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How HIV enters the blood stream For someone to be infected with HIV there needs to be an opportunity for the virus to enter the body. HIV makes its home in the CD4 cells - special infection-fighting cells - found predominantly in blood. Therefore, for HIV to be transmitted, an infected person’s blood or sexual fluids has to enter the bloodstream of another person. There are only two possible entry points: Broken skin: The virus cannot enter through intact, unbroken skin. It can, however, gain entry through open sores, cuts, scratches and needle punctures without any problems Mucous membrane: This is the lining found on the tip of the penis, inside the vagina and rectum, and inside the nose and mouth. If the mucosa is damaged, for example via vaginal abrasions sustained during sex or the presence of a Sexually Transmitted Infection (STI), HIV can enter the body easily and infection is more likely HIV cannot enter through intact skin, but it can enter through intact mucosa. When bruises or small cuts weaken this moist lining - which can occur during sex (more so during rough or violent sex) or caused by Sexually Transmitted Infections (STIs) - the risk of contracting HIV is much greater. As you can see, HIV is not easily transmitted (like the flu or a cold) and prevention is as straighforward as having safer sex (i.e. sex with a condom), abstaining from sex and covering any cuts or sores when working with blood or blood products.
Preventing mother-to-child transmission of HIV It’s important that we all know about mother-to-child transmission of HIV, so we can be proactive in its prevention. HIV can be transmitted to a baby during pregnancy, labour, delivery or breastfeeding. Without treatment, the risk of an HIV-positive woman passing the virus to her child ranges from 16-40 per cent. Around 20 per cent of HIV-positive infants are infected during pregnancy, about 50 per cent during labour and delivery, and 30 per cent during breastfeeding. The following are ways to prevent mother-to-child transmission of HIV: Avoid breast-feeding. This is only possible if clean water and milk formula are readily available. Not breastfeeding reduces the risk of HIV transmission by 10-20% Keep delivery time as short as possible. Avoid instrumental (suction or forceps) delivery of the baby. It often causes trauma to the birth canal and the baby, increasing the amount of infected maternal blood and making it easier for HIV to enter through broken skin on the baby Caesarian section (operation to deliver baby). This reduce the chances of infection, but there are other risks associated with surgery Treat the mother with antiretroviral therapy. By reducing the mother’s viral load with antiretrovirals during pregnancy, the risk of HIV transmission to the baby is lowered  Nevirapine. By giving both the mother and baby a short course of Nevirapine around the time of birth, the likelihood of HIV transmission is significantly reduced.
Prevention through behaviour change  By now, you will know that sexual behaviours are central to the HIV/AIDS epidemic. HIV is mainly spread through sex, and practicing safer sex reduces the risk. A lot. Let’s look at how and why people change behaviour. Perhaps we can learn about ourselves: why we change; why we do not change... Behaviour change is an active process, resulting from our interpretation of a situation, our ideas about what should be happening and what might happen if we change our behaviour. So what this basically means is that you have to want to change, you have to know why you want to change and you have to know the consequences of changing. Characteristics of behaviour change Behaviour change is not a once-off affair, it takes place over time We change our behaviour when we are ready to do so, not before; not when we are told to; not when others think we should Even "new" behaviour needs to be adapted over time as circumstances change Practice is required if the behaviour is to be maintained consistently People will ONLY make changes that make sense to them, that work for them Remember . . . knowledge is power! Knowledge about HIV/AIDS can save lives
HIV Tests HIV testing determines whether or not a person is infected with the Human Immunodeficiency Virus (HIV). This is the virus that destroys the body’s ability to fight off illness, and is the cause of AIDS. The HIV test looks for antibodies in a person’s blood. When HIV (which is a virus) enters a person’s body, special chemicals called antibodies are produced. Different antibodies are produced for different viruses. So if a person has antibodies to HIV in their blood, it means that they have been infected with HIV. Remember, an HIV test will not detect the presence of the HIV virus immediately after exposure to the risk. The time it takes between the moment a person is infected with HIV and the time that an HIV test will detect antibodies to the virus in the blood, is known as the window period. It is essential to know that during this time, even though the test may be negative, the person can still infect others with the HIV virus. In fact, it is during the window period that a person is most infectious and can spread the HIV virus most easily. It is important that everyone knows about HIV tests, how they work, the types available, how to interpret the results and so on. A person can then make an informed choice about getting tested for HIV and knowing his or her status.
