QUESTIONS ABOUT HIV & AIDS

Transcription

1 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV & AIDS AND ARV THERAPY 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY Adapted from the MASA Antiretroviral Therapy programme, August 2007 and the PIA/GTZ/NiBUCAA Workplace Programme NiBUCAA hotline: Nigerian Business Coalition Against AIDS (NiBUCAA) Julius Berger Nigeria PLC Office Complex Ijora Causeway, Lagos. Tel: , Please follow us on Facebook! For further information please contact your Workplace Programme Coordinator The views described herein are the views of this institution, and do not represent the views or opinions of The Global Fund to Fight AIDS, Tuberculosis and Malaria, nor is there any approval or authorization of this material, express or implied, by The Global Fund to Fight AIDS, Tuberculosis and Malaria.

2 CONTENTS INTRODUCTION Introduction Understanding HIV & AIDS Taking the Test I have found out that I have HIV-What should I do? Introduction to Antiretroviral Therapy Men and HIV/AIDS Women and HIV/AIDS I am positive, any question? HIV/AIDS can affect you or your loved ones. Everyone, irrespective of race, culture, country, tribe, religion and occupation can be infected or affected by the virus. It is unwise to discriminate against people living with HIV/AIDS. Such discrimination or stigmatisation is borne out of ignorance of the facts about HIV/AIDS or fear. We owe ourselves, our loved ones and our country a duty to stay uninfected, and to care and support people who are already infected or affected by the HIV/AIDS pandemic A person living with HIV/AIDS can live a longer and more productive life if he or she maintains a healthy lifestyle and adheres to the prescribed healthcare provider. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

3 UNDERSTANDING HIV & AIDS Immune: because it affects the body's defence mechanism or immune system, the part of the body that fight off germs such as bacteria and viruses. Deficiency: because it makes the immune system deficient (not to work properly) THE HI virus Syndrome: because someone with AIDS experience different kinds of diseases and infections. 3. HOW CAN YOU GET INFECTED WITH HIV 1. WHAT IS HIV? HIV is a germ of the viral family. It stands for Human Immuno-deficiency Virus. Like other viruses, HIV needs living cells to make copies of itself. The new copies of HIV infect other previously healthy cells. HIV spreads very quickly, if the process of copying itself is not brought under control. Human: because this virus infect only human cells. Immuno-deficiency: because the virus makes the immune system not to function properly (it makes the immune system incapable of fighting off infections). Virus: this organism does not reproduce by itself. A virus takes over a living cell and causes the cell to make copies of it. The ways in which you can become infected with HIV are: 1. Unprotected sex with an infected person 2. Sharing of sharp objects such as razor blades, circumcision knives or needles with an infected person or even toothbrushes. Unprotected sex is the most common way through which HIV is transmited 3. Through the transfusion of blood or blood products. 4. From an HIV-positive mother to her child. During pregnancy, at birth or through breastfeeding. 2. WHAT IS AIDS? HIV IS THE VIRUS THAT CAUSES AIDS. AIDS is a serious condition in which the body's ability to fight off illnesses is destroyed. AIDS stands for Acquired Immune Deficiency Syndrome. People with AIDS develop many illnesses, which ordinarily the body's immune system would have defeated quite easily. Acquired: because the condition is not hereditary (transmitted through the genes). One is infected with it. One acquires it along the path of life and through Mothers can transmit HIV to their babies through these ways 4. BUT I AM DECENT PERSON SURELY I CANNOT GET HIV? Sure you can! Some people think HIV/AIDS only affect other people especially sex workers, truck drivers or people with multiple sex partners. This is wrong. HIV/AIDS does not only happen to long distant drivers and sex workers, it can also happen to you. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

4 If you have unprotected sex (outside) even though it is once, you put yourself at risk because your partner may be HIV-positive, sometimes even without knowing it. All people, irrespective of religion, colour of the skin, race or tribe, young or old, need to protect themselves against HIV, either by abstaining from sex, being faithful to an uninfected sex partner or by using a condom. Sadly, rape is also a common way through which HIV is transmitted. 5. WHAT HAPPENS AFTER YOU BECOME INFECTED WITH HIV? The virus gradually multiplies inside the body and destroys the body's ability to fight off infections. The white blood cells (CD4 Cells). Which make up your immune system is HIV's main target. Normally, it takes years before a person with HIV start having illness as a result of HIV infection. People with HIV may not know they are infected but can pass the virus to others from the day of infection. 7. WOULD I KNOW WHETHER I WAS INFECTED WITH HIV IF I GOT TESTED IMMEDIATELY AFTER EXPOSURE TO THE VIRUS? No, because the HIV test looks for antibodies to the virus in a person's blood and for most people, these antibodies take six weeks to three months to develop. Getting tested before the end of the three-month period may result in an unclear test result. It is best to repeat the test after three to six months, just to be extra sure. ANTIBODIES An antibody is what your body produces when it identifies a foreign body or a germ such as a virus. Your immune system makes a `blue print' of what the body needs to kill off or isolate the invading body. Antibodies are like solders that fight off invading germs. IMMUNE SYSTEM Your Immune System is part of your blood system. It is a collection of 'soldiers of the body' that protect your body from infections. It consists of cells, called 'white blood' cells. 6. IS IT POSSIBLE TO KNOW THAT SOMEONE IS INFECTED WITH HIV? No, it is not possible. HIV is unusual. One can become infected with HIV for many years but still look and feel healthy. The only way you can know for sure if you or anybody is infected with HIV is by taking the HIV test. Your body produces antibodies to fight HIV 8. WHAT ARE THE FIRST SYMPTOMS OF HIV INFECTION? Before we answer this question, remember that the only way to know for sure if you are living with HIV is to get tested. Many people infected with the virus do not show signs of HIV infection at all for many years, and other illnesses can also cause most of the symptoms normally associated with HIV/AIDS. Keeping all this in mind, however, the following MIGHT be indications of HIV infection: HIV does not show on the face of someone living with the virus 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

