HIV Testing

HIV Testing

The general consensus among those fighting AIDS worldwide is that HIV testing should be carried out voluntarily, with the consent of the individual concerned. This view has been supported by the Indian government and NACO, who have helped to establish hundreds of voluntary counselling and testing (VCT) centres in India. By the end of 2005 there were 873 VCT centres in India, compared to just 62 in 1997. 41 These centres tested 225,600 people for HIV during 2005. 42 In 2007 there was a dramatic scale-up - 4245 testing and counselling centres were in operation by December 2007

Although voluntary testing is officially supported in India, some states have tried to implement policies that would force people to be tested for HIV against their will. In Goa, the state government recently planned to make HIV tests compulsory before marriage, and in Punjab it has been proposed that all people wishing to obtain or retain a driver’s license should be tested for HIV. 44 Neither of these plans has come to pass, but they have concerned activists, who argue that HIV testing should never be imposed on people against their wishes.
Unfortunately, cases of people being tested without their consent or knowledge are common in Indian hospitals. In one 2002 study, it was suggested that over 95% of patients listed for surgical procedures are tested against their will, often resulting in their surgery being cancelled. 45 Hospital staff and health professionals, much like the rest of the Indian population, are often unaware of the facts about HIV. This leads to unnecessary fears and, in some cases, causes them to stigmatise HIV positive people and discriminate against them, including testing them without consent.

Treatment for people living with HIV

Antiretroviral drugs (ARVs), which can significantly delay the progression from HIV to AIDS – have been available in developed countries since 1996. Unfortunately, as in many resource-poor areas, access to this treatment is severely limited in India; an estimated 158,000 people were receiving ARVs by the end of 2007. 46 Some people manage to access the drugs through private health facilities, which dominate India’s healthcare sector, but the vast majority of people cannot afford to buy treatment privately.
While the coverage of treatment remains unacceptably low, improvements are being made. The government has started to expand access to ARVs in a number of areas, and the national number of ARV centres increased from 25 to around 70 in 2005 alone. 47 By 2007 this figure had almost doubled to 137. 48
Increasing access to ARVs also means that an increasing number of people living with HIV in India are developing drug resistance. When HIV becomes resistant to the ARVs the treatment regimen needs to be changed to 'second-line' ARVs. As with many other parts of the world, second line treatment in India is far more expensive than first line treatment.
In 2008, India’s National Aids Control Organisation (NACO) began to roll out government funded second-line antiretroviral treatment in two centres in Mumbai and Chennai. At the beginning of 2009 second-line therapy was available in a total of eight states. 49
There are also plans to improve the provision of nevirapine to pregnant mothers with HIV, which can significantly reduce the risk that they will pass infection on to their child. It has been reported that, even where treatment to prevent mother-to-child-transmission is available, some women do not request it because of the stigma surrounding HIV. 50
The large scale of India’s epidemic, the diversity of its spread, and the country’s lack of finances and resources all present barriers to India’s programme. Ironically, India is a major provider of cheap generic copies of ARVs to countries all over the world.

HIV prevention

HIV prevention

Educating people about HIV/AIDS and how it can be prevented is complicated in India, as a number of major languages and hundreds of different dialects are spoken within its population. This means that, although some HIV/AIDS prevention and education can be done at the national level, many of the efforts are best carried out at the state and local level.
Each state has its own AIDS Prevention and Control Society, which carries out local initiatives with guidance from NACO. Under the second stage of the government’s National AIDS Control Programme, which finished in March 2006, state AIDS control societies were granted funding for youth campaigns, blood safety checks, and HIV testing among other things. Various public platforms were used to raise awareness of the epidemic - concerts, radio dramas, a voluntary blood donation day and TV spots with a popular Indian film-star. Messages were also conveyed to young people through schools. Teachers and peer educators were trained to teach about the subject, and students were educated through active learning sessions, including debates and role-playing.

The next stage of the National AIDS Control Programme will see US$2.5 billion spent on fighting HIV and AIDS, most of which will be spent on prevention. Aside from the government, this money will come from non-governmental organisations, companies, and international agencies, such as the World Bank and the Bill and Melinda Gates Foundation.
The government has announced that this campaign will place a strong focus on condom promotion. It has already supported the installation of over 11,000 condom vending machines in colleges, road-side restaurants, stations, gas stations and hospitals, and plans to increase this number to 100,000 by the end of 2007. 36 With support from the United States Agency for International Development (USAID), the government has also initiated a campaign called ‘Condom Bindas Bol!’, which involves advertising, public events and celebrity endorsements. It aims to break the taboo that currently surrounds condom use in India, and to persuade people that they should not be embarrassed to buy them

This initiative is an example of how HIV prevention campaigns in India can be tailored to the situations of different states and areas. In doing so, they can make an important impact, particularly in rural areas where information is often lacking. Small-scale campaigns like this are often run or supported by non-governmental organisations, which play a vital role in preventing infections throughout India, particularly among high-risk groups. In some cases, members of these risk groups have formed their own organisations to respond to the epidemic.
The government has however funded a small number of national campaigns to spread awareness about HIV/AIDS to complement the local level initiatives.
On World AIDS Day 2007 India flagged off its largest national campaign to date, in the form of a seven-coach train.39 A year later the train journey was completed, having travelled to 180 stations in 24 states and reaching around 6.2 million people with HIV/AIDS education and awareness.

