Managing Illness As A Parent
Although medical advances now allow people with HIV to live full, healthy lives, you may have times where you or your partner is unwell or needs medical care.
As with any longer-term illness, this can impact on your ability to earn an income, manage a household or raise children.
Living with chronic illness can be a challenge and sometimes families need extra support. Trying to sort things out on your own can make life seem overwhelming. Dont be afraid to ask for help from expert organisations that support people with HIV.
If The Viral Load Is Undetectable Can You Stop Treatment
No! Having a viral load below levels that laboratory tests can measure tells us that the HIV drugs are working. An undetectable viral load doesn’t mean the HIV virus is gone from your body, though. Even though the virus is not detected in the blood, it is still present in other parts of your body, such as the lymph nodes, brain, and reproductive organs. If you stop treatment, the virus will start reproducing again and your viral load will increase, putting your health at risk.
Should You Ever Take A ‘holiday’ From The Drugs
Taking a “drug holiday” from your HIV treatments for reasons other than a severe reaction to medications may be harmful to your health. Having said that, your provider may suggest that you temporarily stop your antiretroviral drugs for certain specific reasons. Be sure to talk with your provider about this issue if you have questions about it. How you stop taking your HIV drugs safely can be a complicated process.
Remember, just skipping doses without your provider’s instruction is dangerous you should never change your treatment plan without talking with your provider.
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How Often Should Viral Load Be Tested
The frequency of viral load testing varies. Typically, viral load testing is done at the time of a new HIV diagnosis and then intermittently over time to confirm that antiretroviral therapy is working.
A viral load usually becomes undetectable within three months of starting treatment, but it often happens faster than that. A viral load is often checked every three to six months, but it may be checked more often if there is concern that the viral load may be detectable.
Will I Get Drug Resistance If I Miss A Dose
In general, if you forget to take a dose, take your medications as soon as you realize youve missed the dose. However, if its almost time for your next dose, just wait until your next dose and continue your regular routine. Most important, do not take a double dose you cannot make up for a missed dose that way. Although its important to take your HIV medications every day, you likely will not develop drug resistance from missing just one medication dose.
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Does My Baby Have Hiv
Your baby should be tested for HIV at birth, and again four to six weeks later.
If the result comes back negative, your baby should be tested again at 18 months and/or when you have finished breastfeeding to find out your babys final HIV status. It is very important to take your baby for this final HIV test to ensure they are HIV-negative or to get them on treatment if they are positive.
If any of these tests come back positive, your baby will need to start treatment straight away. Talk to your healthcare professional, and attend follow-up appointments to ensure your baby receives treatment.
How Do You Get Or Transmit Hiv
You can only get HIV by coming into direct contact with certain body fluids from a person with HIV who has a detectable viral load. These fluids are:
- Semen and pre-seminal fluid
- Rectal fluids
- Vaginal fluids
- Breast milk
For transmission to occur, the HIV in these fluids must get into the bloodstream of an HIV-negative person through a mucous membrane open cuts or sores or by direct injection.
People with HIV who take HIV medicine daily as prescribed and get and keep an undetectable viral load have effectively no risk of sexually transmitting HIV to their HIV-negative partners.
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How Does Being Durably Undetectable Affect My Risk Of Transmitting Hiv To A Sexual Partner
People living with HIV who take antiretroviral medications daily as prescribed and who achieve and then maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.
Three large multinational research studies involving couples in which one partner was living with HIV and the other was notHPTN 052, PARTNER and Opposites Attractobserved no HIV transmission to the HIV-negative partner while the partner with HIV had a durably undetectable viral load. These studies followed approximately 3,000 male-female and male-male couples over many years while they did not use condoms. Over the course of the PARTNER and Opposites Attract studies, couples reported engaging in more than 74,000 condomless episodes of vaginal or anal intercourse.
Learn more about HIV treatment as prevention.
What Should People Living With Hiv Do If They Develop Drug Resistance For The First Time
If you develop drug resistance, Wohl advised taking the time to figure out if something went wrong, and to try to keep it from happening again.
Was adherence difficult? Did drug supplies run out? Addressing the underlying cause while moving on to second-line treatment is important to minimize the risk of failure of the new regimen, said Young.
Get help from your clinic and your support network, if possible. If missing doses was the issue, it can be difficult to change the things that made it hard to take meds every day. But you have to try, said Wohl.
The good news is that todays second-line antiretroviral treatments can be both very effective in suppressing resistant virus, and still be very well tolerated. Irrespective of what type of first-line treatment was used, second-line use of integrase inhibitors or boosted protease inhibitors can be successful, Young added.
