What is HIV, and should I be tested?
A: HIV stands for human immunodeficiency virus. This is the virus that can lead to AIDS (acquired immunodeficiency syndrome). Unlike other viruses, like a cold or the flu, the body cannot be cured of HIV. For individuals who are diagnosed with HIV, antiretrovirals (ARV’s), among other drug regimens, are available to achieve and maintain an undetectable viral load (viral supression). As of now, there is not a cure for HIV, but with current advances in medical intervention, individuals living with HIV who are virally suppressed can expect to experience that same quality of life as someone who is HIV negative.
The CDC recommends that everyone between the ages of 13 and 64 get tested as part of their routine health care once per year. If you have a higher risk factor, such as more than one sex partner, have unprotected sex, other sexually transmitted diseases (STD), are a gay or bisexual man, or are an intravenous drug user then you should be tested at least twice a year.
How long after a possible exposure should I be tested for HIV?
A: The time it takes for a person who has been infected with HIV to seroconvert (test positive) for HIV antibodies is commonly called the “Window Period.” Generally, when a person is infected with the HIV virus, the window period for 95-97% of those individuals is within 12 weeks. With recent improvements to rapid HIV testing (such as Insti tests), current rapid tests can detect HIV antibodies in 4 weeks. The CDC has said that in some rare cases it may take up to six months for someone to seroconvert (test positive). At this point in time, the results would be 99.9% accurate.
*What does this mean?
The three-month window period after the last possible exposure is normal for approximately 95% of the population. If you feel any anxiety about relying on the 3-month test result, by all means you should have another HIV test at 6 months just to be sure.
Are HIV and AIDS the same thing?
A: No, HIV and AIDS are not interchangeable terms, although the media often and incorrectly uses them in that way. HIV is a virus. AIDS is a specific condition (Acquired Immunodeficiency Syndrome) caused by having the HIV virus in the body. An individual living with AIDS is considered immunocompromised and is more susceptible to opportunistic infections.
How many people have HIV?
A: It is difficult to estimate the exact number of individuals living with HIV. In 2017, 38739 people were newly diagnosed with HIV in the United States – 52% of all reported new infections were in the South. African American gay/ bisexual men had the largest number of new HIV diagnosis, followed by white and hispanic gay/ bisexual men; however, 24% of the newly diagnosed population was transmitted through heterosexual contact. The CDC also reports that new diagnosis of HIV increased by 13% for individuals ages 25-34 years old.
How do I know if I am at risk for HIV?
A: Knowing your risk can help you make important decisions to prevent exposure to HIV. The CDC has developed the HIV Risk Reduction Tool (provided by the CDC) which can help you determine your risk and better understand the different prevention methods (like using condoms, dams or taking PrEP) to reduce your risk. Recent studies (2018) indicate the risk is:
- 1 in 6 for gay and bisexual men
- 1 in 2 for African American gay and bisexual men
- 1 in 4 for Hispanic gay and bisexual men
- 1 in 11 for white gay and bisexual men
- 1 in 20 for African American men (gay and straight)
- 1 in 48 for African American women overall. Currently, heterosexual African American women account for 9 out of 10 new HIV infections.
- 1 in 5 for transsexual individuals (mtf, ftm, mtx and ftx).
- 1 in 23 for women who inject drugs
- 1 in 36 for men who inject drugs
How can I tell if I have HIV?
A: You can’t rely on signs or symptoms to indicate HIV status. The symptoms associated with acute (new) HIV infections are similar to the symptoms of many common illnesses such as the flu, although not all people who are infected with HIV have any symptoms for many years.
If you are feeling sick, having symptoms or are worried you may have had an exposure to HIV, you should make an appointment to see a doctor or to a local clinic/ texting facility to be tested. If you think you might be at risk of getting HIV; ask your doctor to regularly test for HIV or visit your health department for free, confidential HIV testing. It is recommended for at-risk individuals to be tested between 2 to 4 times per year. An HIV test is the only way to determine whether or not you have the virus.
How is HIV transmitted?
A: HIV can be transmitted through semen, blood (including menstrual blood), vaginal secretions, and breast milk. Blood contains the highest concentration of the virus, followed by semen, then vaginal fluids and lastly via breast milk.
Activities that allow transmission of HIV include unprotected sexual contact (vaginal, anal or oral), direct blood contact such as drug injection needles and in some cases, blood transfusions. Body fluids that are not infectious include saliva, sweat, tears, urine and feces.
Can I get HIV from oral sex?
A: There is some risk associated with performing oral sex without protection if a partner has a detectable viral load.
You can reduce your risk when performing oral sex on a man (fellatio) by using latex condoms, and also by withdrawal before ejaculation without a condom (avoiding semen in the mouth) although the presence of pre-ejaculatory fluid (pre-cum) will increase risk. You should not engage in oral sex when cuts or sores are present in your mouth.
When performing oral sex on a woman (cunnilingus), moisture barriers such as a dam (sheet of latex), a cut-open and flattened condom, or household plastic wrap can reduce the risk of exposure to vaginal secretions and/or blood. While HIV is not believed to be easily transmitted through anal-oral contact (anilingus or rimming) on either a man or woman, safe sex practices include the use of a barrier such as a dam or cut open & flattened condom and avoiding unprotected sex that involves fellatio or cunnilingus after anal contact.
Are all condoms the same?
A: No. While there are many options available in brands, styles, colors, flavors and lubrication, latex condoms are highly effective in preventing HIV transmission when used correctly and consistently each time you have sex. Natural skin or animal membrane condoms (lamb skin, etc.) do not prevent HIV transmission.
Picking out condoms can be a fun experience for you and your partner, but an important thing to consider is whether you plan to use the condom as HIV/ STD protection, or if you just want to use it for play. You should be aware that many condoms such as french ticklers, flavored, glow in the dark, etc. are considered novelty condoms and are generally intended for play, not to prevent infection of any disease. However, some novelty condoms, like flavored, are a good option for lowering the risk of disease transmission during oral sex, but should never be used for any type of vaginal or anal sex.
How do you use a condom?
A: First, always store your condoms in a cool, dry place away from sunlight. It’s not recommended to keep condoms in your pocket for long periods of time. Make sure to check the expiration date on the condom. Be sure to always use a condom for every act of vaginal, anal and oral sex throughout the entire sex act (from start to finish) and never, ever reuse a condom!
- Before any genital contact, put the condom on the tip of the erect penis with the rolled side out.
- If the condom does not have a reservoir tip, pinch the tip enough to leave a half-inch space for semen to collect.
- Holding the tip, unroll the condom all the way to the base of the erect penis while checking for holes and removing air bubbles. If the penis is uncircumcised (uncut), pull back the foreskin before rolling the condom down.
- It’s a good idea to always have a spare condom available
- After ejaculation and before the penis gets soft, grip the rim of the condom and carefully withdraw. Then gently pull the condom off the penis, making sure that semen doesn’t spill out.
- Wrap the condom in a tissue and throw it in the trash where others won’t handle it.
- If you feel the condom break at any point during sexual activity, stop immediately, withdraw the penis, remove the broken condom and put on a new condom.
- Ensure that adequate lubrication to the outside of the condom, vagina or anus is used during vaginal and anal sex, which might require using water-based lubricants. Oil-based lubricants (e.g., petroleum jelly, shortening, mineral oil, massage oils, body lotions and cooking oil) should never be used, because they can weaken latex and cause breakage.
For more information about HIV/ AIDS and how to protect yourself and potential partners, we have many resources available on our Educational Links and Resources page.