Sexually Transmitted Infections
What Are They?
Human Immunodeficiency Virus (HIV)
What is HIV?
HIV stands for Human Immunodeficiency Virus, and is the virus that causes AIDS.
HIV is an incurable sexually transmitted virus that attacks and weakens a person's immune system. Your immune system is a complex system that fights off infection and generally keeps you healthy. A person infected with HIV is said to be HIV-positive.
What is AIDS?
AIDS stands for Acquired Immunodeficiency Syndrome. AIDS is a syndrome, which is the name given to a collection of symptoms and effects that occur together. AIDS is the collection of symptoms, signs, and characteristics that occur once a person's immune system has been substantially weakened by HIV infection.
AIDS can be diagnosed in two ways: A person with HIV may be diagnosed with AIDS if he or she contracts a disease that is listed as an "AIDS-defining" disease. People with healthy immune systems are usually able to easily fight off these "AIDS-defining" diseases, but for a person with a weakened immune system because of HIV, they are very serious and can be life-threatening.
The other way AIDS is diagnosed is if testing shows that part of an HIV-positive person's immune system is determined to have weakened to a very low level, making them vulnerable to a wide range of infections, diseases and cancers. Infections that cause disease in people with a weakened immune system are often called "opportunistic infections".
How long does it take for HIV to cause AIDS?
It is very difficult to say with certainty how long HIV will take to cause AIDS. On average (median), it takes more than 10 years for HIV to progress to AIDS. The time it takes is different for everyone, and depends on many things, including the health and lifestyle of the person, the strength of his or her immune system, and other factors such as a person's age and immunity levels to other diseases. Another factor affecting how long HIV takes to cause AIDS is the growing effectiveness of the antiretroviral drugs that slow the spread of HIV in the body. As these drugs improve, people who are treated for HIV are taking a longer time to develop AIDS.
Because of all of these factors, and the constantly changing effectiveness of medications, there are currently no reliable estimates on how long on average HIV takes to progress into AIDS.
HIV in Canada and around the world
Worldwide, the numbers are disturbing. In a 2004 report, the United Nations Programme on HIV/AIDS estimated that about 38 million people are currently living with HIV worldwide, and that since the first AIDS diagnosis in 1981, more than 20 million people have died from the virus.1 An estimated 3.1 million died in 2004 alone.
In Canada, the number of people living with HIV infection is rising. The face of HIV is also changing. At one time, many people believed that HIV was a disease that only affected homosexual men. This is a myth. Women and particularly women in their teens and twenties have seen a very drastic rise in incidence of the disease. In Canada prior to 1995, only 10% of new HIV cases were among women; in 2004, that percentage had risen to over 25%.2
For several reasons, including the fact that HIV infection usually takes many years for symptoms to appear, there are no reliable statistics on the number of people currently infected in Canada. However, from 2000 to 2004, the Public Health Agency of Canada noted a 20 percent rise in the annual number of reported cases, from 2,111 in 2000 to 2,529 in 2004.3
How do you get HIV?
HIV is transmitted through contact with infected body fluids such as vaginal secretions, semen, pre-semen, breast milk, and blood.
It can be transmitted through anal, vaginal or oral sex. However, oral sex is considered a very low-risk activity for spreading HIV, and the risk of spreading it through vaginal or anal sex is much higher.
HIV can also be transmitted through shared needles, transmitted from an infected mother to a baby during birth, or to a baby through infected breast milk.
You can also become HIV-positive if infected blood gets inside your body. In Canada, this generally only applies to sharing needles for illegal drug use. There is also a potential risk in using unsterilized needles for tattooing, acupuncture or body piercings, though this is likely a very low risk activity. In some countries there may also be risks of contracting HIV through untested blood transfusions or organ transplants. 5,6
HIV is more easily transmitted if the partner has another sexually transmitted disease, such as herpes, chlamydia or gonorrhea.
Prevention
The best way for sexually active people to protect themselves against HIV transmission is by using condoms every single time you have sex. If you are at higher risk of HIV because of high-risk sexual behaviour or intravenous drug use, you may want to consider being tested for STIs. Remember, other STIs such as chlamydia and gonorrhea are curable and may have no symptoms, and having them can increase your risk of contracting HIV. For this reason, getting tested and/or treated for other STIs can also help reduce your risk of contracting HIV.
Though the risk of spreading HIV through oral sex is very low, condoms and dental dams can offer protection during oral sex, and will also protect against other STIs.
Protection is also important if you are having sex while in foreign countries. In other parts of the world (including the Caribbean) HIV infection is much more common than in Canada. Do your homework before you travel, and always use protection.
Visit the Public Health Agency of Canada's Travel Medicine Program for more information on STIs and international travel.
Symptoms
It often takes many years before a person infected with HIV displays any symptoms of infection. During this time a person may spread the virus to many people. This is one of the reasons why HIV is a very difficult illness to control - many people may not know they are infected until it has already been spread.
Some of the more common symptoms of HIV infection - such as constant weight loss and fatigue, night sweats, loss of appetite, constant diarrhea and recurring yeast infections - are easily confused with other illnesses, so the only way to be sure you have an HIV infection is to receive proper testing from a health professional.
Because HIV symptoms are often non-specific, HIV infection may not be suspected unless:
- symptoms fail to go away with time
- other possible causes have been disqualified
- the person is at higher risk of HIV infection because of past sexual behaviour or injection drug use (often going back many years)
- the person is diagnosed with an "opportunistic" illness, which is an illness that points to a weakened immune system.
Symptoms cannot identify an HIV infection. Testing is the only way to confirm if a person has HIV.
Testing
Generally, there is a three month "window" period for HIV testing. This is the approximate time between when a person is infected with HIV and the time when an HIV test will detect the virus in his or her body. For many people, testing may be accurate after several weeks of infection, but in rare cases it takes up to six months.
If you are considering being tested for HIV, you should know that the test may not detect an infection from the past three months. Three months after infection, the test will confirm 97% of HIV cases2. After 6 months, the test will confirm 99% of all cases.
Treatment
Though there is no cure for HIV, treatment has progressed dramatically. People who are infected with HIV are living longer without opportunistic infection or other serious diseases.
Long-term impact
HIV is an incurable, fatal disease. However, HIV/AIDS treatment is rapidly improving, and people treated for HIV now live longer, healthier lives than before.
AIDS itself does not cause death, but it weakens the immune system so that a person's body cannot defend itself against other illnesses. There are many causes of death for people with AIDS, including opportunistic infections, cancers, pneumonia, hepatitis, and lung, cardiovascular and kidney conditions.
What to tell your partner
There is no easy way to tell your partner you have HIV. If you are diagnosed with HIV while in an ongoing sexual relationship, you need to tell your partner and they need to be tested for HIV (don't forget the three month testing window). Remember, early diagnosis can make a huge difference in managing an HIV-infection, and modern drug treatments can slow the progression to AIDS.
Speak to your health care provider about counseling or other support services that may be available to you, and may help prepare you to tell your partner.
HIV is a reportable illness and you will be required to inform your health care provider of your history of past sexual partners. Because a person can have HIV for a long time before experiencing symptoms, sexual partners dating back many years may need to be tested.
Last Modified: May 22, 2007
