HIV Prevention and Care Programs - FAQs

HIV = “Human Immunodeficiency Virus”

HIV is a virus that infects the immune system and damages the ability to fight disease.

AIDS = “Acquired Immune Deficiency Syndrome”

AIDS is the end result of HIV disease. People diagnosed with AIDS lose their ability to fight germs that can make them sick.

HIV is passed from the infectious body fluids of an infected person to another person.

HIV can be passed through an exchange of:

• Blood
• Vaginal fluid
• Semen (cum and pre-cum)
• Breast milk

Some of the ways HIV can be passed between people include:

• Sex (Vaginal, Anal, or Oral)
• Sharing needles or equipment (for any reason)
• Mother to child, before or after birth
• Infected body fluids in contact with:
• Openings in mucous membranes
• Openings in the skin

HIV is not spread through everyday casual contact.

The immune system works in the body to fight germs and keep a person healthy.

T-cells are the “soldiers” of the immune system. T-cells recognize germs in the body, and they work with other cells to destroy them. “Killer” T cells (CTLs) can find and destroy cells that are infected with HIV. HIV infects “helper” T cells (CD4 cells). Helper T cells order “killer” T cells to do their job. When the “helper” T cells are destroyed by HIV, the immune system does not know how to fight the invader. Billions of copies of the virus are created every day by HIV attaching to CD4 (T-cells) and inserting HIV genetic code, the CD4 now replicate HIV. Your immune system attacks and kills the T-cells that have been infected with HIV and the new HIV cells. New T-cells are made because the immune system detects an “enemy” but not as quickly as the number being killed. HIV reproduces very quickly. Eventually, T-cells are overcome by HIV and then cannot do their job of fighting infections.

People infected with HIV…

• May look and feel healthy for a long time
• Can infect others even if they don’t look or feel sick  
• May have symptoms that are like those of many other illnesses 

When people develop AIDS, they get illnesses that healthy people usually don’t get called opportunistic infections AND their T-cell count is at or below 200

Only a doctor can diagnose AIDS.

Acute Infection: May last for one or two weeks. Person may have flu-like symptoms.

Asymptomatic Period: Lasts from 6 months to over 10 years. Person looks and feels well.

Symptomatic period: May last several years. Person may have enlarged lymph glands, tiredness, weight loss, fever, chronic diarrhea, or yeast infections, among other conditions

Window Period: Time it takes for antibodies to become detectable: usually within three months.

AIDS: Average survival after diagnosis of an AIDS-indicator illness had been one and one-half to two years but that has changed because of the treatment regimens. Maximum survival is not known.

The risk of getting HIV from a blood transfusion in the U.S. is extremely low:

• All blood donors are screened for their risk of HIV
• All donated blood is tested for HIV and different communicable diseases
• All blood that tests positive for antibodies to HIV is destroyed and the person notified

Donating blood is not a method to get tested!

Abstaining from or not engaging in risky behaviors is the only way guaranteed to prevent HIV infection.

• Having Sex 
• Sharing needles for body piercing
• Sharing needles or ink for tattooing
• Any activity which breaks the skin

*It is never too late to choose to begin practicing abstinence, even if one has not practiced abstinence in the past

People can choose ways to be affectionate that do not spread HIV infection and other STDs. If people have sex, using latex barriers the right way, every time greatly reduces the risk of HIV infection and other STDs (Condoms, dental dams, gloves, finger cots)

Sexually Transmitted Diseases (STDs) increase the risk of HIV infection by allowing the virus an easier entrance into the non-HIV infected person’s body.

Some common STDs include the following:

• Herpes 
• Chancroid
• Genital Warts 
• Trichomoniasis
• Syphilis 
• Gonorrhea  
• Chlamydia 

Drinking alcohol or taking drugs may make people take the following risks related to HIV:

• Having sex without using a barrier (condom)
• Sharing needles and syringes
• Can impair judgment and positive decision-making

People who think they are at risk of HIV infection are encouraged to seek individual counseling and testing.

*Do not donate blood to get tested for HIV

There are two different HIV testing strategies:

• Confidential - Done in Nevada
• Anonymous 

A simple test that reacts to HIV antibodies in the system called the ELISA. If two ELISA screenings are reactive, a determinate test is performed (Western Blot). Unless it has been 3 months since an exposure, a test may not show as reactive to HIV antibodies. Retest every 3-6 months if risky behaviors continue.

• Blood Testing is the gold standard
• Rapid Testing 
• Orasure 
• Oral test that is proven to be accurate
• Tests for antibodies in cheek cells, NOT THE SALIVA! (Much like paternity tests)

There are three types of testing results:

1. Positive
2. Negative
3. Indeterminate

A NEGATIVE test result means there are no HIV antibodies in detected OR the person is infected, but the body has not produced enough antibodies to show up on the test. This is the Window Period. If a person is at risk for HIV infection, they may be advised to have the test repeated. The test cannot determine if a person will be infected in the future, behaviors determine possibilities of infection.

INDETERMINATE results mean it is unclear if there are HIV antibodies. The test neither clearly shows HIV antibodies, nor is it completely negative. The test must be repeated.

POSITIVE results mean the HIV antibodies are present and a confirmatory test has established that the person is HIV infected. It does not mean that the person has AIDS. The test cannot tell if or when AIDS will develop. A positive person can infect others therefore it is important for them to get evaluated for treatment.

