HIV AIDS

How does HIV transmit to the womb from a positive mother?

Does my wife need to be tested for HIV after a blood transfusion?

Is AIDS more common in poor people?

Can muslim males get AIDS by indulging in sex with 4 wives?

I am HIV positive, can I live a normal life?

Oral sex and HIV infection

AIDS awareness

What is HIV test and when should it be done?

 

How does HIV transmit to the womb from a positive mother?

Q. I have a doubt about the transmission of HIV virus from the positive mother to the baby in the womb. How does the virus go into the blood of the baby in the womb from the mother? It is through blood or digested food?

A. If the mother is HIV infected, she can transmit the HIV infection to her baby either during pregnancy or during delivery or through breast-feeding. During pregnancy, the infection passes from mother to the unborn baby through placenta (through blood).

 

Does my wife need to be tested for HIV after a blood transfusion?

Q. My wife has been transfused with 12 units of blood early this year, on account of portal vein thrombosis (PVT). Her liver is normal and non-alcoholic, leading to varices in her intestine. Now she is responding to beta-blocker & for the last 6 months there has not been any problem. She is now taking Ciplar 40 - 80 mg, twice a day. Does she need to undergo a test for HIV or Hepatitis B or C? Its been 5 months since she received the transfusions & there is no problem with digestion or any thing, her BP is also normal in spite of taking such a high dose of Ciplar 40. Please advise.

A. All blood transfused to patients undergoes mandatory checks for HIV, HBsAg, HCV, VDRL, Malaria, etc. The risk of developing an infection with an episode of blood transfusion is negligible, since the tests used for screening are very sensitive, but may miss a sample in the window phase / incubation phase. However, the risk increases according to the number of transfusions.

For you own mental satisfaction, you could undergo HIV, HBsAg and HCV testing, though it is not recommended as a routine.

 

Is AIDS more common in poor people?

Q. Recently I looked at some statistics of HIV and found an interesting pattern. The economically backward class people are affected by HIV more. But when I dug deeper, I found a correlation between the economic status and AIDS affected rate. I found that not many affluent people are affected by this. Is this because the affluent class have more body resistance due to the diet and vitamin supplements they take, which the economically backward class can't afford? Does it depend on the person's body condition at the time of intercourse or infection? Is it because of unsafe and unhealthy nature of sex practices that poor people follow? Is all the information about HIV over hyped? As there are many diseases that are worse than HIV?

A. You pose an interesting question. Yes it is true that there are more HIV infections in poor people that there are in rich. But as an epidemiologist I look at both numerators (how many infected) and denominators (out of how many). There are very many more poor people in India than rich persons so even if there were an exactly similar risk of infection, there would be many more poor persons infected than rich!

Another factor worth keeping in mind is that (sentinel) surveillance is carried out most frequently in sites in Government hospitals. Poor people tend to predominate there too, rich persons got to large corporate hospitals and so are not really included in the usual surveillance data.

Most HIV infection is through the sexual route (currently 86% in
India) and the better off persons tend to use a higher class of contact than the poorer so are at lesser risk. Yes it also true that the rich people are more likely to be better aware of the risks of unprotected sex and to have access to protective devices such as condoms.

There is no evidence that well nourished persons are less susceptible to HIV. At least I have not come across reliable evidence to that effect. However there is evidence that better nourished persons take longer to succumb to HIV as their immune systems are less stressed and better.

 

Can muslim males get AIDS by indulging in sex with 4 wives?

Q. Why do muslim males do not get infected with AIDS in spite of having sex with 4 wives, which is allowed in their community? What are the chances of infection, if I have sex with a married woman without any precaution?

A. HIV infection has nothing to do with the number of wives, it is connected with unprotected sex with someone who is infected and this means whether or not the infected person happens to be a spouse. In fact, the majority of women who get newly infected with HIV in India are probably infected by their husbands. Men who indulge in unprotected casual sex are at high risk of getting HIV infection and HIV infected men can pass the infection to their wives. There is one other factor that one must remember, though HIV can infect both circumcised and uncircumcised individuals, the chances of infection are less in those who have had circumcision. To be safe from HIV, every person should behave in a responsible manner in sexual matters, avoid casual sex and where sex can not be avoided, practice a form of safer sex including the proper and correct use of condoms.

 

I am HIV positive, can I live a normal life?

Q. I was tested HIV positive twice. But I haven't fallen sick nor felt that I am carrying a virus that causes AIDS. What should I do to be sure of my test results? Should I trust them? Other people don't trust me when I tell them and call me a joker. My fiancee loves me a lot and tested negative for AIDS. She says whatever the results be, she still wants me. What should I do?

A. Generally, if two tests are positive one can assume that the result is correct and HIV infection is present. If you wish you can have a third test also but make sure that a kit different to the first one is used, if it is again positive there can be no doubt about your HIV status.

For the first many years, an average of 9.8 years, there are no signs and symptoms from the infection and the person feels well and, in fact, is well. He is able to work, earn a living, look after his family. In fact he can live a normal life.

You understand of course that when I say an average of 9.8 years it means that there will be persons who develop illness earlier but there will also be persons who continue beyond that period in the quiet stage.

