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Understanding HIV/AIDS: Information, Symptoms, Treatment, and Prevention

Diagnosis and Treatment

How Do I Know If I Have HIV/AIDS?

The only way to know for sure if you have HIV is to be tested.

The CDC provides the national guidelines for HIV testing in the United States. They report that the average person will develop the antibodies to HIV within 25 days of exposure to the virus. HIV testing looks for the antibodies that you produce to fight off an HIV infection.

After 3 months, there's a 97% chance that HIV testing will detect these antibodies, though in rare cases it may take up to 6 months for antibodies to be found. Therefore, the official recommendation of the CDC is for anyone at increased risk for HIV infection to be tested 6 months after possible exposure to HIV. Most people have the test 3 months after exposure to HIV and then re-test at 6 months. The CDC outlines its official recommendations on deciding if and when to be tested, which can help you decide on testing based on your level of risk.

The reason for the waiting periods is because the tests aren't looking for the HIV virus itself; they look for antibodies produced by the body to fight HIV. The two tests, the ELISA and Western Blot, may be used in combination to be sure that any HIV antibodies are found.

Getting tested is simple: A blood sample is taken and sent to a lab. Home testing kits are also available. Testing can be done both confidentially and anonymously, so be sure to ask whether or not your name is associated with your testing if you're concerned about having your test results stay anonymous.

The advantage of being tested by a public health clinic or doctor is the counseling that's provided on test results, prevention, and safe sex practices. Waiting for test results can take from several days to weeks, depending on which test is used. HIV testing is never done without a person's written informed consent.

The Meaning of HIV Test Results

The decision to take the HIV test means accepting that there are risky behaviors that can lead to HIV infection. Testing can be stressful -- so much so that some people avoid getting tested. This is understandable, but it isn't smart. Getting tested as soon as the guidelines recommend assures that if someone is infected, treatment can be initiated that may make a difference.

It's important to talk to someone about what being tested means and how you'll deal with the results. A doctor, counselor, or pastor can help you think about what testing means to you. If you don't have someone to support you during testing, call your local HIV/AIDS community organization. They usually have volunteer counselors who have been through the testing experience and can talk with you. You don't have to go through it alone.

If your HIV test is positive, you need to create a plan for how you'll take care of yourself and protect others. HIV is not the "death sentence" it once was. Many people live long, happy lives with HIV. But ongoing medical care is essential to live successfully with HIV. If you don't have a doctor, your local public health department or HIV/AIDS organization can refer you to a local HIV clinic.

Anyone who tests positive for HIV has a responsibility to tell everyone they've had sexual contact with, so these partners can be tested -- and get treatment if needed. This includes all sexual partners and people who have shared IV drug needles and equipment.

Other than these partners who may be directly affected by your HIV, revealing that you have HIV to other people in your life is a personal decision. You can decide who to tell and when you tell them. If you have children, you may want to include a counselor to help you talk with them and tell them you have HIV/AIDS.

What Is the Treatment for HIV/AIDS?

When people discover they have HIV, they may not begin taking medications immediately, depending on how long they've been infected and their CD4 T-cell count. The decision to start treatment is individual and considers a person's past medical history and current health.

HIV drugs don't have the same results for everyone. Fortunately, many drugs are now available and can be used in combination to try to control the HIV virus.

HIV is a smart virus that's constantly changing, called "mutating." The virus has discovered how to "get around" many of the medications once used to treat it. Treatment includes testing to determine what kind of HIV you have and what drugs the virus is resistant to. This is why it isn't safe for people who have HIV to have unprotected sexual contact, because they may pass different strains of HIV to each other.

Currently, HIV is treated in combination therapies, known as "cocktails" because they're a mix of several medications. This way, when the virus figures out how to get around one drug, there's another drug in the body to block the virus from duplicating itself. Unfortunately, as the HIV epidemic has grown, there are now mutations of HIV that are resistant to many of the drugs available. The good news is that HIV researchers are constantly discovering new drugs to block HIV at different points in its life cycle. Work with a doctor who can determine what combination of new drugs might work for you.

HIV/AIDS Medications

Current HIV medications work at various parts of the HIV replication cycle.

Entry. Viruses depend on other cells to reproduce themselves. This is essential for HIV, since the virus only lives for a short period of time. HIV uses the CD4 T-cell by attaching to the T-cell and getting inside. The newest class of HIV drugs, called entry inhibitors, keep HIV from entering the CD4 T-cell. There are two new drugs of this type being tested in clinical trials.

Replication. HIV depends on the CD4 T-cells' DNA to reproduce itself because the virus has no DNA of its own. To do this, HIV uses an enzyme called reverse transcriptase (RT) to change RNA into DNA. One class of drugs, called nucleoside reverse transcriptase inhibitors (NRTIs), fool HIV into making unusable DNA. There is also a class of drugs -- the non-nucleoside reverse transcriptase inhibitors (NNRTIs) -- that were designed to prevent the RNA from working at all.

People call these drugs "nukes" (nucleosides) and "non-nukes" (non-nucleosides) for short. There are now 12 NRTI drugs ("nukes") available and 3 NNRTI drugs ("non-nukes") available for people living with HIV/AIDS.

Reassembly. Once HIV has invaded a cell's DNA and fooled it into making the pieces of HIV needed, the virus has to put the pieces together. This is done using an enzyme called protease. Drugs called protease inhibitors (PIs) prevent the virus from putting these new pieces together and creating new viral particles. There are now 10 protease inhibitors available to help fight HIV/AIDS. The PIs are given credit for saving the lives of many people living with AIDS who are now recovering and returning to normal lives.

HIV/AIDS Medication Side Effects

These are powerful drugs with side effects, especially when a person first starts to use them. Often, the side effects go away as the body adjusts to the medication.

• Nausea and vomiting are common at the beginning of treatment.
• Diarrhea needs to be managed if it lasts beyond 3 days.
• A rash may be a sign of an allergic reaction and should always be reported to a doctor immediately. If it's not an allergy, a rash usually goes away by itself.
• Sleep disturbances include trouble falling or staying asleep.
• Pain, numbness, or tingling in the hands and feet need to be reported to a doctor.
• Excess fat may appear as the body begins storing fat between the shoulders, in the breasts, or on the belly as a result of some medications. This is calledlipodystrophy syndrome.
• Kidney stones are common with specific medications.

If you experience side effects from medications, note how often they occur and what time of day. This information may help your doctor determine how to best manage the side effects. Never stop taking your medications simply because they have side effects -- this can give the HIV virus a chance to grow more quickly. Working with your doctor to adjust medications is the way to manage side effects.

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