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| Question: What is HIV
and how does it differ from other viruses which infect
human beings? |
| Answer: HIV stands for Human Immunodeficiency
Virus. As the name suggests it only causes disease in
humans, which leads to the depletion of white blood cells
leading to lowering of immunity. Once the virus enters
the body it lies dormant for many years and hence is known
as a 'slow virus'. Most other viruses for example, those
causing measles, mumps, chicken pox, etc., manifest the
disease in 14-21 days after it enters the body. Hence
the incubation period is short (2-3 weeks) whereas in
HIV infection it is very long and runs into years. |
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| Question: How does HIV attack the immune
system? |
| Answer: Once HIV enters the body, it gets attached to
a type of white blood cell called T lymphocyte (which
is the T cell in the human body's protection against infections).
The RNA (genetic material) of the virus then gets converted
to DNA (genetic material) by an enzyme that the virus
produces. This viral DNA then gets incorporated into the
DNA of the human cell (T lymphocyte), and remains there
for the lifetime of that cell. This infected cell now
becomes a virus factory producing more viruses (HIV) which
bud out of the cell, attack new T lymphocytes, and destroy
them. Over a period of years, the T cell count of the
infected person drops to a critical level and the individual
develops many opportunistic infection and hence is then
said to have AIDS. |
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| Question: What is the
difference between a person infected with HIV and one
who has AIDS? |
| Answer: A person living with HIV (medically
known as an HIV positive person) is one who has virus
in his/her body. Such a person, remains infected and is
presumed infective for the rest of his/her life. However,
s/he will appear to be perfectly normal and healthy and
asymptomatic for many years. An asymptomatic HIV infected
person does not have Acquired Immunodeficiency Syndrome
(AIDS). But when an HIV positive person's T lymphocytes
(which are responsible for the immunity) count falls to
200 or less, s/he starts developing symptoms for eg. cough,
fever, diarrhoea, skin lesions, etc. They are due to opportunistic
infections (so called because they develop when the body's
immunity becomes deficient) like TB, Thrush, Pneumonia,
Cryptococcal meningitis, etc. All persons with AIDS are
infected with HIV, but not all persons with HIV infection
have AIDS. AIDS is only the end stage of this infection. |
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| Question: How is HIV transmitted? |
| Answer: Anyone can become infected with HIV. It is transmitted
only through unprotected penetrative sex (vaginal, anal,
oral) with an infected partner, transfusion of infected
blood and blood products, contaminat ed needles and syringes,
and from an infected mother to her baby before, during
delivery or through breast milk. |
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| But since the sexual route accounts for almost 80 percent
of infections, the prevalence is much higher in the sexually
active age group of 15 years to 40 years. It is not who
you are or where you are, but what you do that puts you
at this risk of acquiring the HIV infection and eventually
developing AIDS. Therefore, there are no "risk groups"
but only "risk behaviours". |
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| Question: How is HIV
not transmitted? |
| Answer: HIV cannot spread
by casual contact such as touching, holding hands, body
contact in crowded public places, shaking hands, working
or playing together, sharing food, vessels and clothes,
eating food cooked by an infected person, light kissing,
mosquito and other insect bites, swimming pools, and toilets.
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| Question: Do mosquitoes transmit HIV?
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| Answer: There is no evidence to show that mosquitoes
transmit HIV. Epidemiologically, the incidence of HIV
infection is the highest among the sexually active group
of 15 years to 40 years. However, mosquitoes bite persons
of all age groups and if they were a means of spreading
HIV, the incidence of infection would be uniformly high
and among all age groups. HIV does not survive or replicate
inside the intestine of the mosquito, which is another
reason to believe that mosquitoes cannot spread the HIV
infection. |
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| Question: Can HIV spread
through kissing? |
| Answer: Kissing such as on the cheek
or lightly on the lips carries no risk of transmitting
HIV. In deep kissing there is a small risk because the
saliva of an infected person contains few virus particles
which by itself is not sufficient to cause the infection.
But there could be bleeding gums or ulcers in the mouth
and exchange of infected saliva mixed with blood during
kissing could transmit the HIV. |
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| Question: How long can the virus live
outside the human body? |
| Answer: The Human Immunodeficiency Virus is fragile.
