Buzz - Student Health Services Newsletter (Vol. 3)
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WORLD AIDS DAY December 1, 2002
December 1 is nationally recognized as World AIDS Day. The Centers
for Disease Control (CDC) estimates that between 800,000 to 900,000
Americans are living HIV. Also the number of people living with
AIDS is increasing, as effective new drug therapies are keeping
HIV-infected persons healthy longer and dramatically reducing the
death rate. There is still NO cure for HIV/AIDS and there is NO
vaccine to prevent the disease.
Contents
- Questions and Answers: HIV is the cause of
AIDS
- HIV and Transmission
- Effectiveness of Condoms
- HIV and AIDS: are you at risk
- Myth vs. reality
- Red Ribbon Poem
Questions and Answers: HIV is the Cause of
AIDS
What is AIDS?
AIDS stands for acquired immunodeficiency syndrome.
A diagnosis of AIDS is made by a physician using certain clinical
or laboratory standards.
What causes AIDS?
AIDS is caused by infection with a virus called
human immunodeficiency virus (HIV). This virus is passed from one
person to another through blood-to-blood and sexual contact. In
addition, infected pregnant women can pass HIV to their babies during
pregnancy or delivery, as well as through breast feeding. People
with HIV have what is called HIV infection. Most of these people
will develop AIDS as a result of their HIV infection.
What body fluids transmit HIV?
These body fluids have been proven to spread HIV:
- blood
- semen
- vaginal fluid
- breast milk
- other body fluids containing blood
These are additional body fluids that may transmit the virus that
health care workers may come into contact with:
- fluid surrounding the brain and the spinal cord
- fluid surrounding bone joints
- fluid surrounding an unborn baby
How does HIV cause AIDS?
HIV destroys a certain kind of blood cells--CD4+
T cells (helper cells)--which are crucial to the normal function
of the human immune system. In fact, loss of these cells in people
with HIV is an extremely powerful predictor of the development of
AIDS. Studies of thousands of people have revealed that most people
infected with HIV carry the virus for years before enough damage
is done to the immune system for AIDS to develop. However, recently
developed sensitive tests have shown a strong connection between
the amount of HIV in the blood and the decline in CD4+ T cell numbers
and the development of AIDS. Reducing the amount of virus in the
body with anti-HIV drugs can slow this immune destruction.
How can I get more information about AIDS?
CDC operates a free telephone service that is available
24-hour, 7 days a week. You can contact the CDC National STD and
AIDS Hotlines at 1-800-342-2437. There is also a Statewide STD Hotline
which you may call for additional information and that number is
1-800-78 FACTS and they can also inform you of testing sites all
around the state of Minnesota.
DHAP, NCHSTP, CDC
Atlanta, GA February 6, 2001
Back to Contents
HIV and Its Transmission
Research has revealed a great deal of valuable medical, scientific,
and public health information about the human immunodeficiency virus
(HIV) and acquired immunodeficiency syndrome (AIDS). The ways in
which HIV can be transmitted have been clearly identified. Unfortunately,
false information or statements that are not supported by scientific
findings continue to be shared widely through the Internet or popular
press. Therefore, the Centers for Disease Control and Prevention
(CDC) has prepared this fact sheet to correct a few misperceptions
about HIV.
How HIV is Transmitted?
HIV is spread by sexual contact with an infected
person, by sharing needles and/or syringes (primarily for drug injection)
with someone who is infected, or, less commonly (and now very rarely
in countries where blood is screened for HIV antibodies), through
transfusions of infected blood or blood clotting factors. Babies
born to HIV-infected women may become infected before or during
birth or through breast-feeding after birth.
In the health care setting, workers have been infected with HIV
after being stuck with needles containing HIV-infected blood or,
less frequently, after infected blood gets into a worker's open
cut or a mucous membrane (for example, the eyes or inside of the
nose). There has been only one instance of patients being infected
by a health care worker in the United States; this involved HIV
transmission from one infected dentist to six patients. Investigations
have been completed involving more than 22,000 patients of 63 HIV-infected
physicians, surgeons, and dentists, and no other cases of this type
of transmission have been identified in the United States.
Some people fear that HIV might be transmitted in other ways; however,
no scientific evidence to support any of these fears has been found.
