Frequently Asked Questions

What Is HIV?

HIV stands for “human immunodeficiency virus.” It is a virus spread through certain body fluids (semen, blood, breast milk) that attacks the body’s immune system, specifically the CD4 cells, often called T cells. These special cells help the immune system fight off infections. Over time, HIV can destroy so many of these cells that the body can’t fight off other infections. When someone’s T cell count falls under a certain number that is when they are diagnosed with Acquired Immune Deficiency Syndrome, or AIDS.

How Is HIV Spread?

Even after more than 35 years of the AIDS epidemic, myths persist about how HIV is spread. We are committed to fighting stigma and discrimination against HIV-positive individuals, providing straightforward, easy to understand information about what HIV and AIDS are, how HIV is spread, and ensuring that people have information to help them stay healthy.

Common ways HIV is transmitted between partners:

• Having anal or vaginal sex with someone who has HIV without using a condom, PrEP, or an HIV-positive partner is not virally suppressed (aka “undetectable”)
• Sharing needles or syringes or other equipment used to prepare drugs for injection with someone who has HIV and is not virally suppressed

Uncommon ways HIV is transmitted:

• From mother to child during pregnancy, birth, or breastfeeding.
• By being stuck with an HIV-contaminated needle or other sharp object. This is a risk mainly for health care workers and can now be treated with PEP or prevented via PrEP.

HIV cannot be transmitted through casual contact.

You cannot get HIV from:

• Air or water
• Insects or pets
• Saliva, sweat, tears, kissing, hugging, holding hands
• Toilet seats
• Sharing food or drinks or utensils

What are the Stages of HIV?

HIV disease progresses through several stages:

Stage 1: Acute HIV infection

• Occurs within 2 to 4 weeks after infection with HIV
• People may experience a flu-like illness, which may last for a few weeks
• When people have acute HIV infection, they have a large amount of virus in their blood and can transmit it more easily
• Some people are asymptomatic (no sign of symptoms) during this period

Stage 2: Clinical latency (HIV inactivity or dormancy)

• HIV is still active but reproduces at very low levels
• People may not have any symptoms or get sick during this time
• For those who aren’t taking medicine to treat HIV, this period can last a decade or longer, but some may progress through this phase faster.

Stage 3: Acquired Immune Deficiency Syndrome (AIDS)

• AIDS is the most severe phase of HIV infection; often when someone is diagnosed with AIDS it means he or she has been living with HIV for a long time.
• A clinical diagnosis of AIDS happens when a person’s T cell count falls below a certain number.
• During this stage, people are more susceptible to other illnesses, called opportunistic infections.
• Symptoms of these infections can include weight loss, night sweats, a fever, chronic diarrhea, a persistent cough, mouth and skin problems, and other complications depending on the infection or illness.

Treatment

There is currently no cure for HIV, but with proper medical care, HIV can be controlled. Treatment for HIV is called antiretroviral therapy, or ART. It is often in the form of pills taken once a day. Some people only need to take 1 pill to control their HIV. If ART is taken the right way, every day, most people with HIV will live a long, healthy life. For many people who regularly take ART, the virus level in their blood is so low it cannot be detected (“undetectable”), which means they cannot transmit HIV to a partner. Staying on medication and visiting a medical provider regularly for follow-ups will help ensure a person remains undetectable.

Who Gets HIV?

The short answer: Anyone can get HIV.

Some groups of individuals, however, are at higher risk for HIV than others. Gay, bisexual, and other men who have sex with men (MSM) still account for most new cases of HIV, followed by heterosexual women of color and injection drug users. Most concerning is that young men who have sex with men between the ages of 25 and 34 saw HIV infection rates increase 35% between 2008 and 2014. Latino MSM saw a 20% increase in the same period, underscoring the continued need for APRI and other organizations to do free HIV testing, education, and outreach.

Other noteworthy stats:

• In 2014 (the last year for which we have statistics), an estimated 37,600 people became newly infected with HIV in the United States.
• Approximately 1 in 7 people who have HIV do not know they have it.
• The estimated number of annual HIV infections in the U.S. declined 18% between 2008-14 (from 45,700 to 37,600).
• In Rhode Island, approximately 2,600 people are living with HIV.
• Gay and bisexual and other MSM accounted for more than 50% of all new infections, while injection drug users accounted for fewer than 5% of new infections in 2016.

More Resources

For more information and statistics, please visit:

https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics

http://www.health.ri.gov/data/hiv/

While most STIs are treatable, the best way to avoid them is to use condoms and other safer sex tools to protect yourself, get screened regularly (every 3-6 months if you are sexually active and/or have multiple partners), and alert any of your partners if you have been tested and diagnosed so they can get screened as well. Below is a list of the most common STIs, what they are, how they are spread, and how they are treated. You can read more about all STIs at https://www.cdc.gov/std/.

We can screen you for hepatitis C and syphilis and provide referrals to other locations where you can get screened and/or vaccinated against other STIs.

Chlamydia

A bacterial infection spread via vaginal, anal, or oral sex
Symptoms can be mild or nonexistent (asymptomatic), but may include discharge from the vagina or penis and painful urination.

