HIV

What is HIV?

Human Immunodeficiency Virus or HIV for short is a virus that attacks the body's immune system. With an early diagnosis and effective treatments, most people with HIV will not develop any AIDS-related illnesses and will live a normal lifespan. To learn more about HIV, testing, prevention, and living with HIV click on the tiles below.

• Transmission

  Understanding how HIV is transmitted can help challenge myths and misconceptions about HIV which can lead to discriminatory behaviour. There may be a lot of myths about how HIV is passed on; most of these are not true.

   

  HIV can be passed on through blood, semen, breast milk and other bodily fluids. A person who is HIV positive needs to have a detectable viral load in order to transmit the virus.

   

  HIV cannot be passed on through: Kissing, hugging, or shaking hands, Sneezing or coughing, Sharing cups, plates, or toilet seats.

• How do you get HIV?

  Having unprotected sex with someone who has HIV and has a detectable viral load (viral load is the amount of virus in a person's body). Remember you cannot tell if a person has HIV and they themselves might not even know. So it's always best to be safe and wear a condom.

   

  You can pick up and pass on HIV by sharing drug paraphernalia. St Helens pharmacies and CGL offer a needle exchange programme to help reduce this you can order needle exchange direct from the door from https://www.changegrowlive.org/news/needle-and-syringe-delivery-straight-your-door

   

  Without the right treatment and care, a woman living with HIV can pass HIV on to her baby. But with the right medication and other interventions, the chances of transmission are hugely reduced.

   

  Blood transfusions - This is very rare. In the UK all blood products are screened for HIV.

• What is seroconversion illness?

  When you first contract the HIV virus, some people may experience a short, flu-like illness that occurs 2-6 weeks after infection. This is called seroconversion illness. After this, HIV may not cause any symptoms for several years.

   

  The most common symptoms of seroconversion illness are raised temperature (fever), sore throat, body rash, headaches, other symptoms can include: tiredness, joint pain, loss of appetite, muscle pain, swollen glands, chill's. The symptoms usually last 1-2 weeks but can be longer. They're a sign that your immune system is putting up a fight against the virus.

   

  After the initial symptoms disappear, HIV may not cause any further symptoms for many years. During this time, the virus continues to be active and causes damage to your immune system. This process can vary from person to person, but may take up to 10 years, during which you'll feel and appear well.

   

  After the initial symptoms of seroconversion illness disappear, HIV may not cause any further symptoms for many years. During this time, the virus continues to be active and causes damage to your immune system. This process can vary from person to person, but may take up to 10 years, during which you'll feel and appear well. The only way to know if you have HIV or not, is to take a test! You can test online or by calling our clinic 01744 646 473.

• How do I test for HIV?

  We test everyone for HIV unless you ask us not to. We always do this because:

  • HIV is a virus that damages the immune system
  • Someone can be infected with HIV and not have any symptoms, sometimes for many years
  • If you have HIV, medical treatment can keep you well, so it is good to know your HIV status
  • If you have HIV and do not know about it you could become ill and also pass on the infection to others.
  • If someone is infected with HIV it can usually be detected after four weeks.
  • Treatment for HIV can prevent onward transmission of HIV to others

   

  Just because you have a negative result it does not mean that your partner will. HIV is not necessarily passed on every time someone with untreated infection has sex. This is why everyone needs to have a test.

  You can order a test for HIV and other Sexually transmitted infections on our testing page or call 01744 646 473.

• What does U=U mean?

  To understand U=U you need to know what a viral load is and why it is important. A viral load refers to the amount of virus in an HIV positive person's blood. This is expressed as the number of viral particles in each millilitre of blood. Once a person has tested positive for HIV they are given medication to help reduce the amount of virus to an undetectable level. They will attend regular hospital visits and have regular blood tests check how much virus is in it.

   

  We want everyone to know that a person living with HIV who has an undetectable viral load cannot pass on HIV to their sexual partners.

