HIV

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

HIV (Human Immunodeficiency Virus) is a virus that attacks the body’s immune system, making them more vulnerable to other infections and diseases. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome).

AIDS is the late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus. Without HIV medicine, people with AIDS typically survive about 3 years. Once someone has a dangerous opportunistic illness, like tuberculosis, life expectancy without treatment falls to about 1 year.

There is currently no cure for HIV. Once people get HIV, they have it for life. But with proper medical care, HIV can be controlled. People with HIV who get effective HIV treatment can live long, healthy lives and protect their partners from HIV.

WOMEN AND HIV IN SOUTH AFRICA

Women are disproportionately affected by HIV in South Africa; of the 7.4 million adults living with HIV, 64% are women. A quarter of women in South Africa between the ages of 15 and 49 are HIV positive.

HOW IS HIV SPREAD?

HIV is primarily transmitted through specific bodily fluids, including blood, semen, vaginal fluids, and breast milk. The most common modes of transmission include:

Unprotected sexual intercourse (anal, vaginal, or oral) with an HIV positive partner.
Sharing needles, syringes, or other drug injection equipment with an HIV positive person.
Mother-to-child transmission during pregnancy, childbirth, or breastfeeding.
Less commonly, HIV can be transmitted through blood transfusions or organ transplants from an HIV positive donor (though this is rare in countries with screening protocols in place). Blood services in South Africa currently test all blood donations for HIV-1, HIV-2, hepatitis B, hepatitis C and syphilis.

HIV is not spread by:

Air or water
Mosquitoes, ticks, or other insects
Saliva, tears, sweat, faeces, or urine that is not mixed with the blood of a person with HIV
Shaking hands; hugging; sharing toilets; sharing dishes, silverware, or drinking glasses; or engaging in closed-mouth or “social” kissing with a person with HIV
Drinking fountains
Other sexual activities that don’t involve the exchange of body fluids (for example, touching)
Donating blood

HIV can’t be passed through healthy, unbroken skin.

RISK FACTORS FOR ACQUIRING HIV

Unprotected sexual activity, particularly with multiple partners or partners of unknown HIV status
Early sexual debut
Injection drug use and sharing needles or other drug equipment
Having a sexually transmitted infection (STI) can increase the risk of HIV transmission
Lack of access to HIV prevention and healthcare services
Engaging in high-risk behaviour such as commercial sex work or unprotected sex in exchange for money, drugs, or other resources
Unprotected anal intercourse
Needle stick injury

ADDITIONAL RISK FACTORS FACED BY WOMEN

Gender inequality: Gender inequality is a powerful driver of the HIV epidemic. Women’s risk of HIV infection is increased by gender inequality and the resultant decreased social, cultural and economic status. Limited sexual power is associated with inconsistent condom use and makes it difficult for women to negotiate safe sex practice or refuse sexual advances.
Poverty: The social and economic pressures of poverty reinforce unequal gender power dynamics, which forces women into relationships that expose them to a higher risk of HIV infection than men, by engaging in risky sexual behaviours such as transactional and intergenerational sex.
Sexual and Gender Based Violence: Women with violent or controlling male partners are 1.5 times more likely to acquire HIV compared with women who have not experienced partner violence. Violence against women and girls is a structural problem in South Africa, and a central cause of our high rates of HIV infection. South Africa is considered the rape capital of the world – someone is raped or sexually abused here every 25 seconds. Because rape is a crime of force, the mucosal tearing and bleeding that occurs as a result makes the transference of HIV to victims a certainty.
Biological susceptibility to HIV infection: Biologically, women are more vulnerable than men to infection because of the greater mucus area exposed to HIV during penile penetration. Women under age 17 years are at even greater risk because they have an underdeveloped cervix and low vaginal mucus production.

HOW DO I KNOW IF I HAVE HIV?

The only way to know for sure if you have HIV is to get tested. Testing is relatively simple and is widely available across South Africa. You can ask your healthcare provider for an HIV test. If you test positive, you need to start treatment as soon as possible. Your healthcare provider will provide you with the necessary support. If you test negative, continue to employ preventative measures to prevent you getting HIV in the future.

Everyone between the ages of 13 and 64 should get tested for HIV at least once as part of routine health care. You should get tested every year if you:

are seeking pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) for HIV prevention
have had unprotected anal or vaginal sex with someone who has HIV
have had more than one sexual partner since your last HIV test
have shared needles, syringes, or other drug injecting equipment
have exchanged sex for drugs or money
have been diagnosed with or treated for another sexually transmitted infection
have been diagnosed with or treated for hepatitis or tuberculosis (TB)
have had sex with someone who has done anything listed above or with someone whose sexual history or HIV status you don’t know
are pregnant, as part of routine prenatal care
are seeking pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) for HIV prevention

HIV TREATMENT

HIV can be managed with antiretroviral therapy (ART), a combination of medications that suppress the virus, prevent disease progression, and reduce the risk of transmission. ART should be started as soon as possible after diagnosis and taken consistently as prescribed to achieve viral suppression. Viral suppression means that you have reduced the amount of virus in your system to such a low level that it is undetectable, and therefore it is unlikely that you will transmit HIV to someone else.

PROTECT YOURSELF FROM HIV

Know your HIV status
Practice safer sex by using condoms consistently and correctly, especially
with new or casual partners
Before having sex for the first time with a new partner, talk about your sexual and drug-use history, disclose your HIV status, and consider getting tested for HIV together
Avoid sharing needles, syringes, or other drug equipment
Use sterile equipment for body piercings, tattoos, and medical procedures
Consider pre-exposure prophylaxis (PrEP) for individuals at high risk of HIV infection
Early initiation of antiretroviral therapy (ART) can reduce the risk of HIV transmission to sexual partners

PREVENT MOTHER-TO-CHILD TRANSMISSION

If you have a partner with HIV and are considering getting pregnant, talk to your doctor about PrEP to help protect you and your baby from getting HIV while you try to get pregnant, during pregnancy, or while breastfeeding. If you have HIV and take HIV medication as prescribed by your doctor throughout pregnancy and childbirth, the chances of transmitting HIV to your baby are less than 1%. If you’re in labour, HIV positive, and not on medication or have defaulted, it’s important that you inform your doctor or nurse so they can prescribe treatment to you during labour to reduce the risk of HIV transmission to your baby during delivery. After birth, they will also provide HIV prophylactic treatment for your baby until his/her HIV status can be confirmed.

HIV

HIV