Experts HIV

I just visited the ASHA website and saw your notice about an HIV Awareness Day for Women and Girls. As a female I never really thought of myself as being at great risk for HIV, but the fact there’s a “National Day” for it makes me wonder. How big a problem is this for females?

You are almost certainly not only in thinking you might not be at great risk, so the awareness campaign for women and girls is probably even more important than we thought!

Here’s the deal: females are absolutely at risk for HIV. According to the CDC, nearly 25% of those diagnosed with HIV in the U.S are female. Among those who get HIV through heterosexual (“straight”) contact, two-thirds are girls and women.

When women think about sexual health, HIV testing and prevention should certainly be part of it. CDC recommends HIV testing for everyone ages 13-64. HIV testing is especially important for pregnant women (the earlier in the pregnancy, the better): pregnant women who have HIV and are treated early and appropriately have a small risk of transmitting the virus to their babies.

For more on HIV testing (and to find a clinic near you) go to http://www.ashasexualhealth.org/stdsstis/get-tested/.

–The STI Resource Center Staff

How accurate is a negative HIV test after 40 days of possible HIV exposure? Currently, it has been over 8 weeks since my possible HIV exposure. I don’t have any symptoms. Should I keep testing for HIV until the six month window is over or was the HIV-1 RNA PCR result at 40 days enough?

It sounds like you’ve had two different kinds of HIV tests. The first kind, the one used by most clinics as a screening test, looks for antibodies produced by the immune system against the virus. Detectable antibody levels to HIV usually develop within two to eight weeks (the average is actually about four weeks), but it sometimes takes longer. This test will almost always be reliable three months after exposure, so to be on the safe side, we recommend a second HIV antibody test if the first was done before 90 days after exposure.

The second test you mentioned is the HIV 1 RNA PCR. This is an additional test sometimes performed for people with a high-risk exposure and symptoms of acute HIV disease. An exposure would be considered high-risk, for example, if the partner was known to be HIV positive. If this test was negative at 40 days after exposure, you did not become infected from the exposure you mentioned.

Having said that, I suggest considering how you will plan for HIV testing in the future. Depending on your circumstances, perhaps routine testing every 3-6 months would appropriate. This is because it is sometimes very difficult to determine how risky a given exposure might be. This would also be a good time to request screening for other sexually transmitted infections, and to review recommendations for immunizations (for example, for hepatitis B and HPV) with your doctor.

–J. Dennis Fortenberry, MD, MS

I know this is probably stupid but, I was fingering someone last Saturday night and I had a hangnail on my finger. The area was not bleeding, but I am wondering is this a possible HIV concern or is the chance of it too remote?

The risk of contracting or transmitting HIV (or any other STIs) through hand-to-genital contact is very slight and I’m not aware of any documented cases where this has been proven to transmit HIV.

Viral STIs such as HPV or HIV is spread primarily through anal and vaginal sex. Injecting drug users who share dirty needles and syringes are also at risk for HIV and, while it happens less often, someone who performs oral sex on an HPV or HIV-positive partner may also contract the virus.

According to the CDC, you should have an HIV test if you’ve injected drugs, have had unprotected vaginal, anal, or oral sex, or have had multiple partners. You should also be tested if you’ve been diagnosed with an STI.

–Versie Johnson-Mallard, PhD, RN, APRN, WHNP-BC

What are the symptoms of AIDS, and how soon would you know you have it (if you are infected)?

This is a great question, as you tackle a big misconception by recognizing that Human Immunodeficiency Virus (HIV) is not the same as Acquired Immune Deficiency Syndrome (AIDS). Many people make the mistake of believing that it is possible to recognize if a person has HIV. Most often, however, people infected with HIV don’t know they are infected because they don’t feel sick. Some people may get a fever-like illness with fever, rash, joint pains and swollen glands (lymph nodes) immediately after infection. These symptoms usually occur between 1 and 6 weeks after HIV infection has happened and then the symptoms go away.

A person with HIV may look healthy and feel well, but they can still pass the virus on, especially early on in their infection. That’s why you can’t tell if someone has HIV by just looking at them. Over time, however, the HIV virus can develop into AIDS. This typically takes 10-15 years as HIV continues to destroy a person’s immune system, making them more likely to get many different kinds of infections. Once a person with HIV develops any one of a number of infections–such as herpes, tuberculosis, pneumonia, fungal infections–or cancer that causes tumors in the body, they are said to have AIDS, the syndrome of HIV-related immune deficiency.

AIDS affects various parts of the body in different ways. Common symptoms include: fatigue, weight loss, thrush (white patches in the mouth), recurring fever, and diarrhea. Other body systems, such as the brain, kidneys, heart, and genital organs can also be affected by AIDS and will have symptoms specific to that system. As always, if you are unsure about your status it’s always best to get tested for HIV to know for sure because AIDS can be prevented by taking a combination of antiviral medications.

–Will Wong, MD