Hesperian Health Guides
What is HIV/AIDS?
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HIV (Human Immunodeficiency Virus) is a very small germ you cannot see that weakens the immune system, the part of the body that fights off infection and disease. HIV is most often spread from one person to another during sex. If a man passes HIV to a pregnant woman, or if a pregnant woman is already infected with HIV, the virus can also pass to a baby during pregnancy, during the birth, or during breastfeeding. See more information about the ways someone can and cannot be infected with HIV.
AIDS (Acquired Immune Deficiency Syndrome) is a disease that develops some time after a person has been infected with HIV. A person is said to have AIDS when he or she starts to get many common health problems more often than usual. Some signs of AIDS are losing weight, sores that will not heal, a bad cough, sweating at night, diarrhea, skin rashes, a fever, discharge from the vagina, or feeling very tired all the time. But all of these problems can have other causes. You cannot be sure a person has HIV/AIDS without a special blood test.
Because the immune system of a person infected with HIV gets weaker and weaker with each illness, the person's body is less able to fight illness and recover. This goes on until the person's body is too weak to survive, and he or she dies. Anyone can get HIV/AIDS, both persons with a disability and persons without a disability.
Some people die from AIDS very quickly after they become infected with HIV. But for many people, several years can pass before they get sick with AIDS. This means that a person can be infected with HIV and not know because he or she feels healthy. Regardless of how they feel, they can pass HIV to another person as soon as they are infected. The only way to know if you are infected is to have your blood tested. This can be done at many clinics and hospitals.
Medicines called ARVs (antiretrovirals) can help people with HIV/AIDS live longer and healthier lives. These medicines do not kill HIV or cure AIDS, but they make the sickness easier to live with. For pregnant women, ARV treatment can prevent HIV from passing from the mother to the baby. Unfortunately, ARVs can be expensive and may be difficult to get in some countries. For more information, see AntiRetroviral Therapy (ART).
How HIV/AIDS affects women
Women with HIV often become sick with AIDS more quickly than men do. Poor nutrition and childbearing may make women less able to fight disease. Also, women get infected with HIV more easily than men do. When a man’s semen gets into a woman’s body during sex, it can easily pass through her vagina or cervix into her blood, especially if there are any cuts or sores. This can happen whether or not the woman has a disability.
Knowing if you have HIV
The HIV test
When HIV enters the body, the immune system starts to make antibodies right away to fight the virus. Within 2 to 4 weeks, an HIV test can detect these antibodies in the blood. This is the only way to know if a person has been infected with HIV.
A positive HIV test means you are infected with the virus and your body has made antibodies to HIV. Even if you feel completely well, you can pass the virus to others.
A negative HIV test means 1 of 2 things:
- you are not infected with HIV, or
- you were recently infected but your body has not yet made enough antibodies to HIV to test positive.
If you have tested negative for HIV but think you may be infected, you should take the test again in about 6 weeks. Sometimes a positive test also needs to be repeated. An experienced health worker can help you decide.
NOTE: Testing and counseling for HIV are usually done at the same time and are becoming more available. Ask a health worker where you can be tested in your community. In many health centers and hospitals, rapid HIV testing is available at low or no cost. You can usually get test results the same day. Some testing centers have information in Braille, and some have sign language.
The HIV test should only be done:
- with your permission.
- with counseling before and after the test.
- with privacy. Only you and those you want to know should know the results.
A trained HIV/AIDS counselor can help you decide if you need to get tested for HIV. If your test is positive, the counselor can help you decide how to face this change in your life.
A good counselor can help you make decisions and think about many problems and complicated situations, such as:
- how to accept that you or your partner has HIV.
- when and how to tell others (disclose) that you have HIV.
- how to continue having sex and to have sex safely when one partner has HIV and the
other partner does not.
- where to get condoms and how to use them.
- where to get and how to take medicines and get treatment for illnesses caused by HIV.
- how to decide if you should get pregnant when either you or your partner is HIV positive, and how to prevent passing HIV to a baby.
- where to get food, housing, legal advice, or other help you or your family may need.
Protecting your privacy
Any woman should be able to make her own decisions about who to tell about her HIV status and how to tell them. It is important for a woman to talk with her sexual partner or partners, so they can also be tested or protect their health. Many women tell their families and others who support them. But often, women are afraid everyone in the community will find out.
It can be difficult for a woman with a disability to have a private conversation with a health worker. This may be because:
- the health worker has never learned that a woman with a disability should be treated with the same respect as any woman.
- the health worker will tell the family or friends of a woman with a disability about her health problems, including HIV or an STI, without telling the woman herself. This is especially true if the disabled woman has difficulty communicating.
- the woman’s family will not let the woman see a health worker by herself.
with me, I remind her ahead of time that whatever I talk about with the health worker is private. I try to make sure the interpreter understands that the test results are private. I ask her not to tell anyone else—not even my family—without my permission.
Health problems caused by HIV/AIDS
A person with AIDS can get sick very easily from many different common health problems. Here is some general information about some of these problems, but it is best to talk to a health worker or see a book like HIV, Health and Your Community for more information. The most common health problems caused by HIV/AIDS are:
Fever: Fevers often come and go. It is hard to know if the fever is from an infection that can be treated, like tuberculosis, pelvic inflammatory disease (PID), or malaria, or if it is from HIV itself. If the fever is caused by an infection, then make sure the infection itself is treated.
Diarrhea: Diarrhea may come and go and can be hard to cure. The most common causes of diarrhea in persons with AIDS are infections, or the side effects of some medicines.
Skin rashes and itching: It is often difficult to know what causes skin rashes and itching. Some of the skin problems related to HIV/ AIDS can be caused by:
- allergic reactions to medicines.