The History of HIV/AIDS in India

The History of HIV/AIDS in India

The History of HIV/AIDS in IndiaAt the beginning of 1986, despite over 20,000 reported AIDS cases worldwide 2, India had no reported cases of HIV or AIDS.3 There was recognition, though, that this would not be the case for long, and concerns were raised about how India would cope once HIV and AIDS cases started to emerge. One report, published in a medical journal in January 1986, stated:
“Unlike developed countries, India lacks the scientific laboratories, research facilities, equipment, and medical personnel to deal with an AIDS epidemic. In addition, factors such as cultural taboos against discussion of sexual practices, poor coordination between local health authorities and their communities, widespread poverty and malnutrition, and a lack of capacity to test and store blood would severely hinder the ability of the Government to control AIDS if the disease did become widespread.”Later in the year, India’s first cases of HIV were diagnosed among sex workers in Chennai, Tamil Nadu. It was noted that contact with foreign visitors had played a role in initial infections among sex workers, and as HIV screening centres were set up across the country there were calls for visitors to be screened for HIV. Gradually, these calls subsided as more attention was paid to ensuring that HIV screening was carried out in blood banks.
In 1987 a National AIDS Control Programme was launched to co-ordinate national responses. Its activities covered surveillance, blood screening, and health education. 7 By the end of 1987, out of 52,907 who had been tested, around 135 people were found to be HIV positive and 14 had AIDS. Most of these initial cases had occurred through heterosexual sex, 8 but at the end of the 1980s a rapid spread of HIV was observed among injecting drug users in Manipur, Mizoram and Nagaland - three north-eastern states of India bordering Myanmar (Burma).
At the beginning of the 1990s, as infection rates continued to rise, responses were strengthened. In 1992 the government set up NACO (the National AIDS Control Organisation), to oversee the formulation of policies, prevention work and control programmes relating to HIV and AIDS. 10 In the same year, the government launched a Strategic Plan for HIV prevention. This plan established the administrative and technical basis for programme management and also set up State AIDS bodies in 25 states and 7 union territories. It was able to make a number of important improvements in HIV prevention such as improving blood safety.

Can I get HIV during a procedure at my doctor's office?

Can I get HIV during a procedure at my doctor's office?

recently had a diagnostic procedure involving needles in my doctor's office. Am I at risk of getting an HIV infection during this procedure and from the needles she used?
Answer: Your doctor uses sterile equipment for each and every diagnostic test he or she performs. Therefore, there is absolutely no risk to you with regard to HIV when having a procedure at your doctor's office. Besides that fact, doctors use universal precautions which are steps taken that prevent exposure to infectious bodily fluids from patient to doctor as well as from patient to patient. The doctor changes gloves, gowns, etc. between each patient, preventing cross contamination between patients and protecting the doctor from infectious bodily fluids from patients.
What are the Principles of Universal Precautions
There have been cases of healthcare workers getting HIV, hepatitis B and hepatitis C from dirty needles. However, to my knowledge, the only HIV infection in the U.S. caused by a healthcare worker was that of a dentist who infected some of his patients during dental procedures. Because of precautions taken by your doctor, it is completely safe for you to have diagnostic procedures without fear of contracting HIV.

How long does HIV live outside the body?

How long does HIV live outside the body?

One of the most common questions we get here at About.com's HIV site is regarding HIV and how long it lives outside the body. People get concerned about touching someone or something and getting HIV-infected blood on their hands and becoming infected with HIV. Fortunately, HIV just doesn't infect in that way.
Answer: Studies have proven time and time again that HIV does not survive well outside the body. In artificially high concentrations produced in the lab, HIV drying that occurs outside of the body reduces the number of infectious viral particles by 99 percent in just a few hours. Since the concentration of HIV in blood or other bodily fluids is much lower, HIV drying outside the body virtually eliminates all infectious HIV particles therefore making the risk of HIV infection from blood or bodily fluids outside the body essentially zero.
Keep in mind that while HIV infection from infectious bodily fluids outside the body is essentially zero, other diseases like hepatitis B and C can and do occur. Therefore, any blood or bodily fluid outside the body should be considered a health risk and cleaned up using universal precautions and cleaning fluids that are known to kill viruses on contact.

