Find out what you need to know. We offer a place where you can ask questions about HIV. In Atlanta, GA, Heather Ivy Society addresses your concerns by answering common questions about HIV facts and issues. Read some of them below.
Most of the time, there are no skin problems whatsoever. However, in rare instances, HIV medications can cause skin changes. Emtricitabine, which is in Truvada and many single-tablet regimens, can cause darkening of the skin, mainly on the palms and soles. This may happen in 2% of people and is not harmful. Others may cause a fleeting rash.
Usually not, but HIV medications can cause lipodystrophy. Lipodystrophy is when there is an abnormal accumulation of body fat on your body in places where you do not want it, like your upper back or abdomen. This was more commonly seen with the older HIV medications prescribed in the 1990s and early 2000s than with the newer medicines prescribed today. Protease inhibitors can cause diabetes and high cholesterol, which, in turn, can cause weight gain.
Yes. HIV is carried in vaginal fluid. A man can get HIV through the opening (urethra), the foreskin, or any cuts or sores on the penis when it comes into contact with HIV-positive vaginal fluid. Menstrual or “period” blood, also, carries HIV. Having sex while on your period may cause infected blood to enter through the opening of the penis or any cuts or sores on the penis. Receiving oral sex from a man who has any sores or cuts in his mouth can also cause him to get infected. 1 in 2500 men will acquire HIV from the female-to-male transmission.
Yes, although it is very rare. The chances of spreading HIV from woman-to-woman are very low (negligible). However, unprotected exposure to HIV-infected vaginal fluids or “period” blood during oral sex or during the sharing of sex toys can spread HIV. The rough use of sex toys, to the point of causing bleeding, is a known contributor to the spread of HIV from one woman to another one.
No, you cannot and will not spread HIV to your family members or anyone else through everyday interaction and contact with them. HIV is spread only through the exchange of semen, vaginal fluid, rectal fluid, breast milk, or blood. Only activities that involve the exchange of these bodily fluids will potentially transmit HIV between people. HIV is not spread in spit or saliva, nor in urine or tears. Therefore, you cannot spread HIV by using the same bathroom or dishes, hugging, closed-mouth kissing, or having a good, ugly cry with tears with your family members or friends.
Absolutely. You cannot spread HIV to a pet, and a pet cannot give HIV to you or to anyone else. It is recommended that you avoid animal feces, animals less than six months old, and exotic pets, because these may transmit other infections that can cause severe illness.
Things to be aware of are:
If your CD4 count is very low (less than 100), you may be at risk of getting an infection called Toxoplasmosis from cat feces or changing cat litter. Always wear gloves and take careful precautions when changing the cat litter.
If your pet looks sick or has bad diarrhea, take it to a vet. Animals can carry other infections, such as cryptosporidiosis or Mycobacterium avium complex, which can be harmful to you, especially when your CD4 count is low.
Absolutely. You can have an enjoyable and fulfilling sexual relationship with your partner. First, you must tell your partner that you are HIV-positive before you have sex with him or her. In many states, you can be charged with a crime if you do not disclose your HIV status to your partner prior to sex. If your partner is okay with continuing with sexual activity, then it is advised that you use condoms properly and every time that you have sex. It is also advised that you take HIV medicines so that you are undetectable and nearly incapable of giving HIV to your partner.
Yes, and women do every day. You can safely plan a pregnancy so that you, your partner, and your unborn baby have healthy outcomes. Many women who are HIV-positive have gotten pregnant naturally and delivered healthy babies where neither their partner nor their baby was infected with HIV. Be sure to speak to your health care provider before trying to get pregnant, so this process can be planned for the benefit of your family.
No. Although artificial insemination will virtually eliminate the risk of HIV transmission from you to your partner, it is not your only option to get pregnant. There are other low-transmission-risk conception options that you may explore with your health care provider.
Yes. It is highly recommended that you take HIV medicines while pregnant to protect yourself and your unborn baby. Starting combination drugs early in pregnancy and during the birth process is ideal. Taking HIV medication to decrease your viral load to as low as possible will decrease the risk of giving HIV to your baby.
It is generally recommended that you continue taking the same medications as you were taking before becoming pregnant. However, there are some medications that should be avoided during pregnancy, and your doctor may change you to a different combination of medicines during your pregnancy.