What happens at VCT sites?   Counselling and testing for HIV are just some of the services you can get at a VCT site. Go to a VCT site if: You have any questions about HIV and AIDS You want a government HIV-antibody test You are worried you might have a Sexually Transmitted Infection You want to support you partner or friend when they test for HIV You have been coughing for more than two weeks, and you think you have TB You are pregnant You want counselling to talk about your feelings and thoughts You need advice about healthy living They can tell you about many other services offered free by the government. What all health workers or counsellors should do They should: Treat what you tell them confidentially (wont tell anybody else what you have told them) Provide a private place for you to talk Not judge you or your situation Be understanding, and allow you to express you feelings Advise you of your choices, but not make decisions for you Give you information that will help you make decisions Be supportive Many companies have recognised the need and provide their employees with convenient and confidential VCT facilities at the workplace.
Testing in brief In short, we know that: The only way to find out whether or not you have HIV, is by having an HIV test, which looks for HIV antibodies in a person’s blood An HIV test will not detect HIV antibodies in the blood immediately after exposure to the risk, i.e. during the window period Pre- and post-test counselling is an important part of dealing with HIV, and the results of an HIV test An HIV test can only be done with your written consent and the result may only be disclosed to you When going for an HIV test, you have the right to: Confidentiality (and therefore a private place to talk and be tested Not be judged and to be treated with respect Express you feelings Be advised of your choices, but not to have decisions made for you Information that will help you make decisions Be supported Whether a negative result makes you more determined to live responsibly, or a positive result helps you to take steps to stay healthy, knowing your HIV status can help you make more informed choices about how you live your life.
Testing HIV negative HIV tests can identify HIV antibodies in the blood as early as two weeks after infection, but the body may take up to six months to make a measurable amount of antibodies. The average time is 25 days. A sero-negative result usually indicates that a person is not infected with HIV. However, they should be retested in six months if they have engaged in high-risk behaviour during the past six months, because it can take this long for the immune system to produce enough antibodies. A test result that is negative in the window period, when the person is actually infected with HIV, is known as a false negative result. When to re-test if the result is negative Whether enough time (6-12 weeks) has passed to give an accurate sero-negative result depends on when the person’s last risky encounter was. It is also necessary to ask about the person’s sexual partner and whether they have engaged in any risky activities recently. Risky activities may include: Having sex without a condom Having sex with a sex worker Having multiple partners and not using a condom every time Sharing any needles or syringes in the past six months Having an untreated Sexually Transmitted Infection (STI) or having sex with someone who does It’s important to know that during this time, even though the test may be negative, the person can still infect others with the HI-virus. In fact, it is during the window period that a person is most infectious and can spread HIV most easily.
Pre and Post-Test Counselling Friendly, open-minded and non-judgemental counselling is an important part of having an HIV test, whether it be counselling provided before (pre-test counselling) or after an HIV test (post-test counselling). Before having an HIV test, counselling may be important in helping a person make an informed decision, such as the decision to have an HIV test, and possible scenarios you may have to deal with afterwards, depending on the outcome. It’s important that once you have the HIV test, you know exactly what the procedure is, how long it will take to get the results and how to prepare yourself for that result. Your time with the counsellor is a perfect time to ask any questions and ease any doubts you may have. Counsellors at testing sites have been trained to prepare one for the possible result of the test and to discuss what the plan of action may be. It’s an important issue to think about and discuss with your councellor, so that once you have received your test results, you need to have a plan in place that deals with life after the result, whether you test negative or positive. Pre and Post-test counselling is your right. Make sure you get it and make full use of the service.
