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Questions about AIDS 

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(taken, with minor editing, from Joint United Nations Programme on HIV / AIDS)

AIDS - the Acquired ImmunoDeficiency Syndrome  - is the late stage of infection caused by a virus, the Human Immunodeficiency Virus (HIV).

A person who is infected with HIV can look and feel healthy for up to ten years or more before signs of AIDS appear. But HIV steadily weakens the body's defense (immune) system until it can no longer fight off infections such as pneumonia, diarrhea, tumors and other illnesses. All of which can be part of AIDS. Unable to fight back, most people die within three years of the first signs of AIDS appearing.

You probably know most of these basic facts about HIV and AIDS. But you may not be aware of some others that could be important to you.

1. How can one contract HIV?

AIDS is mainly a sexually transmitted disease. Most of all HIV infections have been transmitted through unprotected sexual intercourse with someone who is already infected with HIV. HIV can also be transmitted by infected blood or blood products (as in blood transfusions), by the sharing of contaminated needles, and from an infected woman to her baby before birth, during delivery, or through breast-feeding. HIV is not transmitted through normal, day-to-day contact.

2. Can I get AIDS from "casual contact" with an infected person?

No. This means that it is OK to play sports and work together, shake hands, hug friends or kiss them on the cheek or hands, sleep in the same room, breathe the same air, share drinking and eating utensils and towels, use the same showers or toilets, use the same washing water and swim in the same swimming pool. You cannot get infected through spitting, sneezing, coughing or through tears or sweat, or through bites from mosquitoes or other insects.

3. How can I recognize if someone is infected with HIV?

There is no way of knowing whether someone is infected just by looking at them. A man or woman you meet at work, school, or a sports stadium; in a bar or on the street might be carrying HIV - but look completely healthy. But during this time of apparent health, he or she can infect someone else.

4. What should I do to protect myself from HIV?

There is no vaccine to protect people against getting infected with HIV. There is no cure for AIDS either. This means that the only certain way to avoid AIDS is to prevent getting infected with HIV in the first place.

5. What is safer sex?

You are safest of all if you do not have sexual intercourse. You are also safe if you are in a stable relationship where both you and your partner are free of HIV and neither of you has other sex partners. Sex without penetration is another way to have safer sex that greatly decreases your risk of getting infected with HIV. You can have a great deal of stimulation and pleasure through caressing, hugging, kissing, and massaging different parts of the body.

Safer sex also includes using a condom - but, using a condom correctly, and using one every time you have sex. Learn how to negotiate the use of condoms with your partner.

6. What can I do to convince my partner to use a condom?

Some people think that sex is not as enjoyable if you use condoms - perhaps you feel this way because of a bad or embarrassing experience, but that is not a good reason to risk your life or the life of your partner by not using them! Research has shown that when people use condoms the right way, and with confidence, there is little or no loss of stimulation or pleasure. For some people, it even lasts longer.

If you do not use condoms often, and if you still feel a bit awkward about using them, try practising a little by yourself. Just go out and get some condoms, read how to use them, practice using them, then use them every time you have sex.

7. Do you sometimes have sex without using a condom?

If you have had sex without a condom just one time, you have already put yourself in danger of infection with HIV. Maybe you have been lucky - maybe you have not yet been infected with HIV. You may not be so lucky next time. First of all, avoiding dangerous situations is the smarter way to go. Having casual sex is dangerous - but having casual sex without a condom is simply taking a needless and foolish chance of getting infected with HIV.

8. I have fallen in love, can I start cutting back on using condoms during sex?

Many people think that once they have fallen in love, it is all right to stop using condoms. Unfortunately, thousands of people around the world have become infected by their steady partner. Unless we are talking about a 100% mutually faithful relationship between two people who are both free of HIV infection, it is important to wear condoms every time you have sex. No matter how well you think you know the other person, you cannot tell if that person is infected with HIV.

9. How can I tell if I am in a safe relationship?

After a minimum of three months of a monogamous and mutually faithful relationship, a medical exam to show that both partners are free of any sexually transmitted disease is reassuring. If HIV-testing is available to you, a negative HIV test after a minimum of three months of your mutually faithful relationship would show that you are free of HIV. Of course, both you and your partner need to stay mutually faithful to ensure that you will stay free of HIV and STDs.

