How Well Does The Use Of Hiv Treatment To Maintain An Undetectable Viral Load Prevent Hiv Transmission Through Injection Drug Use
The limited available research suggests that being on HIV treatment and maintaining an undetectable viral load is effective at helping to prevent HIV transmission among people who inject drugs; however, people who use drugs can get HIV through sex and through sharing drug use equipment. While we know that maintaining an undetectable viral load will prevent HIV transmission through sex, we dont know how much it reduces the chance of passing HIV through shared drug use equipment. The best way to prevent passing HIV through drug use is to use new needles and other equipment every time. People who use drugs need access to enough new equipment to be able to do this consistently and to avoid having to share with others.
The three major studies looking at sexual HIV transmission did not systematically recruit people who inject drugs, they did not ask whether participants were sharing injection equipment and they did not provide any analysis related to participants who reported using drugs.
Can I Get Tested For Hpv
No, there is currently no approved test for HPV in men.
Routine testing to check for HPV or HPV-related disease before there are signs or symptom, is not recommended by the CDC for anal, penile, or throat cancers in men in the United States. However, some healthcare providers do offer anal Pap tests to men who may be at increased risk for anal cancer, including men with HIV or men who receive anal sex. If you have symptoms and are concerned about cancer, please see a healthcare provider.
What Does It Mean To Be Durably Undetectable
Taking antiretroviral therapy daily as prescribed to suppress HIV levels leads to an undetectable status. A person is considered to have a durably undetectable viral load if their viral load remains undetectable for at least six months after their first undetectable test result. It is essential to continue to take every pill every day as directed to maintain an undetectable viral load.
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Fifty Years Of Hiv: How Close Are We To A Cure
Its half a century since the first known HIV-related death and two patients appear to have been cured of the virus. What does this mean for the 37 million still living with it?
Nobody knew what killed Robert Rayford. The African American boy was just 15 years old when he presented at St Louis city hospital in late 1968, but the medical team drew a blank.
Unexplained swelling in Rayfords genitalia soon spread throughout his body. Chlamydia bacteria, usually localised at the point of entry, coursed through his bloodstream. A small purple lesion on the inside of his thigh signalled cancer, but of a form usually found in elderly Ashkenazi Jews and Italians, not teenage black boys who had never left Missouri.
The teenager hardly spoke during the 18 months in which he received treatment at three separate hospitals. He was the typical 15-year-old who is not going to talk to adults, especially when Im white and hes black, one of his doctors would tell the St Louis Post-Dispatch almost two decades later. He told them he had sex with a girl from his neighbourhood, but gave little else away.
Tragically, pneumonia ended Rayfords young life during the night of 15 May 1969, but his body had been compromised some time before. Illnesses that a healthy body would ordinarily expunge met with no resistance. Rayfords clinicians, puzzled by his decline, persuaded his family to submit his body to an autopsy and preserved samples for inspection at a later date.
Who Should Get Vaccinated
HPV vaccination is recommended at age 11 or 12 years and for everyone through age 26 years, if not vaccinated already.
Vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit. Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination.
At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.
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What Are The Symptoms
The initial infection may not cause any symptoms.
Sometimes, warts may appear weeks, months, or even years later. The type of warts present generally depends on the type of HPV that you have.
- Genital warts. Genital warts can present as tiny, stemlike bumps or flat lesions. They can also have a cauliflowerlike appearance. Although they usually dont hurt, they may itch.
- Common warts. Common warts are rough, raised bumps that usually appear on the hands, fingers, or elbows.
- Plantar warts. Plantar warts are hard, grainy bumps that typically occur on the balls of the feet or the heels.
- Flat warts. Flat warts are flat, slightly raised, and smooth lesions that can appear anywhere on the body. Theyre typically darker than the surrounding skin.
Antibodies To The Rescue
Perhaps the most promising avenue of all in HIV research, McNamara says, is that of broadly neutralizing antibodies. These naturally occur in the immune systems of asmall fraction of HIV patients whose infection never progresses to AIDS. Researchers are studying how to harness them to treat other patients.
HIV is mutation-prone, which allows it to thwart the immune system and retroviral drugs that are made to target specific versions of the virus. For most patients with HIV, this means their immune system is always in hyperdrive, struggling to ward off a moving target. Its a nonstop war between the virus and the immune system, McNamara says.
But some patients have a special type of antibody that is continually effective. When it comes to broadly neutralizing antibodies, the virus is never able to win, McNamara says. The antibodies have it check-mated.
Though latent reservoirs are still an obstacle to them, broadly neutralizing antibodies show a lot of promise when it comes to keeping the virus at bay in particular, ensuring that the infection never progresses to AIDS and that its transmission risk is low. Some researchers are examining how they can be used both to treat and prevent HIV, while others are looking at how a combination of neutralizing and non-neutralizing antibodies may even have some effectiveness against latent cells.