If HIV were being transmitted through other routes (such as through
air, water, or insects), the pattern of reported AIDS cases would
be much different from what has been observed. For example, if mosquitoes
could transmit HIV infection, many more young children and preadolescents
would have been diagnosed with AIDS.
All reported cases suggesting new or potentially unknown routes
of transmission are thoroughly investigated by state and local health
departments with the assistance, guidance, and laboratory support
from CDC. No additional routes of transmission have been recorded,
despite a national sentinel system designed to detect just such
an occurrence.
The following paragraphs specifically address some of the common
misperceptions about HIV transmission.
HIV in the Environment
Scientists and medical authorities agree that HIV
does not survive well in the environment, making the possibility
of environmental transmission remote. HIV is found in varying concentrations
or amounts in blood, semen, vaginal fluid, breast milk, saliva,
and tears. (See page 3, Saliva, Tears, and Sweat.)
To obtain data on the survival of HIV, laboratory studies have required
the use of artificially high concentrations of laboratory-grown
virus. Although these unnatural concentrations of HIV can be kept
alive for days or even weeks under precisely controlled and limited
laboratory conditions, CDC studies have shown that drying of even
these high concentrations of HIV reduces the amount of infectious
virus by 90 to 99 percent within several hours. Since the HIV concentrations
used in laboratory studies are much higher than those actually found
in blood or other specimens, drying of HIV-infected human blood
or other body fluids reduces the theoretical risk of environmental
transmission to that which has been observed--essentially zero.
Incorrect interpretation of conclusions drawn from laboratory studies
have unnecessarily alarmed some people.
Results from laboratory studies should not be used to assess specific
personal risk of infection because (1) the amount of virus studied
is not found in human specimens or elsewhere in nature, and (2)
no one has been identified as infected with HIV due to contact with
an environmental surface. Additionally, HIV is unable to reproduce
outside its living host (unlike many bacteria or fungi, which may
do so under suitable conditions), except under laboratory conditions,
therefore, it does not spread or maintain infectiousness outside
its host.
Households
Although HIV has been transmitted between family
members in a household setting, this type of transmission is very
rare. These transmissions are believed to have resulted from contact
between skin or mucous membranes and infected blood. To prevent
even such rare occurrences, precautions, as described in previously
published guidelines, should be taken in all setting "including
the home" to prevent exposures to the blood of persons who
are HIV infected, at risk for HIV infection, or whose infection
and risk status are unknown. For example,
- Gloves should be worn during contact with blood or other body
fluids that could possibly contain visible blood, such as urine,
feces, or vomit.
- Cuts, sores, or breaks on both the care giver's and patient's
exposed skin should be covered with bandages.
- Hands and other parts of the body should be washed immediately
after contact with blood or other body fluids, and surfaces soiled
with blood should be disinfected appropriately.
- Practices that increase the likelihood of blood contact, such
as sharing of razors and toothbrushes, should be avoided.
- Needles and other sharp instruments should be used only when
medically necessary and handled according to recommendations for
health-care settings. (Do not put caps back on needles by hand
or remove needles from syringes. Dispose of needles in puncture-proof
containers
Businesses and Other Settings
There is no known risk of HIV transmission to co-workers,
clients, or consumers from contact in industries such as food-service
establishments (see information on survival of HIV in the environment).
Food-service workers known to be infected with HIV need not be restricted
from work unless they have other infections or illnesses (such as
diarrhea or hepatitis A) for which any food-service worker, regardless
of HIV infection status, should be restricted. CDC recommends that
all food-service workers follow recommended standards and practices
of good personal hygiene and food sanitation.
In 1985, CDC issued routine precautions that all personal-service
workers (such as hairdressers, barbers, cosmetologists, and massage
therapists) should follow, even though there is no evidence of transmission
from a personal-service worker to a client or vice versa. Instruments
that are intended to penetrate the skin (such as tattooing and acupuncture
needles, ear piercing devices) should be used once and disposed
of or thoroughly cleaned and sterilized. Instruments not intended
to penetrate the skin but which may become contaminated with blood
(for example, razors) should be used for only one client and disposed
of or thoroughly cleaned and disinfected after each use. Personal-service
workers can use the same cleaning procedures that are recommended
for health care institutions.
