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HIV and AIDS

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HIV and AIDS



Introduction

HIV is a virus which attacks the immune system, and weakens your ability to fight infections and disease. It's most commonly caught by having sex without a condom.

It can also be passed on by sharing infected needles and other injecting equipment, and from an HIV-positive mother to her child during pregnancy, birth and breastfeeding.

HIV stands for human immunodeficiency virus. The virus attacks the immune system, and weakens your ability to fight infections and disease.

There is no cure for HIV, but there are treatments to enable most people with the virus to live a long and healthy life.

AIDS is the final stage of HIV infection, when your body can no longer fight life-threatening infections. With early diagnosis and effective treatment, most people with HIV will not go on to develop AIDS.

How do you get HIV?

HIV is found in the body fluids of an infected person, which includes semen, vaginal and anal fluids, blood, and breast milk. It is a fragile virus and does not survive outside the body for long. 

HIV cannot be transmitted through sweat or urine.

The most common way of getting HIV in the UK is by anal or vaginal sex without a condom. According to statistics from Public Health England, 95% of those diagnosed with HIV in the UK in 2013 acquired HIV as a result of sexual contact.

Other ways of getting HIV include:



using a contaminated needle, syringe or other injecting equipment



tranmission from mother to baby during pregnancy, birth or breastfeeding



through oral sex or sharing sex toys (although the risk is significantly lower than for anal and vaginal sex) 



Getting tested

The only way to find out if you have HIV is to have an HIV test.

If you think you have put yourself at risk of HIV, you should seek medical advice and have a test as soon as recommended. The earlier HIV is diagnosed, the earlier you can start treatment and avoid becoming ill.

Emergency anti-HIV medication called PEP (post-exposure prophylaxis) may stop you becoming infected, but treatment must be started within three days of coming into contact with the virus.

There are a number of places you can get an HIV test, including your GP surgery and sexual health clinics and clinics run by charities including the Terrence Higgins Trust.

Most HIV tests in the UK involve taking a small sample of blood and sending this to a laboratory for analysis. These tests can provide a reliable result from four weeks after possible infection and results are usually available within a few days. It is also possible to test using a saliva sample or pin-prick (blood-spot) test, and many sexual health clinics now use these tests routinely as the result is available within a few minutes and do not need to be sent to the lab. However, these tests do not reliably detect HIV if you have been infected within the past few weeks.

You may get the results in hours, days or weeks, depending on the type of test you take.

If your test is positive, you will be referred to a specialist HIV clinic where you'll have more blood tests to show what effect HIV is having on your immune system and be able to discuss treatment options.

Anyone who has sex without a condom or shares needles is at risk of HIV infection. However, the two groups with highest rates of HIV in the UK are gay and bisexual men and African men and women.

NICE recommends that annual HIV tests be offered to all men who have sex with men, and more frequent testing be offered to those at higher risk due to multiple partners or unsafe sexual practices.

Living with HIV

Although there is no cure for HIV, treatments are now very effective, enabling people with HIV to live long and healthy lives.

Medication, known as antiretrovirals, work by stopping the virus replicating in the body, allowing the immune system to repair itself and preventing further damage. These medicines come in the form of tablets, which need to be taken every day.

HIV is able to develop resistance to a single HIV drug very easily, but taking a combination of different drugs makes this much less likely. Most people with HIV take a combination of three antiretrovirals and it is vital that the medications are taken every day as recommended by your doctor.

You will be encouraged to take regular exercise, eat a healthy diet, stop smoking and have yearly flu jabs and five-yearly pneumococcal vaccinations to minimise the risk of getting serious illnesses.

Without treatment, the immune system will become severely damaged and life-threatening illnesses such as cancer and severe infections can occur. This is known as late-stage HIV infection or AIDS.

Preventing HIV

Anyone who has sex without a condom or shares needles is at risk of HIV infection.

The best way to prevent HIV is to use a condom for sex and to never share needles or other injecting equipment (including syringes, spoons and swabs). Knowing your HIV status and that of your partner is also important.

How common is HIV?

At the end of 2013, there were an estimated 107,800 people in the UK living with HIV. The majority were infected through sex (43,500 gay and bisexual men and 59,500 heterosexuals).

