World AIDS Day
1 December 2021
Common Misconceptions about AIDS
World AIDS Day is commemorated on the 1st of December every year. And this year’s theme is “End Inequalities, End AIDS, End Pandemics”.
Under the current Covid-19 pandemic with continuing emergence of new variants, AIDS (Acquired Immunodeficiency Syndrome) has been accorded less attention. Nonetheless, the AIDS epidemic in Thailand continues to be a major issue. In 2021; the Department of Disease Control anticipates HIV case prevalence of 493,859, including 5,825 new cases (averaging16 cases/day) and 11,214 deaths (31 cases/day). The Department of Health and the Thai Red Cross Society have pushed for heightened awareness and a sense of urgency to tackle HIV infection relentlessly. UNAIDS (Joint United Nations Program on HIV/AIDS) has set a target to end the AIDS epidemic by 2030.
To promote World AIDS Day, Asst. Prof. Dr Thanomsak Anekthananon, infectious disease specialist at MedPark Hospital and former president of the Thai AIDS Society (Term: 2013-2015), is here to answer and clarify prevailing misconceptions about AIDS.
- HIV-positive = AIDS?
HIV (Human Immunodeficiency Virus) is not synonymous with AIDS; it is a virus that damages the CD4 T lymphocytes of the immune system that play an important role in fighting off germs and other microbial invaders. When HIV-positive persons suffer from a dangerous opportunistic infection such as pneumocystis jiroveci pneumonia (PJP), tuberculosis (TB), cryptococcal meningitis, or when their CD4 count drops under 200 cells per cubic millimeter of blood, which is associated with immunodeficiency state, then the patient is considered to have full blown AIDS.
Can we live or share food with HIV-positive persons?
HIV cannot be passed from one person to another through breathing, sneezing, coughing, hugging, kissing, holding hands, sharing cutlery, straws, or other personal items such as a towel, handkerchief, and gym equipment. HIV cannot be transmitted through touching common surfaces such as toilet seats, doorknobs, or even being bitten by the same mosquito. However, sharing a spoon and straw can pass on other pathogens, and is not advisable.
HIV lives in the blood and secretions including semen, vaginal fluid, and breast milk. Hence, it can be transmitted through sexual activities, needle sharing, tattooing, body piercing, as well as from mother to child during childbirth, and breastfeeding. It is possible to live with HIV-positive persons, if side-stepping the HIV-transmissible activities.
- Can we get HIV from kissing, oral sex, and sex toys?
Open-mouth kissing can pass on HIV if both partners have mouth sores or ulcers, and one partner is HIV-infected. If a partner with mouth sore performs oral sex on a HIV-positive person, the ejaculate harboring HIV could be transmitted. However, both instances are considered very low-risk activities.
Sex toys coated with blood and secretion of a HIV-positive person, on the other hand, can transmit the virus if shared immediately.
- Does HIV virus shorten lifespan?
At present, HIV treatment is highly effective with few side effects. HIV-infected persons can lead a normal life even with AIDS. If timely treated and not seriously affected by opportunistic infections, they can be successfully treated and resume their lives even when the CD4 cell count is at 1 or zero. With treatment, CD4 counts can return to normal values and their health can be recovered. HIV-positive persons should not forego the treatment opportunity. Anyone who is at risk of HIV infection should seek immediate medical attention. If HIV is diagnosed, they should notify their partner to get tested and be treated, if need be, as soon as possible.
- Is Undetectable = HIV-negative?
Undetectable HIV viral load in the blood does not signify you are entirely free of HIV. It simply means that the antiretrovirals have suppressed and killed most of the virus, but some remain hidden in various body’s nooks and crannies such as the brain, lymph nodes, or in the intestine. If HIV-positive persons stop taking antiretroviral treatment, the virus in the latent reservoirs will multiply and weaken the immune system anew.
- Undetectable = Untransmissible?
There is now a conceptual belief called U = U (Undetectable = Untransmissible). If HIV-positive persons regularly and strictly adhered to the prescribed antiretroviral medicines until the viral load is under 40 copies/ml or becomes undetectable, then they would be untransmissible, and unprotected sex with untransmissible HIV persons will be safe. However, condom use is still recommended for protection against other sexually transmitted diseases and the potential viral load spikes in case of HIV drug resistance or irregular drug intakes, and unknowingly pass on the virus to their partners. The number of sexual partners should be limited as well.
Asst. Prof. Dr Thanomsak Anekthananon reassures that we can safely live with persons having HIV or AIDS. We should not discriminate, stigmatize, or despite them. However, we should still take precautions regarding sexual activities, regularly using a condom which not only can prevent HIV, but also other sexual transmitted diseases.
If you have a risky exposure or think you may be HIV-infected, please promptly get a HIV blood test to start HIV treatments as soon as possible. This help reduce the chance of complications, maintains your health, and protects your loved ones.
Currently, there are no effective vaccines that can prevent or treat HIV or medicines that can cure the disease. Long-term treatment is mandatory. Once infected, HIV infection remains for life. It is important to stay healthy and take your medication regularly. Do not buy anti-HIV medicines yourself. It is best to follow your doctor’s advice. Do not use herbs or dietary supplements or other medications which have not been clinically proven effective.
Article by
Asst.Prof.Dr Thanomsak Anekthananon
Infectious Disease
Doctor profile