HIV

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OVERVIEW

What is HIV?

The human immunodeficiency virus (HIV) attacks the body’s immune system. A healthy immune system is what keeps you from getting sick.

When HIV damages your immune system, you are more likely to get sick from bacteria, fungi, and viruses. It is also harder for your body to fight off these infections when you do get them, so you may have trouble getting better.

AIDS (acquired immunodeficiency syndrome) is the term used when persons have advanced HIV disease. This increases your risk for infections and other serious HIV-associated conditions.

SYMPTOMS

When first infected with HIV, a person may not experience any symptoms. However, often a person will develop flu-like symptoms. These include:

  • Fever
  • Headache
  • Fatigue
  • Swollen lymph nodes (lymph glands)
  • Sore throat
  • Rash

As the disease progresses, symptoms may appear and/or get worse. This may take time. Some people who have HIV do not begin experiencing symptoms for up to 10 years. When symptoms do appear, they can include:

  • Swollen lymph nodes (lymph glands)
  • Diarrhea
  • Fever
  • Cough
  • Shortness of breath
  • Unintended weight loss

CAUSES & RISK FACTORS

HIV can only be passed from person to person through infectious body fluids, such as blood, semen and vaginal fluid.

Children born to people with HIV can also acquire HIV during pregnancy, delivery, and breastfeeding. However, this happens less often now. It can be prevented by giving medicines to the pregnant person and to their newborn baby.

The most common ways HIV is passed are:

  • By having unprotected (without using a condom) anal, vaginal or oral sex with a person who has HIV
  • By sharing drug-use equipment (needles or syringes) for injecting drugs with a person who has HIV

A person is more at risk for HIV if they:

  • Have multiple sex partners
  • Have sex with a person who trades sex for money or other items
  • Share needles using illegal injected drugs
  • Exchange sex for drugs or money
  • Have a sexually transmitted infection
  • Currently have or did have a sexual partner with any of the above risk factors.
  • Are a man who has sex with other men

PREVENTION

The best way to prevent HIV is to not have sex (vaginal, anal, or oral) with a person who has HIV, or share a needle with a person who has HIV.

Other ways to prevent HIV include:

  • When you have sex, practice “safer” sex by using a condom. The best condom is a male latex condom. A female condom is not as effective but does offer some protection.
  • Do not share needles and syringes

PrEP

According to CATIE (the Canadian AIDS Treatment Information Exchange):

Oral pre-exposure prophylaxis, or PrEP, is a way for an HIV-negative person who is at risk of HIV infection to reduce their risk of getting HIV by taking antiretroviral drugs. The daily use of oral PrEP is approved by Health Canada to reduce the risk of the sexual transmission of HIV for people at high risk of HIV infection. There is typically an assessment process to determine if PrEP is a good choice for you.  Use of oral PrEP involves regular medical appointments for monitoring and support. It must be taken correctly to be effective. It is available by prescription in Canada.

PEP

Post-exposure prophylaxis (PEP) is a way to help prevent HIV from being transmitted to an HIV-negative person who may have been exposed to the virus. You must start PEP within 72 hours of being exposed. This is different from pre-exposure prophylaxis (PrEP). If you think you need PEP, go to your nearest emergency department right away.

DIAGNOSIS

Many people who have HIV feel healthy, so the only way to know if you are infected with HIV is to be tested.  Your doctor can give you a confidential test or you can be tested anonymously at a clinic.  Call Public Health Services for information about the anonymous testing clinic closest to you.

TREATMENT

Even though there is no cure for HIV, there are many medicines available to help combat it. These medicines (called antiretroviral therapy or ART) will often prevent HIV from progressing to AIDS. Even when HIV does progress to AIDS, antiretroviral therapy is often still effective. However, it is most effective the earlier you begin treatment.

Better ART has changed HIV disease from the leading killer of young adults to a chronic disease that can be controlled for decades. However, even though you can take HIV medicines and feel okay, you could still give the virus to others through unsafe sex (without using a condom) or blood exchanges. The medicines don’t kill the virus — they just keep your immune system strong enough to prevent AIDS or slow it down.

Living with HIV

If you are living with HIV, you need to take very good care of yourself. Be sure to eat a balanced diet, exercise regularly, and get plenty of rest. Make sure you follow your healthcare provider’s instructions and take all of your medicines exactly as directed. You can also take steps to keep yourself from getting other infections or diseases that are more common in people who have HIV.

It is also important to see your healthcare provider regularly so that they can monitor your treatment. Your healthcare provider will probably want to see you every 6 months as long as your CD4 cell count is higher than 500. Your healthcare provider will probably want to see you every 3 months if your CD4 cell counts are below 500. However, if you take a new medicine, your healthcare provider will want to see you more often, to check your response to the medicine or to see if your HIV infection is getting worse.

Some of the things that might tell your healthcare provider that your HIV infection has gotten worse since your last visit are the following:

  • New symptoms of nausea, vomiting, fatigue, fever, headache, chills, night sweats, cough, shortness of breath or diarrhea.
  • Signs of weight loss, mouth sores (such as thrush, which is a yeast infection) or bigger lymph nodes (glands located in your neck, armpits and hip area).
  • A drop in the CD4 cell count in your blood.
  • A rise in the viral load in your blood.

You should also proactively try to prevent other infections and complications. HIV can increase your risk for other diseases and conditions because it weakens your immune system. Here are some things you can do to help protect yourself.

  • A flu shot every fall helps prevent the flu.
  • A periodic pneumonia shot can prevent pneumonia caused by the bacteria called Streptococcus pneumoniae. It’s easier for people who have HIV to get this kind of pneumonia. Your healthcare provider will review your immunization history to determine when you need to get these shots.
  • A tuberculosis (TB) skin test every year can tell if you have TB. TB is a very serious illness, especially in people who have HIV.
  • A Pap test for women to check for dysplasia (a pre-cancer condition) and for cancer of the cervix. Both of these conditions occur more often in women who have HIV infection.

All persons with HIV should also be tested for, and immunized against, hepatitis B.

FOR MORE INFORMATION

About harm reduction services in Nova Scotia

  • Needle Distribution & Disposal (aka needle exchange) & Naloxone training, education, support:
  • Mainline Needle Exchange, (902) 423-9991, Outreach (902) 830-3853; Toll-free 1-877-904-4555 http://mainlineneedleexchange.ca/#
  • Northern Healthy Connections Society(902) 895-0931 902) 965-3965 (mobile) http://www.nhcsociety.ca/
  • Sharp Advice Needle Exchange (ACCB) 902-539-5556 & Ally Centre of Cape Breton (ACCB) (902) 567-1766 )
  • Opioid Treatment & Naloxone training
  • Direction 180 https://direction180.ca/ (902) 420-0566
  • ReFIX Overdose Prevention Site, located lower level Brunswick Street Mission, 2017 Brunswick Street, Mon to Sat, 9am to 2pm

HIV Testing in Nova Scotia

About HIV Treatment and Care in Nova Scotia

  • Referrals to HIV treatment are made by health care provider after a positive result is confirmed by laboratory testing
  • Contact the AIDS Coalition of Nova Scotia (902) 425-4882 https://www.acns.ns.ca/ for information, or
  • Schedule an appointment with your primary care provider to discuss treatment and care options

Sexual health related services in Nova Scotia

This information provides a general overview and may not apply to everyone. Talk to your healthcare provider to find out if this information applies to you and to get more information on this subject.

Contributed by familydoctor.org editorial staff.

Copyright (c) by the American Academy of Family Physicians

Nova Scotia Telecare, Reviewed by Clinical Services Working Group, March 2024.

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