What is HIV, and how is it different from AIDS?

HIV is a virus that attacks the immune system. Your immune system protects you from germs and infections to keep you from getting sick. Once HIV is in your system, it lowers the number of healthy immune cells that you have to fight germs and infections. When the number of healthy cells drops low and you get certain infections, this is known as AIDS (acquired immune deficiency syndrome).

How does someone get HIV?

People get infected with HIV through bodily fluids such as blood, semen, breast milk, and vaginal fluids-but not saliva. These fluids can be passed between two people in a variety of ways, including having unprotected sex (oral, vaginal, or anal), sharing needles, or even from tattooing or body piercing. Kissing is usually okay, but it is safest to avoid “deep kissing.” People do not get HIV by hugging, shaking hands, bug bites, spit or living with someone who has HIV.

You should get tested for HIV if you have had contact with body fluids of someone who may be HIV positive.

What should happen when I am first diagnosed with HIV?

Your doctor should do a complete physical examination, ask you a lot of questions, and take some blood for tests. These tests can tell how your immune system is working and how much virus is in your blood. These tests are called a CD4 and viral load test. These first meetings with your doctor are very important because they give you the chance to talk openly. You may be asked questions that seem very personal, but this information is important for your doctor to understand how best to treat you.

When should I start treatment for HIV?

Experts agree that people who have certain infections or symptoms should start treatment. But many people with HIV infection do not have symptoms. For these people, it can be hard to know the best time to start treatment.

CD4 counts and viral load are evaluated by physicians to help decide when to start treatment. Most experts believe people starting HIV therapy should be mentally and emotionally ready to take their medicines correctly. This is not easy to do every day. HIV medicines have side effects, and often it is hard to remember to take HIV medicines on time. You and your doctor should discuss when to start treatment.

Taking medicines puts you in charge of your health-you are fighting back against the disease.

Once you start taking HIV medicines, though, it is very important to take them exactly as prescribed by your doctor. If HIV medicines are not taken properly, it can allow the virus to take over again. This can lead to resistance, which means that the medicines no longer work against HIV. It helps to be informed before you start taking HIV medicines.

Is anyone ever able to stop taking his or her medicines entirely?

There is currently no known cure for HIV infection or AIDS. Most experts believe that once you are infected, if you stop taking your medicines, your HIV disease may get worse. Some experts are studying the idea that under certain circumstances, certain patients may benefit from a short break from their HIV medicines. However, you should always take your medicines exactly as your doctor prescribes.

How do HIV medicines work?

As HIV takes over a CD4 cell, it makes more copies of itself. Three different families of HIV medicines stop the HIV factory. Two families of HIV medicines stop the “assembly line” early in the process. These families of medicines are called nucleoside reverse transcriptase inhibitors (NRTIs, “nukes”) and non-nucleoside reverse transcriptase inhibitors (NNRTIs, “non-nukes”). They stop HIV from making copies of itself by interrupting the process early on. Although they stop the assembly line at the same place, they do so in different ways.

The third family of medicines called protease inhibitors (PIs) works in a different way. They stop the HIV from making new infectious copies by blocking the last step just before new copies of HIV are assembled.

Why do I need to take several HIV medicines at once?

No one HIV medicine will work by itself. It takes at least three different HIV medicines to keep the amount of virus in your body from going up. Taking several HIV medicines at once is called “combination therapy” or a “drug cocktail.” This kind of therapy often combines medicines that work differently.

Most experts believe attacking HIV in more than one way is the best way to fight HIV infection. Some experts believe a PI with NRTIs is an example of a strong combination. This brings together families of medicines that work at the beginning (NRTIs) and end (PIs) of the viral assembly line, hitting the HIV from both sides. An NNRTI with NRTIs is another example of a strong combination. This brings together families of medicines that work at the beginning of the assembly line but in different ways. You will want to discuss combination therapy with your doctor.

When will I have to change my combination?

There are many reasons why your doctor might make a change in your medicines. This might be due to side effects, if you are having trouble taking your medicines, or if your medicines are not working well enough against HIV. Your doctor may do special tests to find out which HIV medicines aren’t working. These tests are called resistance testing. There are two different types of resistance tests – “genotype” and “phenotype”.

Always remember to talk to your doctor before changing any part of your HIV therapy. Don’t stop taking any of your medicines without first talking to your doctor.

For questions about HIV/AIDS:

  • New York State HIV/AIDS Hotline: 1-800-541-AIDS
  • New York City HIV/AIDS Hotline (English & Spanish): 1-800-TALK-HIV

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