HIV and STI Info and Prevention

Acquired immune deficiency syndrome or acquired immunodeficiency syndrome (AIDS) is a collection of symptoms and infections resulting from the specific damage to the immune system caused by the human immunodeficiency virus (HIV). The late stage of the condition leaves individuals susceptible to opportunistic infections and tumors. Although treatments for AIDS and HIV exist to slow the progression of the virus, there is currently no known cure. HIV is transmitted through direct contact with blood or body fluids that contain HIV such as semen, vaginal fluid, pre-seminal fluid or breast milk. Transmission can come through anal, vaginal or oral sex, blood transfusion, contaminated hypodermic needles, an exchange between mother and baby during pregnancy, childbirth, breastfeeding or other exposures to one of the above bodily fluids.
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 get HIV from a toilet seat, drinking fountain, doorknob, dishes, drinking glasses, food, or pets. You also cannot get HIV from mosquitoes.

HIV is primarily found in the blood, semen, or vaginal fluid of a person with HIV. HIV is transmitted in 3 main ways:

• Having sex (anal, vaginal, or oral) with someone who has HIV
• Sharing needles and syringes with someone infected with HIV
• Exposure of a fetus or infant to HIV before or during birth or through breastfeeding

HIV can also be transmitted through blood. However, since 1985, all donated blood in the United States has been tested for HIV. Therefore, the risk getting HIV through the transfusion of blood or blood products is extremely low. The U.S. blood supply is considered among the safest in the world.

The only way to know whether you have HIV is to be tested. You cannot rely on symptoms alone because many people who have HIV do not have symptoms for many years. Someone can look and feel healthy but can still have the virus. In fact, one-quarter of the persons living with HIV in the United States do not know that they are positive.

STIs are spread through contact with:

• Infected blood and body fluids such as vaginal secretions or semen
• Infected skin or mucous membranes—for example, sores in the mouth

Activities that expose you to infected body fluids or skin include:

• Vaginal, anal, or oral sex WITHOUT the proper use of a latex condom or other barrier methods. Anal sex is especially risky because it often causes bleeding.
• Sharing needles or syringes for drug use, ear piercing, tattooing, etc.

Having an STI may increase your risk of getting HIV. STIs can break down the body's most important defense—the skin and mucous membranes causing sores and thus provide a way for HIV to enter the body.

• Use latex condoms with a water-based lubricant every time you have vaginal, anal or oral sex. Latex condoms will help protect you from STIs much of the time. Both men and women should carry condoms.
• Use plastic (polyurethane) condoms if you are allergic to latex. These come in both male and female styles.
• Talk to your partners about past sex partners and about needle drug use. Avoid having sex with someone that you think may have an STI.
• Look closely at your sex partner for signs of STIs such as a rash, sores or discharge. If you are not comfortable, do not have sex.
• Have regular physical exams.
• If you think you've been exposed to an STI:
  -Get tested
  -Know the signs and symptoms of STI. If you notice a symptom that worries you, get checked.
• Use a new condom every time you have sex, even oral or anal. Discard any "new" condom that's damaged, sticky, or brittle.
• Squeeze tip of the condom to remove any air. Excess air could cause the condom to break.
• When the penis is hard (before any sexual contact), place the condom on the tip and roll down all the way.
• After ejaculation, withdraw penis while still hard.
• Hold on the rim of the condom as you withdraw so nothing spills. Carefully remove the condom and throw it in the trash.
• If more lubrication is needed, use K-Y Jelly or other water-based or silicone lubricant.
• Do not use oil-based lubricants such as petroleum jelly, mineral oil, vegetable oil or cold cream as these could break the condom.
• Don't inject drugs. Sharing needles or syringes can expose you to infected blood. Not injecting drugs is an essential part of protecting yourself from STIs.
• Avoid alcohol and other drugs. They can make you more likely to take chances when having sex.
• Don't douche if you think you have an infection. You may force germs farther into the vagina or alter the natural balance of vaginal fluids.

• Talk to your sex partner(s). Encourage them to get tested and treated. Partners need to be treated to avoid reinfection.
• Avoid sex until your physician says it's okay to resume. Follow your treatment plan and finish all medications, even if you feel well. Follow up exams can make sure treatment was effective.
• Get counseling if you're worried or upset about having an STI. Your physician or STI clinic can recommend a counselor. 
• Condoms help protect from STIs and unwanted pregnancies.

PrEP is a daily pill that, when taken as prescribed, greatly reduces your risk of getting HIV. PrEP does not provide immunity against HIV; as soon as you stop taking PrEP, you lose protection against the HIV virus. PrEP has to be taken every day for optimal protection against HIV. PrEP is not a vaccine. A vaccine provides immunity against an illness for a long period of time with no daily upkeep.

PrEP typically takes 7 days to provide full protection for anal sex and 20 days for vaginal sex. It’s important to use condoms during those times to prevent HIV transmission.

When taken correctly and consistently, PrEP is 92%–99% effective in reducing your risk for HIV.

No. We recognize that people go in and out of “seasons of risk,” where there are certain times it makes sense to take PrEP, and then other times where it doesn’t make sense to take PrEP.

Using condoms is a personal choice made between you and your sex partners. PrEP only protects against HIV so condoms can help you prevent things that PrEP can’t—like pregnancy, or STIs.

Most PrEP users don’t experience side effects. In your first few weeks of taking PrEP, you might experience minor symptoms such as fatigue, headache, abdominal pain and weight loss. These side effects should go away.

No. PrEP (Pre-Exposure Prophylaxis) can only prevent HIV when taken consistently BEFORE exposure. PrEP cannot be started as a method of treatment AFTER an event of HIV exposure (such as sex without a condom, needle-sharing drug use, or sexual assault).

PEP (Post-Exposure Prophylaxis) is the 28-day treatment regimen recommended for people who’ve been exposed to HIV. If you think you have been exposed to HIV, it is important that you start taking PEP as soon as possible. PEP is only effective if taken within 72 hours of possible HIV exposure.

If you are exposed to HIV during a weekend, or you cannot make an appointment for the next day with your primary care doctor, go to an emergency room for immediate treatment. Do not wait more than 36 hours to start PEP treatment.

If you are currently taking PEP, talk to your doctor before starting PrEP. Blood testing and a short wait time are required to make sure you are HIV-negative after finishing a PEP regimen.

If your primary care doctor is unfamiliar with PrEP, call Fulton County Board of Health PrEP Expansion Department at 404-613-4708. Our physicians or PrEP Educators can contact your doctor on your behalf to talk about what PrEP is, and how it might be beneficial to you.