Once the virus is outside the body in a dry form, it dies
immediately. Even in a wet state, it does not live long
when exposed to heat, detergents, or disinfectants. When
stored in blood banks at 4°C, it can live for about 3
weeks (or longer), or till the white cell disintegrates,
but in a frozen state it can survive for years. |
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| Question: Can I get
the HIV infection if I donate blood? |
| Answer: No. This is not possible as
all materials used for collecting blood are sterile. In
fact, persons who are healthy should come forward for
voluntary blood donation. |
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| Question: What is the risk
of getting HIV by going to a dentist? |
| Answer: The risk of getting HIV from a dentist
is low. However, there have been stray reports linking
the infection with dentists. Wherever there is invasive
procedures of skin or mucous membrane, universal precautions
should be practiced. |
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| Question: Is the breast
milk of an HIV positive woman infective? |
| Answer: HIV is known to be present
in the breast milk of an infected woman. Hence, there
is a possibility of acquiring the infection via breast
milk. However, in a country like India where infant mortality
is very high, the advantages of breast feeding (prevention
of other infections) outweigh the risk of HIV infection
through breast milk. Formula feeding should be advocated
on individual cases only after proper counselling. |
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| Question: How would one know if a baby
born to an HIV positive woman has the HIV infection? |
| Answer: Most children born to HIV positive mothers carry
HIV antibodies from the mother in their blood. These take
about fifteen months to disappear. Only after that will
an HIV antibody test show whether the baby is, in fact,
infected with the HIV, or not. In less developed countries,
the chance of a baby born to an HIV infected mother being
infected is about 40 percent. But today there are antiretroviral
drugs available which can be given to the pregnant woman
and babies to prevent the infection in the babies. As
an alternative to pregnancy, women living with HIV could
also be counselled to adopt a baby. |
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| Question: How long does
it take for an HIV infected person to develop symptoms? |
| Answer: This depends on the mode of
the HIV transmission and the lifestyle of the HIV positive
person. Majority of persons who are infected through blood
transfusion develop symptoms on an average from 3 years
to 5 years. With the other modes of transmission when
the quantum of the virus is low, the person can remain
healthy for 8 to 12 years or longer. If an HIV positive
person improves his/her quality of life by adopting safer
sex methods, has good nutrition, regular exercise, regular
medical management, emotional support, does yoga and meditation,
avoids stress and regularly treats other illnesses, continues
to be active, and has an optimistic outlook, s/he is likely
to live longer |
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| Question: How does an HIV positive person
progress to AIDS? |
| Answer: A few weeks after the virus enters the body,
some people have flu-like symptoms such as fever, body
ache, and headache, (every infected person may not experience
these). These symptoms disappear after a while, and then
there is a long phase of 3 years to 12 years which is
asymptomatic. After that, when the immune system starts
failing, AIDS sets in. |
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| The major and minor
signs classified by World Health Organisation are: |
| Major Signs |
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Weight loss greater than 10% of body
weight. |
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Fever for longer than one month, intermittent
or continous. |
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Chronic diarrhoea for longer than
one month, intermittent or constant. |
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| Minor Signs |
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Persistent cough for longer than one month. |
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General itchy dermatitis (skin irritation). |
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Recurrent herpes zoster (shingles). |
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Oropharyngeal candidasis (fungus infection in
the mouth/throat). |
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Chronic progressive and disseminated herpes simplex
infection. |
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Generalised lymphadenopathy (swelling of lymp
glands). |
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| If a person has two major and two minor signs he is
diagnosed as having AIDS. It is important to note that
these symptoms are fairly common in various non-AIDS conditions
also. |
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| Question: How would
I know if any of the people I meet everyday is HIV infected? |
| Answer: You cannot. Individuals may
identify their HIV status only by doing an HIV test. |
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| Question: Is there any treatment for HIV/AIDS? |
| Answer: Almost all opportunistic infections a person
with AIDS develops can be treated with appropriate drugs.
Eg. TB, thrush, diarrhoea, pneumonia can all be treated.
They can also be prevented by drugs - chemoprophylaxis.
When it comes to treatment of HIV itself, there are many
antiretroviral drugs available. These should be given
in combinations of 2 or 3 drugs for lifetime of the patient.
These drugs are expensive, have side effects and need
to be monitored using laboratory tests which are very
expensive. |
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| Question:
What is 'safe sex'? |
| Answer: Sexual activity
which completely eliminates the risk of infection is safe
sex. For eg. 1. any sexual activity between two uninfected
people is safe. 2. any sexual activity which does not
involve the entry of body fluids such as blood, semen,
vaginal fluids, or other contaminated material into the
body is safe |
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| Question: What is 'safer sex'? |
| Answer: Safer sex is a way of adapting your sex life
to minimize the risk of giving or getting the HIV infection.
It includes those sexual practices which reduce the risk
of acquiring or transmitting HIV during sexual activity.
Sex can be made safer by using a condom consistently or
by practicing non-penetrative sex. |
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| Question: What can I
do to protect myself against getting the HIV infection? |
Answer: There is a lot you can do
to keep yourself protected from getting the HIV infection:
- Learn the facts about HIV and AIDS.