A quarter of people with HIV (over 26,100) do not know they are infected.

Around one in every 360 people in the UK has HIV, but the two groups with highest rates of HIV are gay and bisexual men and Black African heterosexuals, where the rates are approximately one in 17 and one in 18 respectively.

The World Health Organization estimates that around 35 million people in the world are living with HIV.

The virus is more common in sub-Saharan African countries, such as South Africa, Zimbabwe and Mozambique.

Symptoms of HIV 

Most people who are infected with HIV experience a short, flu-like illness that occurs two to six weeks after infection. After this, HIV often causes no symptoms for several years.

The flu-like illness that often occurs a few weeks after HIV infection is also known as seroconversion illness. It's estimated that up to 80% of people who are infected with HIV experience this illness.

The most common symptoms are:



fever (raised temperature)



sore throat



body rash



Other symptoms can include:



tiredness



joint pain



muscle pain



swollen glands (nodes)



The symptoms usually last one to two weeks but can be longer. They are a sign that your immune system is putting up a fight against the virus. 

However, these symptoms are most commonly caused by conditions other than HIV, and do not mean you have the virus.

If you have several of these symptoms, and you think you have been at risk of HIV infection within the past few weeks, you should get anHIV test.

After the initial symptoms disappear, HIV will often not cause any further symptoms for many years. During this time, known as asymptomatic HIV infection, the virus continues to be active and causes progressive damage to your immune system. This process can take about 10 years, during which you will feel and appear well.

Once the immune system becomes severely damaged symptoms can include:



weight loss



chronic diarrhoea



night sweats



skin problems



recurrent infections



serious life-threatening illnesses



Earlier diagnosis and treatment of HIV can prevent these problems.

It is recommended you should still take an HIV test if you have put yourself at risk at any time in the past, even if you experience no symptoms.

Want to know more?



Terrence Higgins Trust: Stages of HIV infection



HIVaware: symptoms at a glance



nam aidsmap: HIV and AIDS



Causes of HIV 

In the UK, most cases of HIV are caused by having sex without a condom with a person who has HIV.

A person with HIV can pass the virus to others whether or not they have any symptoms. People with HIV are more infectious in the weeks following infection.

HIV treatment significantly reduces the risk of someone with HIV passing it on.

Sexual contact

According to Public Health England, 95% of people diagnosed with HIV in the UK in 2011 acquired HIV through sexual contact.

The main routes of transmission are unprotected vaginal and anal sex. It is also possible to catch HIV through unprotected oral sex, but the risk is much lower.

The risk of HIV transmission through oral sex will be higher if the person giving oral sex has mouth ulcers, sores or bleeding gums and/or if the person receiving oral sex has been recently infected with HIV (and has a lot of the virus in their body) or another sexually transmitted infection.

The type of sex also makes a difference to the level of risk:



performing oral sex on a man with HIV carries some risk, particularly if he ejaculates (comes) in your mouth



it is possible to catch HIV by performing oral sex on a woman with HIV, particularly if she is having a period, although this is considered to be extremely low risk



receiving oral sex from someone who has HIV is also extremely low risk as HIV is not transmitted through saliva



Other risk behaviours

Other ways of getting HIV include:



sharing needles, syringes and other injecting equipment 



from mother to baby before or during birth or by breastfeeding



sharing sex toys with someone infected with HIV



healthcare workers accidentally pricking themselves with an infected needle (this risk is extremely low)



blood transfusion (now very rare in the UK, but still a problem in developing countries)



 

How is HIV transmitted

HIV is not passed on easily from one person to another. The virus does not spread through the air like cold and flu viruses.

HIV lives in the blood and in some body fluids. To get HIV, one of these fluids from someone with HIV has to get into your blood.

The body fluids that contain enough HIV to infect someone are:



semen



vaginal fluids, including menstrual blood



breast milk



blood



lining inside the anus



Other body fluids, like saliva, sweat or urine, do not contain enough of the virus to infect another person.

