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HIV (Human Immunodeficiency Virus) is a virus that attacks and breaks down the body's immune system -- the "internal defense force" that fights off infections and disease. When the immune system becomes weak, we lose our protection against illness and can develop serious, often life-threatening, infections and cancers.
AIDS (Acquired Immune Deficiency Syndrome) is the name for the condition that people with HIV have if they develop one of the serious infections connected with HIV, or if blood tests show that their immune system has been very badly damaged by the virus.
It usually takes many years before HIV breaks down a person's immune system and causes AIDS. Most people have few, if any, symptoms for several years after they are infected. But once HIV gets into the body, it can do serious damage to the immune system. People who appear perfectly healthy may have the virus, without knowing it, and pass it on to others.
People who have HIV can give it to others when certain of their body fluids (blood, semen ["cum"], vaginal fluids, or breast milk [for infants only] pass into another person's body. There are three main ways that our body fluids can get into another person's body:
Kissing, mutual masturbation, and getting another person's semen/cum or vaginal fluids on your skin do not spread HIV. The HIV virus cannot enter through the skin unless there is a fresh break in the skin. There is no scientific evidence that HIV is passed through saliva, tears, or sweat.
There is absolutely no danger from casual contact with people with HIV. HIV cannot live outside of the human body, so you cannot be infected from toilet seats, phones, or water fountains. The virus cannot be transmitted in the air through sneezing or coughing. You cannot get it from mosquitoes or other insect or animal bites. Living with an HIV-infected person does not put you at risk, unless you have unprotected sex or share needles with him or her.
Blood transfusions and medical procedures in the U.S. are safe. Giving blood is completely risk-free. And although there have been some cases of HIV through blood transfusions in the past, tests have been in place for several years to make sure that the blood you get in the hospital has no HIV.
Anyone can get HIV -- young and old, men and women, straight, gay and bisexual, rich and poor, and all racial and ethnic groups -- but not everyone faces the same risk. Your risk comes from what you do, and who you do it with -- that is, how likely it is that the person you have sex or share needles with is infected. But even if you are part of a community with a high infection rate, you can avoid getting HIV. Staying uninfected takes thinking, planning and follow-through. Often it means talking about things that may make you uncomfortable. It can help to "practice" talking with people you can trust or who are going through the same thing.
In the age of HIV/AIDS, most kinds of sex involve some level of risk. Instead of labeling every form of sexual expression as "safe" and "unsafe," it's more realistic to think of sex as a range of risks, from less risky to more risky. Sex is also something you have with another person, so you might want to think about how you make decisions with a partner. Think about what you find pleasurable about sex, where, and with whom. Consider what risks are involved, and whether those will worry you later. Then try to think about how you might lower the risks while holding on to the pleasure. Some people have decided not to have sex with people they don't know well, or made certain kinds of sex off limits. Some have reduced the number of their sexual partners. Only you can decide what risks are worth taking and what risks are not.
Clean needles and bleach. Using a new, clean needle is by far the best protection against the virus if you are shooting drugs. Some states, including New York, have needle exchange programs (where you can get free, clean needles) or needles for sale in drugstores. If you do not get your set brand-new and sealed from a needle exchange or pharmacy, clean it before you use it.
Latex condoms ("rubbers") prevent HIV infection. Using a condom may not always be easy, but it can save your life or someone else's. When used right, condoms seldom break, tear, or slip. You can also use a dry condom, or a flavored one, for oral sex, or cut a condom to the center and open it up to use for oral-anal or oral-vaginal sex. Never re-use a condom.
Plastic wrap and dental dams stop HIV when used for oral sex on a woman or for oral-anal sex. Dental dams are latex squares available in medical supply stores and from some adult shops. Some people find it easier to use a large sheet of plastic wrap. Be sure the dam or plastic wrap covers the entire vulva (clitoris and vaginal opening) and that you hold it at both edges. Be careful not to turn the dam or plastic wrap inside-out while you use it.
The "female condom" is a plastic sheath that women can insert in their vaginas and use for protection against HIV. The female condom can be inserted up to 8 hours before sex, has rings at both ends to hold it in place, and can be lubricated with oil-based lubricants that stay wet longer. This kind of condom takes practice to use, and is more expensive than a latex condom. Some men have also used the female condom for anal sex, though it has not been tested or approved for this use.
It can be scary to consider, but taking the HIV test is one of the best ways to stay healthy. Finding out that you have HIV can be an important step toward taking care of your health and planning for the future. Learning that you are HIV negative, too, can help you to figure out how to stay that way. It is most helpful to take the test in a situation where the test is voluntary, anonymous, or confidential, and where counseling is offered before and after the test.
Standard HIV tests look for HIV antibodies, which are cells the body makes after HIV enters the blood. It can take up to three months to make enough antibodies so that they will show up on the test, although in most cases, infection can be detected in four weeks. If an infected person tests too soon during this "window period", the HIV test may not find infection, but the person can infect others. There are different kinds of blood tests, including a new test that can give you quicker results and an oral test that looks for HIV antibodies in the mucosal fluid in your mouth. (See our Testing section for more information.)
In many states, public clinics offer a free, anonymous test, which means they do not take your name. Private clinics, including the Geffen Center at GMHC, and doctors also give the test, and they can promise to keep your name "confidential" or allow you to use a name without showing identification. "Confidential" means that while they are required to tell their local health departments the names of all persons who test HIV-positive, they will not otherwise release your name without your consent. Some clinics and "home tests" offer "immediate results," but be warned -- that's only if you are HIV-negative. To confirm that you have HIV, your blood has to be drawn for another test. (See our Testing section for more information.)
People with HIV or AIDS can do a number of things to stay healthy, which is why it's important to know your status. Although there is no treatment that cures HIV, drugs are now available that can prevent AIDS-related pneumonia and other serious diseases; other medications help the body fight the virus itself. However, many of these drugs may have unintended, harmful side-effects. Talk with your doctor or call the GMHC Hotline to discuss your options. (See our Treatment section for more information.)
It is against federal law to discriminate against people who have disabilities, including people with HIV/AIDS. That means it is illegal for people to discriminate concerning jobs, housing, medical care, and in most businesses that are open to the public. Many states and cities have other specific protections against discrimination, as well as laws that prevent your doctor or your employer from telling people that you have HIV. If you feel you have been discriminated against based on your HIV status, call the GMHC Legal Department at 212-367-1040.
GMHC is here to give support and information to people who have HIV/AIDS, to people who are at risk, and to people who just want to understand the issues. If you want more information, or want to talk to someone about your concerns, call GMHC's Hotline at 1-800-AIDS-NYC.