• What is PrEP?

  In the UK, one pill is approved for use as PrEP – under the brand names Truvada or Descovy or It's generic equivalent. (A generic equivalent is the same ingredients but may be branded differently; they all work in the same way.)

  Truvada, Descovy, and the generic tablet contain two drugs:

  • Tenofovir Disoproxil TD
  • Emtricitabine FTC.

  Will taking PrEP prevent me from getting other sexually transmitted infections?

  No. Taking PrEP will only protect you from an exposure of HIV. You still need to wear condoms to prevent you from catching other sexually transmitted infections and don't forget about regular STI testing including a HIV test every three months.

• What else can I do to help prevent myself from getting a sexually transmitted infection?

  The sexual health clinic may offer you vaccinations for hepatitis A, hepatitis B and the HPV vaccine. HPV is the virus that can cause some cancers in the throat and your genitals. Regular testing and consistent condom use along with taking PrEP is a great combination to help prevent you from sexually transmitted infections, not only that you won't need to worry about the HIV status of your partners as you are looking after your sexual health.

• I have HIV and want to know more?

  It is important for you and others around you to understand how HIV is transmitted. This knowledge can help challenge myths and misconceptions about HIV which can lead to discriminatory behaviour. There may be a lot of myths about how HIV is passed on; most of these are not true. HIV cannot be passed on through: Kissing, hugging, or shaking hands, Sneezing or coughing, Sharing cups, plates, or toilet seats

  The only way HIV can be transmitted is through:

  • Bodily fluids (semen, vaginal and anal fluid, blood, breast milk) - HIV can be transmitted through semen, vaginal, and anal fluid during sex (this may include anal, or vaginal sex) if you or your partner is HIV positive and does not have an undetectable HIV viral load.
  • Sharing of injecting equipment and/or drug paraphernalia– HIV can be transmitted by using needle's, syringes or equipment contaminated with HIV.
  • Mother to baby - HIV can be transmitted from mother to baby through pregnancy, childbirth, and breast feeding. However, with the correct treatment, many HIV positive women deliver HIV negative babies.
  • If you have an undetectable HIV viral load on Antiretroviral treatment (ART) you cannot transmit HIV, even without using condoms or PrEP. (Pre Exposure Prophylaxis)
• How can U=U mean no risk?

  The quick answer is when a HIV viral load is undetectable there is too little virus in sexual fluids for an infection to occur. Any risk of sexual HIV transmission relates to viral load and being undetectable reduces this risk to zero.

  HIV drugs stop the virus making copies of itself. This reduces your viral load to very low levels. Your CD4 count (CD4 is a marker of your immune function in your blood)  then has a chance to grow stronger again. As long as you do not develop a drug resistance, the same drugs can work for years.

  These four points are important:

  • To take your drugs on time.
  • To follow advice on taking with or without food
  • Do not miss doses
  • Check in with your doctor for any potential drug interactions when starting new medication.

  By following this guidance, regular testing, keeping appointments; the aim is to get your viral load to undetectable (less than 50 copies/ml) this means you cannot pass on the virus.

• Side effects of medication

  Many people experience some mild side-effects, particularly in the first few days and weeks of starting treatment. For example, you might feel sick or have a headache. Although unpleasant, most side-effects should improve and go away altogether as your body gets used to taking the drug. Some side-effects may be less obvious to you. For example, the commonly used drug TDF (tenofovir disoproxil) can rarely cause problems with the kidneys. Your healthcare professional will check a sample of your urine to look out for early signs of kidney problems. If you think you are experiencing a side-effect, the best thing you can do is talk to a healthcare professional about it.

• What is a late diagnosis?

  Late diagnosis means that you've tested positive for HIV after the virus has already started to damage your immune system. If you're diagnosed when your CD4 count has dropped below 350 (or it reaches this point within three months of your diagnosis) this is considered a late diagnosis.

