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1. What is the difference between HIV and AIDS?

HIV is the viral infection that leads to a diagnosis of AIDS. Once someone is infected with HIV, it usually takes about 7 to 10 years for their immune system to be compromised to the point of an AIDS diagnosis, specifically their CD4+ T-cell count is less than 200 per millimeter of blood and/or they have an onset of one Opportunistic Infection. Usually, CD4 cell counts in someone with a healthy immune system range from 500 to 1,800 per cubic millimeter of blood.

2. What is an Opportunistic Infection (OI)?

HIV-positive people with suppressed immune systems may experience illnesses that are not usually seen (or do not cause symptoms) in people with healthy immune systems. Some common OIs include Pneumocystis pneumonia (PCP), Mycobacterium Avium Complex (MAC), and Cytomegalovirus (CMV).

3. Where did HIV come from?

In 1999, scientists discovered the origins of HIV-1. HIV has been found to be related to a strain of Simian Immunodeficiency Virus (SIV) found in a subspecies of chimpanzees native to west equatorial Africa. Scientists believe that HIV was introduced into the human population when hunters became exposed to infected blood.

The Centers for Disease Control and Prevention (CDC) is sure that the virus existed in the United States since at least the mid- to late 1970s. From 1979-1981 rare types of pneumonia, cancer and other illness were recognized by doctors around the United States. In 1982, public health officials termed the occurrences of rare illnesses Acquired Immune Deficiency Syndrome (AIDS). In 1983, scientists discovered the virus that causes AIDS, which was later named Human Immunodeficiency Virus (HIV).

4. How is someone infected with HIV?

An individual can be infected with HIV if they exchange blood, semen, vaginal fluid or breast milk with an infected person. The main ways that this exchange of fluids happens are during unprotected sex, sharing needles, and a mother to their baby.

5. Can I get HIV from casual contact with someone who is infected?

No. You cannot become infected with HIV by hugging, touching, sneezing, coughing, playing sports, sharing eating utensils, or sharing a bathroom with a person who is infected with HIV. Mosquitoes, fleas and other insects also do not transmit HIV as it is a human virus transmittable from one human to another through the exchange of infected fluids.

6. How can someone reduce the risk of being infected with HIV?

HIV infection can be prevented in several different ways:

• Choose not to have sex, or make an agreement with a partner who is HIV-negative to be sexually faithful to each other.
• Always use a condom for vaginal or anal sex, and barrier methods, such as a condom or dental dam, for oral sex. Latex condoms, when used consistently and correctly, are highly effective in preventing HIV transmission.
• If someone or their partner is HIV-positive, they should talk with their health care provider about how to reduce their risk.
• If someone is HIV-positive and pregnant, they need to see their health care provider for appropriate treatment. Treatments are available to significantly reduce the risk of mother-to-child transmission during pregnancy and delivery.
• Do not share needles or syringes for any kind of injection drug use, including heroin, "meth", steroids, etc. Also, refrain from sharing needles for piercings and tattoos, which can be done by going to reputable businesses for such services.
• Seek regular HIV testing and ask partners to do the same. Asking a partner to get tested may be awkward for some individuals, but it ultimately allows both partners to maintain healthy lifestyles.

7. How does someone know if they are infected with HIV?

The only way someone knows their HIV status is to get tested. The HIV test looks for HIV antibodies that a person’s immune system makes once they are infected with HIV; the average person takes 3 to 6 months to make these antibodies. The test can be performed on a sample of blood or saliva and the results take about 1 to 2 weeks to return. An individual who engages in any risky behavior should be tested every six months.

The Bucks County Department of Health (as well as any other Health Department in Pennsylvania) and Planned Parenthood Association offer free HIV testing. Additionally, an individual can be tested by a private physician or in a hospital; note that testing in these settings is subject to a fee, and is usually covered by most health insurance plans. Remember, an individual should not assume they were tested for HIV just because they had blood drawn for other tests, he or she must specifically request an HIV test to be performed.

