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HIV

“Our people: we are responsible for ourselves and others”

– Traditional Alaska Native Value [10]

Last updated April 2021

What is HIV?

‘HIV’ stands for Human Immunodeficiency Virus. It is a virus that attacks the immune system. It weakens the immune system and makes it harder for the body to fight off infections and some types of cancers. There is no cure for HIV, but with proper medical care, HIV can be controlled[3]. With the proper management plan, a person living with HIV may have a normal life expectancy.

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There are many things to consider when learning more about HIV, such as:

Types of HIV

There are two main types of HIV, called HIV-1 and HIV-2. Both HIV-1 and HIV-2 can be spread between people in the same ways and they both may result in Acquired Immunodeficiency Syndrome (AIDS), without proper management.

This strain is the most common and was discovered first. It is responsible for approximately 95% of all infections worldwide. Within this strain there are four different groups, including Group M, Group N, Group O, and Group P. Group M is responsible for the majority of the global HIV epidemic, while the other groups are fairly uncommon. HIV-1 Group M also has nine different subtypes. The most common subtype of Group M in the United States is subtype B[1].

This strain of HIV is most commonly found in West Africa, but is becoming more common in countries that have ties with West Africa, including France, Spain and Portugal, and for individuals who have had sexual partners from those countries[9]. HIV-2 has two subtypes, A and B. While HIV-2 is 55% genetically different from HIV-1, there is testing available to screen for both types of the virus[7].

How is HIV spread?

HIV spreads through infected blood or other body fluids, like semen and vaginal secretions. Transmission can happen by:

  • having vaginal, anal or oral sex with a person who is HIV positive whose blood, semen or vaginal secretions enter the body. HIV can enter the body through sores in the mouth or small tears that can happen in the rectum or vagina during sex. Using condoms correctly and consistently can help reduce the risk of HIV spreading between partners.
  • sharing needles or syringes used for injecting drugs, hormones, steroids or tattooing puts individuals at high risk for getting HIV. Sharing needles, syringes and other injection equipment also place individuals at high risk for contracting other conditions, like syphilis and hepatitis B and C.
  • blood transfusions can also put individuals at risk of HIV infection. Hospitals and blood banks in the United States screen the blood supply for HIV antibodies, which lowers the risk of HIV transmission.
  • during pregnancy, delivery or through breastfeeding, HIV-positive mothers can pass the virus on to their baby. Getting treatment from a health care provider during pregnancy can significantly lower the risk of transmission to the baby.

How is HIV treated?

There is currently no vaccine to prevent HIV, and there is no cure for HIV or AIDS, but there are treatment options to slow the progression of HIV in the body. The treatment for HIV is called antiretroviral therapy (ART). ART involves taking a combination of medications every day. It is recommended for everyone with HIV, and it should be started as soon as possible. The goal of ART is to reduce the amount of virus in your body, also called the viral load, to an undetectable level. If you are on treatment and have undetectable levels of HIV in your body, you cannot transmit HIV to HIV-negative partners through sex.

Remember: Undetectable = Untransmittable[8].

While ART does not cure HIV, it can help those living with HIV live longer, healthier lives and reduce the risk of HIV transmission to others.

Source: U Equals U Maryland

What happens if HIV is left untreated?

HIV that is mismanaged or ignored can be categorized into four stages of disease:

The primary infection, or acute HIV, happens within two to four weeks after being exposed to the virus[6]. During this time, the amount of virus in the body is at its highest, which can cause persons living with HIV to spread the infection more easily to others. The acute infection may last for a few weeks and often causes flu-like symptoms, sometimes so mild that persons living with HIV might not notice them. Some of the symptoms include:

  • Fever
  • Headache
  • Muscle aches and joint pain
  • Rash
  • Sore throat and painful mouth sores
  • Swollen lymph glands
  • Diarrhea
  • Weight loss
  • Cough
  • Night sweats

The next stage of HIV infection is a latent infection or chronic HIV. During this time, the virus is in the body and the white blood cells, but persons living with HIV might not have many symptoms. If persons living with HIV are not taking ART, this stage can last for several years.

As the virus multiplies and destroys immune cells that help fight off germs, this could result in the development of mild infections or chronic signs and symptoms. This stage is called symptomatic HIV infection, and an individual may experience:

  • Fever
  • Fatigue
  • Swollen lymph nodes
  • Diarrhea
  • Weight loss
  • Oral yeast infection
  • Shingles
  • Pneumonia

If HIV is not treated, it will typically turn into AIDS in about eight to 10 years[2]. When HIV advances to AIDS, the immune system is damaged, and it is more likely to develop opportunistic infections and cancers that would not otherwise occur in a person with a healthy immune system. Some of the signs and symptoms of the opportunistic infections are:

  • Sweats
  • Chills
  • Recurring Fever
  • Chronic diarrhea
  • Swollen lymph glands
  • Weakness
  • Persistent white spots or unusual lesions on your tongue or in your mouth
  • Persistent, unexplained fatigue
  • Weight loss
  • Skin rashes or bumps

Who is at risk for HIV?

HIV can affect anyone regardless of their race, ethnicity, gender, age or sexual orientation. It can also be found in every community – urban, suburban and rural. While HIV does not discriminate, some groups are at higher risk for HIV infection. The individuals at the highest risk for HIV infections are:

  • Sexually active men who have sex with other men
  • People of color, specifically persons who identify as part of the Black, African American, Hispanic and Latino racial and ethnic groups
  • Transgender women who have sex men
  • Persons who inject drugs

In addition to the populations above, there are certain behaviors that may put people at a higher risk for contracting HIV or transmitting it to another person[5].

