HIV/Aids
The test says you have HIV. Your mind is a blur. You're scared, you're
mad, you're sad, you're lonely. Here's what you must know: having HIV
isn't about death. It's about life -- your life, and the life of other people.
There's a lot to know about HIV and AIDS -- but you don't have to learn it
all right now. What's important now is to get some support. Talk to a
trusted family member or friend. In addition, a doctor or nurse can help
you find a trained counselor or psychotherapist. Tell this person about
your diagnosis. Tell this person about what scares you. Ask this person
to go with you to the doctor to help ask the questions that worry you.
You aren't the first person ever to get HIV. Learn from other people's
experience by joining a support group.
Yes, you have to make some tough choices. The first choice is when --
and whether -- to tell people that you're HIV positive. There are some
people you must tell: your sex partners and anybody with whom you've
shared needles. It's going to be hard to do this -- but they need to know
for two reasons. Number one, they must know not to infect other people.
And number two, they'll need to take care of themselves. It's a good idea
be able to give these people the telephone number of a local HIV hotline.
There are some people you might think about telling. These are people
who can offer support. If you do decide to tell someone, remember that
not everybody reacts the way you expect them to. Especially at first,
some people may be stunned and not very supportive. Remember that
you are not responsible for their reactions.
If you have children, talk with someone you trust about how to tell them
about your HIV infection. You don't have to tell them right away. Take
some time to decide what to tell them, and when.
Your most important choice is health. If you're not healthy now, it's time
to get healthy. If you're well, take steps to stay that way. HIV is a virus that
weakens the immune system. To make your immune system stronger,
you need a healthy diet. If you're drinking too much, smoking, or taking
recreational drugs, it's time to stop.
Regular medical care is a must. Modern drug combinations can stop HIV
in its tracks. It's not like taking an aspirin for a headache -- you have to
take these drugs every single day, probably for the rest of your life. Your
doctor will help you decide when to start taking these drugs. They can
have side effects, so be sure to ask your doctor all about them.
HIV is a sneaky virus. Keep an eye on it. Your doctor will keep track of the
virus using something called a viral load test. This shows how much HIV
there is in your body. New drugs can make the AIDS virus seem to go
away -- the viral load test may say that HIV is "undetectable" in your
blood. This is very good news, but it doesn't mean the virus is gone for
good. HIV hides in your body, and surges back if you stop taking anti-HIV
drugs.
Your immune system protects you from getting sick. HIV attacks your
immune system. To keep track of your immune system, your doctor uses
a test called a CD4 T-cell count. Even in normal people, T-cell counts go
up and down. Be sure to ask your doctor to explain the results of every
T-cell test.
Even if you are taking anti-HIV drugs, you're still infected. Don't pass the
infection to anyone else. Learn how to use condoms and latex barriers
when you have sex. Don't share needles or works with anybody else. If
you're thinking about sex with a new partner, tell that person that you
have HIV before you do anything sexual. Learn about how HIV is -- and
isn't -- spread from one person to another.
It's up to you to learn more about HIV and AIDS. Talk to your doctor.
Check out the HIV/AIDS information on WebMD and on other responsible
websites such as HIV InSite, maintained by the University of California,
San Francisco. There's lots of information out there -- but be sure it's
accurate. You can't believe everything you see on the Internet. Discuss
what you learn with your doctor.
People with HIV are living longer than ever before. This is a call to action,
not something you can take for granted. Eat healthy foods. Make a plan to
exercise, and stick to it. Make regular trips to the doctor. Get emotional
support. It's your life -- so live it!

What is It?
AIDS: four letters that have changed the world. They stand for acquired
immune deficiency syndrome. HIV -- human immunodeficiency virus --
causes AIDS. HIV attacks the immune system, the body's defense against
disease.
Getting HIV infection is not the same as having AIDS. It usually takes
years for the virus to wear down a person's immune system. When this
happens, all kinds of deadly infections seize the opportunity to infect the
body. Only at this point -- when a person's immune system is weakened
enough for these "opportunistic" infections to attack -- does a person
have AIDS.
HIV infects and kills a type of white blood cell called the CD4 T cell.
Without these infection-fighting cells, the immune system can't protect
against disease. A normal person has between 500 and 1500 CD4 T cells
in every millionth of a liter (microliter or mcL) of blood. When people have
HIV infection, doctors track their CD4 "counts" to see how well their
immune system is doing.
If a person with HIV infection has a CD4 count that drops below 200 -- or if
opportunistic infections appear -- that person is considered to have AIDS.
Without treatment, HIV infection nearly always leads to AIDS. How long
this takes varies from person to person. It depends on many factors: age
and general health, co-infection with other diseases, nutrition, genetic
makeup, and the aggressiveness of the HIV strain with which a person is
infected.
Anti-HIV treatment usually keeps HIV in check for a very long time.
Treatment isn't easy. These expensive drugs have to be taken every
single day for the rest of a person's life. Side effects are common. Despite
these problems, modern AIDS therapy keeps most people AIDS-free for
many years.
HIV infection used to be the first step on an unstoppable slide into a final
condition of AIDS. Today, HIV disease is seen as a continuum running
back and forth from symptom-free HIV infection to AIDS. AIDS is no
longer the end of the line. While it's best to get treated before AIDS
develops, even people with AIDS can see their health and CD4 counts
improve after treatment.
Even with treatment, there is no cure for HIV infection. A person with HIV
infection will carry the virus for the rest of his or her life -- and can infect
other people through unsafe sex or needle sharing.
Unfortunately, modern AIDS treatments remain unavailable in much of the
world. AIDS has always been a disease of poverty, and the poorest
nations of the world bear the brunt of the AIDS epidemic.

