Treatment Fatigue And Tolerability
Treatment fatigue may lead many LTS to have difficulties adhering to their HIV treatment, which can eventually cause drug resistance. However, multidrug-resistant HIV is already a reality for a number of LTS, for whom effective treatment options are difficult to find.
Many long-term survivors take a dizzying array of pills each day, for HIV and for other health conditions they’re managing . They may also take vitamins, supplements, birth control methods, and pain relievers, all of which can increase the likelihood of drug interactions.
A review of numerous studies of people who acquired HIV at birth found that younger long-term survivors were more likely to have their HIV treatment be unsuccessful than adults, for a number of reasons:
- They may have been exposed to HIV treatment in the womb that increased their chances of HIV drug resistance
- Their treatment histories tend to be just as complex as those described above for older-adult LTS, and complicated by fewer medication options for children due to fixed doses and the need for dose adjustment for weight
- Young people may find it more challenging than adults to take their HIV drugs consistently enough for the drugs to be effective
It is very important for LTS of all ages to have trusting relationships with their health care providers, so that they can work together to find effective, tolerable treatment options. This is a key step not only to improve long-term health outcomes, but also to improve quality of life.
What Is Antiretroviral Therapy
Antiretroviral therapy is used in the treatment and prevention of HIV infection. Antiretroviral drugs work against HIV by stopping or interfering with the reproduction of the virus in the body. Antiretroviral drugs have been able to slow the progression from HIV to AIDS, so that some persons who are HIV positive have lived twenty or more years without developing the symptoms of AIDS. This is a real triumph, as HIV positive persons are able to live relatively normal and active lives, provided they take ART treatment regularly .
When taken the right way, ART greatly reduces the amount of HIV in the blood . In some individuals taking these drugs the HIV viral load becomes undetectable, and when this happens there is little if any risk they will transmit HIV to a partner . It isnt known if someone with an undetectable HIV viral load is able to transmit the virus through sharing needles and injecting equipment, though.
Is There Any Treatment Of A Cure For Hiv/aids
Currently, there is no cure for HIV/AIDS. People living with HIV will need lifelong treatment. The best treatments right now are combinations of prescription drugs. These medications include antiviral treatment, protease inhibitors and other drugs that help people who are living with HIV stay healthy. People living with HIV also can stay healthy by doing things like eating properly, exercising and getting enough sleep.
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How Can I Protect Myself
To protect yourself from getting infected with HIV, you can use protection or practice abstinence. Being faithful to one partner can also reduce your risk of getting HIV. However, you can get HIV with only one partner if the partner is unfaithful and having unprotected sex.
Other methods of protection include taking antiretroviral drugs, male circumcision, and vaccination.
Using condoms is the most effective method of protection against HIV and sexually transmitted infections. It also helps prevent unwanted pregnancies.
- They are very effective if used properly and this means using a condom that fits properly.
- To ensure that you are using a condom in the right way, here are a few basic things you can do:
- Every time you have intercourse, use a new condom.
- Put on a condom before any kind of sexual contact, whether it may be vaginal, oral or anal.
- Avoid using baby oil, vaseline or any other oil-based lubricant as it can cause the condom to break or split.
How Has Treatment Improved
Antiretroviral medications can help to slow damage caused by HIV infection and prevent it from developing into stage 3 HIV, or AIDS.
A healthcare provider will recommend undergoing antiretroviral therapy. This treatment requires taking three or more antiretroviral medications daily. The combination helps suppress the amount of HIV in the body . Pills that combine multiple medications are available.
The different classes of antiretroviral drugs include:
- non-nucleoside reverse transcriptase inhibitors
- integrase inhibitors
Viral-load suppression allows people with HIV to live healthy lives and decreases their chances of developing stage 3 HIV. The other benefit of an undetectable viral load is that it helps reduce transmission of HIV.
The 2014 European PARTNER study found that the risk of HIV transmission is very small when a person has an undetectable load. This means that the viral load is below 50 copies per milliliter .
This discovery has led to an HIV prevention strategy known as treatment as prevention. It promotes constant and consistent treatment as a way to reduce the spread of the virus.
HIV treatment has evolved tremendously since the onset of the epidemic, and advancements continued to be made. Initial reports from a clinical trial in the United Kingdom and a from the United States showed promising results in experimental HIV treatments that could put the virus into remission and boost immunity.
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What Do I Need To Know About Dating With Hiv
Some people feel like their love lives are over when they find out they have HIV, but its just not true. People with HIV can have fulfilling romantic and sexual relationships. People living with HIV can have relationships with partners who dont have HIV or with partners that are also living with HIV . HIV treatment helps keep you healthy and helps you avoid passing HIV to someone else. If your partner does not have HIV, they can also take a medicine called PrEP that can help protect them from getting HIV through sex.
Its important to tell your sexual partners about your HIV status. That way, you and your partners can make more informed decisions about safer sex, testing, and treatment that are right for the both of you.