Globally, only about 2.8% of babies are born with birth defects believed to be from HIV medications. There are risks of preterm birth, small babies, and stillbirth, but these outcomes are often due to other circumstances, like limited nutrition.
Chen. Et al. (2012). Highly Active Antiretroviral Therapy and Adverse Birth Outcomes Among HIV-Infected Women in Botswana. J Infect Dis.; 206(11): 1695–1705.
Ndirangu. Et al. (2012). Maternal HIV infection associated with small-for-gestational-age infants but not preterm births: evidence from rural South Africa. Hum Reprod; 27(6): 1846–1856.
Williams. Et al. (2016). Congenital Anomalies and in utero Antiretroviral Exposure in HIV-exposed Uninfected Infants. JAMA Pediatr; 169(1): 48–55.
Yes. Being infected with HIV should not change your life’s plans and, with proper medication and treatment, you can live a healthy and normal life. You are legally obligated to tell your partner your HIV status if you plan on having a sexual aspect to your marriage or starting a family, but HIV does not change your opportunity to get married.
It is up to you. Some women are too ashamed to ever disclose their HIV status to anyone, especially their children. Other women want their children to be the first, if not only, people to know. You should know that you have no legal obligation to tell your children your HIV-positive status. However, telling your children may establish a valuable support system for you. Disclosing your status may also educate them on ways to protect themselves from HIV or help to erase the stigma associated with the infection.
Yes, you could go to jail if you know you are HIV-positive and do not tell your partner before you have sex with him or her. Many states, such as Georgia, carry a criminal penalty of up to 10 years in prison for not telling your partner that you have HIV before you potentially expose him or her to the infection. Even if you do not give them HIV; do everything you can to prevent giving them HIV; have an undetectable viral load; or use a condom, you still MUST tell your partner you are HIV-positive if you plan on having oral sex, anal sex, or penile-vaginal sex (or any other kind of sex).
It is recommended that you and your partner have a written and signed agreement between you that states that you are both aware of your HIV status and accepting of the transmission risks involved.
Yes, there are 2 FDA-approved options for prevention of HIV transmission from HIV-positive to HIV-negative persons who maintain a sexual relationship. These prevention options are called "PrEP," which stands for pre-exposure prophylaxis. One options is Truvada or "the other little blue pill" which should be taken by mouth every day. This is the only pill option available to persons who may acquire HIV through vaginal-receptive intercourse. If your HIV-negative partner is a man, he may take Truvada or another medicine called Descovy.
The newest PrEP options is called Apretude, an injectable, long-acting medication. This injection is done in your physician's office every 2 months and is safe and effective for women and men.
There are only rare reports of hair loss and only with certain HIV medicines. Early HIV medications, such as Indinavir and Lopinavir, were reported to cause hair loss. There have been very recent reports of hair loss associated with Tenofovir alafenamide use in 6 African-American women,* even though this medication has been prescribed to countless women without resulting hair loss. Overall, HIV medicines generally do not cause hair loss.
*El Zein et al. (2019). Alopecia After Switch to Tenofovir Alafenamide in 6 African-American Women. Open Forum Infect Dis. Jun 6;6(7).
Yes, absolutely! The Affordable Care Act, or ACA, allows people lacking health coverage through an employer or other sources to buy their own health insurance regardless of preexisting conditions. You can also find out if you are eligible for Medicaid through your home state’s eligibility office. You may find it more difficult to obtain life insurance, however. When coverage is found, you may generally expect your life insurance premium to be significantly higher than that of a person of your age, gender, and degree of health who is HIV-negative.
It is within the scope of your level of emotional intimacy, whether you disclose your HIV-positive status to your romantic partner. However, you are legally obligated in many states to disclose your HIV-positive status to anyone with whom you engage in SEX before you have sex with him or her. Having sexual intercourse with an unsuspecting partner is a crime in many states, such as Georgia. You can be charged with a felony if you do not tell your partner your HIV-positive status, even if you used a condom or another type of protection, and your partner does not become infected. If you have had unprotected sex with your partner, it is important to alert him or her to the fact so that he or she may be appropriately tested for HIV.
U=U means Undetectable=Untransmittable. Studies have shown that when an HIV-positive person is taking HIV medicines and his or her viral load has reached undetectable levels (i.e., not enough HIV in the bloodstream for a test to measure its amount), that person cannot transmit HIV to an intimate partner who is HIV-negative.
