EYNTK about HIV and AIDS
Honey Wyatt speaks to a doctor about what you need to know about protecting against, testing for and treating HIV and AIDS
Despite every sex education teacher’s best efforts to scare teenagers about the horrors of HIV and AIDS, the impact of the crisis in the 1980s is lost on younger generations.
While the mass loss brought about by the epidemic is firmly embedded in our parents’ minds, HIV rarely comes up in conversation – unless you’re gay, or visiting the sexual health clinic to get tested.
But condom use is on the decline among young people; while it is easier than ever to treat and prevent HIV, new diagnoses among straight people and older generations are on the rise.
Around 39.9 million people were living with HIV in 2023, according to figures from UNAIDs; of these 1.3 million people newly acquired the virus last year.
Here’s EYNTK about HIV and AIDS.
What Is HIV and how does it develop Into AIDS?
ICYMI in sex education, HIV (human immunodeficiency deficiency virus) is a virus that can damage cells in the immune system and weaken the body’s ability to fight infections, if left untreated.
Untreated HIV then develops into AIDs (acquired immune deficiency syndrome), which describes a group of illnesses and infections.
How HIV/AIDS is transmitted
The AIDS crisis in the 1980s means a lot of people continue to associate HIV with gay people, specifically anal sex, or by touching someone with the virus. However, HIV is spread through body fluids, explains Dr Hana Patel, NHS GP and GP medico-legal expert witness.
“[A common misconception is that] HIV can be transmitted socially, through casual contact, such as hugging, shaking hands, or sharing food and drinks,” she says. “This is untrue, as HIV is transmitted through specific body fluids: this includes blood, semen, vaginal fluids, rectal fluids, and breast milk.”
These fluids can be spread during unprotected anal or vaginal sex through the lining of the anus or genitals, eyes or through open cuts or sores, according to NHS England.
HIV can also be spread through breast milk or during pregnancy. There’s also a very low risk of it being transmitted through oral sex or through sharing sex toys.
Patel continues: ”The virus cannot be transmitted by kissing, shaking hands, hugging or from toilet seats. It can also not be transmitted by tears, sweat, saliva and spitting, urine or faeces.
“It is absolutely safe to share objects someone with HIV has touched or used to eat or drink from, and there is no risk of transmission from swimming pools, showers, hot tubs, or towels.”
Men who have sex with men (MSM), those with a partner who has HIV, or anyone from an area with high HIV rates are most at risk of transmitting HIV.
Prevention: how to protect yourself against HIV
Having sex with someone living with HIV, however, does not necessarily mean you’ll get it too, Patel explains.
“People taking effective HIV treatment cannot pass on HIV through sex,” she says.
As with other STIs, using a condom is the most effective form of preventing HIV, Patel advises.
She says: “A condom is the most effective form of protection against HIV and other STIs. It can be used for vaginal and anal sex, and for oral sex performed on men.
“HIV can be passed on before ejaculation through pre-cum and vaginal secretions, and from the anus, so it's very important condoms are put on before any sexual contact occurs between the penis, vagina, mouth or anus.”
Pre-Exposure Prophylaxis (PrEP) is also available in 122 countries around the world, and can be used to prevent HIV transmission.
Read more: The condoms reframing protection for women's sexual health
How often to test for HIV
While HIV and AIDS has commonly been associated with gay men, straight people are also at risk of contracting HIV. In 2023, the rise in HIV diagnoses was steepest among straight men – particularly those from ethnic minorities – and straight women, according to UK Health Security Agency data.
Nearly half (49%) of all new diagnoses in England in 2023 were as a result of sex between men and women. At the same time, testing for HIV among men who have sex with men (MSM) has increased since 2019, while testing among straight men and women has decreased.
Over eight in 10 (86%) of people with HIV knew their status in 2023, but 5.4 million people with HIV did not know. Anyone who is sexually active should test regularly for HIV to ensure they know their STI status and receive appropriate treatment, Patel explains.
“Testing at least once a year for HIV and other STIs is good sexual health practice for everyone who is sexually active, even if you know you haven’t put yourself at risk of infection,” she says.
“Depending on how many different sexual partners you have in any one year, you might want to consider testing more regularly.”
MSM, Black African men and women, and trans people should get tested more regularly, she added.
Patel advises: “Gay, bisexual and other men who have sex with men (MSM) should get tested routinely for HIV and other STIs – at least annually or every three months if having sex without condoms with new or casual partners.
“Testing at least once a year for HIV is good sexual health practice for everyone”
“Black African men and women; and trans women and trans men who have sex with MSM should have a regular HIV and STI screen if having sex without condoms with new or casual partners.”
How HIV is treated: Antiretroviral therapy and beyond
For those whose test for HIV comes back with a diagnosis, there are options for treating it.
PEP (post exposure prophylaxis) is an emergency medication that can be taken by someone without HIV up to 72 hours after they might have been exposed to HIV (ie. sex without condoms or sharing needles).
Without treatment, people with HIV become unwell, and it can develop into AIDS-related illnesses. Antiretrovirals stop HIV from replicating in the body and are taken daily to prevent this. Of the 39.9 people living with HIV in 2023, 77% (30.7 million) of these were accessing antiretroviral therapy globally.
Read more: We need to talk about STIs and mental health
Symptoms of HIV and AIDS: What to look out for
Around 70-90% of people living with HIV have no symptoms, so getting regularly tested is your best bet for knowing whether or not you have HIV.
However, there are some symptoms to look out for.
In the first stage of HIV infection, there might be a flu-like illness (temperature, sore throat, swollen glands, rash). This is the most infectious stage and could pass unnoticed.
Once the immune system has been damaged (after years of infection) there can be further complications including weight loss, chronic diarrhoea, night sweats, and recurrent infections.
In later stages, HIV can develop into AIDS-defining illnesses such as cancer, TB and pneumonia, which can be deadly.
In 2023, around 630,000 people died from AIDS-related illnesses worldwide, but with early detection and treatment, HIV is unlikely to progress into AIDS.