other STIs increases the levels of HIV in semen and other bodily fluids and therefore increases the risk of HIV transmission. Similarly, HIV may be present in genital ulcers caused by other STIs at levels high enough for HIV transmission to occur.

For HIV negative men having another STI can cause inflammation in the site of infection or ulcers, which increase the chances of picking up HIV.

What are the symptoms or signs?

HIV seroconversion is the term used to describe the process when someone goes from being HIV negative to HIV positive. Shortly after being infected with HIV, a person may (but not always) undergo a seroconversion illness, a severe flu-like illness that will pass in a matter of weeks. Symptoms of this may include fever, rashes, a sore throat and swollen glands. After this time a person becomes HIV-positive as the immune system creates antibodies to fight the infection.

Symptoms of ongoing HIV infection may include unexplained diarrhoea, weight loss, recurrent rashes, fever or an AIDS-related illness. AIDS-related illnesses include illnesses like pneumonia, brain infections, skin cancers, and severe fungal infections.

Testing

The common test for HIV is an antibody blood test. Antibodies are the immune system’s response to infection. It can take between 2 weeks and 3 months for the body to produce antibodies. So if an antibody test is done during this window period it is likely to show up negative.

Can it be treated?

There is no vaccine or cure for HIV, and if left untreated the infection can cause serious illness and death. Treatment for HIV is currently provided by highly active anti-viral medications to prevent further damage to the immune system. These attack the virus at different points and stages in its lifecycle.

How can it be prevented?

The most effective way to prevent getting or passing on HIV is using condoms and water-based lube when fucking and clean equipment if injecting drugs.

For HIV negative men, giving oral sex (that is, sucking a dick) is considered low risk. Having cuts or sores in your mouth, having an STI in your throat or having had recent dental work increases the risk. During these times, using a condom, avoiding cum in your mouth or avoiding oral sex will reduce the risk.

For HIV positive guys, having an STI in your dick will increase the chances of passing on HIV when receiving oral sex. Getting tested regularly and not cumming in your partner’s mouth will reduce this risk.

Post-Exposure Prophylaxis (PEP)

If you think you may have been exposed to HIV you should consider getting PEP. If you think you may have exposed another person to HIV, let them know about PEP and where they can get it.

PEP is a 4 week course of anti-HIV drugs which may prevent HIV infection, provided the treatment is started as soon as possible after the potential exposure.

To be most effective, PEP should be started as soon as possible after exposure to HIV. If it is not started within 72 hours (3 days) it is not likely to work.

To get PEP, contact your local sexual health clinic or hospital emergency department.

Further information on PEP, including a list of clinics or hospitals can be found at www.getpep.info.

Pre-Exposure Prophylaxis (PrEP)

Pre-exposure prophylaxis (PrEP) refers to a drug taken daily over a sustained period to prevent HIV infection before exposure.

PrEP is different from PEP (post-exposure prophylaxis), which is a 28-day course of anti-HIV drugs taken after an exposure incident to prevent infection (see PEP above).

Truvada has been approved by Australia's Therapeutic Goods Administration (TGA) both for the treatment of people with HIV and for use as PrEP; however the drug has not yet been added to the Pharmaceutical Benefits Scheme (PBS - the schedule of medicines that are subsidised by the government so that consumers pay no more than $37.70 per script).

TGA approval means that any doctor can prescribe Truvada for PrEP, but until the drug is subsidised for this use through a PBS listing, individuals wanting to use PrEP must continue to access it through clinical trials or personal import of generic versions of the drug. It is possible for individuals to buy Truvada in Australia but it is expensive (approximately $10,000 for a year's supply).

For more information on PrEP, including how to access PrEP through clinical trials or personal importation, go here.