CDC knows of no instances of HIV transmission through tattooing
or body piercing, although hepatitis B virus has been transmitted
during some of these practices. One case of HIV transmission from
acupuncture has been documented. Body piercing (other than ear piercing)
is relatively new in the United States, and the medical complications
for body piercing appear to be greater than for tattoos. Healing
of piercings generally will take weeks, and sometimes even months,
and the pierced tissue could conceivably be abraded (torn or cut)
or inflamed even after healing. Therefore, a theoretical HIV transmission
risk does exist if the unhealed or abraded tissues come into contact
with an infected person's blood or other infectious body fluid.
Additionally, HIV could be transmitted if instruments contaminated
with blood are not sterilized or disinfected between clients.
Kissing
Casual contact through closed-mouth or "social"
kissing is not a risk for transmission of HIV. Because of the potential
for contact with blood during "French" or open-mouth kissing,
CDC recommends against engaging in this activity with a person known
to be infected. However, the risk of acquiring HIV during open-mouth
kissing is believed to be very low. CDC has investigated only one
case of HIV infection that may be attributed to contact with blood
during open-mouth kissing.
Biting
In 1997, CDC published findings from a state health
department investigation of an incident that suggested blood-to-blood
transmission of HIV by a human bite. There have been other reports
in the medical literature in which HIV appeared to have been transmitted
by a bite. Severe trauma with extensive tissue tearing and damage
and presence of blood were reported in each of these instances.
Biting is not a common way of transmitting HIV. In fact, there are
numerous reports of bites that did not result in HIV infection.
Saliva, Tears, and Sweat
HIV has been found in saliva and tears in very low
quantities from some AIDS patients. It is important to understand
that finding a small amount of HIV in a body fluid does not necessarily
mean that HIV can be transmitted by that body fluid. HIV has not
been recovered from the sweat of HIV-infected persons. Contact with
saliva, tears, or sweat has never been shown to result in transmission
of HIV.
Insects
From the onset of the HIV epidemic, there has been
concern about transmission of the virus by biting and bloodsucking
insects. However, studies conducted by researchers at CDC and elsewhere
have shown no evidence of HIV transmission through insects--even
in areas where there are many cases of AIDS and large populations
of insects such as mosquitoes. Lack of such outbreaks, despite intense
efforts to detect them, supports the conclusion that HIV is not
transmitted by insects.
The results of experiments and observations of insect biting behavior
indicate that when an insect bites a person, it does not inject
its own or a previously bitten person's or animal's blood into the
next person bitten. Rather, it injects saliva, which acts as a lubricant
or anticoagulant so the insect can feed efficiently. Such diseases
as yellow fever and malaria are transmitted through the saliva of
specific species of mosquitoes. However, HIV lives for only a short
time inside an insect and, unlike organisms that are transmitted
via insect bites, HIV does not reproduce (and does not survive)
in insects. Thus, even if the virus enters a mosquito or another
sucking or biting insect, the insect does not become infected and
cannot transmit HIV to the next human it feeds on or bites. HIV
is not found in insect feces.
There is also no reason to fear that a biting or bloodsucking insect,
such as a mosquito, could transmit HIV from one person to another
through HIV-infected blood left on its mouth parts. Two factors
serve to explain why this is so--first, infected people do not have
constant, high levels of HIV in their bloodstreams and, second,
insect mouth parts do not retain large amounts of blood on their
surfaces. Further, scientists who study insects have determined
that biting insects normally do not travel from one person to the
next immediately after ingesting blood. Rather, they fly to a resting
place to digest this blood meal.
Back to Contents
Effectiveness of Condoms
Condoms are classified as medical devices and are regulated by
the Food and Drug Administration (FDA). Condom manufacturers in
the United States test each latex condom for defects, including
holes, before it is packaged. The proper and consistent use of latex
or polyurethane (a type of plastic) condoms when engaging in sexual
intercourse--vaginal, anal, or oral--can greatly reduce a person's
risk of acquiring or transmitting sexually transmitted diseases,
including HIV infection.
There are many different types and brands of condoms available--however,
only latex or polyurethane condoms provide a highly effective mechanical
barrier to HIV. In laboratories, viruses occasionally have been
shown to pass through natural membrane ("skin" or lambskin)
condoms, which may contain natural pores and are therefore not recommended
for disease prevention (they are documented to be effective for
contraception). Women may wish to consider using the female condom
when a male condom cannot be used.
For condoms to provide maximum protection, they must be used consistently
(every time) and correctly. Several studies of correct and consistent
condom use clearly show that latex condom breakage rates in this
country are less than 2 percent. Even when condoms do break, one
study showed that more than half of such breaks occurred prior to
ejaculation.