How Do I Know I Have It?
HIV testing is the only sure way to know whether you have HIV infection.
People at risk of infection should consider getting tested.
There are very few ways to get HIV infection. These are:
• Unprotected sex. This means vaginal or anal intercourse without a
condom or oral sex without a latex barrier. Oral sex -- even without a
condom or latex barrier -- is far less risky than unprotected vaginal or
anal sex.
• Sharing a needle to inject drugs or steroids, or to make a tattoo or body
piercing.
• Being born to a mother with HIV infection. A baby can also get HIV from
the breast milk of an infected woman.
• Transfusion of blood or blood products from an infected person. This is
very unlikely in the U.S. and Western Europe, where all blood is tested for
HIV infection.
HIV tests show whether a person's blood contains antibodies against
HIV. Most people who get HIV infection make specialized immune cells
called antibodies within three months, but some people take as long as
six months to make them. If a person has engaged in risky behavior in the
six months before testing, a second test is needed to make sure that
there is no infection.
You can't tell whether people have HIV by looking at them. And even if a
person shows you a negative HIV test, you can't be sure that person
wasn't infected just before or after the test.
HIV testing involves counseling before and after the test. Before-test
counseling helps people identify risky behavior, and teaches them how
to reduce this risk. After-test counseling helps people deal with a positive
result -- and helps them get the medical care they need.
Home HIV testing is now available. Be careful! The Internet is full of
fraudulent home HIV tests. Use only FDA-approved home tests. These
tests offer telephone counseling along with the test results.
Acute HIV Infection
Soon after infection with HIV, most people get a flu-like illness with mild
fever, fatigue, and sometimes headache and/or rash. It's a lot like the early
signs of the flu, but it soon passes. If you have flu-like symptoms soon
after engaging in risky behavior, see a doctor right away.
At this early point -- known as acute HIV infection -- a person hasn't yet
made anti-HIV antibodies and will test negative on normal HIV tests. More
sophisticated tests, however, can show whether the virus is growing in
the blood.
The bad news is that HIV grows very fast in the first days after infection.
This means a person is highly infectious to other people with whom he or
she engages in risky behavior.
The good news is that when HIV infection is caught at this very early
stage, treatment is much more effective.
The stage of acute HIV infection ends when a person develops anti-HIV
antibodies. By this time, the virus has burrowed deep into the body to
establish life-long infection.

What's the Treatment?
Massive drug-development programs by government and industry have
led to many anti-HIV drugs. Doctors have learned to use various
combinations of these drugs to keep HIV at bay. Even so, none of the
drugs and none of the combinations can cure HIV infection.
Combinations of anti-HIV drugs sometimes are called HAART, for
highly-active anti-retroviral therapy (HIV is a kind of virus called a
retrovirus). There are three main classes of anti-HIV drugs. HAART
combinations often combine drugs from different classes to get the
broadest possible effect. There is no single best HAART combination.
Because every patient is different, HIV treatment is as much an art as it is
a science. For this reason, people with HIV should seek care from
doctors who have a lot of experience treating HIV disease.
HIV is a wily virus. Its genetic code is error-prone, so that every time it
reproduces it makes lots of mutant virus. Some of these mutations help
the virus survive even when a person is taking powerful anti-HIV drugs.
Far too often, multi-drug-resistant virus will appear in a person who has
been taking an anti-HIV drug combination.
People taking anti-HIV drugs must take their drugs at exactly the right
time, every single day. This isn't easy, especially as the drugs can have
serious side effects such as diarrhea, nausea, or abnormal distribution of
body fat.
Doctors keep track of how well anti-HIV drugs are working by measuring
the amount of HIV in a patient's blood. This measurement is called the
viral load. The goal is to get a viral load that is so low it becomes
undetectable. However, even with successful treatment a person may see
a sudden jump in viral load that soon goes back down again. If the viral
load remains high, a doctor usually will recommend a change in
treatment.
Sometimes a person who has taken anti-HIV drugs for a long time
develops multi-drug-resistant HIV infection. Even these patients get a
benefit from continued treatment. Fortunately, drug development
continues. Newer and more powerful anti-HIV drugs are on the way.


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