HIV/AIDS can be treated! The fact that there is still no cure for AIDS, does not mean that once someone is diagnosed with HIV, there is no hope. It is simply the start of a new way of living to ensure optimum health and overall wellbeing. There are many lifestyle changes one can make and affordable treatment options available, which will help the immune system function as best it can for as long as possible. Many of the Opportunistic Infections (OI’s) can be treated effectively if diagnosed early. Some can even be prevented with appropriate medications. Also, much progress has been made in the development of new, more effective anti-retrovirals and making them available to all HIV-positive people. Treatment is an individual process and each person (together with their doctor) needs to find a regime that best accommodates his/her circumstances. Some may opt for the best medicines available, no matter the cost or the amount of pills to be taken. Others have to consider cost, side effects and so on. Remember that a positive attitude and a good support system go a long way in fighting this disease.
Anti-retroviral therapy The overall goal of anti-HIV therapy is to slow or stop the ability of HIV to reproduce, and thereby slow or stop the destruction of the immune system. While other HIV treatment strategies have been proposed and tested, so far only anti-HIV therapy has been proven to slow disease progression and extend life. It’s important to remember that HIV-positive people can live a long time without symptoms and without using anti-HIV therapy. Many (if not most) people don’t have to make a decision about using anti-HIV therapy immediately after learning that they are living with HIV. Assessing your personal risk of HIV disease progression and making decisions you feel comfortable with, and empowered by, is key to a successful long-term anti-HIV strategy. There are many issues for HIV-positive people to think about and discuss with their healthcare providers before taking the medications. Those starting anti-HIV therapies for the first time (first line therapy) or switching therapies (second or third line therapy) should consider the following: Successful long-term use of therapies is the key to their success Reducing viral load as low as possible should be an important goal of anti-HIV therapy There may be some degree of cross-resistance between certain drugs Should I get a resistance test? The use of treatment that is only partly effective speeds the development of viral resistance Learn about drug interactions Using a drug exactly as prescribed is critical to success In addition to overall general health and quality of life factors, both CD4+ cell counts and viral load tests must be considered when making decisions about starting anti-HIV therapy or when considering switching therapies. The complexity of treating HIV has changed dramatically in the last year and doctors also have to keep themselves up to date. Whatever medical strategy a person chooses, it should begin with finding a doctor who is experienced in treating HIV and who keeps abreast of the latest advances.
Complementary therapies to treat HIV What the medical fraternity often refer to as ’alternative’ therapies, such as aromatherapy, homeopathy and acupuncture, have been around for hundreds of years, and some people swear by them. While it’s true that ’alternative’ measures can help with the stresses and strains that come with HIV, most experts agree that these therapies should not be used instead of conventional strategies. Whether an HIV-positive person chooses to look to massage, reflexology, colour therapy or any of the other common (and not so common) therapies out there, an all-round approach that includes healthy living, regular doctor’s visits and drug therapy is still the best path to health. Your doctor should always be your first and most important port of call when it comes to trying out new treatments, even if they’re "just herbs". Certain herbs, supplements and medications can interact and cause side effects or weaken the effectiveness of your medications. So speak to your doctor first.
Caring for an HIV positive person If you or someone close to you is HIV-positive, it’s important to know how to take care of oneself. From the time HIV enters the body, the immune system is engaged in an epic battle to try and control the numbers of HI-virus and keep the body healthy. There is a lot the HIV-positive person can do to help it. Effective stress management, a nutritious immune-boosting diet, enough exercise, emotional and spiritual support will all help in keeping the immune system as active as possible, for as long as possible (many years). There are also medicines available to help prevent and control the various infections and diseases (often referred to as Opportunistic Infections), including anti-retroviral drugs. Learning how to deal with the side-effects associated with these drugs, may help prevent the development of resistance to them. Knowing how to take care of a loved one or a friend with HIV/AIDS at home, both physically and emotionally, will help you cope with the challenges presented by such a situation.
