• Take care of your health

Definition

1. Do you know what HIV is?

HIV is a human immunodeficiency virus which causes the reduction of organism resistibility and makes one exposed to any infection and to malignant tumors. In the process of its development HIV can cause AIDS in 6-11 years.
  
2. Do you know what AIDS is?

AIDS is an acquired immune deficiency syndrome, i.e. the condition when the weakened immune system is not able to resist infections caused by opportunistic originators or developing malignant tumors. HIV and AIDS are not the same. AIDS is the last stage of the HIV-infection to which infection does not always progress. 

Statistics

The disease caused by the Human Immunodeficiency Virus (HIV) has become nowadays one of the main threats to the health of the Earth population.

3. Do you know how many HIV infected persons are registered in Poland?

For the first time found out in Africa in the middle of the XX century, it has struck all countries to a greater or lesser extent. The mankind has learned on June 5, 1981 about the Acquired Immune Deficiency Syndrome (AIDS) from a report published by the Center for the control of sickness rate of the USA.

For this period, more than 20 million people have died of the virus in the world; 42 million live with this terrible diagnosis. In 2002, 5 million new cases of the HIV-infection were registered and 3.1 million persons died.

In Poland since the beginning of the HIV/AIDS in 1985 until June 2006 epidemics there have been:

• 10.203 infected in total
• 5.344 infected by using drugs
• 1.784 AIDS cases
• 819 of AIDS patients died    

1. Origin of HIV Infection

4. Do you know where the virus comes from?

Unfortunately, one can hardly provide any solution of HIV origin. There are only hypotheses. Each of them can be substantiated, but in the scientific world all of them continue to be regarded only as assumptions – possible and for someone rather disputable versions of the occurrence circumstances.  
 
The very first hypothesis of the HIV origin is connected with monkeys. It was advanced by American researcher B. Korbett more 20 years ago. In the opinion of this scientist, HIV got into the human blood for the first time in the 30s of the last century from a chimpanzee- probably, at an animal bite or while cutting a carcass by man. There are serious arguments for this version. One of them is that the chimpanzee blood sample really produced a rare virus capable of causing symptoms similar to those caused by AIDS in humans.
 
In the opinion of another researcher, professor R. Gerry, AIDS was discovered much earlier: from 100 to 1000 years ago. One of the most serious arguments confirming this hypothesis is Kaposi's  sarcoma described at the beginning of the XX century  by Hungarian doctor Kaposi as
"a rare form of malignant neoplasm" evidencing the immunodeficiency virus with a sick person. 
 
Many scientists consider Central Africa to be the land of AIDS origin. This hypothesis is divided, in its turn, into two versions. According to one of them, HIV already existed for a long time in the districts isolated from the external world, for example, in tribal settlements hidden in the jungle. In the course of time, when the people's migration had increased, the virus escaped "outside" and began quickly to spread. The second version is that the virus originated as a consequence of the enhanced radioactivity background registered in some regions of Africa which are rich in uranium deposits.
 
Quite recently, another hypothesis attributed to English researcher E. Hooper came into being: the virus appeared in the early 50s of the twentieth century owing to a mistake of scientists working at the creation of a poliomyelitis vaccine. The mistake was that the chimpanzee liver cells were used for the manufacture of a vaccine presumably containing a virus similar to HIV. One of the most potent arguments for this hypothesis is the fact that the vaccine was tested just in those regions of Africa where the highest level of infection by the immunodeficiency virus is registered today.
 
And, finally, the last of the known versions neither proved nor denied: HIV was obtained in the 1970-s in the course of genetic engineering manipulations aimed to develop a new type of weapon
The mechanism of virus action is the following: on getting into the human organism, HIV affects a certain category of cells having on the surface so-called CD-4-receptors. Immune cells are ranged among them: Т-lymphocytes and macrophages, and also microglial cells referring to the neural tissue. The main effect of the virus become apparent at the stage of AIDS and consists in that the immune system weakens, that is, immunodeficiency develops: anyone becomes vulnerable to many infections named opportunistic.  Pneumocystic pneumonia, tuberculosis, candidacies, shingles, etc. are referred to them.  

Channels of transmission

5. Do you know the ways of transmission of the virus?

HIV can be transmitted only when virus-containing fluids enter the human body.
In the human organism there are four liquids through which HIV can be transmitted: blood, semen, vaginal discharge, breast milk. The virus can be transmitted only if a certain quantity of liquid with a significant virus concentration gets into the organism and there is a risk that the virus can immediately get into the bloodstream.
There are only three channels of HIV transmission: sexual, through the bloodstream and from a HIV-positive mother to child. 