The main ways the virus enters the bloodstream are: 



by injecting into the bloodstream (with a contaminated needle or injecting equipment)



through the thin lining on or inside the anus and genitals



through the thin lining of the mouth and eyes



via cuts and sores in the skin



HIV is not passed on through:



kissing



spitting



being bitten



contact with unbroken, healthy skin



being sneezed on



sharing baths, towels or cutlery



using the same toilets or swimming pools



mouth-to-mouth resuscitation



contact with animals or insects such as mosquitoes



How HIV infects the body

HIV infects cells of the immune system, the body’s defence system, causing progressive damage and eventually making it unable to fight off infections.

The virus enters cells in the immune system called CD4 cells + ve lymphocyte cells, which protect the body against various bacteria, viruses and other germs.

It uses the CD4 cells to make thousands of copies of itself. These copies then leave the CD4 cells, killing them in the process.

This process continues until eventually the number of CD4 cells, also called your CD4 count, drops so low that your immune system stops working.

This can take about 10 years, during which time you will feel and appear well.

Who is most at risk?

People who are at higher risk of becoming infected with HIV include:



men who have had unprotected sex with men



women who have had sex without a condom with men who have sex with men



people who have had sex without a condom with a person who has lived or travelled in Africa



people who inject drugs



people who have had sex without a condom with somebody who has injected drugs



people who have caught another sexually transmitted infection



people who have received a blood transfusion while in Africa, eastern Europe, the countries of the former Soviet Union, Asia or central and southern America



HIV testing 

Some people living with HIV have no signs and symptoms for many years.

People who have recently been infected with HIV often experience a short, flu-like illness two to six weeks after infection. Symptoms include fever, sore throat, and body rash. See symptoms of HIV for more information.

You can only be certain you have HIV if you have an HIV test.

If you think you might be at risk, you should seek medical advice immediately. The earlier HIV is diagnosed, the earlier you can start treatment and avoid becoming ill.

If you do have HIV, delaying diagnosis will allow the virus to cause more damage to your immune system and your health.

The sooner you get tested, the sooner you can start treatment and avoid passing the virus to someone else.

HIV testing is available of charge to anyone. Many clinics can provide test results on the same day the test is taken.

HIV tests

The most common form of HIV test is a blood test, in which a small amount of blood is taken and tested in a laboratory, the result is usually available within a few days, sometimes on the same day. These tests can provide a reliable result four weeks after exposure to HIV.

It is also possible to test for HIV using "point of care test kits" which test a sample of saliva taken from the mouth or a spot of blood taken from pricking a finger with a needle. The result is available within a few minutes, in the clinic. However, it can take up to several week longer after you have been infected with HIV for the virus to show up in saliva and blood spot tests. If you are concerned you may have been infected with HIV within the past few weeks then it's best to have the full blood test for HIV.

If the test finds no signs of infection, then your test result is “negative”. If the HIV virus has been found in your blood then the test result is “positive”.

If a point of care HIV test kit is used, then a positive result will need to be confirmed using a full blood test. All positive test results should be confirmed with another blood test.  

If you test positive for HIV, you will undergo a number of tests to monitor the progress of the infection to work out when HIV treatment should be started.

Where to get tested

There are various places to go for an HIV blood test, such as:



sexual health clinics, also called genitourinary medicine (GUM) clinics 



clinics run by charities such as the Terrence Higgins Trust



some GP surgeries



some contraception and young people’s clinics



local drugs agencies



at an antenatal clinic, if you are pregnant



a private clinic, where you will have to pay



You may be offered a test if you see your GP, are admitted to hospital or attend an outpatient clinic with a condition that could be related to HIV.

Home testing kits are also available, which allow you to take a saliva sample or blood spot and send them off to a laboratory for testing. These are available online and from some pharmacies, but you will generally have to pay for them.

From early 2014, it will also be possible to buy self-testing kits that will allow you to test yourself and find out the results immediately. It is important to check that any test you buy has a CE quality assurance mark and is licensed for sale in the UK, as poor quality HIV self-tests are currently available from overseas.

It is your choice where you would be most comfortable having the test.

 

Emergency HIV pills

If you think you have been exposed to the virus within the last 72 hours (three days), anti-HIV medication, called PEP (post-exposure prophylaxis), may stop you becoming infected.

Treating HIV 

There is no cure for HIV, but there are treatments to enable most people with the virus to live a long and healthy life.

Emergency HIV drugs

If you think you have been exposed to the virus within the last 72 hours (three days), anti-HIV medication may stop you becoming infected.