5 Rapid weight loss Dry cough Recurring fever or heavy night sweats, deep and unexplained fatigue, swollen lymph glands in the armpits, groin, or neck Diarrhoea (running stomach) that lasts for more than one week White spots or unusual blemishes on the tongue Pneumonia Rapid loss in body weight could by a symptom of AIDS 10. HOW LONG CAN THE VIRUS SURVIVE OUTSIDE OF THE BODY? Although HIV can live outside the body for a few hours in certain body fluids, it cannot survive for long. As the body fluid containing HIV dries up, the virus also dies. The virus cannot infect someone unless it enters the body. There is no evidence that anyone has become infected with HIV from exposure to HIV in the environment. Red, brown, pink, or purplish sport on or under the skin or inside the mouth, nose, or eyelids Memory loss, depression, and other brain disorders. 9. I AM SCARED OF GETTING INFECTED WITH HIV. WHICH BODILY FLUIDS COULD CONTAIN THE VIRUS? The amount of HIV that is enough to infect somebody can be found in body fluids such as b l o o d a n d b l o o d products, semen, vaginal fluids or breast milk. Running stomach could be a symptom of AIDS Wear protective gloves when touching someone who is bleeding Very little amount of HIV may be present in saliva (of few people), blister fluid or tears. However, no one has been infected by coming into contact with tears. Please note, HIV has not been found in urine, faces, vomit or sweat You are not at risk of getting HIV from a trained healthcare worker 11. AM I AT RISK OF GETTING HIV WHEN VISITING A DOCTOR, DENTIST, HOSPITAL OR CLINIC? No, all health professionals protect themselves and their patients from infection, by making sure that their equipment is sterilized and by taking other precautions. Make sure that all needles used on you are new. 12. CAN I GET HIV FROM DEEP KISSING? Normally, deep kissing or tonguing is safe, except when you have sores or cuts in your mouth. HIV in your partner's saliva can come into your blood stream through those cuts or sores. People living with HIV/AIDS often develop small sores in their mouths, which increases the risk of infection. HOWEVER, YOU CANNOT GET HIV FROM: Dog bites Mosquito bites Shaking hands with an HIV-positive person Using the same toilet seat as an HIVpositive person 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

6 Swimming in the same pool with HIV-positive person Eating from the same bowl or with the same plate as an HIV-positive person If a person with HIV coughs or sneezes in your face 16. HOW SAFE IS ORAL SEX? Oral sex (one person kissing, licking or sucking the genital areas of another person) and deep kissing are not as dangerous as unprotected intercourse, but do carry some risk. It is especially dangerous when you have sores or cuts in mouth or on your genitals. HIV from your partner's semen, vaginal fluids or saliva can get into your blood stream through those cuts or sores. 13. SURELY I CANNOT GET HIV IF A MAN DOES NOT EJACULATE INSIDE ME WHEN WE HAVE SEX? You are wrong to think that you are safe if he does not ejaculate! There is still a big risk of infection, because seminal fluid (the fluid that comes out of the penis before the man ejaculates) can also carry the virus. To guard against the possibility of infection with HIV or any other sexually transmitted disease, it is best to practise safer sex - that is sex with a condom. 14. SO DOES HIV/AIDS MEAN THAT I CAN NEVER HAVE SEX AGAIN? 17. WHAT SHOULD I LOOK OUT FOR WHEN BUYING CONDOMS? Lubricated latex condoms are the best to use, but always check the expiry dates. Should you require additional lubrication, DON'T YOU EVER USE VASELINE, HAND CREAM OR OTHER OIL BASED LOTIONS, because the oil in Vaseline and lotions makes tiny holes in a condom. These holes are too small to see, but large enough for HIV to get through. ALWAYS use a water-based lubricant. You can get water-based lubricant and lubricated condom at the pharmacy, some clinics and at some supermarkets. No, you can have sex. Make sure you understand the risks and always practise safe sex. 15. WHAT IS THE DIFFERENCE BETWEEN SAFE AND SAFER SEX? You cannot get HIV through kissing Safe sex means sex which is absolutely safe, like kissing cuddling, massaging and rubbing each other's bodies. If you have any cuts or sores on your hands, make sure they are covered with plasters. Safer sex means using a condom during sex. To be effective, condom must be used correctly and consistently. Condoms can kick out HIV and other STIs. 18. HOW LONG DOES IT TAKE FOR HIV TO CAUSE AIDS? About half of the people with HIV develop AIDS within 10 years after becoming infected. This time varies greatly from person to person. It depends on: How healthy you are to begin with Your lifestyle (what you eat, whether you drink or smoke, etc) 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