Risks: Can cause pain and ultimately infertility if left untreated
Testing: Specimen or urine
Treatment: Antibiotics

Crabs (Pubic Lice)

Spread mostly through bodily contact, pubic lice are more of a nuisance than a public health threat, and the lice do not live long once off the body.

Testing: By sight or visit with medical professional.
Treatment: Available via over-the-counter lice shampoo at drug stores and pharmacies.

Gonorrhea

A bacterial infection spread via vaginal, penile, oral, or anal contact. Symptoms can range from mild to nonexistent and may include burning during urination and discharge from the penis or vagina. Men might also have pain in their testicles and women might also experience spotting between periods.

Risks: Can potentially cause infertility and can be life-threatening if left untreated
Testing: Specimen, swab, or urine
Treatment: Antibiotics

Hepatitis A, B, C

Hepatitis is a viral infection that is spread in different ways, depending on the virus. Hepatitis A is often spread through food that is contaminated with small, undetectable amounts of fecal matter or through sexual contact. Hepatitis B is often sexually transmitted and can be spread by blood, semen, or other body fluid infected with the virus. Hepatitis C is most commonly spread through blood-to-blood contact such as injection drug users share needles, but can also be sexually transmitted (though more research needs to be done on this).

As the CDC notes: “All three have different modes of transmission and can affect the liver differently. Hepatitis A appears only as an acute or newly occurring infection and does not become chronic. People with Hepatitis A usually improve without treatment. Hepatitis B and Hepatitis C can also begin as acute infections, but in some people, the virus remains in the body, resulting in chronic disease and long-term liver problems. There are vaccines to prevent Hepatitis A and B; however, there is not one for Hepatitis C. If a person has had one type of viral hepatitis in the past, it is still possible to get the other types.” See https://www.cdc.gov/hepatitis/index.htm for more.

Risks: Many, depending on the virus. Chronic liver problems, cancer, and death if left untreated.
Treatment: Hepatitis C can be treated, though the costs associated with treatment are extremely high and may not be covered by insurance. Hepatitis A & B are not necessarily treatable in a traditional sense. They are, however, preventable through vaccines. It is recommended that ALL men who have sex with men get vaccinated for both hepatitis A and B.

Herpes

Herpes is a virus that is spread through skin-to-skin contact. Though the virus cannot be cured, it can be controlled. Symptoms can be mild to nonexistent but may also include sores/blisters, especially during a “flare up.”

Risks: Can cause recurrent or chronic painful genital sores and pregnancy complications
Testing: Visual inspection, sample, or blood test
Treatment: Of symptoms, not the virus

Human Papillomavirus (HPV)

A virus spread via genital or anal contact, HPV can cause no symptoms or serious ones, depending on the strain. Some strains cause genital warts. Others are known to cause certain types of cancer.

Risks: Genital warts, cancers
Testing: For symptoms and risks, not HPV itself
Treatment: For symptoms; HPV vaccine for younger individuals (recommended ages 11-12)

Syphilis

A bacterial infection spread via vaginal, penile, oral, or anal contact. Early symptoms include the presence of a chancre (one or multiple sores) or a rash. If not seen or treated early, the disease can go into a “latent” stage where no symptoms are present. Later stage syphilis is severe and can include muscle problems, blindness, dementia, and more.

Risks: See above. Also: damage to internal organs
Testing: Specimen and blood/oral test
Treatment: Antibiotics

U=U is a groundbreaking concept and movement that means people living with HIV who take medication as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.

When someone is undetectable, a routine blood test cannot detect copies of HIV in the blood, which means the virus is only present at very low levels.

U=U is an important message in many ways. First and foremost, it educates everyone about the importance of HIV testing and of taking medication if you are living with HIV. In addition, U=U is important in combatting stigma and discrimination that HIV-positive people continue to face. HIV can now be treated as a chronic, manageable condition, much like diabetes, for example.

For more on U=U, please visit the Prevention Access Campaign at https://www.preventionaccess.org/.

Hepatitis C is a liver infection caused by the Hepatitis C virus (HCV). Hepatitis C is a blood-borne virus. Today, most people become infected with HCV by sharing needles or other equipment to inject drugs, though there is indication that hepatitis C can also be transmitted sexually. People who have multiple sex partners, have a sexually transmitted infection, engage in certain kinds of rough sex, or are HIV-positive may be at higher risk.

For some people, hepatitis C is a short-term illness, but for 70-85% of people who become infected with hepatitis C, it becomes a long-term, chronic infection. Chronic hepatitis C is a serious disease than can result in long-term health problems, even death. The majority of infected persons might not know about their infection because they do not feel ill. There is no vaccine for hepatitis C, but there are now treatments that are available. They are, however, very expensive and not all insurance plans cover treatments.

The best way to prevent hepatitis C is by avoiding things/situations that can spread the disease, especially injecting drugs or sharing needles. AIDS Care Ocean State offers a free needle exchange and we offer free, anonymous hepatitis C testing. If you were born between 1945-65, are HIV-positive and sexually active, and/or have a history of injection drug use or sex work, you should be tested for HCV.

To learn more, please visit CDC’s page on hepatitis.