For it to be effective, the medication, called post-exposure prophylaxis or PEP, must be started within 72 hours of coming into contact with the virus. It is only recommended following higher risk exposure, particularly where the sexual partner is known to be positive.

The quicker PEP is started the better, ideally within hours of coming into contact with HIV. The longer the wait, the less chance of it being effective.

PEP has been misleadingly popularised as a “morning-after pill” for HIV – a reference to the emergency pill women can take to prevent getting pregnant after having unprotected sex.

But the description is not accurate. PEP is a month-long treatment, which may have serious side effects and is not guaranteed to work. The treatment involves taking the same drugs prescribed to people who have tested positive for HIV.

You should be able to get PEP from:



sexual health clinics, or genitourinary medicine (GUM) clinics



hospitals – usually accident and emergency (A&E) departments



If you already have HIV, try your HIV clinic if the PEP is for someone you’ve had sex with.

Want to know more?



Terrence Higgins Trust: post-exposure prophylaxis (PEP)



If you test positive

If you are diagnosed with HIV, you will have regular blood tests to monitor the progress of the HIV infection before starting treatment.

This involves monitoring the amount of virus in your blood (viral blood test) and the effect HIV is having on your immune system. This is determined by measuring your levels of CD4+ve lymphocyte cells in your blood. These cells are important for fighting infection. 

Treatment is usually recommended to begin when your CD4 cell count falls towards 350 or below, whether or not you have any symptoms. In some people with other medical conditions, treatment may be started at higher CD4 cell counts. When to start treatment should be discussed with your doctor.

The aim of the treatment is to reduce the level of HIV in the blood, allow the immune system to repair itself and prevent any HIV-related illnesses.

If you are on HIV treatment, the level of the virus in your blood is generally very low and it is unlikely that you will pass HIV on to someone else.

Want to know more?



namlife (aidsmap.com): Why monitor CD4 and viral load?



namlife (aidsmap.com): When to start treatment?



If you have another condition

If you have also been diagnosed with hepatitis B or hepatitis C, it is recommended that you start treatment when your CD4 count falls below 500.

Treatment is recommended to begin at any CD4 count if you are onradiotherapy or chemotherapy that will suppress your immune system, or if you have been diagnosed with certain other illnesses, including:



tuberculosis



HIV-related nephropathy (kidney disease)



HIV-related neurocognitive (brain) illnesses



Want to know more?



nam (aidsmap.com): Starting treatment if you have another condition



Antiretroviral drugs

HIV is treated with antiretrovirals (ARVs), these work by stopping the virus replicating in the body, allowing the immune system to repair itself and preventing further damage.

A combination of ARVs is used because HIV can quickly adapt and become resistant to one single ARV.

Patients tend to take three or more types of ARV medication. This is known as combination therapy or antiretroviral therapy (ART).

Some antiretroviral drugs have been combined into one pill, known as a "fixed dose combination". This means that the most common treatments for people just diagnosed with HIV involve taking just one or two pills a day.

Different combinations of ARVs work for different people so the medicine you take will be individual to you.

Once HIV treatment is started, you will probably need to take the medication for the rest of your life. For the treatment to be continuously effective, it will need to be taken regularly every day. Not taking ARVs regularly may cause the treatment to fail.

Many of the medicines used to treat HIV can interact with other medications prescribed by your GP or bought over-the-counter. These include herbal remedies such as St John's Wort, as well as recreational drugs.

Always check with your HIV clinic staff or your GP before taking any other medicines.

Want to know more?



nam: Anti-HIV drugs (PDF, 1.37Mb)



Terrence Higgins Trust: Treatment for HIV



HIV i-Base: Introduction to combination therapy



Pregnancy

ARV treatment is available to prevent a pregnant woman from passing HIV to her child.

Without treatment, there is a one in four chance your baby will become infected with HIV. With treatment, the risk is less than one in 100.

Advances in treatment mean there is no increased risk of passing the virus to your baby with a normal delivery. However, for some women, a caesarean section may still be recommended.

If you have HIV, do not breastfeed your baby because the virus can be transmitted through breast milk.

If you or your partner has HIV, speak to an HIV doctor as there are options for safely conceiving a child without putting either of you at risk of infection.