The first channel is the sexual channel of infection transmission during an unprotected intercourse – HIV-containing semen or vaginal discharge gets into the blood through the mucosa. Among sick persons there are 31% infected though sexual intercourse (against 18 % in 2002). It is one of the most adverse and dangerous tendencies despite of the stabilization of detectability. The reason is a risky sexual (synonyms - intimal) behavior: single/ multiple episodes of  sexual intercourse and frequent (more than two per year) change of partners, sexual intercourse with injection drug users (IDU), sex sales and purchase, sexual intercourse with a SID-infected partner and acute urogenital diseases, the plurality and often change of sexual partners (more than 2 per a year), sexual intercourse with foreign citizens. The unprotected sex is an aggravating factor when the mucosa and skin contact with semen, vaginal secretion and the partner's blood. The sexual intercourse "traumaticity" is of particular importance during sexual connections. Therefore, unprotected anal intercourse from among sexual contacts carries the highest risk of HIV transmission, while unprotected oral intercourse carries the least risk of contracting HIV. Unprotected vaginal intercourses are classified into the intermediate risk group. 
The risk of infection at an unprotected sexual contact with a HIV-positive partner comes to:

• During oral intercourse (fellatio and cunnilingus) – a few thousandths of one percent; 
• During vaginal intercourse the risk is about 0.1 % (for man) and 0.3 % (for woman);
• During anal intercourse - about 5 %.

Taking into account that the traumaticity of sexual intercourse influences the risk of infection, a violent sexual intercourse is characterized by a higher risk of HIV transmission in comparison with a nonviolent one.
Besides, many venereal diseases (syphilis, genital herpes) evidence genital ulcers, essentially enhancing the risk of HIV infection. Other venereal diseases (gonorrhea, clamidiosis) are accompanied by genital inflammation, also enhancing the risk of HIV transmission at sexual intercourse.
It should be noted that HIV transmission during a safe/protected sexual intercourse (except when a condom rips or comes off) is excluded. The data on that a condom is capable to let through HIV proved to be a myth. Modern scientific researches convincingly evidence that latex condoms, if duly applied, reliably protect against HIV.
At the same time, there is no true evidence of protection against HIV by using chlorine-containing antiseptics or spermicide.

The second channel of infection is by getting into the bloodstream: - the most probable way of transmission.
The virus can be transmitted through the blood in the following cases:

• While sharing needles, syringes and injection equipment;
• While using unsterile toolkit for tattoos and piercing;
• During blood transfusion.

The third way is from mother to child.
The virus can be transmitted from mother to child:

• During pregnancy (through the placenta);
• During labors (by contacting mother's blood);
• During breast feeding (through breast milk).

6. Do you know if HIV is transmitted by sneezing, insect bites or by sharing the same toilette?

It is necessary to know how HIV is not transmitted: 

• HIV is not airborne - by sneezing, coughing, staying together in the same premise or in public transport.
• Through insect stings and pet bites.
• By sharing common dining room, utensils (forks, spoons, cups), linen, towels. 
• By sharing common toilet, common bath, swimming pool or sauna.
• Through a kiss or a touch (massage, mutual caress). 
• So-called "household" contacts with HIV-positive are fully safe.  
• There is no case when somebody would be infected while living in the same room, sharing the same utensils, washing the things of a HIV-positive or even making dressings and nursing an AIDS patient.   
• You do not catch HIV by embracing your HIV-positive friend, by shaking hands with him or by kissing him. 
• Your child will not become infected if there is a HIV-positive at kindergarten or at school.
• Infection can not be transmitted even if the blood of infected person contacts the skin of a healthy person unless the skin was not intact.
• Infection can not be transmitted during a contact with dried biological liquids of HIV-positives since the virus contained in them perishes at desiccation. The virus is also very susceptible to all disinfectants.

Two rules are to be observed in order not to become a HIV-infected

• Any instruments which may affect the integrity of skin and mucosa (syringes, needles, including ones used for tattoos and ear piercing, tooth-brushes, manicure and shaving instruments), must be individual, disposable or sterile;
• Any sexual contacts which you enter must be protected (only by using a condom).

HIV Diagnostics

7. How to clear up whether one is a HIV is positive?

• Within one week you feel sick, getting fever and other signs of infection
• The blood has to be tested for HIV antibodies. 

The only way to clear up whether one is a HIV-positive or not is to test blood for HIV antibodies. There are no other ways like external attributes by which a HIV infection can be detected.

You can find addresses of Confidential HIV Test Walk-in Labs in your place of residence at the following website:
http://www.aids.gov.pl/index.php?page=testy

There are no other ways, i.e. external attributes or specific manifestations by which it would be possible to determine HIV  infection with a person.

When HIV gets into the human body, the organism starts to develop special formations (antibody) for combating the virus. Just these antibodies are detected by the HIV test.   
The standard analysis (EIA) is recommended to carry out in 1.5-3 months after the contact. The PCR analysis shows an infection in 2-3 weeks after the dubious contact.
It is recommended to carry out a test in 1, 3 and 6 months after the dubious sexual contact or another episode during which, in your opinion, there was a risk to become HIV-infected.
In spite of the fact that 3 months elapsed from the contagion to the emergence of antibodies, irrespective of the emergence of antibodies, any person can become infected from another HIV-positive.
 