7 Whether a doctor has prescribed medicines that slow the virus down or that treat some of the Opportunistic Infections and diseases associated with HIV. 19. HOW DO I KNOW IF I HAVE AIDS? AIDS develops over a period of time. If you are HIVpositive and a healthcare worker has diagnosed an AIDSdefining illness, you have AIDS. AIDS-DEFINING ILLNESS An AIDS-defining illness is an illness that is not normally found in healthy people, but very common in people whose immune systems have been weakened by HIV. In our bodies, we carry many germs-bacteria, protozoa, fungi, and viruses. When the immune system is working, it fights these germs. But when the immune system is weakened by HIV, diseases or by some medications, these germs can make you sick. Infections that take advantage of weakness in the immune defences are called "opportunistic". The phrase "opportunistic infection" is often shortened to "OI". Particular OIs associated with AIDS are called AIDS defining illnesses. There are many kinds of drugs for opportunistic infections. 22. IF I HAVE AIDS, DOES THAT MEAN I AM GOING TO DIE? Antiretroviral (ARV) therapy, now gives hope even to those who have already developed AIDS. ARV therapy can reduce the amount of virus in your body and even, repair the brokensystem, making you live longer. 23. I AM HIV-POSITIVE. DOES THIS MEAN I AM GOING TO DIE? No. There is much you can do to live a productive, high quality life for many years after you have become infected, with HIV. You can eat fresh vegetables and fruits, drink clean water, be physically active and get enough rest. It is also very important that you look after your sprit and your soul: friendships, spirituality and keeping a positive outlook on rife are as important as food and medicines. Healthcare workers can also help prevent and treat opportunistic Infections. 20. IF I HAVE AN OPPORTUNISTIC INFECTION, DOES THAT MEAN I HAVE AIDS? No, even people who aren't HIV-infected can develop opportunistic infections if their immune systems are damaged. For example, many people have tuberculosis without being HIV positive, and many drugs used to treat cancer can damage the immune system. 21. CAN OPPORTUNISTIC INFECTIONS BE TREATED? Yes, for each opportunistic infection, there are specific drugs, or combinations of drugs. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

8 TAKING THE TEST 24. WHAT IS AN HIV TEST? The HIV test is a simple and painless blood test, performed in a laboratory or a designated place using a small sample of your blood. The test is done to see if you have been infected with HIV. 25. WHERE CAN I GO TO GET TESTED FOR HIV? You can go to your doctor, or to a hospital or clinic, or to a HIV Counselling and Testing centre (HCT) like the Heart to Heart centres. Heart to Heart...we listen, we care 26. WILL THE DOCTOR, NURSE OR COUNSELLOR TELL MY FAMILY, FRIENDS, EMPLOYER, OR ANYBODY WHO IS NOT A HEALTHCARE WORKER ABOUT MY TEST RESULT? No, the HIV test is confidential and healthcare workers are not allowed to provide information about you to anyone who is not a healthcare worker without your agreement. Counsellors will help you to discuss your HIV status with your family and friends as agreed by you. The worst thing you can do is to wait until you are really sick, almost dying, before seeing a doctor for the first time, because when it is too late, he or she may not be able to help you. 28. I HAVE HEARD THAT THERE ARE MANY DIFFERENT HIV TESTS. HOW DO I KNOW WHICH ONE I SHOULD TAKE? All tests used in Nigeria are good. So don't worry, just go for the test. 29. HOW SOON AFTER GETTING THE VIRUS CAN THE TEST FIND THE HIV IN MY BLOOD? Depending on your body, it could take up to three months after infection before the test will be able to show whether you have HIV. It takes this long, because the body first has to make antibodies for the test to pick up. This period is called the "window period". A test done in this time will be negative, even though you have been infected with HIV and can pass on the virus. This is why you should have another test three months later. WINDOW PERIOD This is the length of time, following infection, for an individual to develop detectable antibodies to HIV. Most people infected with HIV develop antibodies against the virus within three months after the infection. It is highly unlikely that HIV infection would go unrecognized for more than six months. 27. WHY SHOULD I GO FOR AN HIV TEST? Healthcare providers will keep your HIV status confidential Finding out if you are HIV positive is the best thing you can do for yourself, because once you know that you are HIVpositive, you can do many things to live a longer, productive and good life. 30. DO I HAVE REASON TO BE AFRAID OF AN HIV TEST? No, there are no physical risks, but you have to be prepared for an answer that may change your life forever. Many people experience shock, anger, distress and depression when they find out they are HIV-positive. Many people fear they will experience prejudice or discrimination if it becomes known that they are HIV infected, or even that they have been tested for HIV. This is why nobody will be tested for HIV without first talking to an experienced counsellor. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