Missing a dose

HIV treatment only works if you take your pills regularly every day. Missing even a few doses will increase the risk of your treatment not working.

You will need to develop a daily routine to fit your treatment plan around your lifestyle.

Want to know more?

nam: Adherence & resistance (PDF, 1Mb)

Side effects

HIV treatment can have side effects. If you get serious side effects (which is uncommon) you may need to try a different combination of ARVs.

Common side effects include:



nausea



diarrhoea



skin rashes



sleep difficulties



Want to know more?



nam: Side effects (PDF, 1.36Mb)



People with HIV get treatment at a specialist HIV clinic which is usually part of a sexual health or infectious diseases clinic at your local hospital.

Services, including support organisations, may work together to provide specialist care and emotional support.

Preventing HIV 

The main way to prevent HIV infection is to reduce the risk of exposure to HIV, such as having sex without a condom and sharing needles and other injecting equipment.

If you have HIV you can pass it on to others if you have sex without a condom, or share needles, syringes, or other injecting equipment. HIV treatment with ART substantially reduces the risk of passing the virus onto someone else.

Knowing your HIV status and that of your partner is important and if you are at regular risk of potential exposure to HIV you should have a regular HIV test.

Sex

HIV can be transmitted by having vaginal or anal sex without a condom. There is also a risk of transmission through oral sex, but this risk is much lower. 

HIV can also be caught from sharing sex toys with someone infected with HIV.

See causes of HIV for more on transmission of HIV.

The best way to prevent HIV and other sexually transmitted infections (STIs) is to use a condom for penetrative sex and a dental dam for oral sex.

Condoms

Condoms come in a variety of shapes, colours, textures, materials and flavours. Both male and female condoms are available.

A condom is the most effective form of protection against HIV and other STIs. It can be used for vaginal and anal sex, and for oral sex performed on men.

HIV can be passed on before ejaculation, through pre-come and vaginal secretions, and from the anus.

It is very important that condoms are put on before any sexual contact occurs between the penis, vagina, mouth or anus.

Lubricant

Lubricant, or lube, is often used to enhance sexual pleasure and safety, by adding moisture to either the vagina or anus during sex.

Lubricant can make sex safer by reducing the risk of vaginal or anal tears caused by dryness or friction, and it can also prevent a condom from tearing.

Only water-based lubricant (such as K-Y Jelly) rather than an oil-based lubricant (such as Vaseline or massage and baby oil) should be used with condoms.

Oil-based lubricants weaken the latex in condoms and can cause them to break or tear.

Dental dams

A dental dam is a small sheet of latex that works as a barrier between the mouth and the vagina or anus to reduce the risk of STIs during oral sex.

Sharing needles and injecting equipment

If you inject drugs, don't share needles or syringes, or other injecting equipment such as spoons and swabs, as this could expose you to HIV and other viruses found in the blood, such as hepatitis C.

Many local authorities and pharmacies offer needle exchange programmes, where used needles can be exchanged for clean ones.

If you are a heroin user, consider enrolling in a methadone programme. Methadone can be taken as a liquid, so it reduces your risk of getting HIV.

A GP or drug counsellor should be able to advise you about both needle exchange programmes and methadone programmes.

If you are having a tattoo or piercing, it's important that a clean, sterilised needle is always used.

Living with HIV 

How people cope with being diagnosed with HIV, as well as with treatment, varies from person to person.

By properly managing your condition – taking your medication correctly and avoiding illness – you will be able to live as normal a life as possible.

Other issues to consider include getting psychological support, telling people about your HIV, pregnancy and financial support.

Your medication

It’s important to take your pills on time, every time. Even missing one or two doses a week can increase your risk of developing resistance to the medication and your treatment not working. It can be helpful to develop a daily routine around taking your medication, so that you do not forget to take it.

Many of the medicines used to treat HIV can interact with other drugs, which may affect how they work or increase the risk of side effects. You can check the interaction between your HIV medication and other drugs using the online interaction charts provided by the University of Liverpool.

It’s best to tell your HIV doctor or HIV pharmacy about all other drugs –including over-the-counter medications, supplements, and recreational drugs – you are taking to check they won’t interact with your HIV medication.