Stigma, discrimination and your rights HIV does not discriminate - it infects all races, genders, ages... But still, many people living with HIV/AIDS are discriminated against and suffer from stigma. The law says that all people are equal, including people living with HIV and AIDS. Stigma: If you are HIV-positive, you may suffer from negative attitudes from family and friends. Someone might make a bad comment, or stop being friendly to you or even stop caring for you. Your rights: Family and friends can help you feel positive about yourself, and to live a healthy life. You have the right to get counselling on how to live positively. This can from your family, community members, religious leaders and support groups. Discrimination: You may find you are discriminated against at work if you say you are HIV-positive. You may not be given the promotion you deserve or even be dismissed because of your HIV-positive status. Your rights: You have the right to keep your job when you are HIV-positive. Nobody has the right to fire you or to treat differently at work because of your HIV-positive status. If this happens, you have the right to ask for legal help. Discrimination: Some schools discriminated against HIV-positive children or their parents. They also hold back a child’s report or stop the child from writing exams if they can’t pay the fees. Your rights: You have the right to education. Schools are not allowed to turn away a child who cannot pay schools fees or who cannot buy a school uniform. Stigma: Some health workers also discriminate against HIV-positive people. They may tell others what you have told them in confidence. This makes people scared of taking an HIV test. Your rights: You have the right to a stigma-free and confidential Voluntary Counselling and Testing service. However, no one can force you to take an HIV test. You also have the right to free treatment as a state patient if you qualify for it. Discrimination: Insurance companies may refuse to give you an insurance policy when you apply for one. Your rights: Some insurance companies offer special policies for people living with HIV and AIDS. Ask your insurance agent about these. If you already have a policy, make sure it pays out benefits for HIV-positive people. HIV-positive people have the right to fight prejudice and those of us who are HIV-negative, should strive to be tolerant and fair, and speak out against discrimination.
Treating HIV/AIDS – an overview Let’s take another look at the ins and outs of treating HIV/AIDS: There is no#TOP cure for AIDS, but HIV-positive people can live a long time without symptoms, by using affordable medications and making various lifestyle changes Many of the Opportunistic Infections (OI’s) associated with HIV can be treated effectively (and even prevented), if diagnosed early Treatment is an individual process and each person (together with their doctor) needs to find a regime that meets his or her needs The overall goal of anti-HIV therapy is to slow or stop the ability of HIV to reproduce, and thereby slow or stop the destruction of the immune system There are many issues for HIV-positive people to think about and discuss with their doctors before taking the medications Effective stress management, a nutritious diet, exercise, emotional and spiritual support will all help keep an HIV-positive person’s immune system as active as possible, for as long as possible While ’alternative’ measures can help with the stresses and strains that come with HIV, most experts agree that these therapies should not be used instead of, but rather together with more conventional strategies Certain herbs, supplements and medications can interact and cause side effects or weaken the effectiveness of your medications Your doctor should always be your first and most important port of call when it comes to trying out new treatments, even if they’re "just herbs.
HIV and your rights... in short Over the past few weeks, we have explored the legal issues associated with HIV/AIDS. Whether you are HIV-positive or not, you have certain rights as a South African citizen and it’s important to know what these are. To re-emphasise just a few: The South African Constitution has a Bill of Rights that protects its citizens. It states that all people are equal, including those living with HIV and AIDS You have the right to fight discrimination, whether at school, at work or in your community People with HIV/AIDS have the right to confidentiality. No one can give out information about a person’s HIV status without his or her permission Insurance companies can currently refuse life insurance to people living with HIV. Many insurance companies do however, have special policies for people who are HIV-positive You have the right to a stigma-free, confidential and free medical care as a state patient if you qualify for it A woman cannot be forced to terminate her pregnancy if she is HIV-positive These are just some of your rights, HIV-positive or negative. Know about them and do what you can to ensure they are respected and protected. All info supplied by SA Cities Network AIDS Advise Programme (2008)

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What AIDS cannot do

It cannot cripple love,

It cannot shatter hope,

It cannot corrode faith,

It cannot take away peace,

It cannot destroy confidence,

It cannot kill friendship,

It cannot shut out memories,

It cannot silence courage,

It cannot invade the soul,

It cannot reduce eternal life,

It cannot quench the spirit…