There is a time to act before you develop AIDS. Treatment slows down HIV, which can reduce the likelihood of it becoming AIDS. When HIV is well maintained, your viral load goes down. When viral load is down, you are doing better against HIV.

Left untreated, HIV can become AIDS and can result in death.

Testing Locations

Northern Nevada

Multiple agencies such as Northern Nevada HOPES, Planned Parenthood Mar Monte, and Washoe County Health District offer free or low-cost HIV testing.

Southern Nevada

Multiple agencies such as Southern Nevada Health District and Aid for AIDS Nevada (AFAN) offer free or low-cost HIV testing.

Find testing locations and resources or visit the EndHIVNevada Provider Resources page.

Free Condom Resources

Many organizations throughout the State of Nevada offer free or low-cost condoms. 

Want to do more research before you walk in? HIV.gov - Find HIV Services Near You and plug in your ZIP code to see free condom resources nationwide.

Treatment as prevention (TasP) refers to HIV prevention methods and programs that use antiretroviral treatment (ART) to decrease the risk of HIV transmission. When adhered to consistently, ART can reduce the HIV viral load in an individual’s blood, semen, vaginal fluid and rectal fluid to such a low level that blood tests cannot detect it. This is described as an 'undetectable' viral load or viral suppression. In these circumstances, as long as someone’s viral load remains undetectable, their health will not be affected by HIV and they cannot transmit HIV to others via sexual intercourse. Viral suppression can only be confirmed if a person is accessing regular treatment support and monitoring their viral load testing, by a healthcare professional.

The effectiveness of ART as a prevention tool is now undisputed – and it is being used as a public health intervention as well as a patient-specific strategy as a result.

According to the CDC:

“PrEP” stands for Pre-Exposure Prophylaxis. The word “prophylaxis” means to prevent or control the spread of an infection or disease. The goal of PrEP is to prevent HIV infection from taking hold if you are exposed to the virus. This is done by taking one pill every day. These are some of the same medicines used to keep the virus under control in people who are already living with HIV.

PrEP medicine is not injected into the body and does not work the same way as a vaccine. A vaccine teaches your body to fight off infection for several years. For PrEP, you take a pill every day by mouth. The pill that was shown to be safe and to help block HIV infection is called “Truvada” (pronounced tru vá duh). Truvada is a combination of two drugs (tenofovir and emtricitabine). If you take PrEP daily, the presence of the medicine in your bloodstream can often stop HIV from taking hold and spreading in your body. If you do not take PrEP every day, there may not be enough medicine in your bloodstream to block the virus.

CDC recommends that PrEP be considered for people who are HIV-negative and at substantial risk for HIV.

For sexual transmission, this includes anyone who is in an ongoing relationship with an HIV-positive partner. It also includes anyone who 1) is not in a mutually monogamous* relationship with a partner who recently tested HIV-negative, and 2) is a gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the past 6 months; or heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (e.g., people who inject drugs or have bisexual male partners).

For people who inject drugs, this includes those who have injected illicit drugs in the past 6 months and who have shared injection equipment or been in drug treatment for injection drug use in the past 6 months.

For heterosexual couples where one partner has HIV and the other does not, PrEP is one of several options to protect the uninfected partner during conception and pregnancy.

People who use PrEP must be able to take the drug every day and to return to their health care provider every 3 months for a repeat HIV test, prescription refills, and follow-up.

* Mutually monogamous means that you and your partner only have sex with each other and do not have sex outside the relationship.

In several studies of PrEP, the risk of getting HIV infection was much lower—up to 92% lower—for those who took the medicines consistently than for those who didn’t take the medicines.

Some people in clinical studies of PrEP had early side effects such as an upset stomach or loss of appetite, but these were mild and usually went away in the first month. Some people also had a mild headache. No serious side effects were observed. You should tell your health care provider if these or other symptoms become severe or do not go away.

Visit the CDC's web page for more information about PrEP.

PEP stands for post-exposure prophylaxis. It is when you take antiretroviral medicines (ART) after being potentially exposed to HIV to prevent becoming infected.  It must be taken daily for 28 days. 

PEP must be started within 72 hours after a recent possible exposure to HIV, but the sooner you start PEP, the better. Every hour counts. 

Is PEP right for me?

• think you may have been exposed to HIV during sex (for example, if the condom broke),
• shared needles and works to prepare drugs (for example, cotton, cookers, water), or
• were sexually assaulted,

talk to your health care provider or an emergency room doctor about PEP right away.

PEP should be used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV. It is not a substitute for regular use of other proven HIV prevention methods, such as pre-exposure prophylaxis (PrEP), which means taking HIV medicines daily to lower your chance of getting infected; using condoms the right way every time you have sex; and using only your own new, sterile needles and works every time you inject.

PEP is effective, but not 100%, so you should continue to use condoms with sex partners and safe injection practices while taking PEP. These strategies can protect you from being exposed to HIV again and reduce the chances of transmitting HIV to others if you do become infected while you’re on PEP.

Learn more about how to protect yourself and get information tailored to meet your needs from CDC’s  HIV Risk Reduction Tool  (BETA).

The female condom (FC) is FDA approved to prevent pregnancy and sexually transmitted infections during vaginal intercourse, but not for use during anal intercourse. Studies suggest that a sizeable proportion of men who have sex with men use the FC for anal intercourse despite lack of safety and efficacy information.

Read the white paper on the topic here.