How to manage HIV/AIDS, STDS

The origin of the HIV/AIDS, what began as an unknown illness could be traced to Kinshasa, in the Democratic Republic of Congo around 1920 when HIV crossed species from chimpanzees to humans. Since then, the world has been in search of a lasting solution to the spread of the virus.

HIV (which stands for Human Immunodeficiency Virus) is the virus that leads to Acquired Immunodeficiency Syndrome (AIDS) initially comes without symptoms until the late stages.

Although the Federal Government had earlier designed a blueprint to bridge the gap of mother-to-child-transmission (MTCT) of HIV by 2015, it appears the target could not be met, as the 70th UN General Assembly, held in September, 2015 has set 2030 target for global elimination of HIV/AIDS, while Nigeria has been commended for making remarkable strides, leading to a steady decline in HIV prevalence from 2001.

As Nigeria joins the rest of the globe in commemorating World AIDS Day on December 1, with the theme for this year being “Getting to Zero”, stakeholders have called on government to take ownership of the HIV/AIDS management programme which has been funded by foreign partners and donors, adding that this will accelerate the attainment of the set goal.

According to the Principal Investigator, FMC Markudi, Dr Jonah Abah: “Laboratory services and drugs are no longer being paid for by partners in the last two years, hence the cost of rendering services are no longer free.” He explained that the incentives usually given to clients and transportation for indigent clients are no longer forthcoming.

Mr Silas Gurumdi, of the Institute of Human Virology, also called on government to own the HIV/AIDS management programme in Nigeria; stressing that “that is the only way to bridge the funding gap.”

Records have it that as at the end of 2013, the country had 3.2 million persons living with HIV/AIDS, with a prevalence rate of 3.2 per cent. Going by these figures, Nigeria has the second largest burden of HIV in the world; second to South Africa.

Also, existing data reveals that 747,382 persons are on Antiretroviral Therapy (ART) as at the end of 2014. A NACA (National Agency for the Control of AIDS) report had it that Mother to Child Transmission was responsible for a large population of new HIV infections, which is estimated to be 27.3 per cent. Women constitute 58 per cent of the population of People Living with HIV (PLWH).

On the way forward, Ms Taiwo Kikelomo , a New York based HIV/AIDS international advocate, who is also an anti-stigma campaigner, suggested that “the quality of services certainly needs to be improved in the area of availability of ARVs, quality of ARVs provided, cost of other HIV related testing for PLWH who are of low income, attitude of health providers, remuneration of health providers, and provision of adequate infrastructures would assist the nation a great deal in reducing and subsequently eradicating HIV, especially that of mother-to-child transmission.

“    Beyond what the government needs to do in terms of creating policies and programmes and enforcing laws, Nigerians themselves need to become more enlightened. A lot of people do not understand the relationship between the person and the virus. More sensitisation and awareness still need to be done.

“They know HIV is a virus in the blood but they can’t comprehend living with someone who is HIV positive. What is partly responsible for this, is the image the media often portrays of people living with HIV. I must say that the media has a strong role to play in portraying the individual who is HIV positive in a positive way and not what it used to be- an individual looking skinny, with rashes and who is about to die.

“    Nigerians also need to know that the virus doesn’t kill as fast as stigma does. Let’s show love and support for People Living With HIV. Another key thing is this, PLWH should be inspired to live life to the fullest. Being positive doesn’t mean you are incapacitated. You can work and have a normal life like everyone else. What makes us as individuals is not the virus in our blood or the colour of our skin or the amount of material wealth that we have but the state of our heart and our ability to treat others with respect and dignity, she said.

 

How does hiv cause illness?

HIV attacks and destroys a type of white blood cell called a CD4 cell, commonly called the T-cell. This cell’s main function is to fight disease. When a person’s CD4 cell count gets low, they are more susceptible to illnesses.

 

How do people get hiv?

A person gets HIV when an infected person’s body fluids (blood, semen, fluids from the vagina or breast milk) enter his or her bloodstream. The virus can enter the blood through linings in the mouth, anus, or sex organs (the penis and vagina), or through broken skin.

Both men and women can spread HIV. A person with HIV can feel normal and still give the virus to others. Pregnant women with HIV also can give the virus to their babies.

 

Who can get hiv?

