HIV/AIDS

Facts & Numbers

  • HIV/AIDS is one of several issues seen at higher rates among lesbian, gay, and bisexual (LGB) Veterans, including smoking, alcohol and substance abuse, discrimination, stigma, exposure to physical/sexual violence, trauma experiences, STIs, asthma, some cancers, and risk for mental illnesses. Increased rates of PTSD and depression have also been seen.
  • Transgender Veterans are more likely to be HIV+ than non-transgender Veterans with a higher prevalence among transgender women of color. In a 2016 study, it was found that transgender Veterans in VA care were nearly five times more likely to be HIV+ compared to non-transgender Veterans.

What is HIV and AIDS?

HIV stands for the human immunodeficiency virus, it takes over certain immune system cells that are supposed to defend the body. These cells are called CD4 cells, or T cells.

When HIV takes over a CD4 cell, it essentially changes the cell into a viral factory by forcing it to produce copies of the virus. The copies then spread to other cells as the previously infected cell dies. Over time, as more CD4 cells weaken and die, the body’s immune system begins to degrade, leaving it increasingly unable to defend itself against ailments.

When the immune system gets so weak that it cannot fight off certain kinds of infections and cancers, the virus enters the most advanced stage of infection caused by HIV. This stage is referred to as acquired immunodeficiency virus, or AIDS.

When someone has AIDS, the person is susceptible to illnesses such as PCP (a type of pneumonia), Kaposi sarcoma (a cancer type that affects the skin and internal organs), wasting syndrome (involuntary weight loss), memory impairment, or tuberculosis.

Even without one of these infections, a person living with HIV can be diagnosed with AIDS if the number of CD4 cells reaches a number indicating a weakened immune system. It’s important to remember that most HIV+ people will not develop AIDS if they start treatment soon after infection.

 

Symptoms

Symptoms can be different for every person and can show up right away or not at all. Usually, symptoms appears with days or weeks after infection and can last up to one or two week. It can feel like a cold or the flu and can include fever, headache, sore throat, swollen lymph nodes on the neck fatigue, rash, or sores in the mouth.

Because HIV can show up similar to a cold or the flu, that only way to tell is to get tested.

Prevention

HIV is spread mostly through four body fluids: semen (cum), vaginal fluid, blood, and breast milk. Presently, there is no vaccine or cure for HIV but there are many ways you can reduce your risk of HIV.

  • Get Tested: If you never had one before, ask your provider for an HIV test. If you don’t have a regular provider, there are several locations throughout the Sacramento region that provide free HIV testing and help. The VA recommends getting tested at least once.
  • PrEP (Pre-exposure Prophylaxis): This has been a major development in HIV prevention in the past few years. PrEP is a daily medication proven to be highly effective at preventing HIV. The good news is that PrEP (Truvada® and Descovy®) are now available at the VA. Ask your provider as to how you can get PrEP after you get tested.
  • Practice Safe Sex: Even with the invention of PrEP, practicing safe sex remains highly recommended. Using condoms for oral and anal sex & a dental dam for oral sex are effective methods of HIV transmission.
  • PEP (Post-exposure Prophylaxis): If you may have been exposed to HIV in the last 72 hours, talk to your health care provider, ER doctor, or an urgent care provider about PEP. PEP is effective in preventing HIV but is not 100%. The sooner you start PEP, the better.
  • Practice Safe Injection Drug Use: If you share needles, syringes, or other injection equipment with someone who has the virus, you can contract HIV through blood. If you are high on drugs, the risk of transmission increases with sex. If you choose to inject drugs, use new, clean needles/syringes every time; use new, clean water or cotton; take PrEP or PEP; and use condoms.
  • HIV Treatment as Prevention (TasP): If a person with HIV is on HIV meds with a consistently undetectable HIV viral load, research has show that HIV cannot be transmitted to a sex partner. A good way to remember this is U=U or “Undetectable = Untransmittable.”

Treatment

While there currently is no cure for HIV/AIDS, there are several treatments available. Drugs to treat HIV are called antiretrovirals (ARVs) which are part of a determined antiretroviral therapy (ART). ARVs work by directly attacking the virus to cripple its ability to make copies. An ART regimen can consist of three medications from at least two classes of drugs that include:

  • Nucleoside Reverse Transcriptase Inhibitors (NRTIs or “nukes”): Blocks the enzyme (reverse transcriptase) HIV uses to make copies of itself.
  • Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs or “non-nukes”): Also blocks the enzyme but in a different way.
  • Integrase Inhibitors: Blocks HIV integrase, the enzyme used to enable the virus to insert copies of itself into human DNA.
  • Protease Inhibitors (PIs): Blocks protease, the enzyme used to process itself to be released from the cell to infect other cells.
  • Entry Inhibitors: Prevents the virus from entering CD4 cells, blocks the virus from bonding to CD4 cell receptors, and blocks HIV from binding to a coreceptor.

Additional Information

Centers for Disease Control & Prevention: HIV