HIV/AIDS AWARENESS

What is HIV?

HIV infection is a viral infection caused by the human immunodeficiency virus (HIV) that gradually destroys the immune system, resulting in infections that are hard for the body to fight.

What is AIDS?

AIDS (Acquired Immune Deficiency Syndrome) is the final and most serious stage of HIV disease, which causes severe damage to the immune system.

What are the causes for HIV/AIDS?

Transmission of the virus occurs because of

Through sexual contact -- including oral, vaginal, and anal sex.

Through blood -- via blood transfusions (now extremely rare in the U.S) or needle sharing.

From mother to child -- a pregnant woman can transmit the virus to her fetus through their shared blood circulation, or a nursing mother can transmit it to her baby in her milk.

Persons engaging in unprotected sex.

Sexual partners of those who participate in high-risk activities (such as anal sex).

Intravenous drug users who share needles.

Infants born to mothers with HIV who don't receive HIV therapy during pregnancy.

HIV has been found in saliva, tears, nervous system tissue and spinal fluid, blood, semen (including pre-seminal fluid), vaginal fluid, and breast milk. However, only blood, semen, vaginal secretions, and breast milk generally transmits infection to others.

What are the symptoms of HIV/AIDS?

Initial infection with HIV can produce no symptoms. Most people, however, do experience flu-like symptoms with fever, rash, sore throat, and swollen lymph nodes, usually two weeks after contracting the virus. Some people with HIV infection remain without symptoms for years between the time of exposure and development of AIDS.

Patients with AIDS have had their immune system depleted by HIV and are very susceptible to such opportunistic infections. Common symptoms are fevers, sweats (particularly at night), swollen glands, chills, weakness, and weight loss.

What is the treatment for HIV/AIDS?

Drug therapy is often recommended for patients who are committed to taking all their medications and have a CD4 count between 200 and 350 (indicating immune system suppression).

It is extremely important that patients take all doses of their medications; otherwise the virus will rapidly become resistant to the medications. Therapy is always given with a combination of antiviral drugs.

People with HIV infection need to receive education about the disease and treatment so that they can be active partners in decision making with their health care provider.

How can we prevent ourselves from HIV/AIDS?

1) Safe sex:

Safe sex means taking precautions during sex that can keep you from getting a sexually transmitted disease (STD), or from giving an STD to your partner. These diseases include genital herpes, genital warts, HIV, Chlamydia, gonorrhea, syphilis, hepatitis B and C, and others.

A STD is a contagious disease that can be transferred to another person through sexual intercourse or other sexual contact. Many of the organisms that cause sexually-transmitted diseases live on the penis, vagina, anus, mouth, and the skin of surrounding areas.

Most of the diseases are transferred by direct contact with a sore on the genitals or mouth. However, some organisms can be transferred in body fluids without causing a visible sore. They can be transferred to another person during oral, vaginal, or anal intercourse.

Some STDs can also be transferred by nonsexual contact with infected tissues or fluids, such as infected blood. For example, sharing needles when using IV drugs is a major cause of HIV and hepatitis B transmission. An STD can also be transmitted through contaminated blood transfusions and blood products, through the placenta from the mother to the fetus, and sometimes through breast feeding.

The following factors increase your risk of getting a sexually-transmitted disease (STD):

• Not knowing whether a partner has an STD or not
• Having a partner with a past history of any STD
• Having sex without a male or female condom
• Using drugs or alcohol in a situation where sex might occur
• If your partner is an IV drug user
• Having anal intercourse

Drinking alcohol or using drugs increase the likelihood that you will participate in high-risk sex. In addition, some diseases can be transferred through the sharing of used needles or other drug paraphernalia.

Abstinence is an absolute answer to preventing STDs. However, abstinence is not always a practical or desirable option.

Next to abstinence, the least risky approach is to have a monogamous sexual relationship with someone that you know is free of any STD. Ideally, before having sex with a new partner, each of you should get screened for STDs, especially HIV and hepatitis B, and share the test results with one another.

Use condoms to avoid contact with semen, vaginal fluids, or blood. Both male and female condoms dramatically reduce the chance you will get or spread an STD. However, condoms must be used properly:

A condom is a type of birth control (contraceptive). Condoms are worn during intercourse to prevent pregnancy and the spread of some sexually transmitted diseases (STDs), such as HIV, gonorrhea, and Chlamydia.