9 31. DO I NEED TO TAKE AN HIV TEST IN ORDER TO KNOW WHETHER I HAVE HIV? Yes, because most people who are infected remain healthy for many years. Only HIV test can tell whether someone is infected with HIV at a very early stage or not. A POSITIVE RESULT MEANS: You are HIV-positive (carrying the virus that causes (AIDS) You can infect others. WHAT THE HIV TEST MEANS A NEGATIVE RESULT MEANS: No antibodies were found in your blood at this time. A NEGATIVE RESULT DOES NOT MEAN: You are not infected with HIV (if you are still in the window period) You can never contract HIV. ADVANTAGES OF GETTING TESTED: A negative result will put your mind at rest A positive result helps you and your healthcare team to monitor your health, prevent problems and treat your infections or illnesses early. You will be able to make decisions about the rest of your life ( e.g. whether to start a family, study, work, travel, etc) Whatever the result, you will be motivated to use condoms when having sex. 32. AT WHAT AGE SHOULD I HAVE MY BABY TESTED FOR HIV? Babies younger than 18 month as need a special test to see whether they are infected. After 18 months, they can get the normal test. HIV positive mothers should have their baby tested 33. WHY IS COUNSELLING SO IMPORTANT BEFORE AND AFTER THE TEST, AS WELL AS WHEN YOU ALREADY HAVE AIDS? Talking to a counsellor who understands what you are going through will help you to accept and understand the test results. Many people also need help to tell the people who are close to them- their best friends, husband, wives, children, or parents - about being HIVpositive. People who seek support from professional counselors, family, friends or others, have been found to cope better than those who simply try to deal with HIV on their own. 34. HOW CAN COUNSELLING HELP ME? Counselling can and will help you to accept your status and be honest with yourself. The counsellor will create a caring environment in which you can make peace with your past, your present and your future, without being judged. Counsellors are specially trained to understand what you are going through and to guide you. You may be on your own in the counselling session, or you can bring a trusted friend or relative to support you. HIV- positive mothers should have their babies tested for HIV as soon as possible, because their babies are not necessarily HIV-positive as well. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

10 I HAVE FOUND OUT THAT I HAVE HIV- WHAT SHOULD I DO? 35. SHOULD I TELL SOMEONE THAT I AM HIV- POSITIVE? Yes, because this would be the best thing you can do for yourself. Telling a trustworthy friend or relative can make it a lot easier to deal with the stress of being diagnosed HIV-positive. 36. HOW WILL PEOPLE REACT IF I TELL THEM THAT I AM HIV-POSITIVE? It is hard to know how people will react if you tell them (disclose) that you are HIV positive. Some people will be scared of you. Others will j u d g e y o u, o r p i t y y o u. Unfortunately, many people do not understand HIV/AIDS and attach a stigma to the disease. However, many people find that family, close friends and partners are very supportive and understanding, especially when they are given the right information. 37. WHAT SHOULD I THINK OF BEFORE TELLING PEOPLE ABOUT MY HIV STATUS? First, deal with your own feelings. Then look carefully for people you can trust to support you. When you have accepted your condition, ask yourself the following questions: Am I really ready to discuss my HIV status? Can I trust this person with this information? Will he or she offer me support? Is he or she likely to judge me? Will he or she respect my confidentiality? You may discuss these questions with your counsellor or social worker 38. HOW CAN I TELL MY PARTNER, FRIEND OR SPOUSE THAT I AM HIV-POSITIVE? Try to find a suitable time when neither of you feel stressed or hurried Sit with the person in a safe, private place where disruption will be unlikely, because you may need to deal with strong reactions, feelings and emotions Prepare exactly what you want to say: rehearse and role-play what you will say, How your friend is likely to respond and how you will react to that response Begin by acknowledging that you want to tell your friend something that directly affects your life and his or hers Tell them that you are HIV-positive. Indeed this will affect them emotionally and they might display any possible reaction, from shock, anger, and sadness to bursting into tears Make sure that you are prepared for that, and that you allow your friend to share his or her thoughts and feelings, while listening quietly End by giving your friend information about your situation. Discuss how you are going to deal with this together Invite your friend to familiarise him or herself with your illness, and to talk to you about it at any time he or she has questions Encourage your friend or partner to go for an HIV test as well Suggest that your friend accompany you to the Heart to Heart centre, for your next appointment with the doctor or counsellor. 39. HOW DO I PREVENT SPREADING HIV TO OTHERS? Always use a condom when having sex, and even when having oral sex. If your partner is HIV positive as well, you should still use a condom. This will protect you both from reinfection Even if you or your partner is on antiretroviral therapy, and your immune system is almost back to normal, remember ARV is not a cure and you still have to use a condom 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

11 You should not donate blood and make sure that others do not come into contact with your blood if they have open wounds or sores You should encourage your caregivers not to touch any fluid from your body without gloves. This will show they care for you and themselves Remember, simple kissing on the lips or hugging, sharing eating utensils or toilet seats do not spread HIV Many HIV-positive people choose not to have sex, because they are afraid of spreading HIV and reinfecting themselves. REINFECTION Even if you are HIV-positive already you can still get infected with different kinds of HIV or increase the amount of HIV in your blood. This is called reinfection. Always use a condom when practicing sex. Doctors will also prescribe antiretroviral therapy when tests and assessments show that you need it and that you are ready for it. Taking antiretroviral therapy is a very big step. It takes a lot of commitment and hard work, and it is like a marriage for life: you can never stop taking it once you have started. Your healthcare team will explain to you how to take your medicine and why it is so important to take it exactly as you are told Your healthcare team will discuss with you how often you have to come back for checkups. You must never miss these appointments. 40. HOW CAN I MANAGE HIV/AIDS? Accept and understand your status. Have an open mind and take good care of yourself by eating well, exercising, resting and practicing good hygiene. Make sure you see your healthcare team regularly. A professional counsellor and social worker can also help you in your fight. Seek support from your friends and family, but remember that you may have to help them understand the disease before you can rely on them. Practice your religion-faith can make you stronger. 41. WHAT CAN THE HEALTHCARE WORKERS DO FOR ME? Doctors and nurses will always check how healthy or sick you are, as well as how strong your immune system is. To do this, they will sometimes do blood tests and other test They will also try to protect you from other diseases, such as TB and pneumonia You may have to go through regular blood test 42. CAN I STILL WORK? Having HIV does not mean you cannot work. You still have a duty to take care of yourself and the people you support, like your children. Your body will tell you when you are too weak to continue working. Work will take your mind off HIV and help you to take care of your family and other responsibilities. 43. SHOULD I EAT SPECIAL FOODS? You should eat a balanced diet, consuming a variety of fruits, vegetable, meats, dairy and grain products. If you develop problems with diarrhea or a poor appetite, ask your doctor or other healthcare workers for advice. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

