Belgian development agency AIDS WHAT YOU SHOULD KNOW
KEY PRINCIPLES Respect Respect yourself and others. Testing Do not wait until tomorrow. Adherence Adhere to treatment and enjoy a long and happy life. Equality No stigma or discrimination. Life The world is yours! 1
INTRODUCTION BTC is concerned about your well-being and that of your family. BTC staff often have to work in a context where the fight against HIV and AIDS is still ongoing. HIV and AIDS can no longer be a taboo. Accurate information is important in order to reduce the risks of being infected with HIV. If in doubt, get a test. If the test is positive i.e. if you are infected with HIV do not delay treatment unnecessarily. Accurate information and appropriate treatment enable people with HIV to keep their job and to enjoy life. 3
HIV AND AIDS HIV is a virus that affects your immune system. There are different types of HIV. They make the body more susceptible to all kinds of infections and certain forms of cancer. A person with HIV is HIV positive. You cannot tell whether a person has HIV just by looking at him or her. Sometimes it can take years before a person with HIV starts having serious health problems. In the meantime, however, he or she can transmit the virus. Only a blood test can tell whether a person has HIV or not. Appropriate medication can slow the progression of the virus. If the immune system of a person with HIV can no longer protect his or her body, then this person has developed AIDS. The first external signs that a person has AIDS are rashes, fungal infections, fever, fatigue or persistent diarrhoea. But be careful, a person who has one or more of these symptoms, should not automatically be diagnosed with AIDS. Only a medical doctor can make the right diagnosis! 4
HOW IS HIV TRANSMITTED? HIV can be found in blood, semen, pre-seminal fluids, vaginal fluids or breast milk. You run a risk of being infected with HIV through: 1. Unprotected sexual contact with a person who has HIV. This is the most common route of transmission. 2. Exposure to infected blood through blood transfusions, the use of non-sterilised syringes, the sharing of needles, prick accidents or cuts. 3. Transmission from mother to child during pregnancy, delivery or breast-feeding. There is NO risk of being infected with HIV through working, socializing or living with people with HIV. HIV is NOT transmitted through shaking hands, kissing, using the same toilet or the same utensils, neither through breathing, coughing or sneezing, etc. HIV cannot be transmitted through insect bites, swimming pools, saunas or food. 5
HOW TO PREVENT HIV? In the past people with HIV inevitably developed AIDS and died from it. Thanks to new treatments AIDS is increasingly becoming a chronic disease. But prevention is still recommendable since there is no cure for AIDS. A vaccine for HIV does not yet exist. Since HIV is mainly transmitted through unprotected sexual contacts, the so-called ABC approach is still the best way of reducing the risk of being infected: A: stands for abstinence from sexual intercourse B: stands for being faithful to your partner C: stands for condoms! Use a condom when you have sex or make love. In case you have any doubt or feel unsure, do not hesitate and GET TESTED! Let yourself also be tested for sexually transmitted infections. They can seriously damage your health and increase the risk of HIV. 6
CONDOMS Condoms protect against HIV while making love provided that: The condom is of good quality: check the quality mark and the expiry date on the package. The condom is stored in the right way: in a firm, protective package; do NOT keep your condom loose in your bag, your pocket, your wallet or in the sunlight on the dashboard in your car. The condom is properly used: carefully read the instructions. Never use a condom twice. Do not use two condoms one over the other. This increases the risk of tearing. Making love with a condom demands some dexterity, which you can only acquire practicing. Talk with your partner about how best to integrate the use of condoms in your love life. 7
GETTING TESTED FOR HIV In the period of 4 weeks to 3 months following the possible exposure to infection with HIV, there is no sense for you to go for a HIV test because your body has not yet generated sufficient antibodies. During this so-called window period you are highly contagious and can easily transmit the virus. Testing for HIV is done by a simple finger prick or a blood sample taken by your doctor or at a specialised centre and should always be preceded by a confidential counselling session. Sometimes the result is known within a few hours, but sometimes you will have to wait for some days, depending on the logistic facilities available. Possible risks that one might have incurred consciously or unconsciously can create doubt, uncertainty and anxiety. A test takes the anxiety away. A negative result meaning that you do not have HIV puts you immediately at ease. If the result is positive meaning that you have HIV you can immediately take measures to protect yourself and your partner as much as possible. A positive test will always be followed by a second control test to eliminate false positive results. 8
No one can force you to get tested for HIV. This is a decision that you take yourself. The results of a HIV test are strictly confidential and bound by the rules on the protection of privacy. It is never too late to get tested for HIV. 9