Other than a vasectomy, the condom is the only available method of birth control for men.

A condom blocks sperm from coming in contact with the inside of the vagina, where it could reach an egg. (If sperm reaches an egg, pregnancy can result.) A condom also prevents disease-causing substances from spreading from one person to another.

Until recently, the condom was used only by men. A female condom is now available.

The male condom is a thin cover that fits over a man's erect penis. Condoms are made of latex rubber, polyurethane, or animal skin. For the best protection, the condom must be put on before the penis comes into contac

t with or enters the vagina (because pre-ejaculation fluids carry both sperm and disease). The condom must be carefully removed immediately after ejaculation so that no semen leaks out.

The female condom fits inside the vagina. It has two rings to keep the condom in place -- one ring is placed over the woman's cervix and another one is placed over her vulva. This positioning prevents the condom from being pushed up into the vagina, and creates a protective covering over the outside of the vagina, which prevents sperm from contacting the area.

HOW WELL DOES A CONDOM WORK?

Theoretically, if a condom is used consistently and correctly, it should prevent pregnancy 97% of the time. The actual effectiveness among users, however, is only between 80% and 90%. This is due to:

• Occasional rupture of a condom during intercourse
• Semen spilling from a condom during withdrawal
• Waiting too long to put a condom on the penis (penis comes into contact with vagina before condom is on)
• Break in condom due to manufacturing problems (rare)
• Failure to use a condom during each act of intercourse

How well a condom works to prevent STDs also depends on the above-mentioned factors.

It should be noted that only latex and polyurethane condoms, but not those made of natural animal membranes, effectively prevent the spread of viral infections such as HIV.

Condoms that contain spermicides may slightly further reduce the risk of pregnancy, but they are no more likely to reduce the risk of HIV or STDs than condoms lubricated with other substances.

CONVENIENCE

• Condoms are available without a prescription
• They are inexpensive
• They can be bought at most drugstores, in vending machines in some restrooms, by mail order, and at certain health care clinics.
• Some pre-planning is needed in order to have a condom handy at the time of intercourse.
• Since the condom must be put on when the penis is erect, but before contact is made between the penis and vagina, there is usually a brief interruption during foreplay. Many couples solve the problem by incorporating the process of placing the condom on the penis into foreplay.

ADVANTAGES

• Provides protection against pregnancy and sexually transmitted diseases.
• Condoms have a slight tourniquet effect on the outer veins of the penis. This may be beneficial for men who have trouble keeping an erection.
• The condom frequently prolongs a man's ejaculation.

DISADVANTAGES

• A few men can not maintain an erection after putting on a condom.
• The woman is not aware of warm fluid entering her body (important to some women, not to others).
• Friction of the condom may reduce clitoral stimulation and reduce lubrication, making intercourse less enjoyable or even uncomfortable. (Lubricated condoms may reduce this problem.)
• Intercourse may be less pleasurable since the man must withdraw his penis immediately after ejaculation.
• Allergic reactions to latex condoms are rare, but they do occur. (Changing to condoms made of polyurethane or animal membranes may help.)

HOW TO USE A MALE CONDOM

• Remove the condom from its package, being careful not to tear or poke a hole in it while opening the package.
• If the condom has a little tip (receptacle) on the end of it (to collect semen), place the condom against the top of the penis and carefully roll the sides down the shaft of the penis. If there is not a receptacle, be sure to leave a little space between the condom and the end of the penis. Otherwise, the semen may push up the sides of the condom and come out at the bottom before the penis and condom are withdrawn. Be sure there is not any air between the penis and the condom. This can cause it to break.
• Some people find it helpful to unroll the condom a little before putting it on the penis. This leaves plenty of room for semen collection and prevents the condom from being stretched too tightly over the penis.
• After ejaculation the condom must be removed from the vagina. The best way is to grasp the condom at the base of the penis and hold it as the penis is withdrawn.
• You should always throw out condoms after use. Keep in mind that flushing a condom down the toilet may clog plumbing. Instead of flushing condoms, you can wrap them in toilet tissue or put them in plastic bags before throwing them in a garbage can. If necessary, put the condom in a garbage can that is out of reach of children and pets.