Risk factors include:

  • Injection-drug use
  • People who exchange sex for money or drugs
  • Sex partners of people with HIV
  • Sexually active men who have sex with men
  • Heterosexuals who themselves or whose sex partners have had ≥1 sex partner since their most recent HIV test
  • People receiving treatment for hepatitis, tuberculosis or a sexually transmitted disease
  • People who themselves or their sex partner(s) have been diagnosed with any STIs

How do I reduce my risk for HIV?

There are more tools now than ever to help protect against HIV. Persons living with HIV also have several opportunities to take action on preventing the transmission of HIV.

Getting tested is the only way to determine a HIV status. Testing is often quick, free and painless. You can find a local clinic that offers testing or if you live in Alaska, you can get self-testing kit through the iknowmine store.

Using barrier protection during sex can reduce the risk of HIV transmission. Condoms are highly effective in preventing HIV and other sexually transmitted infections (STIs). Using condoms consistently and correctly every time during sex can help protect everyone from HIV and other STIs[4]. Try to avoid having sex when under the influence, as people may be more likely to engage in risky sexual behaviors while under the influence. Also, have open and nonjudgmental conversations with sex partner(s) – sometimes transmission occurs because people are unaware of their sex partner(s) risk factors.

Talking to a health care provider can help people decide what their best options are in order to prevent HIV infection, what to do if exposed, and how to protect themselves if they have a partner living with HIV.

Pre-exposure prophylaxis (PrEP) is a medication individuals can take daily if they are HIV negative but at high-risk for contracting HIV.  

If there is exposure to HIV, talk to a health care provider within 3 days about post-exposure prophylaxis (PEP). Starting PEP immediately after exposure and taking it every day for four weeks can reduce the chances of getting HIV[11].

Talking to partners who are HIV-positive and encouraging them to get and stay on HIV treatment, like ART, can help reduce their viral load. Having an undetectable viral load means there is not enough HIV in their body fluids to transmit it to sexual partners. Undetectable = Untransmittable.

Never share needles, syringes or other drug injection equipment. If needles, syringes or other injection equipment are shared, disinfect them with chlorine tablets or bleach. Learn how to disinfect injection equipment here[4]. Many communities have syringe services programs where old needles and syringes may be disposed of or exchanged for new ones.

Where can I go for testing or treatment?

To learn more about HIV testing or treatment, visit our page on HIV testing. To receive guidance on safer practices to reduce your risk, consider speaking to a local health care provider or trusted adult.

Where can I go for more information on HIV?

Learn how to talk to a partner, or others, about HIV status and risk. The Centers for Disease Control and Prevention (CDC) provides information and resources to those at-risk for HIV, or HIV-positive about HIV, how to prevent it, finding local testing and treatment, and support for HIV-positive individuals and their partners.

The Centers for Disease Control and Prevention (CDC) provides information to patients, educators, and providers about HIV, how to prevent it, finding local testing and treatment, and support for HIV-positive individuals and their partners.

National Native HIV/AIDS Awareness Day (NNHAAD) provides educational materials and resources for health care providers and educators. NNHAAD aims to promote HIV testing in Native communities; to encourage Native people to become educated about HIV/AIDS and the impact in their community; and help decrease the stigma associated with HIV/AIDS. They offer free educational materials

Healthy Native Youth (HNY) provides resources for tribal health educators, teachers and parents. They offer free curricula and lesson plans about HIV and related topics that people can adapt to their communities. HNY also offers the Talking is Power text line that provides culturally appropriate tips and resources for caring adults discussing sensitive topics with teens.

[1]Avert. (2019). Science. HIV strains and types. Reference: https://www.avert.org/professionals/hiv-science/types-strains

[2]Centers for Disease Control and Prevention [CDC]. (2019). Terms, Definitions, and Calculations. Terms, definitions, and calculations used in CDC HIV surveillance publications. Reference: https://www.cdc.gov/hiv/statistics/surveillance/terms.html#:~:text=HIV%20diagnoses%20and%20stage%203%20(AIDS)%20classifications&text=In%20the%20absence%20of%20treatment,be%20delayed%20by%20many%20years

[3]CDC. (2021a). HIV. HIV basics. Reference: https://www.cdc.gov/hiv/basics/index.html

[4]CDC. (2021b). Protect Yourself if You Inject Drugs. How can I prevent getting HIV from injection drug use? Reference: https://www.cdc.gov/hiv/basics/hiv-prevention/inject-drugs.html

[5]HIV.gov. (2020). Who Is at Risk for HIV? Is the risk of HIV different for different groups? Reference: https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/who-is-at-risk-for-hiv

[6]Mayo Clinic. (n.d.). HIV/AIDS. Primary infection (acute HIV). Reference: https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524#:~:text=Untreated%2C%20HIV%20typically%20turns%20into,with%20a%20healthy%20immune%20system

[7]Pebody, R. (2021). How HIV Works. HIV-1 and HIV-2. Reference: https://www.aidsmap.com/about-hiv/hiv-1-and-hiv-2

[8]Prevention Access Campaign. (2021). Undetectable. Undetectable = untransmittable. Reference: https://www.preventionaccess.org/undetectable

[9]Spach, D. H., Budak, J. Z. (2020). Background. HIV-2 infection. Reference: https://www.hiv.uw.edu/go/key-populations/hiv-2/core-concept/all

[10]UAF. (2021). Alaska Native Values for Curriculum. Alaska Native cultures. Reference:http://ankn.uaf.edu/ancr/Values/index.html

[11]What Works in Youth HIV. (2018). Reducing the Risk. Getting tested and talking to health care providers.  Reference: https://whatworksinyouthhiv.org/youth-hiv/hiv-prevention-treatment/reducing-risk

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