When condoms are used reliably, they have been shown to prevent
pregnancy up to 98 percent of the time among couples using them
as their only method of contraception. Similarly, numerous studies
among sexually active people have demonstrated that a properly used
latex condom provides a high degree of protection against a variety
of sexually transmitted diseases, including HIV infection.
For more detailed information about condoms, see the CDC publication
"Facts about Condoms and Their Use in Preventing HIV Infection
and Other STDs."
CDC's Response
CDC is committed to providing the scientific community
and the public with accurate and objective information about HIV
infection and AIDS. It is vital that clear information on HIV infection
and AIDS be readily available to help prevent further transmission
of the virus and to allay fears and prejudices caused by misinformation.
For a complete description of CDC's HIV/AIDS prevention programs,
see "Facts about CDC's Role in HIV and AIDS Prevention."
Back to Contents
HIV and AIDS: Are You at Risk?
What is HIV and how can I get it?
HIV - the human immunodeficiency
virus - is a virus that kills your body's "CD4 cells."
CD4 cells (also called T-helper cells) help your body fight off
infection and disease. HIV can be passed from person to person if
someone with HIV infection has sex with or shares drug injection
needles with another person. It also can be passed from a mother
to her baby when she is pregnant, when she delivers the baby, or
if she breast-feeds her baby.
What do I need to know about HIV?
The first cases of AIDS were identified in the United
States in 1981, but AIDS most likely existed here and in other parts
of the world for many years before that time. In 1984 scientists
proved that HIV causes AIDS.
Anyone can get HIV. The most important thing to know is how you
can get the virus.
You can get HIV:
- By having unprotected sex- sex without a condom- with someone
who has HIV. The virus can be in an infected person's blood, semen,
or vaginal secretions and can enter your body through tiny cuts
or sores in your skin, or in the lining of your vagina, penis,
rectum, or mouth.
- By sharing a needle and syringe to inject drugs or sharing drug
equipment used to prepare drugs for injection with someone who
has HIV.
- From a blood transfusion or blood clotting factor that you got
before 1985. (But today it is unlikely you could get infected
that way because all blood in the United States has been tested
for HIV since 1985.)
Babies born to women with HIV also can become infected during pregnancy,
birth, or breast-feeding.
You cannot get HIV:
- By working with or being around someone who has HIV.
- From sweat, spit, tears, clothes, drinking fountains, phones,
toilet seats, or through everyday things like sharing a meal.
- From insect bites or stings.
- From donating blood.
- From a closed-mouth kiss (but there is a very small chance of
getting it from open-mouthed or "French" kissing with
an infected person because of possible blood contact).
How can I protect myself?
- Don't share needles and syringes used to inject drugs, steroids,
vitamins, or for tattooing or body piercing. Also, don't share
equipment ("works") used to prepare drugs to be injected.
Many people have been infected with HIV, hepatitis, and other
germs this way. Germs from an infected person can stay in a needle
and then be injected directly into the next person who uses the
needle.
- Don't have sex.
- Or, if you do make this decision, have sex only with one partner
who you know doesn't have HIV and is only having sex with you.
The more sex partners you have, the greater your chances are of
getting HIV or other diseases passed through sex.
- Use a latex condom every time you have sex, including oral and
anal sex. If you are allergic to latex, there is a polyurethane
(a type of plastic) condom that you can try. There also is a condom
that women can use to protect themselves. Don't use lambskin
condoms - they might not protect you against HIV.
- Don't share razors or toothbrushes because of the possibility
of contact with blood.
- If you are pregnant or think you might be soon, talk to a doctor
or your local health department about being tested for HIV. Drug
treatments are available to help you and reduce the chance of
passing HIV to your baby if you have it.
How do I know if I have HIV or AIDS?
You might have HIV and still feel perfectly healthy.
The only way to know for sure if you are infected or not is to be
tested. Talk with a knowledgeable health care provider or counselor
both before and after you are tested. You can go to your doctor
or health department for testing or buy a home collection kit (for
testing for HIV antibodies) at many pharmacies. To find out where
to go in your area for HIV counseling and testing, call your local
health department or the CDC National AIDS Hotline, at 1-800-342-AIDS
(2437).
