Does AIDS still exist? Isn’t it the same thing as HIV? We need to talk. CONTENT WARNING: This story discusses drug use and LGBTQI+ issues. If this story raises any issues for you, please call DirectLine on 1800 888 236 or QLife on 1800 184 527. As the AIDS pandemic started emerging in Australia in the 1980s, Australia adopted a model of prevention to help curb the spread of this new blood borne virus. And it worked. Throughout the early 90s, Youth Projects played a critical role in informing and educating the community on the transmissibility of blood borne viruses (primarily AIDS and HIV) and provided access to harm reduction and needle syringe programs for people in Melbourne’s northern suburbs. A lot has changed in the past thirtysomething years, and this World AIDS Day we want to help bring you up to speed on what AIDS and HIV is, how you can prevent transmission, what to do if you’ve been exposed to HIV and understanding what support is available for living with HIV. Does AIDS still exist? People living with HIV in Australia may still develop AIDS, but it is very rare. Here in Australia, HIV diagnoses have generally been on the decline over the past 5 years – by about 12%. According to UNAIDS Global HIV & AIDS statistics, new HIV infections have been reduced by 52% since peaking in 1997, and AIDS-related deaths have been reduced by 64% since the peak in 2004, globally. Isn’t AIDS and HIV kind of the same thing? HIV and AIDs are not the same thing. HIV (Human Immunodeficiency Virus) is a condition that can cause AIDS (Acquired Immune Deficiency Syndrome). AIDS is the most severe stage of the human immunodeficiency virus (HIV). AIDS is not an interchangeable term with HIV. Without treatment, people with HIV are at risk of developing AIDS. By the time HIV has progressed to this stage, the immune system has become damaged by the virus and is vulnerable. People living with AIDS are more likely to develop infections and the body can no longer effectively do its job to fight off nasties. How does HIV spread? HIV is a blood borne virus and can be spread from person-to-person through contact with certain bodily fluids (blood, semen, pre-seminal fluid, rectal/vaginal fluids, and breast milk are the most common). HIV is primarily spread as a result of unprotected sex and sharing drug injection equipment (like needles) with someone who has HIV. Mothers can also transmit HIV to their child through pregnancy, childbirth, or breastfeeding. Prevention is important! Prevention is the most important tool available in combatting the spread of HIV, like: Practicing safer sex and using condoms Pre-Exposure Prophylaxis (PrEP) for HIV (to learn more about PrEP chat to your doctor or sexual health clinic) Anti-retroviral therapy (ART) / Treatment as Prevention (TasP) can help reduce the amount of HIV in a person’s body and may lead to what is called ‘viral suppression’. Chat to your doctor or sexual health clinic to learn more about ART. Sharing isn’t always caring. If you’re sharing injecting equipment, please don’t. Hit up your local NSP to access free, safe, clean injecting equipment. Know your HIV status! Blood tests for HIV are covered by Medicare in Australia which means your doctor can order a test free of charge for you! Most tests in Australia can detect HIV as early as 2 to 4 weeks after infection. How do I know if I’ve got HIV? Blood tests are the most common and reliable tests for HIV (and pretty easy to get through your doctor!). The virus is detected by taking a sample of your blood and testing for traces of the human immunodeficiency virus in your system. If your blood test results show HIV or its antibodies are present, you are HIV Positive. If you have no antibodies in your blood, you are HIV Negative. There is a period of time between exposure to HIV and the ability for tests to detect HIV or its antibodies (usually 2-12 weeks) so it’s always best to do a follow-up test! Our friends at Thorne Harbour Health run a free rapid HIV testing service called PRONTO, a peer-based service site for people at high risk for HIV (primarily gay, bisexual, and mean who have sex with men). If you’ve been exposed to HIV, Post Exposure Prophylaxis (PEP) may be considered as an emergency measure and must be taken within 72 hours of exposure. In Australia, PEP can be accessed through sexual health clinics or GPs who specialise in HIV or through emergency departments (EDs). What happens if I test positive for HIV? If your initial test is positive for HIV antibodies, then additional testing is required to confirm that the first test was accurate (sometimes this involves a second blood test). Part of testing best-practice includes pre and post-test counselling services which can provide emotional support, further information about HIV and referrals to support services. If your test result is negative, counselling can provide education about HIV and how to reduce your future risk. If your test result is positive, your doctor will discuss treatment and management options, and there are a heap of places to seek further support (like our friends at Living Positive Victoria or Thorne Harbour) Is there treatment available for HIV? Yes. HIV treatments available today involve medications that reduce the amount of virus in a person’s body by preventing it from multiplying (making copies of itself) and is sometimes referred to as ART (antiretroviral treatment). Treatment can reduce the amount of virus in a person’s body to such low levels that it is undetectable on blood tests used to measure the amount of virus in the blood – which means HIV cannot be transmitted to others. Thanks to antiretroviral treatment, HIV has now become a manageable chronic condition (like high blood pressure of diabetes) and allows people to live long, healthy lives. Covid-19 and HIV People living with HIV experience more severe outcomes and have higher comorbidities from Covid-19 than people not living with HIV. Studies out of England and South Africa have found that the risk of dying from Covid-19 among people with HIV was double that of the general population. The most important thing you can do is talk to your doctor, know your risk and get vaccinated if you are eligible. Living with HIV Living with HIV in 2021 should not be scary. HIV has now become a manageable chronic condition, that with early intervention, treatment and the right support, people can live long, healthy lives. Just like Dan shares, “HIV does not define who we are, but it motivates us to live a healthy life, to work together and change peoples’ views about HIV. We are not dirty. We have a disease that is manageable with treatment.” (you can read more of Dan's story here) HIV can affect anyone, and by normalising conversations around HIV and knowing that treatments are available, that there is no shame in living positive and support is available, we can continue breaking down community stigmas. More information on HIV and support services can be found at World AIDS Day Australia.