12 44. I HEARD THERE IS A CURE FOR HIV, CALLED ANTIRETROVIRAL THERAPY, IS THIS TRUE? No, there is no cure for HIV or AIDS. Antiretroviral (ARV) therapy helps people with HIV/AIDS to live longer, more productive lives if they take it exactly as the doctor prescribes and for the rest of their lives. 45. WHY DO I NEED TO GO FOR REGULAR BLOOD TESTS NOW THAT I KNOW THAT I AM HIV- POSITIVE? Doctors need to check regularly how much virus is in your blood (viral load test) and how strong your immune system (CD4 count) is. This helps them to see if you need ARV therapy, and when you are on ARV therapy to see how well it is working. THE CD4 TEST In our blood, we have soldiers that protect us from diseases. They are called the white blood cells. The doctor can count white blood cells, or the soldiers, with a special blood test, called a CD4 count. The more white blood cells you have, the better your immune system is at fighting diseases. When HIV makes copies of itself, the number of white blood cells becomes less, making it difficult for your body to fight illnesses The white blood cells are the soldiers that help the body fight infections 46. WHY CAN'T I GO FOR REGULAR Cd4 COUNTS INSTEAD OF THE HIV TEST? Doctors will generally not do many CD4 tests before insisting on an HIV test, because other diseases can also break down the immune system. 47. WHAT SHOULD I TELL HEALTH WORKERS WHEN I AM SICK? Always tell them you are HIV positive If you are on ARV therapy, tell them about your treatment, even if they forget to ask Tell them if there are any medicines you cannot take (ask your healthcare team about this) Tell them what medicines you take, even traditional medicines. THE VIRAL LOAD TEST A viral load test measures the amount of HlV in the blood. The more HIV in your blood, the faster your immune system will become weak. The less HIV, the stronger your immune system is likely to be. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

13 INTRODUCTION TO ANTIRETROVIRAL THERAPY 48. WHAT IS ANTIRETROVIRAL (ARV) THERAPY? This is the main type of medication for HIV/AIDS. It is not a cure, but it can stop most people with HIV/AIDS from becoming ill for many years. The therapy always consists of one or more different medicines that have to be taken every day for the rest of the patients' lives. 49. IS ARV THERAPY A CURE FOR HIV/AIDS? ARV therapy must be taken as prescribed No, ARV therapy is not a cure for HIV/AIDS. If you take your medication as prescribed, you will start to feel better. If used properly, ARV therapy can often reduce the amount of virus to the point where it can no longer be found in your blood. However, it can never take the virus out of your body completely. 50. IS ARV THERAPY THE ONLY MEDICATION AVAILABLE FOR PEOPLE WITH HIV/AIDS? No, people with HIV/AIDS often receive other medications for Opportunistic Infections (0Is), such as TB, diseases of the brain and cancer. 51. HOW MUCH EXTRA TIME CAN ARV THERAPY GIVE A PERSON LIVING WITH HIV/AIDS? For now, doctors think ARV therapy can allow most people with HIV/AIDS to live up to ten and above years longer, depending on how far advanced the HIV infection had been when the therapy was started. New medications are likely to increase this period. The general health, lifestyle, and adherence of a person living with HIV/AIDS will determine how well ARV will work for him or her. ADHERENCE "Adherence" means patients understand why and how they have to take their medication and then do exactly that. They immediately see or contact the ARV healthcare provider if a problem arises, and never make any changes without consulting with the health worker first. ARV therapy will only work if patients adhere 100%. If not, the virus will no longer be suppressed and may become resistant to the medication-meaning that the medication will no longer work. 52. HOW IS ARV THERAPY DIFFERENT FROM OTHER MEDICINES? ARV therapy is like other medicines in many ways: it has some side effects and is governed by law and medical principles of safety and proven efficacy. The difference is that ARV requires 100% adherence in order to prevent HIV from becoming resistant to medication. 53. WHY ARE PEOPLE SO WORRIED ABOUT HIV BECOMING RESISTANT TO ARV THERAPY? The danger of developing drug-resistant HIV is that we will have no substitute drugs to treat HIV and to prolong your life. The new resistant HIV can start spreading countrywide and even to other countries. This is why the use of ARV therapy will require a lot of responsibility and commitment from all of us, as individuals and as a country. DRUG RESISTANCE~ Drug resistance means the ARV therapy can no longer fight the HIV in your body. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

