HIV

What causes HIV ?

HIV is contracted through exposure to an infected person’s blood, semen, vaginal fluids or milk. The most common HIV infection routes are unprotected vaginal or anal sex.

The virus may also be passed from mother to baby, and 250 Canadian babies were exposed this way in 2020 according to Public Health Canada.

Once HIV gets into the bloodstream it attacks cells of the immune system and uses them to produce more viral particles. The body then finds it harder to fight off other infections and also to defend itself against cancers.

What are the symptoms of HIV ?

Between two weeks and three months after exposure to the HIV virus, you experience flu-like symptoms such as:

• diarrhea
• fever
• headache
• joint pain
• night sweats
• rashes
• swollen glands
• weakness

Some people also get oral or vaginal thrush (a yeast infection) that keeps recurring.

At this point, you will be very infectious, which means it is easy to pass on the virus to other people. The symptoms often pass, but they return from time to time, in between periods of good health. This is because the immune system can fight the virus to a degree, but it can’t completely win the battle.

HIV and excessive weight loss

Another symptom of HIV is a type of weight loss known as wasting syndrome. It occurs in 20% of people who have HIV. It is the loss of more than 10% of the body weight, with chronic diarrhea or chronic fever. Chronic in this instance means longer than 30 days.

What is AIDS?

Eventually, HIV weakens the immune system and AIDS begins. AIDS is HIV with an opportunistic infection, such as:

• cryptococcal meningitis
• cryptosporidium
• cytomegalovirus
• mycobacterium avium complex (MAC)
• pneumocystis jerovicii pneumonia
• progressive multifocal leukoencephalopathy (PML)
• toxoplasmosis

AIDS makes you more susceptible to cancers. Some cancers linked to AIDS are lymphomas and Kaposi’s sarcoma.

What should I do if I think I have HIV?

If you are experiencing the symptoms of an HIV infection, you can get an HIV test from your healthcare provider or from a sexual health clinic. You can get an anonymous HIV test, and many sexually active men do this regularly as part of their self-care routine. Untreated HIV is a very serious illness with far-reaching consequences – but if you start HIV treatment soon and get good care you can expect to have a normal lifespan.

What should I do if I think I’ve been exposed to HIV?

If you think you have been exposed to HIV, seek medical advice, the sooner the better. An HIV test will only show a useful result about three weeks after infection. So, a post-exposure HIV treatment known as PEP has been developed for people who have been exposed to HIV.

How does a doctor diagnose HIV ?

HIV is diagnosed with a blood test. It is usual to get a rapid preliminary test and then confirm a positive result with a laboratory test. There is no need to confirm a negative preliminary test result.

The doctor will ask questions about your lifestyle, including sexual activity and drug use. Where there is a risk that you have recently been exposed to HIV, they can prescribe a course of PEP (post-exposure prophylaxis) which helps to prevent an HIV infection taking hold.

What happens if my HIV result is positive?

If your HIV test result is positive, the doctor will offer support and advice, as well as signposting to services that will help you with practical issues like housing, finance and employment. You may wish to seek out a doctor who specializes in HIV, as they will have a better understanding of the types of support you need, as well as up-to-date knowledge about the latest HIV treatments.

After a positive HIV test, your doctor will help you to contact current and past sexual partners so that they can check their own HIV status. Most provinces and territories have services for notifying partners and helping them to access testing.

How will a doctor treat my HIV ?

Doctors and drug companies are developing new HIV treatments and prophylaxis very quickly and getting your care from an HIV specialist will ensure you have access to the best treatments.

Your doctor can treat you with PEP to reduce your risk of getting HIV if you are exposed to it.

Confirmed HIV is treated with HAART (highly active antiretroviral therapy).

AIDS is treated with a range of meds to help with opportunistic infections.

Treatment after recent exposure to HIV

If you think you’ve been exposed to HIV then seek medical help quickly so that you can start a course of post-exposure prophylaxis (PEP).

PEP after exposure to HIV

PEP (post-exposure prophylaxis) are meds that you take if there a strong possibility that you have been exposed to HIV, either through unprotected sex or through use of a contaminated needle. It will be too early to confirm diagnosis with an HIV test at this stage.

You need to start taking PEP within 72 hours of exposure to HIV, and the sooner the better. The ideal window for taking PEP is 24-48 hours. The course of PEP treatment usually lasts 28 days, and it will be a combination of drugs.

Treatment after a positive HIV test

If you have HIV, it’s important to start treatment as soon as possible so that you can live a longer and more healthy life and protect those you love by not passing on HIV.

A positive HIV test result may leave you shaken, so it is very important to consult a doctor who has expertise in helping people with HIV manage their condition.

HAART

HAART (highly active antiretroviral therapy) cannot cure HIV, but it can reduce the amount of virus in the blood (viral load). It will also improve the immune system and slow disease progression. HAART involves at least three different meds because HIV is highly adaptable and quickly becomes resistant to treatment.

It is very important to keep taking your HIV meds because stopping, or not taking enough of your meds increases the virus’s resistance, making it harder to treat.