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What Is Involved In The Consistent And Correct Use Of Hiv Treatment To Maintain An Undetectable Viral Load For Hiv Prevention
The consistent and correct use of HIV treatment to maintain an undetectable viral load includes:
- high adherence to medications, to achieve and maintain an undetectable viral load
- regular medical appointments to monitor viral load and receive adherence support, if needed
Regular testing and treatment for sexually transmitted infections is also important because HIV treatment does not protect against STIs.
A person on HIV treatment needs to work with their doctor to determine an appropriate schedule for medical checkups and viral load monitoring.
Why Might People Living With Hiv Get Tested For Hiv
Because we connect with every single person who tests positive at one of our locations, we always ask why people get tested for HIV if theyve already been diagnosed in the past.
It happens for many reasons: People may test with a partner they havent yet disclosed to, they may have mental health concerns that come into play, or they need a letter of diagnosis to access services . Sometimes its because they are confused about the kind of information an HIV test will provide.
Now that weknow undetectable equals untransmittable , some people may have the misconception thatif youre undetectable, you will no longer test positive for HIV. They may think that if they test HIV-negative on an HIV test, theyll be able to show this to their sex partners as a way to prove that theyre undetectable and untransmittable. Or, they may think it will be easier to tell partners theyre HIV-negative rather than undetectable and uninfectious.
If you are living with HIV and have an undetectable viral load, you will still test positive for HIV. But, if you are living with HIV, have been taking HIV medications every day as directed, have a durably suppressed viral load and have been undetectable for at least six months, you will not transmit HIV to sex partners. You are not infectious. Thats the meaning of U=U.
Heres why you will still test positive for HIV even if you are undetectable.
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Sars Was Driven To Extinction By A Combination Of Sophisticated Contact
Fast-forward two years, and the virus had infected at least 8,096 people, 774 of whom died. But it could have been so much worse.
Like its close relative Covid-19, Sars had many of the necessary qualities for world domination it was an RNA virus, meaning it was able to evolve rapidly, and it was spread through droplets expelled when breathing, which are hard to avoid. At the time, many experts were concerned that the virus could cause devastation on the same level as the HIV crisis, or even the 1918 flu pandemic, which infected a third of the worlds population and killed 50 million.
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Instead, Sars disappeared as abruptly as it arrived. By January 2004, there were just a handful of cases and by the end of month, the last suspected natural infection was announced. Oddly, while patient zero describes the first known person to be infected with a virus, there is no equivalent label for the last ever person to catch it in the wild. But this would arguably apply to a 40-year-old man with the family name of Liu from the southern city of Guangzhou. .
So what happened?
In a nutshell, we got lucky. According to Sarah Cobey, an epidemiologist at the University of Chicago, Sars was driven to extinction by a combination of sophisticated contact-tracing and the quirks of the virus itself.
It took a global effort of surveillence and control measures to eliminate Sars
How Has Testing An Important Covid
HIV testing is critical becauseas with COVID-19many people who have the virus dont know it. An estimated 14% of people with HIV in the U.S. are not aware they have it. Symptoms arent always a tip-off, since about a third of newly infected people dont develop symptoms but are still able to transmit it to others.
In 2006, the Centers for Disease Control and Prevention recommended offering HIV tests to anyone between the ages of 18 and 65 coming into the health care system for any reason, regardless of their background or risk factors. Dr. Barakat would go a step further. Every single person should be tested for HIVannually, if they are at higher risk, she says. High-risk groups would include those who use drugs and share needles or engage in unprotected sex.
Testing is important because once a person is diagnosed, he or she is more likely to be treated, and therefore less likely to spread the disease to others, says Dr. Virata.
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Why Theres No Hiv Cure Yet
Over the past two years, the phrase HIV cure has flashed repeatedly across newspaper headlines. In March 2013, doctors from Mississippi reported that the disease had vanished in a toddler who was infected at birth. Four months later, researchers in Boston reported a similar finding in two previously HIV-positive men. All three were no longer required to take any drug treatments. The media heralded the breakthrough, and there was anxious optimism among HIV researchers. Millions of dollars of grant funds were earmarked to bring this work to more patients.
But in December 2013, the optimism evaporated. HIV had returned in both of the Boston men. Then, just this summer, researchers announced the same grim results for the child from Mississippi. The inevitable questions mounted from the baffled public. Will there ever be a cure for this disease? As a scientist researching HIV/AIDS, I can tell you theres no straightforward answer. HIV is a notoriously tricky virus, one thats eluded promising treatments before. But perhaps just as problematic is the word cure itself.