HIV Transmission

HIV Transmission

How HIV SpreadsThere is still misunderstanding about how HIV is transmitted from one person to another. Knowing the basics helps you avoid getting the virus if you are HIV-, and avoid passing it on if you are HIV+.

HIV is spread through the following body fluids:

Blood (including menstrual blood) Semen and other male sexual fluids ("pre-cum") Vaginal fluids Breast milk HIV is not spread through these body fluids:

Sweat Tears Saliva (spit) The spread of HIV can be prevented! There are ways to avoid, or at least, reduce contact with the bodily fluids that spread HIV (blood, sexual fluids, and breast milk). This info sheet will explain how.

Methods of TransmissionIn the past, HIV was spread in blood products, such as whole blood or the "factor" used by hemophiliacs. Many people were infected this way. The blood supply is now much more strictly tested and controlled. The odds of being infected from receiving blood or factor in the U.S. are extremely low.

You cannot get HIV from donating blood – a new clean needle is used for each donation.

Some people, primarily healthcare workers, are occasionally infected through needle sticks with infected blood, or through other medical accidents. This is a very tiny percentage of overall infections.

Today, the most common ways HIV is passed from one person to another are:

Re-using and sharing needles Unprotected/unsafe sex (no condoms or other barrier devices) Mother-to-child
Re-using and Sharing NeedlesMany HIV infections occur when people share needles to inject heroin, methamphetamine, or other drugs. This risk can be greatly reduced by cleaning needles with a bleach solution before re-using them. The risk can be eliminated by using fresh needles each time. Many cities now offer free needle exchange programs.

When getting a tattoo or body piercing, always go to a licensed professional and make sure the equipment is autoclaved, not just "sterilized" with alcohol.

Un-protected/unsafe SexEvery sexual act that involves sexual fluids of some kind has at least some risk. Barriers, such as condoms (male and female), dental dams, latex gloves, and even plastic food wrap (such as Saran Wrap), help reduce risk substantially.

Unsafe sex (sex without condoms or barriers) puts you and your partner at risk for HIV or other sexually transmitted diseases (STDs).

Safer sex (sex using condoms or other barriers correctly and consistently) protects you and your partner.

Which common sexual activities are most likely to cause HIV transmission when safer sex isn't used? (Listed from most to least risky.)

Receptive anal sex ("bottoming") remains the most risky activity, due to the likelihood of direct semen-blood contact. But penetrative anal sex ("topping") with someone can result in HIV transmission, too. Vaginal intercourse puts both partners at risk, but HIV is transmitted from men to women much more easily than from women to men. Oral sex can be risky for the person performing it, particularly if he or she swallows semen, vaginal fluids, or menstrual fluids. Sharing sex toys without sterilizing them can be dangerous. Rimming (licking the anus) is very unlikely to result in HIV infection. Mutual masturbation (hand jobs) and fisting (using a hand to penetrate the anus or vagina) are relatively risk-free, as long as your hand has no open cuts or sores. Sexual assault can result in infection if the assailant is HIV+. The risk increases when rape involves anal penetration, force, and/or multiple assailants. Some forced sexual acts involving wounds can place a victim at very high risk.

In major cities, PEP (post-exposure prophylaxis) is often offered to victims of sexual assault. This month-long treatment reduces the likelihood of HIV infection substantially. It is currently only used on a regular basis for victims of sexual assault and for healthcare workers who have been exposed to HIV on the job. PEP must be started as quickly as possible, always within 72 hours of the exposure.

Mother-to-Child TransmissionHIV+ mothers can pass the virus to their babies while pregnant, during birth, or by breastfeeding. New medical techniques have almost eliminated the risk of a baby getting HIV from its mother when precautions are taken. HIV+ mothers should not breastfeed their babies.

Freak TransmissionsThere are a few isolated cases of people infected from using a razor that had just been used by an HIV+ man or in other off-beat ways. To be safe, always avoid direct contact with blood and sexual fluids in any context.

Don't worry too much about freak cases. For instance, there is a documented case of transmission from deep or "French" kissing – in two people who had terrible dental problems. The odds of getting HIV from kissing, even when one person is HIV+, are less than the odds of being struck by lightning.