10. I think sex should always involve penetration to be enjoyable!

Non-penetrative sex, where the penis does not enter the vagina or anus, is a way to have safer sex that greatly decreases your risk of getting infected with HIV. Maybe you do not believe that non-penetrative sex can be as satisfying as penetrative sex. But you can give and receive a great deal of stimulation and pleasure through non-penetrative sex, such as mutual masturbation, massage, caressing, hugging, and kissing different parts of the body. It may take patience, practice, imagination and trying different things out with your partner, but when you become skilled at non-penetrative sex, you will find, as others have found, that it can be an exciting and sensual alternative.

11. What about oral sex, is it safe?

You need to know that the AIDS virus is present in sexual secretions, including the vaginal secretions of a woman and the semen (in both the pre-ejaculation lubricating mucus and the ejaculate, or "cum") of a man. This means that taking the partner's sexual secretions into the mouth can pose a risk of infection.

It is strongly advisable to carry out oral sex only with some kind of protection. You should use a condom on the erect penis, and place a thin rubber sheet or "dam" over the woman's genitals.

12. What about the risk of kissing - and what about "wet" or "tongue kissing"?

The AIDS virus is not found in the saliva of the mouth under normal conditions. So, when two healthy people kiss, or even kiss with touching tongues or inserting the tongue deeply into the other person's mouth, there should not be any significant risk.

However, everyone has times when there is bleeding from the gums or a small ulcer in the mouth. Some people have this almost all the time. If this is true for both individuals who are kissing, and if there is any exchange of blood between the two mouths, there is a potential risk that the virus could pass from one person to the next. Obviously, the risk would be higher in "wet" kissing. It is not possible to know exactly how important this risk is.

13. Can I have anal sex?

Maybe you have anal sex to avoid unwanted pregnancies. Or maybe you have anal sex because you believe that is how you can best avoid getting infected with HIV. Unfortunately, many people believe this myth. In fact, the opposite is true: the AIDS virus is more easily passed from an infected person to another person during anal sex than during vaginal sex.

In these circumstances, using a well-lubricated condom is absolutely essential for protection. Unlike the vagina, which produces secretions that lubricate vaginal sex, the anus does not produce lubricating secretions. Without such lubrication, the additional friction during anal sex can cause regular condoms to tear. In some places, it is possible to get condoms made especially for anal sex. If these are not available, you should really try to be on the safer side - look for other ways to have sexual satisfaction.

14. I am worried that I might have a sexually transmitted disease (STD).

You may have a sexually transmitted disease, such as gonorrhea or hepatitis B, if you have a burning sensation when you urinate. Signs of an STD in a woman may be unusual discharge or unexpected bleeding from the vagina during or after intercourse. A man infected with an STD may have a discharge from his penis, or he may have sores or discoloration on his penis.

If you think you have an STD, you should consult a doctor right away, get the full treatment you need, and ask for some advice on how to avoid this risk in the future.

If you have an STD, you have been given a very serious warning that you have been having unprotected sex, exposing yourself to risks by not using a condom with great care every time you have sex.

You may be lucky if you became infected with one of the curable STDs. But remember that AIDS is also a sexually transmitted disease, and that there is no cure or vaccine for it.

15. Have you noticed any sores or lesions on the genitals of your sex partner?

Never have sex if you know or suspect that either you or your partner has an STD. Any STD can increase the risk of catching or transmitting HIV. With an STD you have a 5 to 10 times higher risk of getting infected with HIV. For your own safety and that of your partner, DO NOT have sex if there is any chance that either one of you has an STD.

16. I have sex with a lot of different partners. Is that risky?

Yes, men and women who have many different sex partners run a higher risk of being exposed to and getting infected with HIV than do people who stay in a mutually faithful relationship with a single partner. The simple fact is that you increase your chances of being exposed to HIV every time you have sex with a different person. However, you can reduce your risk by always using condoms.

17. Are there people who are more likely to be infected with HIV than others?

Some people are, statistically, more likely to be infected with HIV than others.