- Assess your own risk behaviours (unsafe sex, sharing
needles, etc.)
- Postpone, as much as possible, sex until marriage, or
else practice safe or safer sex.
- Do not feel shy to talk about your doubts and fears.
Get these clarified.
- Verify that any blood product you receive has been screened
for HIV.
- Verify that any needles/ syringes or invasive equipment
being used on you is sterile.
- If you are going for procedures such as tattooing, ear
piercing, or acupuncture, verify that the equipment to
be used on you is sterile.
- Avoid alcohol and drugs as they affect your judgement,
and can induce you to take risks you would not otherwise
take, like having unsafe sex, sharing needles, or driving
rashly.
- Do not let peer pressure force you into unsafe activities.
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| Question: What is the role of HIV/AIDS
awareness programmes in preventing the spread of HIV/AIDS? |
| Answer: The objective of AIDS awareness programmes is
to create awareness about the problem, to give accurate
and reliable information about HIV/AIDS, to clear existing
myths and misconceptions, and to provide practical skills
that can be implemented at the individual's level so as
to lead to behaviour change that minimize the risk of
HIV infection. |
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| Question: How safe are
condoms in the prevention of HIV infection? |
Answer: Condoms make sex safer when
used properly but they are not 100 percent safe. Safety
factors to check on when buying and using condoms are,
- Expiry date of the condom - do not use one which has
expired.
- Storage - condoms should be kept away from the heat
(for example, from car glove compartments, direct sunlight),
and pressure (for example, sitting on a wallet containing
condoms).
- Making sure that sharp objects do not tear a condom
during use.
- Making sure that the air is expelled from the teat of
the condom while wearing, so as to prevent it from bursting
during intercourse. |
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| Question: Does the use of a condom reduce
sexual pleasure? |
| Answer: Condoms do not reduce sexual pleasure, as sexual
pleasure is a perceived pleasure. Psychologically, some
people perceive a loss of pleasure when using a condom.
Whereas, ribbed condoms, for example, are known to increase
sexual pleasure. |
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| Question: Do contraceptives
like 'Today', diaphragm, and the pill protect a woman
from getting the HIV infection? |
| Answer: No, they do not. These contraceptives
only prevent a woman from getting pregnant but do not
prevent the potentially infected semen from coming into
contact with the lining of the vagina or cervix. If the
HIV or organisms causing STD are present in the semen,
they can still get into a woman's body and infect her. |
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| Question: What are the different tests
to detect HIV? |
Answer: There are a number of tests to
detect the HIV. Blood tests are done to look for specific
antibodies produced by the HIV. These include,
Screening tests: ELISA (Enzyme Linked Immunosorbent
Assay - the most commonly followed procedure). Spot test
or Rapid Test These may give false positive results and
hence should be confirmed.
Confirmatory Tests: Western Blot, the most commonly
used procedure. There are other tests that are done to
detect the virus or its protein or genetic material. These
are however, expensive, complicated or may take long and
hence, are used only for research and academic purposes. |
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| Question: Why are consent
and confidentiality important during voluntary testing? |
| Answer: HIV positive persons are discriminated
against by family, friends, neighbours, colleagues, employers,
and the society in general. Unless an individual is assured
confidentiality, s/he will not come forward for testing
for fear of such discrimination and stigma. Testing for
HIV without consent violates human rights and should not
be done. Only consented testing with pre- and post-test
counselling should be encouraged. |
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| Question: How can I know the HIV status
of the person I am going to marry? |
| Answer: Marriages are based on mutual trust. It is important
that any concerns about HIV are communicated to the prospective
spouse in a sensitive and sensible manner. The HIV status
of a person cannot be determined without a HIV test. A
fully informed voluntary consent is a pre-requisite before
a HIV test can be performed on someone. Please be prepared
to likewise undergo a test should your prospective spouse
so requests. In some states of USA, HIV and VDRL testing
are mandated by law as pre-requisite to marriage registration.
In India, there is no such law. |
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| Question: Should premarital
HIV testing be done? |
| Answer: This cannot be made mandatory
as it would undermine confidentiality as a pre-requisite
for testing. But if individuals request consented voluntary
testing, it should be encouraged. Unfortunately in India,
given the lack of code of conduct in reporting test results,
it may be possible to "purchase" a negative result. |
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| Question: What is ‘window period’?
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| Answer: The common test for HIV is screening blood for
antibodies. The antibodies take 2 to 24 weeks to appear
in blood. This is known as the ‘window period.’ During
this period, an infected individual is infective, but
the HIV tests for antibodies are negative. Hence, to be
sure, the test should be repeated again 6 months after
the last contact or exposure to HIV. |
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