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HIV/AIDS Training - My Care Home Care
In the United States, HIV is spread mainly by having sex or sharing injection drug equipment such as needles with someone who has HIV.
Only certain fluids—blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk—from an HIV-infected person can transmit HIV. These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (from a needle or syringe) for transmission to possibly occur. Mucous membranes can be found inside the rectum, the vagina, the opening of the penis, and the mouth.
In the United States, HIV is spread mainly by:
– Having sex with someone who has HIV. In general:
– Anal sex is the highest-risk sexual behavior. Receptive anal sex (bottoming) is riskier than insertive anal sex (topping).
– Vaginal sex is the second highest-risk sexual behavior.
– Having multiple sex partners or having other sexually transmitted infections can increase the risk of infection through sex.
– Sharing needles, syringes, rinse water, or other equipment (works) used to prepare injection drugs with someone who has HIV.
Less commonly, HIV may be spread by
– Being born to an infected mother. HIV can be passed from mother to child during pregnancy, birth, or breastfeeding.
– Being stuck with an HIV-contaminated needle or other sharp object. This is a risk mainly for health care workers.
– Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This risk is extremely small because of rigorous testing of the US blood supply and donated organs and tissues.
– Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when infected blood from a caregiver’s mouth mixes with food while chewing, and is very rare.
– Being bitten by a person with HIV. Each of the very small number of documented cases has involved severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken.
– Oral sex—using the mouth to stimulate the penis, vagina, or anus (fellatio, cunnilingus, and rimming). Giving fellatio (mouth to penis oral sex) and having the person ejaculate (cum) in your mouth is riskier than other types of oral sex.
– Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids. These reports have also been extremely rare.
– Deep, open-mouth kissing if the person with HIV has sores or bleeding gums and blood is exchanged. HIV is not spread through saliva. Transmission through kissing alone is extremely rare.
Confidentiality
In the patient’s home, health care workers should allow the patient to determine who is present during an interview. Family members or friends should be present and participate in the discussion only if the patient specifically requests this. In the field there are important measures that can be taken to protect patient confidentiality:
- Don’t leave sensitive or confidential information with a neighbor or friend, and be careful not to disclose the patient’s condition when gathering information on his or her whereabouts
What is HIV treatment?
HIV treatment involves taking medicines that slow the progression of the virus in your body. HIV is a type of virus called a retrovirus, and the combination of drugs used to treat it is called antiretroviral therapy (ART).
Although a cure for HIV does not yet exist, ART can keep you healthy for many years, ART reduces the amount of virus (or viral load) in your blood and body fluids. ART is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are. ART also reduces your chance of transmitting HIV to others if taken as prescribed.
ART is usually taken as a combination of 3 or more drugs to have the greatest chance of lowering the amount of HIV in your body. Ask your health care provider about the availability of multiple drugs combined into 1 pill.
If the HIV medicines you are taking are not working as well as they should, your health care provider may change your prescription. A change is not unusual because the same treatment does not affect everyone in the same way.
Let your health care provider and pharmacist know about any medical conditions you may have and any other medicines you are taking. Additionally, if you or your partner is pregnant or considering getting pregnant, talk to your health care provider to determine the right type of ART that can greatly reduce the risk of transmitting HIV to your baby.
Where can I find an HIV health care provider?
You can find HIV care and treatmentexternal icon across the U.S. provided by Ryan White HIV/AIDS Program medical providers. The Ryan White HIV/AIDS Programexternal icon provides HIV primary medical care, medicationexternal icon, and essential support services to low income people living with HIV.
When should I start treatment?
Treatment guidelinesexternal icon from the U.S. Department of Health and Human Services recommend that a person with HIV begin antiretroviral therapy (ART) as soon as possible after diagnosis. Starting ART slows the progression of HIV and can keep you healthy for many years.
If you delay treatment, the virus will continue to harm your immune system and put you at higher risk for developing AIDS, which can be life threatening.
Follow your treatment plan exactly as your health care provider has prescribed. Medicines should be taken at specific times of the day, with or without certain kinds of food. If you have questions about when and how to take your medicines, talk to your health care provider or pharmacist.
Does HIV medicine cause side effects?
Like most medicines, antiretroviral therapy (ART) can cause side effects. However, not everyone experiences side effects from ART.
Some common side effects of ART that you may experience can include:
- Nausea and vomiting,
- Diarrhea,
- Difficulty sleeping,
- Dry mouth,
- Headache,
- Rash,
- Dizziness,
- Fatigue, and
- Pain
Contact your health care provider or pharmacist immediately if you begin to experience problems or if your treatment makes you sick. Your health care provider may prescribe medicines to help manage the side effects or may decide to change your treatment plan.
What should I do if I miss a dose of my HIV medicine?
Taking your HIV medicines exactly the way your health care provider tells you to will help keep your viral load low and your CD4 cell count high. If you skip your medicines, even now and then, you are giving HIV the chance to multiply rapidly. This could weaken your immune system, and you could become sick.
Talk to your health care provider if you miss a dose. In most cases, if you realize you missed a dose, take the medicines as soon as you can, then take the next dose at your usual scheduled time (unless your pharmacist or health care provider has told you something different).
If you find you miss a lot of doses, talk to your health care provider or pharmacist about ways to help you remember your medicines. You and your health care provider may even decide to change your treatment regimen to fit your health care needs and life situation, which may change over time.
Do I need to keep taking my HIV medicine if my viral load is undetectable?
Yes. If your viral load goes down after starting ART, then the treatment is working, and you should continue to take your medicine as prescribed. If you keep an undetectable viral load, you can stay healthy and have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
What are the benefits of taking my HIV medicine every day as prescribed?
Sticking to your HIV treatment provides many benefits. Among them, it:
- Allows HIV medications to reduce the amount of HIV in your body. If you skip your medications, even once in a while, you are giving HIV the chance to multiply rapidly. Keeping the amount of virus in your blood as low as possible is the best way to protect your health.
- Helps keep your immune system stronger and better able to fight infections.
- Reduces the risk of passing HIV to others. If you take HIV medicine as prescribed and get and keep an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
- Helps prevent drug resistance. Drug resistance develops when the virus changes form (mutates) and no longer responds to certain HIV medication. This limits the options for successful HIV treatment. Drug-resistant strains of HIV can be transmitted to others, too.
What are some challenges I might face when taking my medication?
Staying on an HIV treatment plan can be difficult. That is why it is important to understand some of the challenges you may face and to think through how you might address them before they happen:
- Problems taking medications, such as trouble swallowing pills, can make staying on treatment challenging. Your health care provider can offer tips and ideas for addressing these problems.
- Side effects from medications, for example, nausea or diarrhea, can make a person not want to take them. Talk to your health care provider. There are medicines or other support, like nutritional counseling to make sure you are getting important nutrients, which can help with the most common side effects.
- A busy schedule. Work or travel away from home can make it easy to forget to take pills. Planning ahead can help. Or, it may be possible to keep extra medicines at work or in your car for the times that you forget to take them at home. But talk to your health care provider—some medications are affected by extreme temperatures, and it is not always possible to keep medications at work.
- Being sick or depressed. How you feel mentally and physically can affect your willingness to stick to your treatment plan. Again, your health care provider is an important source of information to help.
- Alcohol or drug use. If substance use is interfering with your ability to keep yourself healthy, it may be time to seek help to quit or better manage it.
- Treatment fatigue. Some people find that sticking to their treatment plan becomes harder over time. Every time you see your health care provider, make it a point to talk about staying on your treatment plan.