Its normal to be worried about how your partners going to react. And theres no way around it: some people might get freaked out. If that happens, try to stay calm and talk about your plan to stay healthy and how they can stay HIV negative. It might help to give your partner a little time and space to process. You could also suggest they talk with your HIV doctor about ways to protect themselves from HIV.
If you tell someone you have HIV and they hurt you, shame you, or make you feel bad, its not ok. You deserve to be with someone who respects and cares about you, and there are plenty of people out there who will.
What Is The Prognosis Of Untreated Hiv Infection
The prognosis in patients with untreated HIV infection is poor, with an overall mortality rate of more than 90%. The average time from infection to death is 8-10 years, although individual variability ranges from less than 1 year to long-term nonprogression. Many variables have been implicated in HIV’s rate of progression, including CCR5-delta32 heterozygosity, mental health, concomitant drug or alcohol abuse, superinfection with another HIV strain, nutrition, and age.
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Have Society’s Attitudes Also Changed
While Bisi’s personal outlook has changed greatly, he believes the rest of the world has a lot of catching up to do.
He lives a very happy and healthy life, but says there’s a long way to go with the conversation around HIV.
“We can’t talk about a world without HIV and AIDS unless we discuss homophobia across the world. In Africa for example, HIV prevalence among gay men is 20% on average. However, it seems people think that the best way to deal with this is to criminalise same sex relationships. Look at places like Nigeria, Ghana and Kenya, where there is a correlation between the criminalisation of LGBTQ+ people and an increase in HIV infections,” he explains.
“There can also sometimes be a self-righteous approach to sex and sex education, and we’re still having conversations about access to PreP.”
Days To 20 Years After Exposure
The chronic stage of infection occurs once the immune system brings the virus under control. During this phase, HIV will go into hiding, where it resides in various cells and tissues throughout the body in a dormant state known as latency. HIV latency can persist without symptoms for 10 years or more, although some people may experience signs within a year or two.
During the early chronic phase, lymphadenopathy may be the only notable sign of an HIV infection. In some cases, the glands may be visibly enlarged and reach up to an inch or more in size. If the condition persists for more than three months, its referred to as persistent generalized lymphadenopathy .
Even during latency, the virus will multiple imperceptibly and gradually deplete immune cells known as CD4 T-cells. As immune deficiency develops, a number of nonspecific symptoms are likely to appear, including:
- Oral candidiasis , a fungal infection that causes the formation of creamy, white lesions on the sides of the tongue and lining of the mouth
- Unexplained fevers and drenching night sweats that soak through bedsheets and nightclothes
- Severe, uncontrolled diarrhea that lasts for more than three days
Each of these symptoms is commonly seen in persons with immune deficiency. They may, in some cases, be caused by HIV itself or by an infection that has yet to be diagnosed.
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How Does An Hiv Diagnosis Change Your Outlook On Life
Accepting his HIV status has been a long process for Bisi. He’s battled with depression, self-doubt and shame over the 17 years since his diagnosis.
He says, “I have also had to deal with guilt, the fact that I am the one who got to live when many of my wonderful friends had to die. This has also caused anger and frustration. Seeing the medicines now available, even the conversation around vaccines, makes me want to scream. Imagine if my friends had access to life-saving HIV medications in the early 2000s.”
It’s been a journey for Nathaniel too, who didn’t tell his family about his HIV for 15 years, a kind of secrecy he says isn’t uncommon.
“Stigma and discrimination haven’t gone away. I’ve faced rejection from partners and now I just worry all the time about who to tell. I’m a performer, so when I went public with my diagnosis in a solo show and on TV, it was my way of ridding myself of the toxic shame I’d carried all those years. My mission is to educate and empower people to become HIV allies, as there are many misconceptions out there. For example, people still think HIV is a ‘gay’ disease, yet over 50% of people living with HIV in the UK are heterosexual. Many people also don’t know about U=U or the options to protect themselves and their partners.”
Following his struggle, Nathaniel wants to raise awareness so fewer people feel the shame he did.
Likewise, Musa’s outlook on life has changed over the years.
How Does Hiv Spread
HIV spreads when blood or certain bodily fluids that have high amounts of active virus are exposed to ones bloodstream.
For a person to contract HIV, there must be enough active virus in the fluid that encounters the bloodstream. This can occur through:
- a mucous membrane, or moist skin, such as in the mouth, rectum, penis, or vagina
- a significant opening in the skin
- injection
Transmission of the virus most often happens during anal or vaginal sex, but it can also occur by sharing needles.
Factors that affect the survival of HIV outside the body include:
- Temperature. HIV stays alive and active when kept in the cold but is killed by heat.
- Sunlight. Ultraviolet light in sunshine damages the virus, so its no longer able to reproduce.
- Amount of virus in the fluid. Generally, the higher the level of HIV virus in the fluid, the longer it will take for all of it to become inactive.
- Level of acidity. HIV survives best at a pH around 7 and becomes inactive when the environment is even just a little more or less acidic.