14 54. IF THE ARV THERAPY IS SUCH A GOOD MEDICINE, WHY ARE SO MANY PEOPLE STILL DYING OF AIDS-related ailments? ARV therapy helps you to live longer, but if you wait until you are very sick before going to a doctor, the therapy may not work for you. This is why it is important to find out your status, enrol in the ARV care and treatment programme. To be monitored regularly, treated and checked by healthcare workers and make all the lifestyle changes (food, hygiene, rest, exercise and support) to stay healthy as long as possible. 55. WHY DON'T YOU GIVE EVERYONE WHO IS HIV- POSITIVE ARV THERAPY? The healthcare team will test to see whether your body and your mind are ready for it. It is not a cure, so there is no need to give it to everybody. If you live a healthy lifestyle it is possible to have a long and productive live before going on the lifelong ARV therapy. 56. DOES ARV THERAPY WORK FOR EVERYBODY? 58. IS ARV THERAPY SAFE TO USE? Yes, every time any new medicine is developed, it must go through clinical trials. A clinical trial is a study with people to test how well the new medicine or treatment works and how safe it is. All ARV in use have passed through clinical trials. 59. IS IT TRUE THAT ARV THERAPY IS A WAY TO GET RID OF HIV-POSITIVE PEOPLE? NO, THIS IS NOT TRUE! In fact, this is a way to provide care and treatment to HIV-positive people. It is a medicine to help HIV-positive people to live longer. 60. WHAT SIDE EFFECTS CAN I EXPECT FROM ARV THERAPY? Two out of three people will experience some side effects, including: Bad dreams; Hearing voices or seeing things that are not really there; No, for some people ARV therapy can fail, for many different reasons. Some of the most important reasons include: They did not take the ARV therapy exactly as prescribed by the doctor: always at the same time, in the same way (for example, with or without food) and NEVER, EVER skipping a dose. This is called adherence. They experienced strong side effects and became reluctant to take the medicine, or severe nausea made it impossible to keep the medicine down. 57. WHY CAN'T WE MAKE NEW CD4 CELLS OR NEW IMMUNE SYSTEMS? Doctors do not know how to do this yet, but they still keep trying. ARV therapy can make you see things that are not really there. Nausea; Vomiting; Diarrhoea; Muscle pains; Headaches; Tiredness Changes in menstrual patterns; 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

15 Skin rashes; Peripheral neuropathy (tingling and numbness in hands and feet); Changes in body shape related to the distribution of fat (lipodystropy); Changes in glucose and cholesterol levels. Some people only experience the side effects mildly and find them easy to manage. But for some people the side effects are so strong that they have to go back to the ARV healthcare Team for help. Not everyone on ARV therapy will have side effects. SIDE EFFECTS Side effects are the unwanted reactions that your body may have to the medicine you are taking. Almost all medicines used to fight diseases can cause side effects in most people. These side effects normally go away after a short while. 61. CAN OTHER DRUGS BE CAUSING THE SIDE EFFECTS? Yes, this is why no other medicines-not even traditional or herbal medicines- should be taken without first seeking advice from the ARV healthcare team. 62. IF ARV THERAPY SIDE EFFECTS CAN BE SO BAD, WHY ARE DOCTORS STILL GIVING IT TO PEOPLE? The benefits of ARV therapy (allowing people with HIV to live much longer with more productive lives) are normally far greater than the side effects. If the side effects are severe, the doctor will be able to help you. 63. IS IT TRUE THAT PEOPLE ON ARV THERAPY HAVE BEEN DYING FROM BRIEF ILLNESSES? Yes, normally because they were too sick before they went to a clinic or healthcare worker for help. It is best for everybody to know their status and if they are HIVpositive, to see a doctor regularly. The doctor will tell you when to start ARV therapy before it is too late. 64. CAN A PREGNANT WOMAN TAKE ARV THERAPY OR WILL IT HARM HER BABY? Certain ARV medication should not be taken during pregnancy.!t is therefore very important that a woman on ARV therapy should tell her doctor or healthcare worker as soon as she thinks she might be pregnant. Antiretroviral therapy can only be used during pregnancy if the right medication is prescribed. 65. DOES ARV THERAPY INCREASE OR DECREASE SEXUAL DESIRE? ARV therapy does not have a direct effect on sexual desire. When you are sick, you are less likely to be sexually active. Once ARV therapy starts to work and is taken properly, you will start to feel well again and gain strength. It is important that once you start having sex again, that you should always use a condom. 66. DO I HAVE TO STOP SMOKING NOW THAT I AM ON ARV THERAPY? Smoking is very bad for your health, even if you are HIVnegative. Tobacco breaks down your immune system. You may need a different kind of ARV therapy if you are pregnant 67. WHY DO I HAVE TO STOP DRINKING ALCOHOL NOW THAT I AM ON ARV THERAPY? Alcohol and other drugs like igbo make you forget to take your pills and break down your immune system. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

