HIV & PrEP: The Need-to-Know Basics
HAPPY HIV TESTING DAY & HAPPY PRIDE! And, per my Pride traditions, today I will be educating you all on HIV and PrEP so you can have a happy Pride and healthy life...
PrEP, or Pre-exposure prophylaxis, is when people at very high risk for Human Immunodeficiency Virus (HIV) take HIV medicines daily to lower their chances of getting infected. PrEP can stop HIV from taking hold and spreading throughout your body. It is highly effective for preventing HIV if used as prescribed and taken consistently. So, for clarification purposes, let’s break down what HIV is before we start talking about protection.
HIV is a virus that travels through the body and attacks the immune system. HIV is spread through the exchange of certain bodily fluids like blood, semen, and vaginal and anal fluids, and breastmilk. It is most commonly contracted in the following ways:
- Unprotected penetrative and oral sex
- Sharing used needles through intravenous drug use
- Breastfeeding while HIV positive
- Blood to blood contact
HIV is NOT transmitted by:
- Using toilets
- Being in the same room with an HIV positive person
- Or any number of other everyday activities or contact
And while the HIV virus is present in all bodily fluids, the amount of HIV in saliva, sweat or tears is so minute that it’s next to impossible to transmit. And if you work in an industry where you have to clean up accidents, you can rest assured that your skin acts as a protective barrier from the virus as well, but I also recommend safeguarding with the use of latex or other surgical grade gloves.
So, what happens if you do get infected? Well, this is what happens: think of the virus as a covert soldier, okay? We’ll name the soldier, Halo. Now it’s Halo’s mission to get to the nearest cell, also known as the CD4 cell or T-cells, and destroy it! T-cells are also soldiers, their job is to defend the body from enemies like infections and disease. But Halo is a sniper and is highly skilled at taking out the army.
As a result, in the simplest of metaphorical terms, the T-cell army has been drastically reduced and Halo has cloned itself so it can outnumber the T-cell army. This biological warfare occurs in the fist 2-4 weeks after infection and you will most likely begin to exhibit flu-like symptoms (it is important to note here that flu-like symptoms are not necessarily present, nor do they indicate and HIV infection, this is why it's important to know your status). Flu-like symptoms can include some or all of the following symptoms:
- Night sweats
- Muscle aches
- Sore throat
- Swollen lymph nodes
- Mouth ulcers or cold sores
These symptoms can last anywhere from a few days to several weeks. During this time, HIV infection may not show up on an HIV screening, but people who have it are highly infectious and can easily spread the virus to others. Remember, exhibiting flu-like symptoms DOES NOT mean you have contracted HIV, but if you present with these symptoms after a potential exposure to HIV, see a health care provider and tell them about your risk. The only to know for sure whether or not you have contracted the HIV virus is to get tested.
How can you protect yourself from Halo, the HIV Virus? The answer is PrEP, who, in this metaphor, we will refer to as Poet. Poet is the secret weapon of the T-cell army. Poet is like kevlar armor, Halo cannot take out the T-cells that are protected by Poet. The T-Cells have a brave Gandalf moment declaring to Halo: “You shall not pass!” So, even if Halo is running wild trying to declare biological warfare on your immune system, it can’t do anything because of the protection of Poet. And that’s pretty badass. So, does this mean that Halo the HIV Virus disappear? No, Halo now becomes a prisoner of war. Meaning, it is trapped by Poet and can no longer run amuck on your system.
Now, if you do become HIV positive, and you weren’t taking PrEP or taking it correctly and consistently, all is not lost. People with HIV are still able to live long, full lives, it is no longer the death sentence it once was. Work with your doctor to understand your viral loads (the amount of virus in a blood sample) and T4 counts (the number of T-cells in a blood sample). When your viral load is high, and the T4 count is low, that means your immune system is compromised, and you’re more susceptible to developing AIDS. When your T4 count, the number of T-cells in a blood sample, is high and your viral count is low, your immune system is excellent. Your susceptibility to developing AIDS is reduced.
Now, if your viral load is less than 50 milliliters, you are considered undetectable. Undetectable means you CANNOT transmit the virus to someone else. And in July of 2016, the CDC signed on to a consensus statement with more than 400 international groups to declare that undetectable = untransmittable (U=U) This is HUGE news. In my lifetime, contracting the HIV virus went from being a death sentence to, with the intervention of modern science, something that can be suppressed to levels of someone who does not have HIV. Let's just take a moment to appreciate what decades of advocacy for HIV can do.
It is important to note, however, that if you have an undetectable viral load, it does not mean you stop taking anti-retroviral therapy, start-up harmful behaviors like sharing old needles, or engaging in unprotected sex with new or multiple partners. Your viral load is low because you are consistently taking your medication and are living a save, protected lifestyle.
Populations at the most risk of HIV infection are people who engage in high-risk drug use (like sharing needles), and, unfortunately, those in the LGBTQ community. But there are quite a few ways to protect yourself and decrease your chances of contracting HIV:
- Get tested regularly
- Get tested before having sexual contact with any and all new partners
- Use a new condom and dental dam for each sex act (oral, anal, vaginal)
- Use new needles every and every time
- Safely dispose of old needles
- If accessible to you, get PrEP
Talk to your *doctor or find a Planned Parenthood near you where you can discuss your options and learn more about PrEP.
*As sexual health educators, we understand that not all people in the LGBT community have access to medical professionals who respect them. This makes it even more important for you to take your health and safety into your own hands. We are always happy to answer any questions you may have or point you in the right direction. Please, reach out any time you need. We are here for you.
Know your status, protect yourself and be well.
Click here to find an HIV testing center near you!
BETHANY KILLEN - RESIDENT ADVICE COLUMNIST & SEX THERAPIST
Bethany Killen (she/her), whose time spent finding ways to navigate through her own personal struggles led her to pursue a career in social work.