HIV Frequently Asked Questions
Information Line | Antibodies | HIV FAQ | Transmission | Treatments
Introduction
The general questions in this pamphlet derive from phone calls to the HIV Information line at the Albion Street Centre.
The callers accessing the HIV Information Line include members of the public in domestic or workplace settings; health workers such as doctors, nurses, social workers, students and researchers; students researching HIV projects; people living with HIV and partners, relatives and friends of people living with HIV.
The Albion Street Centre publishes these general questions and answers as a contribution to public education. Please contact (02) 9332 9700 or NSW-toll free 1800 451 600 or (02) 9332 4268 (TTY for the deaf only) if you require further information. Information Line staff and volunteers are happy to help you directly, or by referral to specialist staff.
Information Line staff do not give information about HIV over the telephone to students for assignments or projects however they may give information on resources to access for assignments.
General Questions
What is AIDS?
AIDS is a condition, which can result from infection with HIV (Human Immunodeficiency Virus). HIV weakens the immune system (the body’s natural defence against disease), which makes the person vulnerable to certain opportunistic infections and malignancies; these are called AIDS defining illnesses. AIDS is a medical diagnosis. It may take years for signs and symptoms of HIV to occur. Most AIDS defining illnesses are treatable and may be prevented with treatment. With current medications, many people living with HIV remain well for many years and do not need hospitalisation.
What are the categories of HIV infection?
Australian
Categorisation of HIV infection |
|
Category/Stages |
Description |
| Category A – Includes one or more of: |
|
| Category B | Symptomatic conditions not included in category C |
| Category C | Diagnoses with an AIDS-defining condition. (US definition also includes <200 CD4 cells) |
It is important to remember HIV infection requires a specific blood test for diagnosis.
What is the window period?
This is the time it may take following infection with HIV for antibodies to the virus to be made and to appear in the blood. In Australia this is considered to be 12 weeks. During this time, a person may be infected and infectious despite having a negative HIV test. Therefore it is recommended that people have an HIV test at least 12 weeks after they been at risk of infection.
What are the symptoms of becoming HIV positive?
There are no specific symptoms which will tell you that you have HIV. Some people experience symptoms a few weeks after becoming infected. This is called the seroconversion illness or acute primary infection. At this time your immune system is reacting to the presence of the virus and so the symptoms may be the same as for any viral illness. Anxiety may also cause some of the same symptoms. The only way to tell if you have become infected with HIV is to have a specific blood test allowing for the window period (see above.)
What is the incubation period of the virus? (This is not the same as the window period.)
This is the period of time it takes from becoming infected with HIV to developing symptoms of disease. This period varies from person to person. This period may vary due to interventions with anti-retroviral medications. During this time there may be no outward evidence of illness, but the virus remains active (replicating and mutating) in the body and can still be detected by a blood test and the person is infectious.
How does HIV cause illness?
HIV causes illness by damaging the immune system through infecting the immune system’s helper cells. The immune system is the body’s natural defence mechanism against infection. An important part of this system is a group of white blood cells called lymphocytes. Lymphocytes can be further divided into various subgroups which each perform specific tasks. T4 cells, also called CD4 cells, are a type of lymphocyte which recognise anything foreign and activate the immune system to protect the body.
When HIV enters the blood stream, it infects and destroys these T helper cells. By doing this, it causes a gradual destruction of parts of the immune system. Eventually, the body becomes vulnerable to certain infections.
What type of virus is HIV?
HIV (Human Immunodeficiency Virus) is a retrovirus. Most viruses infect blood cells and reproduce in the main body of the cell simply by inserting their genetic material (DNA) into the cell’s reproductive machinery. However, a retrovirus has a different type of genetic material (RNA), which needs an enzyme called reverse transcriptase to take over the cell’s reproductive machinery. This turns the cell into a virus factory, reproducing copies of itself rather than new, healthy cells. The viruses then go on to infect new cells. When an infected cell is activated, supposedly to protect the body from invading infection, it produces more HIV instead.