16 68. SOME PEOPLE ON ARV THERAPY SAY THAT THEY HAVE NO HIV IN THEIR BLOOD. ARE THEY CURED? No, they are not. When we say the HIV (or viral load) is undetectable, it means that the tests are unable to find the HIV in somebody's blood. Even if the blood tests, cannot find the virus, it is still hiding in his or her body somewhere! Some people make the mistake of thinking they can now stop taking ARV therapy. The danger is that, when they start again, the ARV therapy may no longer work, because the virus has become resistant. MEN AND HIV/AIDS 71. HOW WILL MY RESPONSIBILITIES CHANGE WHEN MY PARTNER GOES ON ARV THERAPY? You may have to accept responsibilities your partner has been carrying out before - he or she may feel too weak to do all the work he/she did before, especially when he or she starts the therapy. This is a small price to pay for a longer life together. 72. IS IT TRUE THAT SEX WITH A VIRGIN WILL CURE ME OF HIV OR AIDS? This is an evil lie. There is no cure for HIV/AIDS. 69. WHAT DOES IT MEAN WHEN THE DOCTOR CHANGES MY ARV THERAPY? It just means that your doctor wants to use a type of ARV therapy that works better for you, because each individual is different, and what works for one person may not work for you. He or she may have noticed that you have an increased viral load, or you have indicated that you cannot tolerate the side effects. 70. MY RELATIVE/FRIEND WHO IS ON ARV THERAPY DIES-WHAT SHOULD I DO? Notify the Care and Treatment team as early as possible Give all your friend's medication back to the healthcare team Don't allow anybody to use the medication, as this could be very dangerous! 73. IS SEX WITH A YOUNG GIRL OR CHILD SAFE? Absolutely not! You may go to jail for life! Sex with a child is always rape and rape is a very serious crime. 74. HOW CAN YOU ASK ME TO STICK TO ONE WOMAN IF A REAL MAN HAS MANY PARTNERS? Your life depends on it! Once you become infected with HIV, it will never go away. If you cannot be faithful to one partner, make sure you always use a condom when having sex. Know your status, and encourage your partners to go for an HIV test as well. It is a serious crime to have sex with a child! Be faithful to one faithful partner 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

17 75. IF I USE A CONDOM, MY PARTNER WILL THINK I SLEEP AROUND Use this opportunity to educate yourself and your partner about how HIV is spread, and remind yourselves that everyone is at risk of getting HIV. Using a condom, even with a long-term partner, shows that you care for your partner. 76. CONDOMS INTERFERE WITH ENJOYMENT AND ARE NOT AFRICAN. WHY SHOULD I USE THEM? If you are going to have sex, condoms are the only way to protect yourself against HIV. How can you enjoy sex if you have to worry about getting or spreading HIV? 79. IS IT TRUE THAT WOMEN DIE MORE QUICKLY FROM HIV THAN MEN? No, there is no scientific data to support this, the speed at which HIV breaks down the immune system depends on a number of things. The most important factor is the lifestyle of the person living with HIV/AIDS. What he or she eats and drinks, how clean he or she keeps himself or herself, and how much emotional support he or she gets. WOMEN AND HIV/AIDS 77. DOES HIV/AIDS AFFECT WOMEN DIFFERENTLY FROM MEN? No, there is no convincing medical evidence for that. For every individual, there may be some physical, social or psychological differences in how he or she experiences HIV/AIDS. 78. ARE WOMEN AT HIGHER RISK OF GETTING HIV? Yes, because of the way that the vagina is built. It is like a fragile cup. Sex can sometimes be quite rough, making tiny cuts and bruises inside the vagina, where HIV can find its way into the blood stream. The penis is not as easily damaged. The lifestyle of someone living with HIV can determine how long the person will live before having AIDS 80. SHOULD I TELL MY CHILDREN THAT I AM HIV- POSITIVE? Children should be told as much as they can understand and handle. Counsellors will help you decide how much or when to tell your children. They will also guide you when the time is right. It is a good idea to tell some other people who can provide support for the child - maybe an aunt or a good friend whom your child trusts. You may also wish to tell the child's teacher or the school principal when you are sick, in case your child needs to talk to somebody or has difficulties at school. 81. CAN I INFECT SOMEONE WITH HIV WHEN I AM MENSTRUATING? Menstrual fluid does contain HIV, although there has been little research about the levels of HIV in it. Use a condom to reduce the risk to your partner. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

18 82. WILL HIV INFLUENCE MY MENSTRUAL CYCLES? Most women experience menstrual irregularities at some stage of their lives, regardless of HIV status. If you experience menstrual irregularities, it is important to remember that HIV or HIV treatment may not always be to blame. Often the problems are caused by hormonal changes that occur naturally in most women over time. It is important to report any changes in your menstrual cycle to a healthcare worker. If your period is late, you may be pregnant. Please tell your ARV care and treatment team immediately. 83. CAN I INFECT MY BABY WITH HIV, EVEN IF IT IS STILL IN MY WOMB? Yes, HIV can be transmitted from an HIV-positive woman to her child in three ways: During pregnancy During labour and delivery Through breastfeeding. Talk to your doctor or ARV healthcare team-they will be able to give advice and information about what you can do to reduce the risk of HIV transmission to your baby. 84. MUST I STILL GO FOR PAP SMEAR TESTS WHEN I AM HIV POSITIVE? Yes, in fact, you should go more often. In general, HIV negative women are advised to have Pap smears every two years. Women living with HIV and AIDS are advised to have a Pap test every six months. PAP SMEAR A Pap smear is a test done to see if there are any early signs of cancer at the entrance to the uterus (womb). 85. IF MY PARTNER IS NOT PREPARED TO USE A CONDOM, WHAT CAN I DO? There are condoms especially for women. It may or may not be available for free from the clinics, but you can buy it at pharmacies. If your partner does not allow you to use the female condom, explain to him that you cannot have sex without a condom, because you are both at risk from getting HIV and there is no cure. This will be very difficult, but you have to protect your life. 86. WHAT SHOULD A WOMAN CONSIDER BEFORE TAKING ARV THERAPY? Ask people to help you, to take care of your children and to take over some of your daily household duties, especially at the beginning of treatment. 87. COMPARED TO MEN, IS IT MORE DIFFICULT FOR WOMEN TO ADHERE TO ARV THERAPY? Both men and women sometimes find adherence difficult, because ARV therapy requires a commitment for life. 88. DOES ARV THERAPY INFLUENCE THE CONTRACEPTIVE PILL? Yes, you can fail pregnant despite taking the pill if you are on ARV therapy. However, this should not be a real danger, as you should always use a condom when you have sex. Your doctor or ARV care and treatment team can advise you. 89. WILL ARV THERAPY MAKE ME STERILE AND UNABLE TO HAVE CHILDREN? ARV therapy will not make you sterile. However, there is a high risk that the baby of an HIV positive woman will be born with HIV. Becoming pregnant also requires that a couple must have sex without a condom, which increases the chance of reinfection. Please do not consider having a baby without discussing these and other dangers with a healthcare worker. If you are HIV-positive and pregnant, please go to the nearest healthcare facility for counselling and ask about the Prevention of Mother-To- Child Transmission of HIV programme. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