True versus False Risk of TransmissionHIV cannot be transmitted except when certain bodily fluids are exchanged. You can greatly reduce the risk of transmission by:

Avoiding contact with sexual fluids by always practicing safer sex Abstaining from sex unless you and your partner are both HIV- and in a long-term, monogamous relationship Not using injection drugs, or if you do, always using new or clean needles Finding our your HIV status if you are planning to get pregnant and working with a knowledgeable doctor and obstetrician if you are HIV+ If you protect yourself in these ways, you do not need to be afraid of getting or passing HIV by casual contact. Remember, HIV is not transmitted by:

Hugs Dancing Sharing food or drinks Using a shower, bath, or bed used by an HIV+ person Kissing (between people with no significant dental problems) Sharing exercise equipment

What is HIV?

What is HIV?

what is HIV?HIV stands for Human Immunodeficiency Virus. HIV is the virus that causes AIDS.

While many viruses can be controlled by the immune system, HIV targets and infects the same immune system cells that are supposed to protect us from illnesses. These are a type of white blood cell called CD4 cells.

HIV takes over CD4 cells and turns them into virus factories that produce thousands of viral copies. As the virus grows, it damages or kills CD4 cells, weakening the immune system.

What is AIDS?AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is the most advanced stage of HIV infection.

HIV causes AIDS by attacking the immune system’s soldiers – the CD4 cells. When the immune system loses too many CD4 cells, you are less able to fight off infection and can develop serious, often deadly, infections. These are called opportunistic infections (OIs) because they take advantage of the body's weakened defenses.

When someone dies of AIDS, it is usually opportunistic infections or other long-term effects of HIV infection that cause death. AIDS refers to the body’s immune-compromised state that can no longer stop OIs from developing and becoming so deadly.

What is the Difference Between HIV and AIDS?You don't have AIDS as soon as you are infected with HIV. You can be HIV+ for many years with no signs of disease, or only mild-to-moderate symptoms. But without treatment, HIV will eventually wear down the immune system in most people to the point that they develop more serious OIs.

The Centers for Disease Control and Prevention (CDC) defines someone as having AIDS if he or she is HIV+ and meets one or both of these conditions:
Has had at least one of 21 AIDS-defining opportunistic infections Has had a CD4 cell count (T-cell count) of 200 cells or less (a normal CD4 count varies by laboratory, but usually is in the 600 to 1,500 range)
How Do I Know if I Have HIV?Most people can not tell that they have been exposed or infected. It can take up to 12 weeks for an HIV test to come back positive. However most people respond much faster. Within two to four weeks of exposure to HIV, you might have flu-like symptoms such as fever, swollen glands, muscle aches, or rash.

The only way to know for sure if you are infected is take an HIV test. If you are infected, your immune system will make antibodies to fight the virus. The HIV test looks for these antibodies. If you have them in your blood, it means that you have HIV infection.

Do I Need to Get Tested for HIV?The CDC estimates that more than 25% of HIV+ people are unaware of their HIV status. Many of these people look and feel healthy and do not think they are at risk. But the truth is that anyone of any age, gender, race, sexual orientation, or social or economic class can become infected. It is your actions (or the actions taken against you), that put you at risk. You should be tested if:
You have had vaginal, anal, or oral sex without a condom You have shared needles or syringes to inject drugs (including steroids or hormones) You are uncertain of your partner’s status or your partner is HIV+ You are pregnant or are considering becoming pregnant You have ever been diagnosed with a sexually transmitted disease You have hepatitis C
Why Should I Get Tested?If you test HIV+ there are effective medications to help you stay well. But you cannot get the health care and treatment you need if you do not know your HIV status. Being unaware of your status also makes it more likely to unknowingly pass HIV to others.

If you test HIV- you can take steps to stay that way. You can also spare yourself unnecessary worrying.

What Tests are Available?The most common test for HIV is the antibody test (called ELISA). It can be done on blood, saliva, or urine. According to the CDC, it is more than 99% accurate. Results are generally available within two weeks. (There is a rapid ELISA test that gives results in less than half an hour.)

A positive result means your body has developed antibodies for HIV, so you are infected with the virus. To be completely certain, positive results are confirmed with a more sensitive test called the Western blot.

A negative result means your body has not developed antibodies and are probably not infected. To get truly accurate results, it's necessary to wait three to six months after your last possible exposure to the virus before being tested. That is because the immune system can take anywhere from three to twelve weeks to make antibodies. In this "window period," someone may get an unclear result or a false negative.

Where Can I Get Tested?You can get tested at your doctor’s office, a clinic, the local health department facilities, or at a hospital. In addition, many states offer anonymous HIV testing. You can also purchase a kit that allows you to collect your own blood sample, send it to a lab for testing, and receive the results anonymously. (Only the "Home Access" brand kit is approved by the Food and Drug Administration.)

It is important to get tested at a site that provides counseling. Counselors can answer questions about high-risk behavior and suggest ways you can protect yourself and others in the future. People who test HIV+ can receive support and referrals to health care and other services. The counselor can help you through the whole testing process – from start to finish.