No. HIV-positive women can have healthy pregnancies and give birth to healthy babies without passing on HIV. Most of the advice for women with HIV is the same as it is for anyone else who is thinking about starting a family or having another baby. Some extra steps are necessary to reduce the risk of HIV being passed on to your baby. HIV treatment during pregnancy is strongly recommended to reduce the level of virus in your body. Keeping your viral load very low, ideally ‘undetectable,’ is good for your health and also reduces the risk of HIV being passed on to your baby. If your viral load is high, your doctor is likely to recommend a planned cesarean delivery. During vaginal births, babies may come into contact with HIV in their mother’s blood and other fluids. A cesarean section reduces the risk of passing on HIV to your child.
The benefits of HIV treatment during pregnancy far outweigh the risks associated with treatment for you and for your unborn baby. There are different combinations of HIV medications that have been shown to be effective and safer in pregnancy. Inform your doctor about your plans to become pregnant or as soon as you find out that you are pregnant so that your doctor can prescribe the safest medicines to you.
Additionally, you may be asked to participate in a pregnancy registry that tracks your medical journey during and after your pregnancy for adverse events.
In certain states, the answer is yes, particularly if your partner knowingly transmitted the infection to you after being informed that he or she was HIV positive. Refusing to disclose his/her HIV-positive status to you before having unprotected sex with you is a crime in many states.
Being diagnosed with an HIV infection is not a death sentence with proper care and treatment. There are many people who have been living with HIV for decades, and the overall life expectancy for persons who are HIV-positive AND are in consistent care is not significantly decreased from what it would be without an HIV diagnosis.
There are no increased health risks to you or to babies/ children simply because of your HIV diagnosis. However, anyone with an advanced HIV infection that has resulted in a weakened immune system should avoid sick contacts, whether they are children or adults.
HIV-positive mothers who have questions about breastfeeding or who desire to breastfeed should receive patient-centered, evidence-based counseling on infant feeding options, allowing for shared decision-making. Here's what you should know in order to make your decision. HIV can be spread through certain body fluids, including breast milk. If you adhere to antiretroviral therapy (ART) and maintain an undetectable HIV viral load during pregnancy, the risk of HIV transmission through breastfeeding is less than 1%, but not zero. While treatment of HIV substantially reduces the risk of transmission during pregnancy, birth, or breastfeeding, it does not eliminate the risk. You should therefore weigh the benefits of breastfeeding against the potential risks of HIV transmission to your infant.
The surest way to prevent transmission of HIV to your infant through breast milk is to not breastfeed. In the United States, where mothers have access to clean water and affordable replacement feeding (infant formula), it has been recommended in the past that mothers living with HIV completely avoid breastfeeding their infants, regardless of consistent HIV treatment and maternal viral load. Infant formula and pasteurized donor human milk are safe feeding alternatives to breastfeeding for mothers living with HIV. These recommendations differ from those in certain parts of the world, where mothers do not have access to the same infant feeding options. In countries where resources are limited, it is recommended that mothers living with HIV breastfeed exclusively for the first 6 months of life and continue breastfeeding for at least 12 months, with the addition of complementary foods. These mothers should be fully supported with HIV treatment access that reduces the risk of transmission through breastfeeding.
If you choose to breastfeed, you are supported through science in your decision to do so. It is recommended that you remain fully committed to taking your HIV treatment to achieve and maintain an undetectable viral load. You should, also, receive close follow-up with your HIV provider to maintain risk-reduction measures that minimize the risk of HIV transmission to your infant.
Your healthcare provider(s) may consult the National Perinatal HIV/AIDS Hotline (1-888-448-8765) if he or she has questions regarding mothers with HIV who want to breastfeed.
In nearly every case, the answer to this question is NO. The Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities, including those who are living HIV/AIDS. However, you may be excluded from the activities or services of a public or private entity if you pose a significant risk to the health or safety of others, known as a “direct threat.” Direct threat is a rare circumstance because HIV is transmitted only through the exchange of particular body fluids and is not airborne.
Yes, sort of. The HIV Organ Policy Equity (HOPE) Act allowed scientists to research organ donation in people with an HIV infection and was signed into law in 2013. Johns Hopkins University in Baltimore, MD, was the first center in the United States to perform an HIV-positive-to-HIV-positive organ transplant using deceased donors. Other transplant centers have adopted the same model for transplanting multiple organ types.
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