  • Both men and women who work as prostitutes are more likely to be infected with HIV because they have had so many sexual partners. Any one of these partners could have been infected with HIV and transmitted HIV during sex.
  • People who inject drugs are also more likely to be HIV- positive, because the virus spreads so easily through injections using needles and syringes contaminated with HIV- infected blood.
  • Men who have sex with men have a greater chance of becoming infected with HIV than do men who have sex only with women. This is because HIV is more likely to pass from an infected person to another person during anal sex than during vaginal sex. This is because anal sex can injure or tear the delicate lining of the anus and rectum, and bleeding from these injuries allows the virus to pass more easily into the body.

18. What about the risks of getting HIV through injecting drug use ("shooting drugs") - can that risk be reduced?

Obviously, to avoid the very high risk of being exposed to HIV in this way, it is best to use sterile, never-used needles and syringes, and to use them only once. If you have nothing available but already-used syringes and needles, the only way to be sure you are protected against HIV is not to inject drugs at all.

You may have heard that bleach has been recommended to disinfect drug injection equipment. But you should know that this is not guaranteed to be effective in killing HIV. If you decide to use this to reduce the risk of exposure to HIV, be sure that the product you use is full strength liquid household bleach. First, wash out the syringe and needle with clean water to get rid of all traces of blood; then, completely fill and flush the syringe and needle with the bleach at least 3 times, leaving the bleach inside the syringe for at least a full 30 seconds, using fresh bleach each time. Finally, after the bleach, rinse the syringe and needle by filling several times with fresh, clean water to remove all traces of bleach.

19. What precaution should I take when I am at the disco or a bar?

Give some thought to what you do when you are at a disco. Some of the people you meet in discos are there every night and have gone out with many other people before you. Any one of the casual sex partners you meet there could be infected with HIV or another STD.

If you drink a lot of alcohol or take drugs, this will interfere with your judgment about many things, including sex. Think about it: being just "high", could kill you. When you lose control, you could get infected with HIV. Even if you think about condoms, you may not be careful enough to use them correctly.

20. What should I do if I think I might already have HIV?

If you think you might have HIV (if you have had unprotected sex, you may be starting to worry), and you would like to know for sure, ask your physician about getting an HIV blood test and some counselling. If you need to check it out yourself, many cities have testing centers where you can get an HIV test and some good counselling without even having to give your name.

21. What is the use of knowing whether or not I am infected?

It may take a great deal of courage to go and get the answer to this question. But it will permit you to get full and proper medical care should you be infected. By taking extra care, people with HIV infection can live for many years. If you are infected, you can find out what to do to stay as healthy as possible for as long as possible. For example, it is very important not to get another STD, or expose yourself to other types of infection.

There are two other reasons why it is important to know if you are infected.

  • First, if you are infected with HIV and have sex with other people, there is a great risk you could transmit the virus to them. In this situation, you need to prevent passing on the virus to others. You need to be sure that the infection stops with you.
  • Secondly, if you are infected with HIV, you certainly do not want your blood to be used in a transfusion in the event you donate blood to someone in need of a blood transfusion. In this sense, it is essential to know if you are infected with HIV, so that your donated blood does not cause someone to contract HIV.

22. What if I do not want to have an HIV test?

Then you really need to play it safe, just as if you know you are HIV-positive. Either choose abstinence and do not have sex with anyone, or practice non-penetrative sex, or use condoms without fail, taking great care to avoid any condom accidents. That way, you will not get any new infections your partners may have, and they will not get yours.

23. I think I know of someone who has HIV or AIDS. What should I do?

Because people with HIV look and feel perfectly healthy for a long time, they can do their job as well as they could before they were infected. They are part of society. Therefore, it is understandable that someone with HIV should want to be treated just like anyone else. Respect that person's privacy and do not spread the word about his or her infection. Remember: you cannot get HIV from "casual contact" with this person.

We all need to learn to live with HIV and AIDS. We all have a responsibility in the AIDS era to talk openly about HIV and to take action to prevent its spread. This includes understanding people with HIV/AIDS and giving them love and support, not prejudice and rejection.

AIDS help line in South Africa

Phone 0800 012322 or 0800 012312 (toll free). Provides counseling and also provides information on particular resources (e.g. where to get an aids test done). 

Compiled by Hamish Robertson  

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