- Environmental humidity. Drying will lower the viral concentration of active virus as well.
When any of these factors arent perfect for HIV in its environment, survival time of the virus goes down.
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Study Construction: A : 10 Comparison Of Americans Receiving Health Care
In total, 39,000 HIV-positive Kaiser Permanente members age 21 or older were matched with 387,767 HIV-negative members of similar age, sex, and race. The average age of the entire cohort was 41 although there was racial diversity , participants were mostly male , and no data were available regarding transgender identification. Risk demographics loosely resembled those of the current U.S. epidemic, with 70% of the cohort identifying as men who have sex with men, 20% as heterosexual, and 8% as people who inject drugs.
In analyzing morbidity and mortality data, Marcus et al sought to answer two questions:
What Is Life Expectancy
LE is an important indicator of health that is used widely by governments, healthcare agencies, and insurance companies to monitor trends in survival over time, and to determine resource allocation . Formally, LE indicates the average number of years that a person would be expected to survive beyond a given age. That given age would usually be birth however, in the context of HIV, the given age may be difficult to interpret as, in most cases, individuals are not born with HIV but acquire it at some point during their life. Thus, LE is commonly quoted from a specific given age or after some specific event, such as HIV diagnosis . Of note, LE at a particular age is not the same as LE at birth minus that age, as LE at a particular age is calculated after conditioning on the fact that the individual has already survived to that age.
Table 1 Estimates of LE reported in the cART era
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How Long Does Hiv Live Outside The Body: In Air On Surfaces
Overview
There are many myths and misconceptions about how long HIV lives and is infectious in the air or on a surface outside the body.
Unless the virus is kept under specific conditions, the true answer is not very long.
Although it causes a serious disease that cant be cleared by the body, HIV is very fragile in the outside environment. It quickly gets damaged and becomes inactive, or dies. Once inactive, HIV cant become active again, so its the same as if its dead.
HIV spreads when blood or certain bodily fluids that have high amounts of active virus are exposed to ones bloodstream.
For a person to contract HIV, there must be enough active virus in the fluid that encounters the bloodstream. This can occur through:
- a mucous membrane, or moist skin, such as in the mouth, rectum, penis, or vagina
- a significant opening in the skin
- injection
Transmission of the virus most often happens during anal or vaginal sex, but it can also occur by sharing needles.
Factors that affect the survival of HIV outside the body include:
When any of these factors arent perfect for HIV in its environment, survival time of the virus goes down.
HIV cant survive for long in the environment. When fluid leaves the body and is exposed to air, it begins to dry up. As drying occurs, the virus becomes damaged and can become inactive. Once inactive, HIV is dead and no longer infectious.
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Despite Medical Advances People With Hiv Still Live Shorter Sicker Lives
HealthDay Reporter
THURSDAY, June 18, 2020 — HIV may not be the death sentence it was 20 or 30 years ago, but people who are HIV-positive still face much shorter lives than other adults — even if they’re treated with medications that make the virus undetectable.
A new study reports that people who were HIV-positive at age 21 had an average life expectancy of 56 years — nine years fewer than their virus-free peers.
The likely reason: a weaker immune system and a greater risk for other chronic health issues, even when HIV is kept in check.
“Our findings suggest that people with HIV who initiate treatment early are approaching the same lifespan as people without HIV, but that we need to be paying closer attention to preventing comorbidities among people with HIV,” said lead author Dr. Julia Marcus, an assistant professor at Harvard Medical School in Boston.
When antiretroviral therapy — or HAART — was introduced for HIV treatment in 1996, it was a game-changer.
Taken daily, the medications can suppress the virus to undetectable levels, keeping patients healthy and eliminating the risk of sexual transmission. The U.S. Department of Health and Human Services recommends starting HAART immediately after an HIV diagnosis.
To find out, they reviewed disease and death histories drawn from Kaiser Permanente records for nearly 430,000 people between 2000 and 2016. About 39,000 were HIV-positive, and nearly nine in 10 of these patients were male .
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JAMA Network Open
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Managing Hiv On A Daily Basis
Nathaniel takes one tablet a day, which keeps his HIV at undetectable levels. We now know that people living with HIV on effective treatment cannot pass on the virus to partners . Nathaniel says this has revolutionised the lives and relationships of people living with HIV.
“My current partner takes PrEP , which helps protect him from contracting HIV as well. The psychological impact of the diagnosis still needs day-to-day management, however, as I also have complex PTSD and generalised anxiety. I try to eat well and exercise regularly, and stress management is really important.”
Musa echoes the importance of self-care, as HIV has become integrated into her life.
“Apart from taking daily antiretroviral treatment, I’m just doing what is necessary for every other person to live a healthy lifestyle. HIV is part of my life. There’s no ‘HIV special plan’. It falls under health and wellness and general management alongside my other chronic conditions. There’s no exception for HIV so it doesn’t hold me back.”