Anyone can get HIV if they engage in certain activities. You may have a higher risk of getting HIV if you:

• Have unprotected sex. This means vaginal or anal intercourse without a condom or oral sex without a latex barrier with a person infected with HIV.
• Share needles to inject drugs or steroids with an infected person. The disease can also be transmitted by dirty needles used to make a tattoo or in body piercing.
• Receive a blood transfusion from an infected person. This is very unlikely in the U.S. and Western Europe, where all blood is tested for HIV infection.
• Are born to a mother with HIV infection. A baby can also get HIV from the breast milk of an infected woman.

If you fall into any of the categories above, you should consider being tested for HIV.

 

You cannot get HIV from:

• Touching or hugging someone who has HIV/AIDS
• Public bathrooms or swimming pools
• Sharing cups, utensils, or telephones with someone who has HIV/AIDS

 

Health care workers are at risk on the job and should take special precautions. Some health care workers have become infected after being stuck with needles containing HIV-infected blood, or less frequently, after infected blood comes into contact with an open cut or through splashes into the worker’s eyes or inside his or her nose.

 

HIV tests

The only way to know if you have HIV is to take an HIV test. Most tests looks for signs of HIV in your blood. A small sample of blood is taken from your arm. The blood is sent to a lab and tested for HIV.

Clinics that do HIV tests keep your test results secret. Some clinics even perform HIV tests without ever taking your name (anonymous testing). You must go back to the clinic to get your results. A positive test means that you have HIV. A negative test means that no signs of HIV were found in your blood.

 

Before taking an HIV test:

• Ask the clinic what privacy rules it follows.
• Think about how knowing you have HIV would change your life.
• Ask your doctor or nurse any questions you have about HIV, AIDS, or the HIV test.

 

What are the symptoms of HIV?

Some people develop HIV symptoms shortly after being infected. But it usually takes more than 10 years.

There are several stages of HIV disease. The first HIV symptoms may include swollen glands in the throat, armpit, or groin. Other early HIV symptoms include slight fever, headaches, fatigue, and muscle aches. These symptoms may last for only a few weeks. Then there are usually no HIV symptoms for many years. That is why it can be hard to know if you have HIV.

 

AIDS symptoms appear in the most advanced stage of HIV disease. In addition to a badly damaged immune system, a person with AIDS may also have

• thrush — a thick, whitish coating of the tongue or mouth that is caused by a yeast infection and sometimes accompanied by a sore throat
• severe or recurring vaginal yeast infections
• chronic pelvic inflammatory disease
• severe and frequent infections
• periods of extreme and unexplained tiredness that may be combined with headaches, lightheadedness, and/or dizziness
• quick loss of more than 10 pounds of weight that is not due to increased physical exercise or dieting
• bruising more easily than normal
• long periods of frequent diarrhoea
• frequent fevers and/or night sweats
• swelling or hardening of glands located in the throat, armpit, or groin
• periods of persistent, deep, dry coughing
• increasing shortness of breath
• the appearance of discoloured or purplish growths on the skin or inside the mouth
• unexplained bleeding from growths on the skin, from the mouth, nose, anus, or vagina, or from any opening in the body
• frequent or unusual skin rashes
• severe numbness or pain in the hands or feet, the loss of muscle control and reflex, paralysis, or loss of muscular strength
• confusion, personality change, or decreased mental abilities

 

What infections do people with AIDS get?

People with AIDS are extremely vulnerable to infection, called AIDS-defining illnesses, and often exhibit the following conditions:

• Kaposi’s sarcoma, a skin tumour that looks like dark or purple blotches on the skin or in the mouth
• Mental changes and headaches caused by fungal infections or tumors in the brain and spinal cord
• Shortness of breath and difficulty breathing because of infections of the lungs
• Dementia
• Severe malnutrition
• Chronic diarrhoea

 

How is AIDS diagnosed?

If a person with HIV infection has a CD4 count that drops below 200 – or if certain infections appear (AIDS-defining illnesses) – that person is considered to have AIDS.

 

How is HIV treated?

We’ve come a long way from the days when diagnosis with HIV equalled a death sentence. Today, there are a variety of treatments that, when used in combination can significantly slow down and, in some cases, stop altogether, the progression of HIV infection.

After HIV infection is confirmed, your doctor will start you on a drug regimen, consisting of several drugs. Combinations of different types of anti-HIV drugs sometimes are called HAART, for highly-active antiretroviral therapy (HIV is a kind of virus called a retrovirus).