Your health

In addition to taking HIV medication, there are many things you can do to improve your general health and reduce your risk of falling ill.

These include:



regular exercise



healthy eating



stopping smoking



Reviewing your treatment

Because HIV is a long-term condition, you will be in regular contact with your healthcare team, who will review your treatment on an ongoing basis.

A good relationship with the team means that you can easily discuss your symptoms or concerns. The more the team knows, the more they can help you.

Services, including support organisations, may work together to provide specialist care and emotional support. Find local HIV support services.

Preventing infection

If you have HIV, you should take extra precautions to prevent exposure to other infections.

Everyone with a long-term condition such as HIV is encouraged to get a flu jab each autumn to protect against seasonal flu (influenza).

It is also recommended that they get a pneumoccocal vaccination. This is an injection that protects against a serious chest infection called pneumococcal pneumonia.

Want to know more?



Terrence Higgins Trust: Living with HIV



nam: smoking



nam: exercise




Psychological impact of HIV 

 

 

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Being diagnosed with HIV can be extremely distressing, and feelings of anxiety or depression are common. Your HIV clinic can provide you with counselling so that you can fully discuss your condition and your concerns.

You may find it helpful to talk to a trained counsellor or psychologist, or to someone at a specialist helpline. Your HIV clinic will have information on these.

Some people find it helpful to talk to other people who have HIV, either at a local support group or in an internet chatroom.

Want to know more?



Terrence Higgins Trust: My HIV



Terrence Higgins Trust: Your diagnosis



namlife: Being diagnosed HIV positive





Telling people about your HIV 

 

 

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Telling your partner and former partners

If you have HIV, it is important that your current sexual partner or any sexual partners you have had since being exposed to infection are tested and treated.

Some people can feel angry, upset or embarrassed about discussing HIV with their current or former partners. Discuss your concerns with your GP or the clinic staff. They will be able to advise you about who should be contacted and the best way to contact them, or may be able to contact them on your behalf. They will also advise you on disclosing your status to future partners and how you can reduce the risk of transmitting the virus to someone else.

Nobody can force you to tell any of your partners about your HIV, but it is strongly recommended that you do. Left untested and untreated, HIV can have devastating consequences and will eventually lead to death.

Telling your boss

People with HIV are protected under the Equality Act (2010). 

There is no legal obligation to tell your employer that you have HIV, unless you have a frontline job in the armed forces or you work in a healthcare role where you perform invasive procedures (as you will need to be monitored by your occupational health team and HIV doctor to ensure you are not putting your patients at risk of infection).

The Equality Act 2010 also places restrictions on the health questions that employers can ask during a job application process. Employers are allowed to ask health questions only after an offer of employment has been made, to help them decide whether you can carry out tasks that are essential for the job.

If you are asked a question that you think is not allowed under the Equality Act 2010, you can tell the employer, or you can tell the Equality and Human Rights Commission. Learn more in recruitment questions about health and disability.

If you are an employee with HIV, you may worry that if you do tell your employer, your HIV status will become public knowledge or that you may be discriminated against. On the other hand, if your boss is supportive, telling them may make it easier for adjustments to be made to your workload or for you to have time off.

The HIV organisations below have lots of information and can advise you on these and other work-related issues.

Want to know more?



NAT: Criminal prosecutions



NAT: Telling other people



NAT: Employment & HIV



namlife: Practicalities of telling somebody



namlife: HIV and employment




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Pregnancy 

 

 

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If you have HIV and become pregnant, contact your HIV clinic. This is important because:



Some anti-HIV medicines can harm babies, so your treatment plan will need to be reviewed.



Additional medicines may be needed to prevent your baby getting HIV.



Without treatment, there is a one in four chance that your baby will develop HIV. With treatment, the risk is less than one in 100.

Advances in treatment mean that a normal delivery is now recommended for women who have an undetectable viral count and whose HIV is well managed. For some women, a caesarean section may still be recommended, and may also be indicated for other reasons not related to your HIV.

Discuss the risks and benefits of each delivery method with the staff at your HIV clinic. The final decision about how your baby is delivered is yours, staff will respect that decision.

If you have HIV, do not breastfeed your baby because the virus can be transmitted through breast milk.