YOU HAVE HIV. WHAT IS NEXT? In the case of a positive test you will be referred to a centre that is specialized in the treatment of HIV and AIDS. Together with the doctor who treats you, you will search for the proper combination of anti-hiv drugs with as few secondary effects as possible. It can take several months before the right cocktail is found. After some time, when resistance has developed or new drugs are on the market, you will have to start looking again for the best combination. Do not delay your anti-retroviral treatment until you have already developed AIDS. Thanks to timely treatment the progression of the virus can easily be suppressed. In any case, a life-long treatment will always be required and you will have to go for medical consultations on a regular basis. Temporary interruption of the treatment can generate drug resistance. 10
Proper medication and a healthy life style (healthy food, sports, recreation) will allow you to have a relatively normal and good quality life. Everything is still possible: working, having a career, doing sports, eating, drinking, falling in love, making love (with a condom!), having children, etc. No one needs to know whether you have HIV or AIDS, except, of course, your doctor. But you can opt to reveal your status with the aim to break the taboo or to sensitize others. For obvious reasons it is also recommended that you notify your previous, as well as current or future sexual partner(s). This will not always be easy, but it is important that he or she also gets tested and, if necessary, starts treatment in time. 11
POST-EXPOSURE PROPHYLAXIS Acute situations can occur where you run a high risk of infection with HIV. For example, a torn condom while making love with a partner who is HIV-positive, or because you had a prick accident with a used needle, or and let us hope that this does never happen to you in the case of rape. In such case your doctor might advise you to start a post-exposure prophylaxis (PEP) treatment. A PEP-treatment might prevent the progression of the HIV virus at a very early stage, but success is not guaranteed. In case you had a risk contact, it is important to start treatment as soon as possible, preferably within a few hours and no later than 48 to 72 hours after your exposure. A PEP-treatment takes one month and is quite heavy, physically as well as psychologically. 12
HIV AND WORKING AT BTC Your HIV status or that of your partner will not affect your employment chances or promotion opportunities at BTC. Since 2011 BTC has a HIV workplace policy that applies to all staff in Belgium and abroad as well as to their next of kin. BTC will sensitize and inform its staff about HIV and AIDS. At all BTC offices there will be a list with the coordinates of local specialized centres where you can go for HIV counselling, testing and treatment. BTC aims to have the HIV workplace policy fully operational in 2013. 13
USEFUL WEBSITES You can find more information about HIV and AID on the following websites: The AIDS referral centre at the Institute for Tropical Medicine in Antwerp: http://www.itg.be/itg/generalsite/default. aspx?wpid=575&l=e The Centers for Disease Control and Prevention: http://www.cdc.gov/hiv/topics/basic/ UNAIDS, the Joint United Nations Programme on HIV and AIDS: http://www.unaids.org/en/resources/presscentre/ fastfactsabouthiv/ AVERT, an international AIDS charity based in the UK: http://www.avert.org/. 15
In this booklet you find a Lovepack condom. Lovepack condoms are produced according to the Fair Trade principles. They are made of natural rubber latex, which is produced in a sustainable and socially responsible way in plantations in South India. The condoms are produced CO 2 neutrally by CPR GmbH, a German factory near Hannover. The distribution of the Lovepack condoms in the Benelux is done by Lotika, a Dutch company that only sells socially and ecologically sound products. Lovepack condoms are available in several varieties, flavours and colours. More information can be found at: http://www.lovepack.info/ 0197 ISO 4074:2002 CPR GmbH Im Kirchenfelde 8 D-31157 Sarstedt Latex 2012 BTC, Belgian Development Agency, Brussels. BTC cannot be held responsible or liable for any damage arising from this booklet. 16
Condoms: instructions for use Condoms are a reliable protection against unwanted pregnancies, sexually transmitted infections and HIV, but unfortunately the protection is never 100%. One of the reasons is that condoms are not always used in the right way. FREE CONDOM Instructions: 1. Remove the condom from the protective foil immediately before use, not sooner. Take care to avoid damage from fingernails, jewellery, etc. 2. Place the condom on the erect penis, while holding the nipple of the condom between thumb and forefinger to prevent air from entering. Place the condom with the ring facing outwards. If the ring happens to be inwards, throw the condom away and use another one. Hold the nipple with one hand while you fully unroll the condom as far as possible with the other hand. 3. Withdraw the penis carefully soon after ejaculation when it is still erect, whilst holding the condom firmly at the ring to prevent leakage. 4. Close the condom with a knot and put it in the rubbish bin. Never throw a used condom in the toilet. 5. If you need additional lubrication, use only lubricants designed to be used with condoms. Never use oil-based substances, such as petroleum jelly, body lotion, massage oil, butter, margarine, etc. as they can damage the condom. 6. In case of allergic reactions or irritation, always consult a doctor, particularly in the case of combined use with spermicides or other creams that are put on the penis or the vagina.
BTC Belgian development agency rue haute 147 1000 Brussels T +32 (0)2 505 37 00 F +32 (0)2 502 98 62 INFO@BTCCTB.ORG www.btcctb.org Managing editor: Carl Michiels, rue Haute 147, 1000 Brussels - Photograph cover: BTC / Martin Van der Belen