The progression from HIV infection to AIDS and eventual death occurs in over 99% of untreated casesmaking it more deadly than Ebola or the plague. Despite being identified only a few decades ago, AIDS has already killed 25 million people and currently infects another 35 million, and the World Health Organization lists it as the sixth leading cause of death worldwide.
How Well Does The Use Of Hiv Treatment To Maintain An Undetectable Viral Load Prevent Hiv Transmission To A Baby During Breastfeeding
Without HIV treatment, the risk for HIV transmission through breastfeeding is estimated to be roughly 15%. The rates of HIV transmission through breastfeeding for people who are taking HIV treatment are much lower. A systematic review of HIV transmission in breastfed infants of cisgender women on treatment found that the risk of transmission after birth was 1% after six months of breastfeeding, rising to almost 3% after one year. However, in these studies, the women were on treatment for varying amounts of time and did not continue treatment beyond six months after giving birth. The systematic review did not account for adherence or for viral load, which means that even though the women were taking HIV treatment we do not know how many of them had a detectable viral load at the time of transmission.
There is very limited research on the impact of treatment and an undetectable viral load on HIV transmission during breastfeeding. A study in Tanzania between 2013 and 2016 found two HIV transmissions among 177 infants who were breastfed by cisgender women who started treatment before the infant was born. However, in both cases the women had a detectable viral load. No transmissions occurred in the context of treatment and an undetectable viral load.
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The Death Toll From Aids Is Astronomic
Since the HIV/AIDS epidemic began in 1981, more than 70 million people worldwide have been infected with the virus, and approximately 35 million people have died from AIDS, including more than 675,000 in the United States, according to agencies such as the World Health Organization and the CDC. People in other parts of the world are much more severely affected; in sub-Saharan Africa, almost 1 in every 25 adults has HIV. Overall, however, the rate of new HIV infections and diagnoses is now dropping in the United States, likely thanks to prevention efforts, the CDC reports. But progress has been uneven. Certain groups, such as Hispanic and Latino gay and bisexual men, have had rising numbers of infections and diagnoses.
How To Figure Out The Cause Of Body Pains In Hiv
The main causes of the body pains are usually unknown to the patient of HIV, but you should be clear that it is not the HIV causing it. Instead, it is some opportunistic infection culminating inside your body.
There can be plenty of reasons why your body aches including muscle tensions or sprains, sharp pains, cyclic pains, muscle cramping, and exercise pain.
The pain is usually related to the hips, back, and lower hips area of the body.
Moreover, the pain can result in critical weakness as well. That is why you should get yourself checked by a doctor immediately when you experience even slight permanent pains.
It is necessary to get yourself examined in order to rule out neurologic diseases, as they might be the primary reasons for the pain.
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What Are Drug Interactions
Your HIV medications can be affected by other medicines, including other prescription drugs you are taking and drugs you buy over the counter at a pharmacy. Even herbal therapies, nutritional supplements, and some things found in common foods can affect your HIV medicines.
When one drug affects how another drug behaves, this is called a drug-drug interaction. For example, some drugs become less effective or cause side effects when they are taken with certain other drugs.
When something in food affects how a drug behaves, it is called a drug-food interaction. For example, grapefruit juice, taken at the same time as certain drugs, can boost the amount of these drugs in your bloodstream to an undesirable level. Everyone taking HIV drugs needs to be very careful about these interactions. Luckily, many of these interactions are well known to your provider and can be managed.
Your provider can give you a list of drugs and foods to avoid, depending on what treatment you are taking. Ask for this information for each drug that you are taking.
Also, be sure that you tell your provider about every single medication, drug, supplement, and herb you are taking–whether you got them by prescription or not.
How Well Does The Use Of Hiv Treatment To Maintain An Undetectable Viral Load Prevent Hiv Transmission To A Baby During Pregnancy And Birth
Without treatment, there is a 15% to 30% chance that a baby born to a person living with HIV will get HIV during pregnancy or delivery. Taking HIV treatment is the most effective way to reduce transmission to the baby. In fact, research has shown that if a pregnant person starts HIV treatment before conception and maintains an undetectable viral load throughout pregnancy and delivery, they do not transmit HIV to their baby. A short course of HIV medications is also given to the infant to prevent HIV transmission.
For the last three decades, a growing body of evidence has shown that babies are much less likely to be born with HIV if the pregnant parent is on treatment. A study of the French Perinatal Cohort, conducted between 2000 and 2011, is the largest study to show the impact of treatment on preventing HIV transmission to a newborn.;This study found that no HIV transmissions occurred among 2,651 infants born to cisgender women who were on treatment before they conceived and throughout their pregnancy, who had an undetectable viral load at delivery and who did not breastfeed.
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