- brown or purple patches on the mouth or skin, caused by a cancer of the blood vessels or lymph nodes called Kaposi’s sarcoma.
- herpes zoster (shingles), which usually begins as a painful rash with blisters that break open. It is most common on the face, back and chest.
Nausea and vomiting: This can be caused by infections, some medicines, problems with the stomach and intestines, or the HIV infection itself.
Cough: This can be a sign of lung problems, such as pneumonia or tuberculosis (TB). The lungs make more mucus when they are irritated or infected, which causes coughing.
Tuberculosis is a serious infection caused by a germ that usually affects the lungs. The signs of AIDS and TB are similar, but they are different diseases. Most women, men and children with TB do not have AIDS. But someone with AIDS can get TB very easily because the person’s body is too weak to fight it. For 1 of every 3 people who dies from AIDS, it is TB that actually kills them.
Problems with the mouth and throat: The problems can include: soreness, cracks, sores and blisters, and white patches on the tongue (thrush).
Weight loss and malnutrition: A person with AIDS can become malnourished from constantly being sick, from diarrhea that prevents the body from absorbing the nutrients in food, from loss of appetite, and from mouth infections that make eating difficult. Weight loss is so common in people with HIV that in some areas of Africa, AIDS is called “slim disease.”
Treatment for HIV/AIDS
Neither modern medicine nor traditional healing systems has found a cure for AIDS. But there are many things that can be done to help a person with AIDS. Clean water, good food, clean clothes, a clean place to rest and sleep, and loving relationships with friends and family can all help someone with AIDS stay healthy. The same foods that are good for someone who is healthy are good to eat when someone has an AIDS-related sickness.
Although there is no cure for AIDS, antiretroviral medicines (ARVs) are now being used successfully to treat people who are sick with AIDS. ARVs help strengthen the immune system so the person with HIV can fight off infections and stay healthy. But the HIV is not cured. Small amounts of the virus always remain in the person’s body. When a person has HIV, he or she can always pass the virus to someone else.
Getting good health care is often not easy for women with disabilities, and for those who are also infected with HIV/AIDS, it can be even more difficult. Health workers may not want to test or treat them because they think disabled women cannot have sex, cannot get infected with HIV/AIDS, or will die quickly if they are infected.
But just as women with disabilities have the same risk of getting infected with HIV as other women, they will also live longer and healthier lives if they get treatment.
AntiRetroviral Therapy, or ART, means taking a combination of 3 antiretroviral medicines at least 2 times a day. Once a person with AIDS begins ART, the medicines must be taken faithfully every day. A woman on ART will gain weight, and look and feel healthier. But if she stops ART, misses doses of medicine, or takes them at the wrong times, her HIV can become stronger and make her sick again. See more information about medicines for treating HIV/AIDS for women with disabilities, or for preventing the spread of HIV from a mother to her baby.
Although ART is costly, it is becoming cheaper and more available in many countries. Government health facilities and other programs may offer ART at low or no cost.
Even so, in many communities, medicines are not available for most people with HIV/AIDS. The power of large pharmaceutical companies in rich countries has often stopped other countries from making their own less expensive medicines. This has denied millions of women access to the medicines they need to treat HIV/AIDS.
AIDS affects the body’s ability to digest food properly, and it also causes people to lose their appetite so they become very thin. This can also happen because of the side effects of medicines, mouth and throat problems, diarrhea, and difficulty digesting fats.
If you have HIV, it is especially important to try to eat well so you do not lose weight, and your body and immune system can be as healthy as possible. To do this, try to eat a varied or balanced diet, drink clean water, and take a daily multivitamin. If available, you may also want to take supplements of vitamins A, C, and E, as they may slow the ability of the HIV virus to grow in your body.
Foods with vitamin A include carrots, mangos, papayas, sweet potatoes, milk, eggs, and dark green leafy vegetables (such as kale, spinach, turnip greens).
Foods with vitamin C include red and green peppers, dark leafy green vegetables (such as kale, cassava or manioc leaves, collard, turnip, mustard greens, and spinach), orange, yellow, and red fruits.
Foods with vitamin E include eggs, and oils made from almonds, corn, palm nuts, peanuts, sunflower seeds, wheat germ, and olives.
If you lose your appetite, you may find that eating a larger meal in the morning works best for you. Or you may prefer to eat 6 to 8 small meals throughout the day. Drinking cold liquids with meals can make food easier to swallow.
Living positively with HIV/AIDS
You will stay healthier if you can:
- drink and prepare food only in clean, safe water.
- avoid uncooked vegetables—they are hard for the body to digest and may have germs.
- drink a lot of liquids and watch for dehydration.
- rest whenever you are tired and sleep at least 8 hours every day.
- spend time with friends and family.
- do things you enjoy. Feeling good is part of being healthy.
- try not to worry too much. Stress can harm the immune system.
- try to keep active by doing your daily work.
- exercise as much as possible.
- avoid tobacco, alcohol and other drugs.
- prevent infection by washing often.
- practice safer sex to prevent new infections and unplanned pregnancies that could weaken the immune system.
- take care of medical problems early. Each infection can weaken your immune system more.
- take cotrimoxazole to prevent diarrhea .
- sleep under a bed net if you live where malaria is common.
Stigma and HIV/AIDS
In some communities, people who are HIV-positive or have AIDS are made to feel ashamed. No one in the community will associate with them, and they think the family of someone who has HIV/AIDS has disgraced the community.
Thousands of HIV-positive people hide their status. They are frightened of rejection by friends, family, and neighbors, even though HIV/AIDS is not passed from one person to another through casual contact.
Many people with AIDS and their families do not ask for help from their communities because of the shame and disgrace they are made to feel. This can make it very difficult for someone with AIDS to get the help and treatment he or she needs, even though there are medicines available that allow people with AIDS to live longer, healthier lives.