   

  If you've been diagnosed late your doctor may want you to start treatment straight away unless they need to treat any other conditions you have first.

   

  Treatment protects your immune system (even if it has been damaged) and if you are taking it and have an undetectable viral load you cannot pass on HIV.

• How do I keep healthy with HIV?

  In addition to complying with medication that is prescribed for you, it is important to look after your body. A healthy lifestyle can help prevent other potential health complications of HIV such as obesity, heart disease, and cancer as well as having a positive effect on your overall health. Maintaining a healthy lifestyle should be a long term goal of all people living with HIV.

   

  Smoking

  Stopping smoking can improve your health and reduce the risk of smoking-related illnesses whether you're HIV positive or not. However, smoking can be even more damaging to your health if you have HIV.

   

  Smoking has not been shown to make HIV progress any faster than in non-smokers; however, HIV positive smokers are at a higher risk of smoking related illnesses than HIV negative smokers, Readytostopsmoking.co.uk can offer you advice and support to quit smoking. For further information, see signposting at the end of this booklet.

   

  Exercise

  Regular exercise can offer many benefits to people that are HIV positive such as keeping the heart and immune system healthy, relieve stress, and improve fatigue and sleep. It's recommended 30 minutes of exercise 5 days a week will help keep the heart healthy and provide essential energy. However, it is important to start slowly and progress at a suitable level e.g. 30 minutes doesn't have to be one 30 minute session, it could be broken down into two 15 minute sessions. The Healthy Living Team offer a range of physical activity classes to suit all abilities including a variety of exercise classes, guided walks and activities for those with long term health conditions. For further information, see signposting at the end of this document.

   

  Drug and Alcohol

  Alcohol can damage your health if you drink more than the recommended guidelines. The damaging effects of alcohol most often relates to the amount of alcohol that is consumed, so the more you drink the more likely it is that it may be damaging your health. Some of the damaging effects include liver problems, high blood pressure, fertility problems and heart disease. Alcohol and drugs can lower inhibitions and make people likely to engage in risky   behaviour, including unprotected sex. Knowing the recommended guidelines may help to reduce the risk of alcohol on your health.

   

  Sex

  A HIV positive diagnosis does not mean that sex has to be a thing of the past. Many people who are HIV positive enjoy healthy sex lives, remember that if you’re on treatment and have an undetectable viral load, you can't pass on HIV.

   

  It is important to understand how to practice safer sex to help protect yourself and your partner(s) from other STIs as well as HIV.

   

  Sex with or without a HIV positive diagnosis carries risks such as sexually transmitted infections (STIs) and unintended pregnancy, so an effort should always be made to practice safer sex.

   

  If you are going to have sex, using external (or male) condoms or internal (or female) condoms correctly is a very effective way of preventing HIV, STIs and unplanned pregnancy.

  Sexual Health testing and Condoms by Post is a scheme that  allows people 16+ living in St Helens to access free sexual health  testing  and condoms that are delivered by post.

• How do I tell people I am living with HIV?

  After your diagnosis, one of the most difficult decisions you may make is about which people you choose to disclose your HIV diagnosis. You may be very open and honest about your diagnosis and do not feel under pressure to keep your diagnosis private. However, for many people, choosing the right person to tell can be difficult, but remember that it is a personal decision. Although you don't have to disclose your diagnosis to anyone, it is still advisable to tell someone you can trust so they can offer you support. You may also want to inform your past sexual partners so that they can get tested for HIV. As this proess may be challenging for some you may want to seek support form your HIV care providers or support agencies. 

   

  Current sexual partners

  Telling someone you are HIV positive can be a positive experience, but it is important to be prepared when you disclose your diagnosis to others, as reactions can differ. Some people may react badly if they do not know the facts around HIV, hopefully the facts in the transmission section may help dispel myths and offer reassurance. Be prepared for a variety of reactions, everyone will react differently and sometimes it may not be in the way you may have hoped. You may think about disclosing first to someone that may offer you emotional support when you disclose to others.

