A Banner Publication
June 7, 2007 – No. 10
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Questions & Answers

1. Viruses are very common and, to a large extent, harmless, such as the common cold. What makes HIV so different and dangerous?

Most viruses are harmless. They attack the body, our body identifies them and neutralizes them, and we get better. However, HIV — the human immunodeficiency virus — causes AIDS, or the acquired immunodeficiency syndrome. HIV is a different and very dangerous virus because it attacks the immune system — the body’s primary method of fighting infections. Not only can the body not neutralize HIV, but HIV destroys our ability to fight infections gradually until we can be harmed by infections that we would usually be able to handle.

2. Is there a time when an HIV-positive person is no longer infectious?

Once you have HIV, you can always spread it and are always considered infectious. Some of the new medications bring the amount of HIV in the body — the viral load — to very low levels. Having an “undetectable viral load” does not mean, however, that a person is no longer infectious. Patients with undetectable blood levels may still have enough HIV in their semen or vaginal fluids to transmit infection. This is very, very important to know. Once you have HIV, you absolutely need to have safe sex, no matter what the circumstance.

3. Should people who are low risk for HIV get tested?

Anyone who has ever had unprotected sex should get tested for HIV. If you have unprotected sex between HIV exams, you should get tested again and get tested routinely. It is impossible to know if a sexual partner has HIV just by looking at them, or by assuming that they don’t have it because they haven’t had many sexual partners. If you engage in high-risk behaviors, such as frequent unprotected sex, or use intravenous drugs, you should get tested routinely as well.

For women who plan to become pregnant, testing is even more important. If a woman is infected with HIV, medical care and certain drugs given during pregnancy can lower the chance of passing HIV to her baby. All women who are pregnant should be tested during each pregnancy.

4. Can women with HIV infect men?

Absolutely, without a doubt. Vaginal secretions, and menstrual blood from an infected woman can contain HIV and infect a man during intercourse.

5. Is it possible for a person to be unaware that he or she has HIV?

One of the biggest challenges in tackling HIV infection locally and around the world is encouraging people who have no symptoms to get tested. The reason it is important that people get tested is because you can have HIV for many years and not know it, as you may have no symptoms at all. If you have HIV and don’t know it, not only are you at risk of infecting others during this time, but you are missing precious time when you could be getting treatment to slow down the progression of the disease to AIDS.

6. Can HIV survive outside the body?

HIV is a fragile virus. It cannot live for very long outside the body. As a result, the virus is not transmitted through day-to-day activities such as shaking hands, hugging, or a casual kiss. You cannot become infected from a toilet seat, drinking fountain, doorknob, dishes, drinking glasses, food, or pets. You also cannot get HIV from mosquitoes.

Maria-Pamela Janairo of the Disparities Solutions Center assisted in the preparation of these responses.

Joseph R. Betancourt, M.D.
Director of the Disparities Solutions Center, Massachusetts General Hospital

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