What is AIDS?

AIDS (acquired immunodeficiency syndrome) is a life- threatening illness caused by infection with the HIV (human immunodeficiency virus).

General statements about risks

Although AIDS is preventable, the number of cases of AIDS will most likely continue to increase over the next five years and probably into the next century. Cases of AIDS have been reported in every state. An increasing number of infections is being diagnosed and treated in both urban and rural areas, especially among the female partners of infected men.

AIDS is a life-threatening condition that can be passed on to other people even though there may be no sign of illness. HIV damages the immune system. With time, the HIV-infected person loses the ability to fight off serious infections. When this phase of HIV infection occurs, the individual is considered to have AIDS.

AIDS is an emotionally-charged disease because it can be associated with lifestyles not accepted by all individuals, it brings with it the realistic concern of premature death, and because family members and other close contacts of infected persons often fear catching the disease. Fortunately, there is ample evidence supporting the view that people in close, but nonsexual, contact with these persons do not appear to be at increased risk. People are at increased risk, however, if they come in contact with blood, share a needle with, or are born to or breast fed by an HIV-infected person.

Intravenous-drug users and persons receiving blood transfusions can be exposed to the virus through infected blood or blood products. However, spread of the virus from contaminated transfusions in North America has been greatly reduced since testing of donated blood for the virus began in the mid-1980s.

Sexual transmission is mainly the result of exposure to infected sexual secretions. Both women and men can transmit the virus sexually. The virus has been detected in semen, vaginal secretions, tears, and saliva, but exposure to saliva has not been shown to transmit the infection.

Certain sexual practices increase the risk of exposure among homosexual and bisexual men. Anal intercourse, injury to the rectum, and intercourse with numerous partners are associated with a high risk of getting AIDS.

As the HIV infection spreads through the heterosexual population there is increasing concern for women and men who engage in vaginal, anal, and oral intercourse with high-risk partners. Also, heterosexual intercourse with many partners increases the risk of exposure.

The sexual practices of homosexual women do not appear to increase the risk of getting AIDS.

The following groups are at high risk for contracting HIV infection and possible development of AIDS:

• sexually active homosexual men
• bisexual men and their male and female partners
• intravenous-drug users and their sexual partners
• people who share needles (for IV drug use, tattooing, or piercing)
• heterosexual men and women with more than one partner
• people with medical or surgical conditions (such as blood clotting disorders) requiring transfusions of blood or blood products
• people who have received transfusions of blood and blood products in foreign countries where the blood is not rigorously screened
• immigrants from areas with many cases of AIDS (such as Haiti and east central Africa)
• people who have sex with anyone in the above groups
• people who have sex with anyone with AIDS or HIV infection
• people who share IV needles with anyone in the above groups
• infants born to HIV infected mothers.

Who should be tested?

You should be tested for HIV if:

• You are or were in a high-risk group (listed above).
• You have engaged in high-risk behavior.
• You have ever had unprotected sex and have never been tested.
• You are or plan to become pregnant (in this case testing is especially important).

Where can one go to be tested?

Ask your regular health care provider where you can be tested or call the Centers for Disease Control National AIDS Hotline at 1-800-342-AIDS for the locations of the testing centers near you. Many community health centers, family planning clinics, hospitals, STD clinics, and county health departments offer testing. Do not use donating blood as a way of being tested.

Test results

If your test is negative, it means you have not been infected with the AIDS virus before two to six months ago. As long as you do not engage in any high-risk activity and always practice safe sex, you have almost no risk of becoming HIV-infected and developing AIDS. If you are or were at high risk, however, you should discuss with your health care provider how frequently you should be retested.

If your first test is positive, a second, different test will be done to confirm that you are infected with the virus.

If there are questions about your test results, your health care provider will tell you how soon you should be retested and what precautions you should take in the meantime.

Prevention of transmission

People with HIV should take these precautions to avoid transmitting the virus to others:

• Abstaining from sex and high risk behaviors, such as sharing needles, is the only way to prevent transmission of the virus. Persons with a positive HIV antibody test can transmit the virus to partners before learning of their own infection. Therefore, "safe sex" should be practiced to prevent the spread of infection to the uninfected partner.
• If you are sexually active, you should engage only in "safe sex." Avoid exchanging blood and sexual secretions during sex. This means:
  • Avoid vaginal and anal intercourse unless latex condoms are used.
  • Avoid oral-genital sex without latex condoms.
  • Avoid oral-anal sex.
  • Avoid getting semen or blood in cuts or in the eyes.
• Reduce the number of your sexual partners.
• Do not donate, plasma, sperm, body organs, or other tissue if you are at ANY risk of being HIV positive.
• Do not share or reuse IV needles and syringes. Do not self-inject drugs unless directed to do so by your doctor. Do not share needles for tattooing or body piercing. Boiling does not guarantee sterility of needles or syringes.
• Do not use nitrate inhalants (poppers).
• Do not share razors, toothbrushes, or anything that could be contaminated with body fluids or blood.
• Inform health care providers of your positive HIV antibody status when seeking medical or dental care, so they can take precautions in handling blood and specimens. Discuss any concerns you may have about confidentiality with your health care provider.
• If you work in a dental, medical, or other health care profession and perform invasive procedures or have skin sores, use latex gloves to protect patients from risk of infection.
• Seek medical evaluation and follow-up at least once a year, or more frequently if your doctor recommends it or if you develop symptoms that suggest AIDS.
• Discuss pregnancy with your doctor, because HIV may be transmitted to the baby during pregnancy, delivery, or breast-feeding. (Zidovudine, also called AZT, has been shown to decrease transmission of the virus from mother to baby.)
• Maintain a healthy lifestyle. Eat well, exercise, get proper rest, and avoid infections. If you are healthy you may be less likely to develop AIDS, but it will not prevent transmission of the virus.

Follow these instructions for using latex condoms:

• Use a latex condom every time you have intercourse or engage in other acts that involve contact with a man's penis.
• Put the condom on after the penis is erect but before intimate contact. Sores, any secretions from the penis (including semen), vaginal secretions, urine, feces, and possibly saliva can contain sexually transmitted disease organisms.
• Put the condom on the head of the penis and unroll or pull it all the way to the base.
• Leave an empty space at the end of the condom to collect semen. Remove any air remaining in the tip of the condom by gently pressing the air out toward the base of the penis.
• If a lubricant is desired, use one that is water-based. Do not use oil-based lubricants made with petroleum jelly, mineral oil, vegetable oil, or cold cream, because these may damage the condom.
• After ejaculation, carefully withdraw the penis while it is still erect. Hold onto the rim of the condom as you withdraw so the condom doesn't slip off.
• Store condoms in a cool, dark, dry place.
• If a condom appears sticky, brittle, discolored, or obviously damaged, don't use it.
• Use each condom only once.
• Use commercial spermicides with condoms (for example, nonoxynol-9) to further reduce the chance of transmitting the virus. Do not use spermicides without a condom.

For more information on risk factors or HIV testing, contact your doctor or the National AIDS Hotline at 1-800-342-AIDS (1-800-342-2437) (24 hours, 7 days a week). Hotline numbers are also available for Spanish-speaking persons at 1-800- 344-7432 (8 a.m. to 2 a.m., EST, 7 days a week), and for the hearing impaired at TDD 1-800-243-7889 (10 a.m. to 10 p.m., EST, Monday through Friday). These hotlines are provided by the Centers for Disease Control and Prevention.