What are antibodies?
Antibodies are chemical compounds found in the blood, which are produced by the immune system in response to the presence of a foreign substance, such as an infection. With many infections, the antibodies help the body to recover and fight off infections. With some viruses such as measles, hepatitis A and chicken pox, the antibodies can protect a person from future infection. This is not the case with HIV.
What is the HIV antibody test?
This is a special blood test to determine whether there are antibodies to HIV in the blood. More than one test may be used. The first test done is known as ELISA or EIA (Enzyme-linked immuno-sorbent assay.) This test is extremely sensitive.
A positive result needs to be confirmed by what is called the Western Blot test, which detects antibodies against the major antigenic and viral proteins of HIV. When this is done results are considered extremely reliable and thus determines the test result. A positive Western Blot test means that a person is infected with HIV, a negative result on the Western Blot test means that a person does not have HIV even if the result has come back positive on the antibody ELISA or EIA test.
When should the test be done?
It is recommended to wait at least 12 weeks after the possible exposure. This is to allow enough time for HIV antibodies to appear which is what the HIV test is designed to detect. During this period it is recommended that a person practice safe sex and use condoms. There may be circumstances when testing earlier than 12 weeks would be recommended eg. due to the presence of symptoms .
If the risk exposure is high (e.g. sexual intercourse with no condom or sharing needles with a person of unknown HIV status or a HIV positive partner) and has occurred recently (within 72 hours) there is the option of being prescribed what is called Post Exposure Prophylaxis (PEP). This involves a course of HIV medication for one month. People who have been in a high-risk situation within the previous 72 hours who wish to access PEP may do so at Sexual Health Clinics, Accident and Emergency Departments at public hospitals, or certain specialist general practitioners. PEP treatment is thought to be more effective when it is taken sooner rather than later. In other words, starting the course of PEP treatment within the first few hours may be more effective than if it is taken towards the end of the 72 hour period.
How can I get a blood test?
Tests are available from your nearest sexual health clinic, Family Planning clinic, or general practitioner. Some drug and alcohol centres also offer testing. At a Sexual Health Clinic where testing for HIV and other sexually transmissible infections (STI) is free of charge and confidential.
HIV testing for insurance or immigration purposes must be undertaken privately as testing at public facilities is not permitted for immigration purposes.
An HIV test has many implications. Someone should discuss these implications with you as HIV testing should only be done with informed consent (see below). For this reason we suggest going to a centre where pre and post test counselling is carried out.
Informed consent
This means you should be able to understand what you are testing for and weigh up the advantages of having an HIV test and assess the potential implications of a positive result. Things to consider are how you would cope with a positive result given your current life circumstances, what supports you would have, and how you have coped with a crisis in the past. Implications for insurance, superannuation, major loan applications as well as travel and immigration should be explained to you as part of pre-test counselling. It is also necessary under law in New South Wales that a person diagnosed with HIV must inform current and future sexual partners of the diagnosis before engaging in sex. These things should be discussed with you prior to having a test. The testing procedure will also give information regarding how to potentially prevent HIV infection.Protection of your privacy.
Testing and reporting of an HIV result using a person’s full name and address is unlawful except under specific circumstances, such as for insurance or immigration purposes, testing a hospital patient, or when the person being tested has consented to their name being recorded. It is a good idea to ask the centre where you wish to be tested if they use a coding system that does not identify people by personal details.
Where did HIV originate?
There is strong evidence that HIV one and two (HIV-1 and HIV-2), originated in Central Africa from chimpanzees and monkeys infected with SIV (Simian Immunodeficiency Virus).
HIV-1 is the main strain found in and affecting Europe, Asia, Australasia, North and South America. HIV-2 is found mainly in West Africa.
Albion
Street Centre
150 - 154 Albion Street Surry Hills NSW 2010 Australia
Telephone: +61 2 9332 9600 Fax: +61 2 9331 3490