Normal social interactions at work, in public life, in the family do not pose a risk to anyone else and there be no cause for concern.

However, the virus can be spread through blood and via sexual intercourse. You must not donate blood and never share a syringe for injection.

The matter of sex is more difficult. You will always have to use measures to prevent passing on the infection. Even an infected person must protect himself/herself against reinfection as that can have a bad effect on the progress of the disease.

If you and your fiancee decide to marry after considering all aspects that is only the business of the two of you. You must decide for yourself. Please keep in mind that even if your fiancee and you have had sex and she has not got infected it is no guarantee that she will not acquire the infection later on increased exposure. She will also not be able to bear your child without the risk if becoming HIV positive herself -- then who will look after the child in the long run?

The chance of condom failure and your wife getting infection is 15% over time.

Obviously in a short letter I cannot give you all the information you need and you should consult a reliable counsellor or HIV/AIDS doctor so that you get all the support and information you need. Another good source that can be a great help is a network of HIV positive persons in your city.

For your self I would suggest that you try a live a healthy and regular life with adequate nutrition, physical exercise and rest. Do not neglect any illness, no matter how mild and always seek treatment. One last suggestion, do not rush into taking anti-retro viral drugs. These drugs should be saved for when you need them, Generally I do not suggest that they are started unless the CD4 cell count falls below 200.

 

Oral sex and HIV infection

Q. Is HIV infection possible by having oral sex or having been masturbated by an infected person? What are the most common symptoms of infection? Do the infected patients lead a normal life for years? After how many years can the disease show some symptoms?

A. Being masturbated by an HIV infected person or masturbating an HIV infected person does not normally carry any risk of HIV transmission. The exception is in case the semen of an infected person is used as a lubricant for masturbation of a non-infected person or if the non-infected person has a open cut or wound on the hand and this cut comes in contact with the semen of an infected person. The risk of HIV transmission from oral sex is not as high as other forms of unprotected penetrative sex, but we now know that HIV can be transmitted by this route. The risk is greater if the infected person ejaculates in the mouth of his partner. Saliva too can be infective and the mouth often has cuts and bleeding points from gums increasing the risk of HIV transmission. It is best to avoid all penetrative sex except with a mutually faithful and regular partner or to always use a condom for oral sex. These general comments also apply in the case of sex between man and woman.



AIDS awareness

Q. 1) I wanted to improve my awareness about AIDS Will a person be contracted with AIDS by a single sexual intercourse. 2) I have read that the AIDS virus dies as soon as it is exposed to air, so will it be contracted if one is using a shaving blade which might have dried blood stains? 3) How early can a person come to know that he/she might have AIDS, and how much time will it take for the AIDS to show its effects.

A. 1) Yes, if it is unprotected sexual intercourse with an unknown person. Although the sexual mode of transmission is inefficient, it is responsible for 75 - 85% of infections world wide especially in India. Sex with one's wife is the safest. One's wife ought to be the most beautiful woman in the world.

2) Though HIV is very sensitive to heat, it is very stable at room temperature(25-27C) for 15 days and at 37C for 11 days even in dried blood spots. This is because proteins in the blood form a protective layer around the virus particles and protect it from destruction. However, heating at 56C for 10 minutes or boiling at 100C for 1 min destroys the virus completely.

3) After contracting HIV infection (by any route), the progress of infection varies from person to person. It depends on several factors. It may vary from 2-3 years to more than 15 years. Nonetheless, it is estimated that 50% persons would die of AIDS within 10 years and 75% will die within 15 years after contracting HIV infection, if not treated. Once AIDS develops, the course is rapidly downhill and majority die within 24 months.

What is HIV test and when should it be done?

Q. I had an anti-HIV antibody test from Grant Medical Foundation Ruby Hall Clinic in Pune and the test was performed 4 and 6 months after the last exposure. Both the times the result was non-reactive. My question is: 1. What does this result mean i.e. is infection there or not; 2. Is this test performed for both types of HIV i.e HIV 1 & HIV 2 or for only one type because the report does not mention this? The report says: TEST NAME RESULT ANTI-HIV ANTI BODY NON REACTIVE So what should I do or do you want me to get some other tests done or should I ask the lab for details regarding HIV 1 & 2 separately because I recently read in a book that false negative result is obtained if the test is peformed only for 1 type of HIV as the person may be infected with the other type. 3. Which is the ideal period for the test - 3 months or 6 months after exposure?

A. A non-reactive test means a negative test -- no HIV anti-bodies found. If sufficient time has elapsed since exposure this means that there is NO infection. I do not know the clinic in question but I am confident that a clinic in Pune should use the current test kits available in India. The current practice in India is to use a kit that detects both HIV 1 and HIV 2. If after 4 and 6 months of the last risk exposure the tests are negative, please stop worrying as it means that you are NOT infected. You do not need to do any more testing for that exposure. Please remember that as you have been fortunate on that occasion, you must be sure that you do not run any further risks. Either avoid all casual sex or if you can not, please be sure to use a fresh condom from start to finish. Remember that accidents do happen with condoms and they burst or tear occasionally exposing the partners to the risk of infection. In most cases where HIV infection has taken place, the usual ELISA test is positive by 3 months. Very rarely it may take a little longer for the test to show results.