IMPORTANT TIPS

• Make sure condoms are available and conveniently located. If no condoms are handy at the time of a sexual encounter, you may be tempted to have intercourse without one.
• Carefully withdraw the penis immediately after ejaculation so that semen cannot leak out of the condom as the erection is lost.
• Use each condom only once.
• Do not carry condoms in your wallet for long periods of time. Replace them every once in a while. Friction from opening and closing your wallet, and from walking (if you carry your wallet in your pocket) can lead to tiny holes in the condom. Nevertheless, it is better to use a condom that has been in your wallet for a long time than to not use one at all.
• Don't use a condom that is brittle, sticky, or discolored. These are signs of age, and old condoms are more likely to break.
• If a condom package is damaged, don't use the condom because it also may be damaged.
• Do not use a petroleum-based substance such as Vaseline as a lubricant. These substances break down latex, the material in some condoms.
• If you feel a condom break during intercourse, stop immediately and put on a new one. Remember, ejaculation does not have to occur for a pregnancy to result (pre-ejaculatory fluids can contain active sperm), or for a disease to be transmitted.
• If ejaculation occurs with a broken condom, insert a spermicidal foam or jelly to help reduce the risk of pregnancy or STD transmission. (Do NOT use nonoxynol-9.)
• Store condoms in a cool, dry place away from sunlight and heat

• The condom should be in place from the beginning to end of sexual activity and should be used every time you have sex.
• Lubricants may help reduce the chance a condom will break. Use only water-based lubricants, because oil-based or petroleum-type lubricants can cause latex to weaken and tear. Do NOT use condoms with nonoxynol-9 -- these help prevent pregnancy, but may increase the chance of HIV transmission.
• Use latex condoms for vaginal, anal, and oral intercourse.
• Keep in mind that STDs can still be spread, even if you use a condom, because a condom does not cover surrounding skin areas. But a condom definitely reduces your risk.

Here are additional safe-sex steps:

• Know your partner. Before having sex, first establish a committed relationship that allows trust and open communication. You should be able to discuss past sexual histories, any previous STDs or IV drug use. You should not feel coerced or forced into having sex.
• Stay sober. Alcohol and drugs impair your judgment, communication abilities, and ability to properly use condoms or lubricants.
• Be responsible. If you have an STD, like HIV or herpes, advise any prospective sexual partner. Allow him or her to decide what to do. If you mutually agree on engaging in sexual activity, use latex condoms and other measures to protect the partner.
• If pregnant, take precautions. If you have an STD, learn about the risk to the infant before becoming pregnant. Ask your provider how to prevent the fetus from becoming infected. HIV positive women should not breastfeed their infant.

In summary, safe sex requires prior planning and good communication between partners. Given that, couples can enjoy the pleasures of a sexual relationship while reducing the potential risks involved.

2. Try not to use intravenous drugs. If IV drugs are used, do not share needles or syringes. Many communities now have needle exchange programs, where used syringes can be disposed of and new, sterile needles obtained for free. These programs can also provide referrals to addiction treatment.
3. Avoid contact with another person's blood when the HIV status of the bleeding individual is unknown. Protective clothing, masks, and goggles may be appropriate when caring for people who are injured.
4. Anyone who tests positive for HIV can pass the disease to others and should not donate blood, plasma, body organs, or sperm. An infected person should warn any prospective sexual partner of their HIV-positive status, should not exchange body fluids during sexual activity, and should use whatever preventive measures (such as condoms) will afford the partner the most protection.
5. HIV-positive women who wish to become pregnant should seek counseling about the risk to unborn children, and medical advances which may help prevent the fetus from becoming infected. Use of certain medications can dramatically reduce the chances that the baby will become infected during pregnancy.
6. Mothers who are HIV-positive should not breast feed their babies.
7. Safe-sex practices, such as latex condoms, are highly effective in preventing HIV transmission. HOWEVER, there remains a risk of acquiring the infection even with the use of condoms, if the condom breaks. Abstinence is the only sure way to prevent sexual transmission of HIV.

The riskiest sexual behavior is unprotected receptive anal intercourse -- the least risky sexual behavior is receiving oral sex. Performing oral sex on a man is associated with some risk of HIV transmission, but this is less risky than unprotected vaginal intercourse. Female-to-male transmission of the virus is much less likely than male-to-female transmission. Performing oral sex on a woman who does not have her period carries low risk of transmission.