8. If you are tested HIV positive are you forced by law to report your employer?

ATTENTION! Pursuant to the legislation, the findings and the information that you were tested are not subject to disclosure.

9. If you are HIV positive, does it mean that you have AIDS?

What does test result evidence?   
The negative result means that antibodies are not found in your blood. It means that you are most likely not HIV-infected.
It is true only in the event if you have your blood tested not earlier than in 3 months after your last "risk." The negative result does not mean that you possess any "immunity" to HIV infection. You can become infected later if you get involved in a risky situation.  
The positive result means that the antibodies are found in your blood. It means that you are HIV positive (though it is necessary to pass another test). 
The positive result does not mean that you are ill with AIDS. It means that you are HIV-positive and you can infect other people if you give them your syringe or have unprotected sexual intercourse.
There are medicines restraining the virus development and treating the diseases which have appeared due to HIV. Unfortunately, there is no medicine which would completely treat HIV-infection.

Life with  HIV-infection

10. If the HIV infection is detected with you what does it mean?

• You have to change your life radically
• Living with HIV does not mean to change your life radically, but some changes are necessary. 
• As soon you are infected you are no longer able to work, because of the symptoms
• IT DOES NOT MEAN that you are sick while you do not have any signs of other accompanying diseases. 
• IT DOES NOT MEAN that you are helpless. There are many ways to strengthen the immune system and to prolong your health and life. 
• IT DOES NOT MEAN that you will soon die. More and more new medicines helping to combat the HIV infection are found.  
• IT DOES NOT MEAN that your life should change radically if you do not want it.

Does the diagnosis "HIV-INFECTION" mean that something should change in your life?

• YES, because it is important to feel like the master of the situation at HIV-infection, but not like a helpless victim. Knowledge is force; therefore, try to learn more about the development of HIV infection, the importance of various analyses, about the ways to maintain your health, new medicines and the methods of treatment. You should know your rights and assert them.
• YES, because it is necessary to take care of your physical and mental health already now. Try to give up narcotics, smoking, reduce the consumption of alcoholic drinks. Organize wholesome nutrition rich with calories, proteins and vitamins. Avoid stresses; do not deny yourself sound sleep, rest, movement in fresh air, entertainments and social intercourse.
• YES, because you are able not to allow that your sexual partner contracts HIV. It is possible to avoid the infection if you use a condom during each sexual intercourse. The law provides for criminal liability for the deliberate transmission of HIV infection.
• YES, therefore, in order to avoid infecting other people it is necessary to use only individual injection needles. Avoid any contact of your blood, semen or vaginal discharge with the mucosa or injured skin sites of another person. 
• NO, because almost in all situations, you may continue to work in whatever position you might work. You are not obliged to notify your employer and colleagues that you are a HIV-positive.
• NO, because you cannot infect your natives, friends, neighbors, i.e. those people with whom you have no sexual contacts and do not share a syringe, and there is no necessity to inform them about your diagnosis. You can cook, share utensils, and not be afraid to infect your people. It is self-evident that you, irrespective of your HIV-status, do not allow anybody to use your razor or your tooth-brush.
• NO, because HIV infection is not a reason to abandon your plans and interests, studies, work and entertainments love and sex.
• You will soon ensure that your daily life has little changed, and it is normal. However, you should keep in mind that, in connection with criminal liability for infecting another person with HIV, you shall inform your sexual partner about your HIV-positive status.

Legal Questions

11. Is your employer allowed to request a HIV test when you want to get an employment?

You should know that you have the right to MEDICAL SECRECY. Only in some cases stipulated by law, for example, upon request of investigative agencies, a public prosecutor and a court in connection with carrying out an investigation or proceeding, the law provides for the disclosure of your diagnosis without your consent.  

If your diagnosis is disclosed by persons who have learned about it in discharge of their functions, they may be brought to trial. If you are requested to produce a HIV test certificate when you want to get employment, it is illegal in most cases.
All other requests for information on a HIV test during one's employment are contrary to the Polish legislation.

Consequences of HIV infection

13. Can HIV be healed?

Unfortunately, no radical drugs for HIV treatment are developed to date. 
If the HIV infection is not treated, in 6-10 (sometimes up to 20) years the immunity, i.e. the ability of the organism to resist various diseases begins gradually to diminish and AIDS (Acquired Immune Deficiency Syndrome) develops.
However, timely treatment allows considerably increases the life span
Sometimes it seems to us that we cannot make anything with the epidemic and the virus is not to stop. Actually, we can make enough, including the conscience of responsibility for our health.