One of the aims of HAART is to reduce your viral load to an undetectable level, which means you cannot pass the virus on.

If you have any problems with side-effects, or with remembering to take your meds, talk to your pharmacist or doctor. The organisation CATIE has information about treatments for HIV in Canada.

Drugs used for AIDS

People with AIDS are prescribed antibiotics, antivirals and antifungal medications.

Meds that treat wasting syndrome

Wasting syndrome is treated with medications including anabolic steroids and appetite stimulants.

How do I get medications for HIV ?

The meds used for HAART, PEP and PrEP are not available over the counter. You need to get a treatment plan from a doctor, who will prescribe the right meds for you. You can then get the doctor’s prescription for HIV medication or prophylaxis filled at a pharmacy.

In Canada you can depend on NX Pharmacies for your HIV meds. We serve all areas of Canada and can fill your prescription of HIV medication. We can help with renewals and refills. Our discretion is assured, and you can depend on us for authentic Health Canada-approved medications.

If something changes with your HIV , talk to your doctor. Ask for a medicines review if you get unbearable side-effects. Your pharmacist may also be able to advise on managing side-effects of your HIV meds.

How do I protect myself from HIV?

If you think it likely that you will often be exposed to HIV, then talk with your doctor about starting PrEP, or pre-exposure prophylaxis.

There are some lifestyle steps you can take to reduce your risk of exposure to HIV.

PrEP to protect against HIV

PrEP – or pre-exposure prophylaxis – is a drug called Tuvada (generic name emtricitabine/tenofovir) that is taken to prevent HIV infection. People who need protection from HIV take it once a day, every day.

When you use PrEP for protection against HIV, you need to visit your doctor every three months to get your bloodwork done. You may also need regular tests for sexually transmitted infections, as PrEP does not protect against syphilis, hepatitis, gonorrhea and chlamydia.

Lifestyle changes to avoid HIV

There are some types of sexual activity that will increase your risk of being exposed to HIV. Drug users are also at increased risk from HIV.

Sex and HIV

To reduce the chances of exposure to HIV, use condoms during sex. These steps will also reduce your risk of getting STIs such as hepatitis, syphilis and gonorrhea, which in themselves increase the risk of HIV infection. If you engage in high-risk sexual activities, get regular STI tests and treat infections promptly.

Knowing your HIV status

In parts of Canada, you have a legal duty to tell your sexual partner if you are HIV positive.

For many people, regular anonymous HIV tests are part of their self-care routine. By knowing your HIV status, you can protect your sexual partners from infection. Get information about HIV testing through CATIE.

Drug use and HIV

People who inject drugs using contaminated needles, or who experience needlestick injuries are at increased risk of exposure to HIV and other blood-borne diseases. Avoid sharing works, particularly needles. Other kinds of works can carry hepatitis C – for example, pipes and mouthpieces. Seek out needle exchange schemes, and learn about needle safety. Use new works every time you inject, and the risk of exposure to HIV is eliminated. There are other advantages of using new needles, too: they are sharp so they are less likely to damage your veins, and they will help you avoid infections and blood clots.

What is it like to live with HIV?

Your GP will recommend some lifestyle changes to alleviate your HIV symptoms. Ask for support if you need help with implementing any of these lifestyle changes.

Take your HIV meds

New HIV drugs are much easier to take than older treatments. There may still be side-effects, but these usually go away after a while. Your doctor or pharmacist can help if the side effects of your HAART or PEP are unbearable – just ask.

It’s really important to take your HIV meds exactly as directed, as taking too little or missing doses will cause the virus in your body to become resistant to the drugs you are taking. Pharmacists can help if you have difficulty remembering to take your meds. There are apps and devices that can remind you, and equipment such as dosette boxes to help you see exactly where you are with the day’s pills.

Lead a healthy lifestyle to help manage your HIV

A healthy lifestyle with appropriate activity levels and a nutritious diet, as well as a good emotional support network will help you to manage your HIV. Exercise will make your body stronger so it is better equipped to fight HIV, and it will reduce your risk of cardiovascular disease and diabetes. A good diet will give you all the nutrients you need to stay healthy, but ask your doctor if you need any nutritional supplements.

Look after your emotional wellbeing

An HIV diagnosis is stressful – you’ll be dealing with health concerns and stigma, finance and work, telling people, finding a treatment regime that works for you. Sometimes the stress becomes too much, and you may experience anxiety, isolation or low mood. These can affect your physical health, so ask for help if your emotions are hard to manage.

Can I protect my sexual partners from HIV?

People who are successfully treating HIV so that their viral load is undetectable cannot pass it to a sexual partner. Maintaining treatment for HIV is the best way to protect your sexual partners.

Can I start a family if I or my partner has HIV?

It is possible to have a safe pregnancy if you have tested positive for HIV as long as you are being treated. If you maintain an undetectable viral load throughout pregnancy, the virus cannot be passed to the baby.

Talk with your doctor if you want to start a family and you or your partner has tested positive for HIV. They can advise you on the options available to you.