Prevention for Positives
Why is prevention for positives important? What does it matter if the other person already has HIV?Prevention for positives helps people living with HIV to avoid becoming infected with other illnesses (co-infections), especially sexually transmitted diseases (STDs). These other illnesses may put a strain on the immune system, especially if it is weaker because of HIV. In addition, HIV+ people can get infected with another strain of HIV that may be different from the strain they already have. Certain "mutations" (genetic changes) in HIV can make it resistant to some HIV medications. These drug-resistance mutations can be transmitted from one HIV+ person to another. Why does this matter? Because some HIV treatments might not work even before a person has taken them. Prevention for positives is also very important to slow the spread of new HIV infections.
Is prevention for positives only about sexual behavior?No. Prevention for positives focuses on two main areas: 1) sexual behavior and 2) injection drug use. However, HIV+ individuals should practice general prevention for all illnesses including chronic (long-lasting) diseases, such as diabetes and hypertension, and acute (lasting for a short time) illnesses such as the flu or chicken pox -- just like HIV-negative people. It is important for people with HIV to be aware that any health/prevention messages for the general public may be extra important for themselves because of the status of their immune system.
What actions should an HIV+ person NOT take?
How can an HIV+ person make sex "safer"?Research studies have shown that viral load plays a part in how likely a person will transmit HIV to someone else through sex. An HIV+ person can also reduce transmission risk by keeping her or his viral load as low as possible through the use of HIV medications. But, other research studies have shown that the viral load found in the blood can often be different from the viral load that is in the genital tract and fluids. Often, the viral load in the genital tract can actually be higher than that found in the blood, which is where HIV viral load is usually measured. Therefore, it is still important that a person with HIV always practice safe sex with his or her partner(s). Low or "undetectable" viral load is just another layer of protecting sexual partners by reducing risk of transmission.
Sexual contact with another person can be made safer in the following ways:
How can an HIV+ person make using drugs "safer"?An HIV+ person can make using drugs safer by doing the following:
What are barriers to prevention for HIV+ people?The following are major barriers to prevention for HIV+ people:
What if my HIV-negative partner is accidentally exposed to my HIV?In 2005, the Centers for Disease Control and Prevention (CDC) recommended that "post-exposure prophylaxis" or PEP be offered to individuals who have been accidentally exposed to HIV in non-work-related situations. (PEP for work-related exposures, such as a needle-stick injury in a healthcare worker, has been recommended for several years).
PEP is simply HIV therapy taken by an HIV-negative person who has been exposed to HIV. If taken soon enough, PEP may prevent that person from getting HIV. PEP requires that a person start taking HIV medications within 72 hours (3 days) after the possible exposure to HIV. A person on PEP must take 2 or 3 HIV medications for at least 1 month. These HIV medications often have side effects that might make it difficult to continue therapy. However, a person should always check with his or her healthcare provider before stopping PEP therapy.
To get PEP, it is probably easiest for a person to visit his or her local emergency center, however some clinics or healthcare providers are now also offering PEP.
This article was provided by The Center for AIDS. Visit CFA's website to find out more about their activities and publications.