8. What are the symptoms of HIV infection?

When someone is infected with HIV they may have symptoms of Acute Infection, which is the period of time when the virus establishes itself in the body, which can cause the following symptoms to occur 2 to 6 weeks after HIV infection:

• Diarrhea - Runny bowel movements that occur several times daily for many weeks
• Cough - A dry cough lasting several days or longer in the absence of an illness such as a cold
• Fatigue - Chronic tiredness during daily activities, despite plenty of sleep
• Persistent fever - Prolonged temperature of about 99-101 degrees in absence of illness such as the flu
• Swollen glands - Enlarged lymph glands in the neck, groin or armpit, which may be sore or tender
• Night sweats - Sweats that noticeably wet the bed sheets, with or without fever
• Skin rash - Itchy bumps or ulcers appearing anywhere on the body
• Weight loss - Loss of about 10 pounds or change in eating patterns
• Oral problems - Sores or white patches (thrush) on the gums, tongue or palate

Many of these symptoms are common to a variety of illnesses; however, persistence of any of them for several weeks could signal the progression of HIV disease. About half of infected persons do not experience any symptoms, so an individual should not depend on symptoms to occur as a signal to get tested.

9. Is there a cure for HIV?

There is no known cure for HIV/AIDS. Even though antiretroviral treatment helps people to live longer and healthier lives, it is not a cure and has not benefited all people with HIV. Also, these medications are expensive and not everyone who needs them has access. They may also cause serious side effects. Lastly, it is important to adhere strictly to a medication regimen once started.

10. Does everyone who has HIV eventually develop AIDS?

There is no certain answer to this question; it is known that the majority of untreated HIV-positive people do eventually become ill from HIV infection. However, with regular medical care and adherence to treatment, many people have been living with HIV/AIDS for almost two decades or more. The likelihood of long-term survival increases if an HIV-positive individual finds out their status as soon as possible and begins treatment earlier in the course of HIV disease. With proper treatment and the emergence of new treatments, it has become possible to further postpone, and possibly even prevent, illness.

11. Where should someone begin if they want to get HIV care?

The first step in getting care for HIV/AIDS is to find a physician. It is best to find a doctor who is familiar with treating HIV disease; usually they are called Infectious Disease (ID) doctors. Doctors who don’t specialize in HIV treatment may not keep up with rapidly changing developments in antiretroviral medications and other treatment strategies. An individual should remember that it is always okay to get a second opinion if they have any doubts about a doctor’s approach to treating their HIV. Remember, it is always better for an individual to inform any doctor providing them with medical care about all of their medical conditions.

12. When should someone start taking HIV treatment?

There are varying opinions on when is the best time to begin HIV treatment; however, the Centers for Disease Control and Prevention (CDC) recommends starting antiretroviral treatment if an individual has a history of opportunistic infections (OIs) or other severe symptoms of HIV disease, or if their T-cell count is between the range of 350 to 200. Preventative treatment against Pneumocystis pneumonia and other OIs is recommended when the CD4 count indicates severe immune suppression. The bottom line is that treatment is a personal choice; it is helpful for an individual to find a doctor that they can trust and who can help them determine what treatment strategy makes the most sense for them.

13. How much does HIV care cost?

People with health insurance can usually get their care through private doctors, clinics, or hospitals. For people without health insurance, the Bucks County Department of Health (as well as any other Health Department in Pennsylvania) provides CD4 and viral load testing for free. Additionally, each state has their own AIDS Drug Assistance Program (ADAP) to cover HIV medications for uninsured HIV-positive individuals; the Pennsylvania ADAP is called Special Pharmaceutical Benefits Program (SPBP). Also, there are a variety of funds that cover visits to see an Infectious Disease (ID) doctor as well as other social support services (see Local HIV/AIDS Resources).

14. If someone is diagnosed with AIDS, does that mean they will die soon?

Receiving an AIDS diagnosis does not necessarily mean that the diagnosed person will die soon; some people have lived for many years after being diagnosed with AIDS. Routine medical care and antiretroviral treatment has extended the lives of thousands of people living with HIV and AIDS. In addition, many opportunistic infections can be prevented or treated more effectively today. Improved treatments for both HIV and opportunistic infections have substantially increased the longevity and quality of life of people living with HIV/AIDS.

15. If someone is HIV positive, what else can they do to stay healthy?

Nutrition is a valuable supportive measure, so eating a balanced diet can contribute greatly to maintaining immune system health. An HIV-positive individual can eat a variety of foods that can help strengthen the immune system and maintain optimum body weight. A balanced diet is based on selecting foods from the basic food groups including proteins, fruits and vegetables, breads and grains, and dairy products. Since some AIDS-related conditions affect the ability to eat and some treatments have dietary restrictions, it is important to consult a physician and an HIV-knowledgeable dietitian to ensure adequate nutrition.