Your doctor or health care provider can give you a confidential
HIV test. The information on your HIV test and test results are
confidential, just as your other medical information. This means
it can be shared only with people authorized to see your medical
records. You can ask your doctor, health care provider, or HIV counselor
at the place you are tested to explain who can obtain this information.
For example, you may want to ask whether your insurance company
could find out your HIV status if you make a claim for health insurance
benefits or apply for life insurance or disability insurance.
In many states, you can be tested anonymously. These tests are
usually given at special places known as anonymous testing sites.
When you get an anonymous HIV test, the testing site records only
a number or code with the test result, not your name. A counselor
gives you this number at the time your blood, saliva, or urine is
taken for the test, then you return to the testing site (or perhaps
call the testing site, for example with home collection kits) and
give them your number or code to learn the results of your test.
- You are more likely to test positive for (be infected with)
HIV if you:
- Have ever shared injection drug needles and syringes or "works."
- Have ever had sex without a condom with someone who had HIV.
- Have ever had a sexually transmitted disease, like chlamydia
or gonorrhea.
- Received a blood transfusion or a blood clotting factor between
1978 and 1985.
- Have ever had sex with someone who has done any of those things
What can I do if the test shows I have HIV?
Although HIV is a very serious infection, many people
with HIV and AIDS are living longer, healthier lives today, thanks
to new and effective treatments. It is very important to make sure
you have a doctor who knows how to treat HIV. If you don't know
which doctor to use, talk with a health care professional or trained
HIV counselor. If you are pregnant or are planning to become pregnant,
this is especially important.
There also are other things you can do for yourself to stay healthy.
Here are a few:
- Follow your doctor's instructions. Keep your appointments. Your
doctor may prescribe medicine for you. Take the medicine just
the way he or she tells you to because taking only some of your
medicine gives your HIV infection more chance to grow.
- Get immunizations (shots) to prevent infections such as pneumonia
and flu. Your doctor will tell you when to get these shots.
- If you smoke or if you use drugs not prescribed by your doctor,
quit.
- Eat healthy foods. This will help keep you strong, keep your
energy and weight up, and help your body protect itself.
- Exercise regularly to stay strong and fit.
- Get enough sleep and rest.
Back to Contents
MYTH vs. REALITY
MYTH: Since I only have oral sex, I'm not at risk for HIV/AIDS
REALITY: You can get HIV by having oral sex
with a man or a woman. That is why it is important to use a latex
barrier during oral, vaginal or anal sex.
MYTH: HIV/AIDS is a gay disease
REALITY: Anyone can be susceptible to HIV/AIDS,
regardless of their sexual orientation. Everyone is at risk of getting
HIV from blood-to-blood contact, sharing needles or unsafe sex.
Worldwide, HIV is spread most often through heterosexual contact.
"It isn't who you are, it is what you do that places you at
risk"
MYTH: I can get HIV by sharing exercise equipment or playing sports
with an HIV-positive person
REALITY: Contact with sweat or tears has
never been shown to result in transmission of HIV.
MYTH: You cannot get HIV if you are using birth control methods
like the pill, Depo-Provera, contraceptive patch, spermicides, diaphragms,
etc.
REALITY: These birth control methods do not
prevent the transmission of sexually transmitted diseases (STD)
such as HIV. They only aim to prevent pregnancy. The surest way
to prevent both pregnancy and an STD infection is through abstinence.
One way people who are sexually active may prevent pregnancy and
STD infection is to use a condom in combination with another form
of birth control, such as the ones listed above.
MYTH:Getting tested for HIV is pointless.
REALITY: Knowing you are HIV-positive will
allow you to seek early treatment that can help you stay healthy
longer and enable you not to pass the virus to someone else.
MYTH: There is no such thing as safer sex.
REALITY: Safer sex is sexual activity without
penetration, or sex with a latex condom or a latex barrier (in case
of oral sex).
Back to Contents
Ribbon of Red by Michael Watts
A woman came up to me and said
"Why do you wear that there"
I said "To show I remember to show I care"
A man came up to me and said
"Why do you wear that there"
I said "To show it's out there to show I'm aware"
A child came up to me and said
"Why do you wear that ribbon of red"
I said "I wear it for the living and for the dead"
A Teenager came up to me and said
"I know why you wear that ribbon there"
"Oh" I said "Please tell my why"
"I don't need to" he said "I can see the pain in
your eyes
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