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HIV/AIDS (cont.)

Follow-up for HIV Infection

People with HIV infection should be under the care of a physician who is experienced in treating HIV infection. This is often an infectious-disease subspecialist, but may be a health-care provider, such as an internal medicine or pediatric specialist, who has special certification in HIV treatment. All people with HIV should be counseled about avoiding the spread of the disease. Infected individuals are also educated about the disease process, and attempts are made to improve the quality of their life.

What Can People Do to Prevent an HIV Infection?

Despite significant efforts, there is no effective vaccine against HIV. The only way to prevent infection by the virus is to avoid behaviors that put one at risk, such as sharing needles or having unprotected sex. Unprotected sex means sex without a barrier such as a condom. Because condoms break, even they are not perfect protection. Many people infected with HIV don't have any symptoms and appear healthy. There is no way to know with certainty whether a sexual partner is infected. Here are some prevention strategies:

  • Abstain from oral, vaginal, and anal sex. This obviously has limited appeal, but it is the only 100% effective way to prevent HIV.
  • Have sex with a single partner who is known to be uninfected. Mutual monogamy between uninfected partners eliminates the risk of sexual transmission of HIV.
  • Use a condom in other situations. Condoms offer some protection if used properly and consistently. Occasionally, they may break or leak. Only condoms made of latex should be used. Only water-based lubricants should be used with latex condoms; petroleum jelly dissolves latex.
  • Use condoms the right way every time you have sex. Learn the right way to use a male condom.
  • Choose less risky sexual behaviors. Anal sex is the highest-risk sexual activity for HIV transmission, especially for the receptive partner (bottom). Oral sex is much less risky than anal or vaginal sex. Sexual activities that don't involve contact with body fluids (semen, vaginal fluid, or blood) carry no risk of HIV transmission.
  • Do not inject street drugs. When people are high, they're more likely to have risky sex or share unsterile needles, which increases the chance of getting or transmitting HIV.
  • If you do inject drugs, never share your needles or works. Use only sterile needles. You can get them at many pharmacies without a prescription, or from community needle-exchange programs. Use a new sterile needle and syringe each time you inject. Clean used needles with full-strength laundry bleach, making sure to get the bleach inside the needle, soak at least 30 seconds (sing the "happy birthday" song three times), and then flush out thoroughly with clean water. Use bleach only when you can't get new needles. Needles and syringes aren't designed to be cleaned and reused, but it is better than sharing uncleaned needles and works.
  • Use sterile water to fix drugs.
  • Clean skin with a new alcohol swab before injecting.
  • Be careful not to get someone else's blood on your hands or your needle or works.
  • Dispose of needles safely after one use. Put them in an old milk jug and keep used needles away from other people. Pharmacies accept used needles in containers for safe disposal.
  • If you work in a health-care field, follow recommended guidelines for protecting oneself against needle sticks and exposure to contaminated fluids.

The risk of HIV transmission from a pregnant woman to her baby is significantly reduced if the mother takes ART during pregnancy, labor, and delivery and her baby takes ART for the first six weeks of life. Even shorter courses of treatment are effective, though not as optimal. The key is to be tested for HIV as early as possible in pregnancy. In consultation with their physician, many women opt to avoid breastfeeding to minimize the risk of transmission after the baby is born.

PrEP is short for pre-exposure prophylaxis. People who do not have HIV can take a daily pill to reduce their risk of becoming infected. PrEP is not right for everyone and must still be used in combination with safer sex and injection practices. It requires commitment to treatment and does not replace other prevention measures like condom use. It also requires very regular medical visits and frequent blood tests for STDs and HIV, because unknowingly continuing PrEP medication while HIV-infected can lead to resistance and limit HIV treatment options. Resistance has already been reported in a person who became infected while taking PrEP.

PEP is short for post-exposure prophylaxis and refers to preventive treatment after occupational exposure to HIV. Occupational transmission of HIV to health-care workers is extremely rare, and the proper use of safety devices minimizes the risk of exposure while caring for patients with HIV. A health-care worker who has a possible exposure should see a doctor immediately. PEP must be started within 72 hours after a recent possible exposure to HIV. While PEP after occupational exposure is clearly defined by guidelines, it is less clear whether PEP is as effective after sexual or IV exposure.

Medically Reviewed by a Doctor on 8/24/2016

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HIV Disease »

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