   

  Telling healthcare providers

  It is standard practice for us to inform your GP so that you get the best possible care. They cannot tell friends or family and only discuss your care with other health professionals. Please tell us if you have any  objection to this.

   

  Telling your employer

  You do not have to tell your employer that you are HIV positive unless stated otherwise e.g. some healthcare workers may be asked to disclose their HIV status. If you do decide to disclose your diagnosis then your employer may be able to make suitable adjustments for you e.g. allowing time off for hospital appointments. However, it is a personal decision whether to tell your employer and all the pros and cons should be considered.

   

  Life Insurance

  Another important note is that when applying for life insurance, you may be asked about your HIV status. If you lie about your diagnosis then your policy may be invallid.There are specialist insurane providers who are experienced in providing cover for people living with HIV. 

• What support can I access?

  Local support

  The Healthy Living Team's overall aim is to make significant, on-going contribution to the improvement of the physical and mental health, well-being and quality of life of the people of St. Helens. healthysthelens.co.uk

   

  The Smokefree St Helens service can offer you advice and support to quit smoking.

  CGL In St Helens, a free and confidential drug and alcohol service is provided by CGL (Change, Grow, Live), the service for adults

   

  HIV specific support local

  Sahir House support services are for people living with HIV in the Merseyside area.

   

  HIV specific support Nationwide

  Terrence Higgins Trust (THT) provides a My HIV webpage that offers advice and support for people living with HIV. Alternatively, you can receive direct support from THT direct on 0808 802 1221.

   

  George House Trust provides services to people living with, and affected by HIV ght.org.uk

   

  HIV I-base is a treatment activist group, providing timely and up to date information about HIV treatment to HIV positive people and to health care professionals.

• Does St Helens Sexual Health clinic specialise in HIV?

  The Sexual Health Clinic at St Helens Hospital has a team of dedicated nurses who run weekly nurse lead clinics offering monitoring, support and care of patients living with HIV.  Consultant clinics are held on a weekly basis for patients referred into our service or who are diagnosed within the service.  We liaise with maternity services for any pregnancies that we manage within our service.  We also have strong links with the Dermatology department and with The Royal Liverpool Hospital who often review our patients referred.

   

  How do I contact the HIV team?

  Sexual Health Clinic

  Lower Ground Floor

  St Helens Hospital

  WA9 3DA

  Email:  sthelens.clinic@nhs.net

  HIV nurses:                          01744 646 482 

  HIV Support worker:            07341 795 401

   

  What support do you offer HIV patients?

  We have a range of support available to our patients, Psychological support is available for our patients struggling with or coming to terms with their HIV diagnosis. We have a HIV support worker, working within the team. Sahir House also offer a wide range of services to individuals and families living with, or affected by HIV on Merseyside. Sahir house support service attend the clinic on a week offering one to one support for attending our clinics, who are living with and affected by HIV.

   

  What do I need to know about my HIV appointments

  Attending regular appointments is very important to ensure you stay healthy, it is also an opportunity for you to discuss any other medical or holistic support you may require for our service.  If you can’t attend your appointment you must telephone the service to reschedule.

   

  How do I get my HIV medication?

  Your clinical team will arrange for Sciencus ( a home care delivery provider) to manage, dispense and deliver your medication. It is your responsibility to inform the clinic as soon as you open your last bottle of medication (you must always have one months supply), this is to ensure that you never run or of medication. The HIV clinic does not keep a supply of HIV medication and all prescriptions go through Sciencus.

   

  I want to transfer my care to St Helens

  Any concerns regarding transferring your HIV care to the St. Helens service, please contact 01744 646 482, you will need to ask your current health care provider to email a copy of your notes to our secure email address sthelens.clinic@sthk.nhs.uk Once we have received your notes we will contact you to arrange an appointment.