Taking HAART therapy is very manageable yet isn’t necessarily easy. These drugs must be taken at the right time, every single day. Also, a range of side effects may occur, including: diarrhoea, nausea, rash, vivid dreams, or abnormal distribution of body fat. And, especially if medications are taken incorrectly or inconsistently, the virus can mutate, or change, into a strain resistant to treatment. The good news is that there are now several HIV medications that are only taken once a day. If there is resistant virus, however, these may not work and other medication options must be used.

If your disease has progressed to AIDS, your treatment may also include drugs to combat and prevent certain infections.

 

How do I know if the HIV treatments are working?

Your doctor can monitor how well your HIV treatment is working by measuring the amount of HIV in your blood (also called the viral load.) The goal of treatment is to get the viral load undetectable on labs tests; ideally less than 20 copies. This does not mean the virus is gone or cured, it means the medication is working and must be continued.

 

How can i protect myself from getting HIV?

The best way to protect yourself from HIV is to avoid activities that put you at risk. There’s no way to tell by looking at someone if he or she has HIV. Always protect yourself.

• Use latex condoms (rubbers) whenever you have any type of sex (vaginal, anal, or oral).
• Don’t use condoms made from animal products.
• Use water-based lubricants. Oil-based lubricants can weaken condoms.
• Never share needles to take drugs.
• Avoid getting drunk or high. People who are drunk or high may be less likely to protect themselves.

 

How can i prevent hiv from progressing to AIDS?

You can help prolong your life by taking good care of yourself and developing a good relationship with an experienced doctor specialising in HIV and AIDS. Also, be consistent about taking your HIV medications as prescribed and getting regular lab work to catch any problems early.

 

What is the outlook for someone with HIV or AIDS?

It depends on if that person is on treatment and how the virus responds to early treatment. When treatment fails to decrease the replication of the virus, the effects can become life threatening, and the infection can progress to AIDS.

Even with treatment, some people seem to naturally experience a more rapid course towards AIDS. However, the majority of HIV patients who receive appropriate treatment do well and live healthy lives for years.

 

Is there a cure for HIV/AIDS?

There is currently no cure for HIV/AIDS. But there are treatments for people living with HIV/AIDS.

If you have HIV/AIDS, you can take combinations of medicines called “cocktails.” The drug cocktails are designed to strengthen the immune system to keep HIV from developing into AIDS or to relieve AIDS symptoms. These drugs are often very expensive, may have serious and very uncomfortable side effects, and may not be available to everyone. They only work for some people and may only work for limited periods of time.

But thanks to “cocktails” for the immune system and improved therapies for the symptoms of AIDS, people are now able to live with HIV/AIDS for many years. New treatments and research may help people live even longer.

 

Safer Sex and HIV

Some kinds of sex play are “safer” because they have lower risk of infection than others. “Safer-sex” activities are those we choose to lower our risk of exchanging blood, semen, or vaginal fluids — the body fluids most likely to spread HIV. Each of us must decide what risks we will take for sexual pleasure.

Here are some common sexual behaviours grouped according to risk.

 

HIGH RISK —

Millions of reported HIV infections due to these behaviours

• vaginal intercourse without a condom
• anal intercourse without a condom

Talk with your health care provider about testing and treatment for STDs. Women and men with open sores from herpes and other infections get HIV more easily than other people.

 

Where can I get a test for HIV?

Tests are available from most physicians, hospitals, and health clinics. Local, state, and federal health departments offer free testing. You can also buy an HIV home test kit.

 

Should I be tested?

HIV tests are a normal part of health care. If you think you may have been exposed to HIV, talk with a health care provider about testing. Talking about what risks you’ve taken can help you decide whether testing is right for you.

 

What If I have HIV/AIDS?

• Consult a health care provider who has experience treating HIV/AIDS.
• Inform sex partner(s) who may also be infected.
• Protect your sex partner(s) from HIV by following safer sex guidelines.
• Do not share needles or “works.”
• Get psychological support with a therapist and/or join a support group for people with HIV/AIDS.
• Get information and social and legal support from an HIV/AIDS service organisation.
• Don’t share your HIV status with people who do not need to know. People with HIV may still face discrimination. Only tell people you can count on for support.

Maintain a strong immune system with regular medical checkups and a healthy lifestyle:

• Eat well.
• Get enough rest and exercise.
• Avoid illegal or recreational drugs, including alcohol and tobacco.
• Learn how to manage stress effectively.

Consider using medicines that may slow the progress of the infection.

 

What If I have HIV/AIDS and I’m Pregnant?