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What If I Miss One Dose Will My Viral Load Become Detectable Again
If you are undetectable, and have been taking your medications every day recently, your viral load will very likely stay undetectable even if you miss one dose. The HIV medications are so good these days that it can take a week or even sometimes up to several weeks or more for peoples viral loads to become detectable after medications are stopped.
If My Viral Load Is Undetectable Can I Transmit Hiv To Other People
Im very happy to say that we know the answer to this. If you are undetectable, and have been on HIV medications for at least six months, and you continue that treatment, the risk of transmitting HIV is effectively zero.
This finding has been well-established over the last six to seven years . After studying thousands of couples, over many years, research has shown that if an HIV-positive person is on effective HIV medications for at least six months, is undetectable, and stays on their HIV medications, they will not transmit HIV to other people.
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How Would I Know If Prep Is Right For Me
PrEP is one of many options for preventing HIV. HIV is passed from one person to another through sharing injection drug equipment or through anal or vaginal sexual intercourse. People can avoid getting HIV by: 1) not sharing drug injection equipment , 2) avoiding anal or vaginal intercourse 3) having only one monogamous sex partner whose HIV status is known to be negative: 4) having only one partner who is living with HIV and has an undetectable viral load. It is important to be aware that a person living with HIV who is on HIV treatment and is virally suppressed for six months or longer cannot pass HIV to a partner through sex. If you have sex with more than one partner, taking PrEP or consistent and correct use of condoms each time you have sex, can prevent you from getting HIV.
New York HIV State Clinical Guidelines indicate that healthcare providers should discuss PrEP as an HIV/STD prevention option for adults or adolescents who:
It is important to weigh the pros and cons and have an open and honest conversation about PrEP with your healthcare provider before beginning PrEP. PrEP is always voluntary and only you can determine if PrEP is right for you.
Would I Have To Take Prep For The Rest Of My Life What If I Want To Stop
PrEP is not intended to be a life-long program. Rather, it is a program where the healthcare provider works with you to develop an individualized plan with as many renewals of the prescription as you and the healthcare provider agree to. For many people, life circumstances change over time and the risk for HIV may be reduced or eliminated. You should discuss the issue of how long you want to take the PrEP medication with your provider. If for any reason you want to stop taking the PrEP medication, consult with the healthcare provider who prescribed it, or another provider who is familiar with PrEP. Generally speaking, cis-gender men taking on-demand PrEP should continue taking the PrEP medication for at least 2 days after any possible exposure. Anyone taking daily PrEP should continue taking the medication for 28 days after the last possible exposure.
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Questions To Ask About Each Drug
One of the most important things you can do to make sure you take your medicine correctly is to talk with your medical provider about your lifestyle, such as your sleeping and eating schedule. If your provider prescribes a drug, be sure and ask the following questions :
- What dose of the drug should be taken? How many pills does this mean?
- How often should the drug be taken?
- Does it matter if it is taken with food, or on an empty stomach?
- Does the drug have to be kept in a refrigerator?
- What are the possible side effects of the drug?
- What should be done to deal with the side effects?
- How severe do side effects have to be before a provider is called?
During every medical visit you should talk about whether you are having trouble staying on your treatment plan. Studies show that people who take their medicine in the right way get the best results: their viral loads stay down, their CD4 counts stay up, and they feel healthier.
I Have Sex Partners Who Are Living With Hiv And Have An Undetectable Viral Load Because They Are On Hiv Treatment Do I Still Need To Take Prep
Individuals living with HIV who are taking HIV treatment consistently and have an undetectable viral load for at least 6 months cannot transmit the virus to an HIV-negative partner through sexual activity. In sero-discordant or magnetic couples , PrEP may be used by the HIV-negative partner for additional protection.
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How Do You Know If The Drugs Are Working
After you’ve started taking drugs for HIV, your provider will look at how much HIV virus is in your bloodstream to see how well the drug therapy is working. If the drugs are working, your viral load goes down. You will have less of the virus in your bloodstream. A very important goal of treatment is to reduce the viral load to below the level that can be counted by laboratory tests, and to keep it there. This sometimes is called an “undetectable” level of HIV.
Other ways you and your provider can see if the drugs are working are:
- Your CD4 count. This number should stay the same or go up if your drugs are working.
- Your health checkups. Your treatment should help keep you healthy and help you fight off infections and diseases.
Talk With Your Hiv Health Care Provider
Talk with your health care provider about the benefits of HIV treatment and which HIV medication is right for you. Discuss how frequently you should get your viral load tested to make sure it remains undetectable.
