What is HIV?
HIV is found in 4 body fluids: blood, semen/pre-cum, vaginal fluids, and breast milk. It is contracted when one of these infected fluids enters into the bloodstream of another person via points of entry, known as mucous membranes (anus, vagina, penis, mouth, eyes, nose). This most commonly happens through unprotected sex (anal, vaginal, and oral), and sharing equipment like snorting straws or needles (for drugs, hormones, tattooing/piercing). HIV is NOT found in spit, piss, on toilet seats or shared utensils; it is not transmitted by basic daily activities.
HIV
Human – the virus can only be passed between humans, not between species
Immunodeficiency – it weakens the immune system
Virus – this is a microscopic organism that needs your cells to reproduce
HIV is the virus that causes AIDS. It attacks the body’s immune system by infecting CD4 white blood cells. HIV, like all viruses, cannot reproduce by itself. Viruses need to use cells’ more complicated structures to make copies of themselves. In the process, they destroy the very cells that protect the body from illness.
What are the symptoms of HIV?
There are no symptoms of HIV infection until it’s reached the advanced stages. Over one third of the people who are living with HIV in Quebec do not know they are HIV positive.
What is the immune system?
The immune system protects the body against infection by viruses, bacteria, and fungus. These microbes are all around us, and we come into contact with them on a daily basis. As soon as this system detects a foreign organism, it mounts its attack. This means that most microbes don’t even get a chance to make us sick.
The immune system is made up of different types of cells, and each one plays a specific role. The CD4 cells detect infections and tell the other cells how to respond. Without enough CD4 cells, the body’s immune system is crippled. It becomes less and less able to deal with disease because it doesn’t even realize that it’s there.
AIDS
Acquired – this is something you develop, not something you’re born with
Immune Deficiency – your immune system is not able to function properly
Syndrome – a group of signs and symptoms that point to a certain type of illness
When does someone develop AIDS?
A healthy person has 800-1200 CD4 cells per millilitre of blood. This varies depending on factors such as stress, infection, what you’ve been eating, and how late you went out last night.
As HIV progresses, CD4 cells are destroyed faster than the body can replace them. The total number slowly decreases, making it more and more difficult for the immune system to do its job. The person gets sick more often and it takes them longer to recover.
Eventually, the immune system is so damaged it can’t fight off infections that healthy people never get. These are called opportunistic infections because they only happen when the immune system is weak.
In Canada, a person is diagnosed with AIDS if he or she is HIV positive and has contracted an opportunistic infection (one of a list of infections that generally occurs only when a person’s immune system is seriously weakened). The specific definition of AIDS varies depending on the country, sometimes including having an absolute CD4 count of below 200. In practice, in settings where antiretroviral medications are available and affordable, the AIDS diagnosis is less meaningful, as treating HIV with antiretroviral medications stops the replication of HIV and allows the immune system to rebuild to a point where a person is no longer vulnerable to opportunistic infections.
Post Exposure Prophylaxis
What is PEP?
Post-Exposure Prophylaxis (PEP) is a medication regimen that can be prescribed after a potential exposure to HIV. These medications might be able to prevent the HIV virus from taking hold in someone’s immune system.
No one knows how effective PEP is. It’s impossible to tell whether the medications worked to prevent transmission or if the person would never have become infected in the first place (even when someone’s exposed to HIV, they don’t always become infected).
How do you take it?
PEP is exactly the same regimen that someone living with HIV takes to slow down the virus. It involves a minimum of three medications, all of which have to be taken at specific times and following specific guidelines (i.e., with food, on an empty stomach). The medications are expensive and come with the possibility of severe side effects for the duration of treatment.
PEP lasts for one month, and is most likely to be effective if started within 72 hours of the potential exposure.
Who is qualified to take it?
The guidelines for taking PEP vary depending on where you are and what happened. Right now, PEP is most likely to be prescribed for needle pricks in a medical setting or sexual assault where the assailant was known to be HIV positive. If you fear you have been exposed to HIV and are interested in taking PEP, get in touch with a doctor to discuss your situation.
Some places where PEP is available in Montreal are:
Hôpital St. Luc: 514-890-8000 ext. 36519
Clinique Medicale du Quartier Latin: 514-285-5500
Clinique l’Actuel : 514-524-1001
Goldberg, Leblanc, Rosengren Clinic : 514-935-1197