If you or your partner has HIV, there may be options available that will allow you to conceive a child without putting either of you at risk of infection. You should ask your HIV doctor for advice.

Want to know more?



HIV i-Base: HIV, pregnancy and women’s health



namlife: Mother-to-baby transmission of HIV



nam: HIV & Pregnancy tool




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Opportunistic infections  

 

 

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If your CD4 count drops below 200, you will be at risk of developing many different types of infection. Infections that 'take advantage' of an HIV-weakened immune system are known as opportunistic infections. However, if you stick to your HIV therapy, the likelihood of developing an opportunistic infection is low.

The four main types of opportunistic infections are:



bacterial infections, such as pneumonia or tuberculosis (TB)



fungal infections, such as oral thrush and pneumocystis pneumonia (PCP) 



parasitical infections, such as toxoplasmosis



viral infections, such as shingles (herpes zoster) 



People with advanced HIV also have a higher risk of developing some forms of cancer, such as lymphoma (cancer of the lymph system).

Pneumonia

Bacterial Pneumonia is more common in people with HIV, but also occurs in people without HIV, particularly those with chronic respitory conditions. It can develop as a complication of other infections, such as flu. Left untreated, pneumonia can be fatal because the infection can spread through your blood.

Pneumonia can be treated using antibiotics. There is also a vaccine that can protect you against many of the bacteria that can cause pneumonia. People living with HIV are recommended to receive annual flu vaccinations.

Tuberculosis (TB)

TB is another bacterial infection of the lung. Globally, it is one of the leading causes of death for people who are HIV positive. TB can be treated using antibiotics, but some strains of bacteria have developed resistance to this medicine, and these can be more difficult to treat.

Candidiasis (thrush)

Candidiasis is a fungal infection that is common in people living with HIV. It causes a thick, white coating to appear on the inside of the mouth, tongue, throat or vagina.

Though rarely serious, candidiasis can be both embarrassing and painful. It can be treated with antifungal creams.

Tell the staff at your HIV clinic if you have repeated bouts of candidiasis because it could be a sign of a low CD4 count.

Pneumocystis pneumonia (PCP)

PCP is a fungal infection of the lungs, which can be life-threatening if it is not treated promptly. Before the advances in anti-HIV medicines, PCP was the leading cause of death among those with HIV in the developed world.

Symptoms of PCP include:



a persistent dry cough



shortness of breath



difficulty breathing



in some cases, fever



Report any symptoms of PCP straight away because the condition can suddenly worsen without warning. PCP can be treated with antibiotics and, if your CD4 count drops below 200, you may be given antibiotics to prevent a PCP infection.

Cancer

People with advanced HIV have an increased risk of developing some cancers. It is estimated that somebody with untreated late-stage HIV infection (AIDS) is 100 times more likely to develop certain cancer than somebody without the condition.

The two most common cancers to affect people with HIV are lymphoma and Kaposi's sarcoma. Lymphoma is a cancer of the lymphatic system (a network of glands that makes up part of our immune system). Kaposi's sarcoma can cause lesions to grow on your skin, and can also affect your internal organs.

HIV treatment is important in reducing your risk of cancer and long-term conditions, such as cardiovascular and respiratory disease. If you smoke, stopping smoking is also important in reducing this risk.  


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Money and financial support 

 

 

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If you have to stop work or work part time because of HIV, you may find it hard to cope financially. However, you may be entitled to one or more of the following types of financial support:



If you have a job but cannot work because of your illness, you are entitled to Statutory Sick Pay from your employer. 



If you do not have a job and cannot work because of your illness, you may be entitled to Employment and Support Allowance.



If you are aged 64 or under and need help with personal care or have walking difficulties, you may be eligible for Disability Living Allowance (DLA) or Personal Independence Payments (PIP).



Want to know more?



NAT: Benefits and financial issues



Carers Direct: Benefits for carers and Benefits for the person you care for



GOV.UK: Benefits and financial support




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How will HIV affect your life?



You will not be able to donate blood or organs.



You will not be able to join the armed forces.



You will need to declare your HIV status to any company from whom you wish to purchase a mortgage, life insurance or travel insurance, in the same way as anyone with any other long-term medical condition.



There are some countries that you will not be able to visit.





HIV and AIDS