If your lab results show that the virus is detectable or if you are having trouble taking every dose of your medication, you can still protect your HIV-negative partner by using other methods of preventing sexual transmission of HIV such as condoms, safer sex practices, and/or pre-exposure prophylaxis for an HIV-negative partner until your viral load is undetectable again.
Taking HIV medicine to maintain an undetectable viral load does not protect you or your partner from getting other sexually transmitted diseases , so talk to your provider about ways to prevent other STDs.
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When To Start Hiv Treatment
Its now recommended that everyone diagnosed with HIV starts treatment straight away after being diagnosed.
In the UK, national guidelines set out standards for HIV treatment. They currently recommend that anyone with HIV who is ready to commit to treatment should start it regardless of their CD4 count .
What Is An Undetectable Viral Load
- Taking antiretroviral treatment reduces the amount of HIV in your body.
- With proper adherence, ART can reduce HIV to such low levels that the virus can no longer be detected in normal blood tests. This is called having an undetectable viral load.
- People with undetectable viral loads cant pass HIV on through sex.
- To know that youre undetectable, you must have your viral load monitored regularly.
- Remember your viral load can change. If you stop taking your treatment properly your viral load will go up again.
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Get And Keep An Undetectable Viral Load
- If you take HIV medicine and get and keep an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
- We dont know whether getting and keeping an undetectable viral load prevents HIV transmission through sharing needles, syringes, or other drug injection equipment . It very likely reduces the risk, but we dont know by how much.
- Getting and keep an undetectable viral load is the best thing you can do to stay healthy and protect others.
- Learn more about HIV treatment.
What if I cannot get an undetectable viral load?
Some people face challenges that make it hard to stick to a treatment plan. A few people cannot get an undetectable viral load even though they take HIV medicine as prescribed. If your viral load is not undetectableor does not stay undetectableyou can still protect your partners by using other prevention options.
Ways Hiv Can Be Transmitted
How is HIV passed from one person to another?
Most people who get HIV get it through anal or vaginal sex, or sharing needles, syringes, or other drug injection equipment . But there are powerful tools that can help prevent HIV transmission.
Can I get HIV from anal sex?
You can get HIV if you have anal sex with someone who has HIV without using protection .
- Anal sex is the riskiest type of sex for getting or transmitting HIV.
- Being the receptive partner is riskier for getting HIV than being the insertive partner .
- The bottoms risk of getting HIV is very high because the rectums lining is thin and may allow HIV to enter the body during anal sex.
- The top is also at risk because HIV can enter the body through the opening at the tip of the penis , the foreskin if the penis isnt circumcised, or small cuts, scratches, or open sores anywhere on the penis.
Can I get HIV from vaginal sex?
You can get HIV if you have vaginal sex with someone who has HIV without using protection .
Can HIV be transmitted from a mother to her baby?
HIV can be transmitted from a mother to her baby during pregnancy, birth, or breastfeeding. However, it is less common because of advances in HIV prevention and treatment.
Can I get HIV from sharing needles, syringes, or other drug injection equipment?
You are at high risk for getting HIV if you with someone who has HIV. Never share needles or other equipment to inject drugs, hormones, steroids, or silicone.
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Viral Load Test Procedure
A doctor can test the viral load using a simple blood test. No preparation is needed.
The doctor or technician will draw a small amount of blood and send the sample to the labs to test the viral load and CD4 count.
It often takes a few days for the results to come back. Once they are back, the doctor will likely call to discuss the results with the individual.
Other Prevention Benefits Of Hiv Treatment
In addition to preventing sexual transmission of HIV there are other benefits of taking HIV medication to achieve and maintain an undetectable viral load:
- It reduces the risk of mother-to-child transmission from pregnancy, labor, and delivery. If a woman living with HIV can take HIV medication as prescribed throughout pregnancy, labor, and delivery and if HIV medication is given to her baby for 4-6 weeks after delivery, the risk of transmission from pregnancy, labor, and delivery can be reduced to 1% or less. Scientists dont know if a woman living with HIV who has her HIV under control can transmit HIV to her baby through breastfeeding. While it isnt known if or how much being undetectable or virally suppressed prevents some ways that HIV is transmitted, it is reasonable to assume that it provides some risk reduction.
- It may reduce HIV transmission risk for people who inject drugs. Scientists do not yet know whether having a suppressed or undetectable viral load prevents HIV transmission through sharing needles or other injection drug equipment, but it is reasonable to assume that it provides some risk reduction. Even if you are taking HIV medication and are undetectable, use new equipment each time you inject and do not share needles and syringes with other people.
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