If you have HIV and are pregnant, consult a health care provider who knows about HIV disease. Without treatment, about 25 out of 100 babies born to women with HIV are also infected. However, the use of HIV medicines, cesarean delivery, and refraining from breastfeeding can reduce the risk of transmission to less than 2 out of 100.

 

What’s PrEP and how does it prevent HIV?

PrEP (Pre-Exposure Prophylaxis) is a way to help prevent HIV by taking a pill every day. It reduces your risk of getting infected. When PrEP is combined with condoms and other prevention methods it works even better. PrEP may not work if you skip doses. Even if used correctly, there’s no guarantee that PrEP will work.

PrEP is only used for people who are at very high risk for HIV through sex or IV drug use. PrEP might be right for you if

• your partner is HIV-positive
• your partner is HIV-negative and either you or your partner has sex with someone whose HIV status isn’t known
• you’re a gay or bisexual man who has had anal sex without a condom or been told you have an STD in the past 6 months
• you’re a heterosexual man or woman who doesn’t use condoms every time you have sex with people who inject drugs or have bisexual male partners
• you have injected drugs in the past 6 months and have shared needles or been in drug treatment for IV drug use in the past 6 months.

Talk with your doctor or nurse about whether or not PrEP might be good for you. They can tell you more about how it works and what you can expect while taking it.

 

What’s PEP and how does it prevent HIV?

PEP (Post Exposure Prophylasis) is a way to prevent HIV after being exposed to it. With PEP, you take anti-HIV medicines as soon as possible after you may have been exposed to HIV to try to reduce your chance of becoming HIV positive. This could happen because of a sexual assault, or having unprotected sex with someone who has HIV, or sharing needles with someone who has HIV.

One or more medicines are taken several times a day for at least 28 days. The medicines work by keeping HIV from spreading through your body. Even if taken correctly, there’s no guarantee that taking PEP will work.

It should only be used rarely, right after a possible exposure. Your doctor or nurse will help decide if PEP is right for you, depending on what happened, when it happened, and what you know about the HIV status of the person whose blood or body fluids you were exposed to.

 

What are STDs?

STDs are sexually transmitted diseases. This means they are most often – but not exclusively – spread by sexual intercourse. HIV, chlamydia, genital herpes, genital warts, gonorrhoea, some forms of hepatitis, syphilis, and trichomoniasis are STDs.

STDs used to be called venereal diseases or VD. They are among the most common contagious diseases. STDs are serious illnesses that require treatment. Some STDs, such as HIV, cannot be cured and can be deadly. By learning more about STDs, you can learn ways to protect yourself.

You can get a STD from vaginal, anal, or oral sex. You can also be infected with trichomoniasis through contact with damp or moist objects such as towels, wet clothing, or toilet seats, although it is more commonly spread by sexual contact. You are at high risk if:

• You have more than one sex partner
• You have sex with someone who has had many partners
• You don’t use a condom when having sex
• You share needles when injecting intravenous drugs
• You trade sex for money or drugs

HIV and herpes are chronic conditions that can be managed but not cured. Hepatitis B also may become chronic but can be managed. You may not realise you have certain STDs until you have damaged your reproductive organs (rendering you infertile), your vision, your heart, or other organs. Having an STD may weaken the immune system, leaving you more vulnerable to other infections. Pelvic inflammatory disease (PID) is a complication of gonorrhoea and chlamydia that can leave women unable to have children. It can even kill you. If you pass an STD to your newborn child, the baby may suffer permanent harm or death.

 

What causes STDs?

STDs include just about every kind of infection. Bacterial STDs include chlamydia, gonorrhoea, and syphilis. Viral STDs include HIV, genital herpes, genital warts (HPV), and hepatitis B. Trichomoniasis is caused by a parasite.

The germs that cause STDs hide in semen, blood, vaginal secretions, and sometimes saliva. Most of the organisms are spread by vaginal, anal, or oral sex, but some, such as those that cause genital herpes and genital warts, may be spread through skin contact. You can get hepatitis B by sharing personal items, such as toothbrushes or razors, with someone who has it.

 

What are the symptoms of STDs?

