What you need to know about HIV

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PULSE Clinic

PULSE Clinic

Established in Bangkok, PULSE Clinic is a gay-owned private clinic whose mission is to promote and provide excellence in standards of care and education in sexual wellbeing, HIV and related infections, and to actively engage in the formulation of public health policy and research, with the aim of reducing HIV disease burden worldwide.

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What are some of the basic things you need to know about HIV and AIDS? Take a look.

HIV stands for Human Immunodeficiency Virus and it is is a blood-borne virus that affects the immune system.

AIDS, or Acquired Immune Deficiency, is becoming less and less prevalent. It’s the name of a group of infections that a person can get if their immune system is severely damaged as a result of them not receiving effective HIV treatment.

HIV ≠ AIDS, and with treatment, HIV positive people can expect to live normal lives.

How to get It?

HIV is mainly passed on through cum and blood-to-blood contact with people who have the virus in their bodies.

High risk activities include:

– Barebacking (sex without condoms)

– Long sessions (more risk of damaging the lining of your anus or vagina)

– Fucking without lube (more risk of damage to the arse)

– Sharing injecting equipment

HIV is actually harder to pass on than you might think and four things need to be in place for transmission to occur:

– Exist – You or one of your partners actually have HIV

– Enough – There needs to be a lot of the virus in their body (i.e. they’re not on treatment)

– Exit – It needs to leave their body (through cuts, blood, precum, cum, and anal mucous in men)

– Entry – It actually needs to get into a negative person’s blood (through barebacking, cuts, abrasions, etc.)

Without just one of those four things and HIV transmission is not likely.

HIV dies pretty quickly once it leaves the body (unlike Hep C).

At least half of people in Thailand who know they have HIV are on treatment meaning the virus is suppressed or undetectable. These people cannot pass the virus to other people. (Ask them for undetectable viral load less than 20 copies, they will be showing you proudly. Be happy for them and their sex partners.) For this reason, the majority of new infections come from people fucking bareback who don’t know they have it or people who don’t get tested.

Symptoms

Some guys won’t have any symptoms for years; while others go through a seroconversion illness a few weeks after contracting HIV. The symptoms of this illness can include any or all of the following:

Flu-like symptoms, fever, rashes, sore throat, swollen glands, vomiting and diarrhoea. The seroconversion illness varies in severity and usually lasts a couple of weeks; afterwards, a person will recover and feel as healthy as they normally do.  If HIV isn’t tested for and treated, a person’s health will start to fail within the next decade. They might notice skin problems, stomach issues or oral thrush, but as their immune system becomes more damaged they are at risk of conditions like pneumonia, brain infections, and certain cancers. It’s important to say that this is very rare nowadays, and it can be easily avoided with regular HIV testing and treatment.

Management

HIV treatment has come a long way, with new breakthroughs happening every year. Medication is taken daily, often just one pill a day, and includes a combination of three different antiretroviral drugs that control the virus in different ways.

See a doctor every 6 months for regular check up to make sure everything is perfect. Today, most people with HIV will experience no short or long-term side effects from their HIV treatment.

Read more about HIV treatment here.

A newly diagnosed guy can expect to start treatment early, even on the same day as your doctor’s visit. The treatment usually suppresses their viral load (the amount of virus in their body) to undetectable levels (UVL), meaning they will live a long and healthy life and be very unlikely to transmit the virus to others. Treating early is recommended. The START study has shown that the earlier treatment is initiated, the better your long term health outcomes are.

Undetectable

When a HIV positive guy is taking treatment (“antiretroviral therapy” or “ART” for short) the amount of HIV in his body (known as his ‘viral load’) can be reduced to a level that is ‘undetectable’. This means the treatment has suppressed the virus from replicating, making it almost impossible to be passed on if you’re barebacking or into higher risk play. It also means HIV is not multiplying and so it reduces harm to your body. The studies that back up this information show this is true as long as a person’s meds are taken daily and after they have had an undetectable or suppressed viral load for 6 months or more.

Want to know more on what an undetectable viral loads (UVL) means? Have a look here.

Reducing risk

Sexually adventurous men make up 35% of all new HIV diagnoses but it can be easy to avoid getting infected or passing it on, if we use some form of protection:

1. Undetectable viral loads in HIV positive guys on treatment are proven to make transmission almost impossible

2. PrEP, when taken daily by negative guys, is proven to make transmission almost impossible

3. PEP, taken 72 hours after a possible infection can help prevent catching  HIV after a potential exposure

4. Condoms stop cum with HIV in it getting into your body

5. Lube reduces the chances of damage to the lining of your anus

6. Matching HIV statuses to only barebacking with guys with the same status as you can lower your risk (remember any current test result is only accurate for your status three months ago)

7. Strategic positioning means a HIV negative guy only topping a UVL positive guy bareback (it reduces your risk, but not by much)

8. Relationship agreements could be put in place, such as a couple deciding to only fuck raw with each other and use condoms with everybody else

9. Pulling out before you cum reduces risk, but not by much – precum and anal mucous can contain high levels of HIV is the person’s not on treatment

10. Using your own, clean injecting equipment, not sharing, and using a new fit each time

Knowing your status

The more you have sex, the more you need to test. For sexually adventurous men, it’s best to test every three months for HIV. A small sample of blood is taken and the doctor or nurse will probably do a syphilis test at the same time.

In Asia, some clinics offer a rapid finger prick test as well. The results of these are delivered back to you within 20 minutes. This test has a high sensitivity, high specificity and high accuracy.

HIV and Other STIs

Having an STI like syphilis, chlamydia or gonorrhoea in your genitals or throat can make it easier to pick up HIV.

Most infections in the throat and in the ass don’t show symptoms. You only know if you have an infection by getting an easy and painless throat swab and butt swab, which will look for DNA of all bacteria and viruses. Most clinics will offer these swabs.

STIs can cause inflammation of that area which increases the risk of the virus entering the body and getting  into your blood.

If you’re positive and not on treatment, having another STI can cause a spike in your viral load, making it easier to transmit the virus to someone else. If you have UVL, a spike is unlikely.

Most positive guys get an STI check-up at least every time they get their bloods taken by their doctor; it’s a nice, easy way of staying on top of your health and look after your sexual partners.

HIV and Hep C

If you’re HIV positive, Hep C can cause damage to your liver faster  than in someone without HIV and have higher concentrations in your blood and cum.

Having an HIV and Hep C co-infection doesn’t mean that you can’t treat both viruses, but your doctor may have to consider which medications are best for you to take. This could mean switching your HIV treatment to a combination that is proven to be less harmful to your liver. You should always talk to your doctor about this.

Check with your doctor before taking herbal supplements, like St Johns Wort, as they can have an adverse reaction combined with your treatment.

Hep C and HIV may both be treated with a class of drug called protease inhibitors and these can make taking party drugs like Ice, MDMA and Cocaine much more dangerous. The protease inhibitor affects your kidneys and liver, so the other drugs aren’t flushed out as usual; instead they build up in the body to dangerously high levels.

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