SYMPTOMS CAUSES OTHER WAYS OF GETTING AND TREATMENT OF (HIV)

SYMPTOMS CAUSES OTHER WAYS OF GETTING AND TREATMENT OF (HIV)

People who are infected with HIV, often experience a short flu like illness that occurs 2 to 6 weeks after infection. This is known as primary HIV infection.

The most common symptoms are:

fever (raised temperature)

sore throat

body rash

Other symptoms can include:

tiredness

joint pain

muscle pain

swollen glands (nodes)

However, these symptoms are most commonly caused by conditions other than HIV, and do not mean you have the virus.

If you have several of these symptoms, and you think you have been at risk of HIV infection within the past few weeks, you should get an HIV test.

After the initial symptoms disappear, HIV may often not cause any further symptoms for many years. During this time, HIV continues to be active and causes progressive damage to your immune system.

Once the immune system becomes severely damaged symptoms can include:

weight loss

chronic diarrhoea

night sweats

skin problems

recurrent infections

serious life-threatening illnesses

Earlier diagnosis and treatment of HIV can prevent these problems occurring and reverse them.

Read more about treating HIV

It is recommended you should still take an HIV test if you have put yourself at risk at any time in the past, even if you experience no symptoms.

Causes of HIV

Routes of HIV transmission

In Scotland, HIV is most commonly transmitted by having sex with someone who has HIV without using any form of protection, such as HIV PrEP or condoms.

A person with HIV can only pass the virus to others if they have a detectable level of virus. People living with HIV who are taking treatment and have undetectable levels of virus in their bodies can't transmit HIV to others.

Over 90% of people living with HIV in Scotland have undetectable levels of virus.

The main routes of transmission are unprotected receptive or insertive vaginal and anal sex. The risk of transmitting HIV through oral sex is extremely low.

Other ways of getting HIV include:

sharing needles, syringes and other injecting equipment

from mother to baby before or during birth when the mother isn't taking HIV medication

from mother to baby by breastfeeding when the mother isn't taking HIV medication

sharing sex toys with someone infected with HIV and who isn't taking HIV medication (or by not using a fresh condom on sex toys for each person using it)

blood transfusion (outside of the UK)

How is HIV transmitted?

HIV is not passed on easily from one person to another. The virus does not spread through the air like cold and flu viruses.

HIV lives in the blood and in some body fluids. To get HIV, one of these fluids from someone with HIV (who has detectable levels of virus in their body) has to get into your blood.

The body fluids that contain enough HIV to infect someone are:

semen (including precum)

vaginal fluids, including menstrual blood

breast milk

blood

lining inside the anus

Other body fluids like saliva, sweat or urine do not contain enough of the virus to infect another person.

The main ways the virus enters the bloodstream are:

by injecting into the bloodstream with a contaminated needle or injecting equipment

through the thin lining on or inside the anus and genitals

via cuts and sores in the skin

HIV is not passed on through:

kissing

spitting

being bitten

contact with unbroken, healthy skin

being sneezed on

sharing baths, towels or cutlery using the same toilets or swimming pools mouth-to-mouth resuscitation

contact with animals or insects such as mosquitoes

Who is most at risk?

Having unprotected sex increases the risk of being infected with HIV. Unprotected sex means having sex where you are not taking HIV PrEP or using condoms. People who are at higher risk of becoming infected with HIV include people who are not taking PrEP medication and who are:

men who have had unprotected anal sex with men

women who have had unprotected sex with men who have sex with men people who have had unprotected sex with a person who has lived or travelled in a high HIV prevalence country

people who inject drugs

people who have had unprotected sex with somebody who has injected drugs

people who have caught another sexually transmitted infection

Diagnosing HIV

The only way to find out if you have HIV is to have an HIV test, as symptoms of HIV may not appear for many years.

HIV testing is provided to anyone free of charge on the NHS. Many clinics can give you the result on the same next day and home-testing and home-sampling kits are also available. Home-testing and home sampling kits are also available from some services and charities or to buy online.

Who should get tested for HIV?

Anyone who thinks they could have HIV should get tested.