Sometimes, there are no symptoms of STDs. If symptoms are present, they may include one or more of the following:

• Bumps, sores, or warts near the mouth, anus, penis, or vagina.
• Swelling or redness near the penis or vagina.
• Skin rash.
• Painful urination.
• Weight loss, loose stools, night sweats.
• Aches, pains, fever, and chills.
• Yellowing of the skin (jaundice).
• Discharge from the penis or vagina. Vaginal discharge may have an odor.
• Bleeding from the vagina other than during a monthly period.
• Painful sex.
• Severe itching near the penis or vagina.

 

Can STDs be passed on to a baby?

During early prenatal care, most women undergo tests to determine whether or not they have any STDs. Some STDs can be transmitted to the foetus during pregnancy and others may be transmitted during the birth process if a woman has a STD at that time. If you suspect that a partner is having sex with others, talk with your doctor about your risks for STDs and how to reduce the chances of passing them to your baby.

 

Can I still get pregnant in the future, if I’ve had an STD?

Chlamydia can impair a woman’s ability to become pregnant. This is especially true if she has the infection for a long time or multiple times and her reproductive organs become damaged. Other STDs can also lead to infertility if they are left untreated. If Chlamydia or any other STD is treated early, it is less likely that it will affect your ability to get pregnant later on. This is one of the reasons it is important to get tested for STDs on a regular basis and get any infection treated as soon as possible.

However, having a STD does not automatically cause infertility, so anyone wishing to avoid pregnancy should use reliable birth control even if they’ve had an STD in the past.

 

Can I get an STD from a toilet seat?

No. STDs/STIs are transmitted from one infected person to another during vaginal, anal or oral sex or through intimate sexual contact (i.e., hand jobs, genital-to-genital contact without penetration, etc.) The only other way that STDs can be transmitted is from an infected pregnant woman to her foetus or baby during childbirth. Some infections, such as Hepatitis B and HIV are sexually transmitted but can also be transmitted from an infected person to another through direct blood-to-blood contact (i.e. sharing an intravenous needle). To learn more about specific STDs and how they are spread, check out our Uncovering STDs tool.

 

What should I do if I think I have an STD?

First off, don’t panic. You should go see a medical provider and get tested right away. It’s also a good idea to hold off on having sexual contact with anyone until you know for sure what is going on and whether or not you have a STD.

People with multiple sexual partners, those who think they may have been exposed, those who’ve had unprotected sex with a partner whose health status was unknown, or anyone who has symptoms of an STD should definitely get tested. It’s the first crucial step on the road to proper treatment.

 

How do I know if I have an STD?

Talk to your doctor. He or she can examine you and perform tests to determine if you have an STD. Treatment can:

• Cure many STDs
• Lessen the symptoms of STDs
• Make it less likely that you will spread the disease
• Help you to get healthy and stay healthy

 

How are STDs treated?

Many STDs are treated with antibiotics.

If you are given an antibiotic to treat an STD, it’s important that you take the entire drug, even if the symptoms go away. Also, never take someone else’s medicine to treat your illness. By doing so, you may make it more difficult to diagnose and treat the infection. Likewise, you should not share your medicine with others. Some doctors, however, may provide additional antibiotics to be given to your partner so that you can be treated at the same time.

 

How can I protect myself from STDs?

Here are some basic steps that you can take to protect yourself from STDs:

• Consider that not having sex or sexual relations (abstinence) is the only sure way to prevent STDs.
• Use a latex condom every time you have sex. (If you use a lubricant, make sure it is water-based.)
• Limit your number of sexual partners. The more partners you have, the more likely you are to catch an STD.
• Practice monogamy. This means having sex with only one person. That person must also have sex with only you to reduce your risk.
• Choose your sex partners with care. Don’t have sex with someone whom you suspect may have an STD. And keep in mind that you can’t always tell by looking if your partner has an STD.
• Get checked for STDs. Don’t risk giving the infection to someone else.
• Don’t use alcohol or drugs before you have sex. You may be less likely to use a condom if you are drunk or high.
• Know the signs and symptoms of STDs. Look for them in yourself and your sex partners.
• Learn about STDs. The more you know, the better you can protect yourself.

How can I avoid spreading an STD?

• If you have an STD, stop having sex until you see a doctor and are treated.
• Follow your doctor’s instructions for treatment.
• Use condoms whenever you have sex, especially with new partners.
• Don’t resume having sex unless your doctor says it’s okay.
• Return to your doctor to get rechecked.
• Be sure your sex partner or partners also are treated.

 

Reports compiled by Temitope Obayendo with additional materials from: Planned Parenthood Organisation, WebMD Medical Reference; nigeriahivinfo.com and Premium Times.