19 I AM HIV - POSITIVE, ANY QUESTION 90. HOW DID YOU GET INFECTED? It does not matter how I got infected. All people should be treated the same. However, to answer your question; most of us were infected the same way- the commonest being by having sex without a condom with our partners. Most of our partners don't know that they were HIV-positive either. If you really love one another; go for an HIV test together. Remember, you cannot tell if people have HIV by just looking at them. This is why, no matter what, you must always use a condom!. Tragically, some of us were raped by an HIV-positive r a p i s t a n d b e c a m e infected that way. 91. WHO GETS HIV? If you really love yourself and your partner, both of you should go for HIV test. 93. WHEN ARE YOU GOING TO DIE? Just like you, I do not know exactly when I am going to die. However, I have HIV in my body and if I do not take special care of myself with the help of my doctor, I will get AIDS and I may die. Many of us believe in maintaining a positive state of mind and keeping ourselves healthy. There are medicines to treat the illnesses that come with AIDS. Antiretroviral therapy also helps us to live longer, more productive lives. But there is no medicine that will kill HIV or cure AIDS. We keep hoping and praying for a cure. Make sure that all drinking and cooking water is clean and stored in clean containers Anyone can get infected with HIV and develop AIDSchildren, men and women; the rich, the poor people of different ages, religions and cultures. We are all somebody's daughter or son, mother or father, sister or brother-even grandmother or grandfather. HIV/AIDS does not discriminate. Eat lots of fresh fruits and vegetables to boost your immunity 92. CAN 1 GET HIV FROM TALKING TO YOU? No, you cannot get HIV from talking to me, shaking hands or sharing cutlery with me, or by hugging me. You can only get infected if you have unsafe sex, or if you have a wound that comes into contact with the blood of an HIV-positive person, for example when you share a razor blade. The person you are about to share your shaving blade with could be HIV positive 94. DO YOU GET SICK A LOT? No, I personally do not because I live a healthy lifestyle by eating well, resting, exercising and practising good hygiene. However, many people with HIV do get sick often. 95. IS YOUR PARTNER ALSO HIV-POSITIVE? Yes, sadly my partner is also HIV-positive. But sometimes HIV-positive people have partners who are not infected. I love my partner and we support one 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY

20 another. Sadly, many HIV-positive people do not have the support of a loving partner- when people cannot understand and accept their partner's status, they prefer to reject. Whether one or both partners are HIVpositive, always use a condom. My advice to you is: that you should not consider having a baby without discussing these and other dangers with a healthcare worker. If you are HIV-positive and pregnant, please go to the nearest healthcare facility for counselling and ask about the Prevention of Mother-To Child Transmission of HIV programme. 96. WAS IT DIFFICULT TO TELL PEOPLE THAT YOU ARE HIV-POSITIVE? Yes, it took me some time to understand and accept my HIV status, before I could tell anyone about it. Also, I was afraid of people's reaction. I was scared they would think I behaved badly and would reject me. I knew that they would be afraid that I could give them the virus. But my counsellor helped me to accept my situation and together, we worked out a plan, to tell my family and friends. Today I am truly happy that I told them I could not have come this far without their love and support. 97. HOW DO YOU STAY HEALTHY? I live a healthy life. I exercise, eat lots of fruit and vegetables, drink only clean water, practise good hygiene and make sure I get enough rest. I find comfort in God, my family, my friends and other people living with HIV/AIDS. I also regularly see a healthcare team that helps me and treats me whenever I need it. 98. CAN YOU STILL HAVE A BABY? Make sure you get sufficient physical exercise I have chosen not to get pregnant, because there is a high risk that my baby will be born with HIV and I do not think that this is right. It would also mean that my partner and I would have to have sex without a condom, which increases the chance of reinfection. Discuss with your healtcare provider before making the decision to have a baby 99. DO YOU CRY A LOT? I used to cry a lot, because I made the mistake of seeing HIV/AIDS as a death sentence. But, now I understand that people with HIV can live long, productive lives and have more hope. On the days I feel depressed, I rely on my friends and family, as well as my counsellor to help me find hope again IF YOU HAD ANOTHER CHANCE IN LIFE, WHAT WOULD YOU HAVE DONE DIFFERENTLY? Not much, I would have delayed sex until I got married to an uninfected partner, or would have been faithful to one faithful and uninfected partner or would never have had sex without a condom if I had understood the risks of HIV/AIDS. I thought I could escape it. Now I know that HIV does not discriminate. 100 FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY FREQUENTLY ASKED QUESTIONS ABOUT HIV/AIDS AND ARV THERAPY