Certain groups of people are at particularly high risk and are advised to have regular tests. For example:

gay and bisexual men or men who have sex with men are advised to have an HIV test at least once a year, or every 3 months, if having sex without HIV PrEP or condoms with new or casual partners

women and men from countries with high HIV prevalence, especially from sub Saharan Africa are advised to have an HIV test, if having sex without using HIV PrEP or condoms with new or casual partners

people who inject drugs or who have sex without using HIV PrEP and condoms with people who inject drugs

Read more about how you get HIV

When should I get tested for HIV?

Seek health care advice immediately if you think there's a chance you could have HIV. The earlier it's diagnosed, the earlier you can start treatment and avoid becoming ill.

Some HIV tests may need to be repeated four weeks after exposure to HIV infection, but you shouldn't wait this long to seek help.

Where can I get an HIV test?

There are various places you can go to for an HIV test, including:

sexual health clinics

clinics run by charities such as the Terrence Higgins Trust or Waverly Care Scotland

some GP surgeries

local drug dependency services

a private clinic, where you will have to pay

An HIV test is one of the range of tests routinely offered to all women in Scotland as part of antenatal screening. There are also home-sampling and home-testing kits (see below) you can use if you don't want to visit any of these places.

Types of HIV tests

There are 4 main types of HIV test:

full blood test – where a sample of blood is taken in a clinic and sent for testing in a laboratory. Results are usually available within a few days.

"point of care" test – where a sample of saliva from your mouth or a small spot of blood from your finger is taken in a clinic. This sample doesn't need to be sent to a laboratory and the result is available within a few minutes.

home-sampling kit – where you collect a saliva sample or small spot of blood at home and send it off in the post for testing. You'll be contacted by phone or text with your result in a few days. You can buy them online or from some pharmacies.

home-testing kit – where you collect a saliva sample or small spot of blood yourself and test it at home. The result is available within minutes. It's important to check that any test you buy has a CE quality assurance mark and is licensed for sale in the UK, as poor quality HIV self-tests are available from overseas.

If the test finds no sign of infection, your result is "negative". If signs of infection are found, the result is "positive".

The full blood test is the most accurate test and can normally give reliable results from four weeks after infection. The other tests whilst also accurate, may not give a reliable result for a longer period after exposure to the infection (this is known as the "window period").

For all these tests, a full blood test should be carried out to confirm the result if the first test is positive. If this test is also positive, you'll be referred to a specialist HIV clinic for some more tests and a discussion about your treatment options.

Treating HIV

Although HIV cannot be cured, it's a very manageable long term condition and effective treatment is available to enable individuals to live a long and healthy life.

If you're diagnosed with HIV, you'll be referred to a specialist HIV clinic for treatment, regular monitoring and care.

It's recommended that everyone diagnosed with HIV starts treatment shortly after being diagnosed to keep in good health and free of symptoms. Treatment for HIV is generally very well tolerated.

Medication, known as antiretrovirals, work by stopping the virus replicating in the body, allowing the immune system to repair itself and preventing further damage. These medicines come in the form of tablets which need to be taken every day.

HIV can develop resistance to a single HIV drug very easily, but by taking a combination of different drugs or with support from your doctor in taking your treatment, resistance is less likely. Most people with HIV take a combination of three antiretrovirals (although some people take 1 or 2) and it's vital that the medications are taken every day as recommended by your doctor.

For people living with HIV, taking effective antiretroviral therapy (where the HIV virus is "undetectable" in blood tests) will prevent you passing on HIV to sexual partners.

Read more about treating HIV:

Terrence Higgins Trust: Treatment for HIV

HIV i-Base: Introduction to combination therapy

Missing a dose

HIV treatment works best if you take your pills regularly every day. You will need to develop a daily routine to fit your treatment plan around your lifestyle.

Side effects of HIV treatment

HIV treatment is generally very well tolerated. Your HIV clinic will monitor your health for side effects.

Common side effects include:

nausea

diarrhoea

skin rashes

sleep difficulties

People with HIV get treatment at a specialist HIV clinic which is usually part of a sexual health or infectious diseases clinic at your local hospital.

Services, including support organisations, may work together to provide specialist care and emotional support.