Every Question You’ve Ever Had About HIV Answered

When I came out I can remember having a conversation with my father a few days after I came out. He told me “just please don’t get HIV”. This was when I was getting sober, so my memory was comparable to a hummingbird with ADD, so although there may have been other conversations that took place about my sexuality…I don’t remember any.

I was afraid to be an out gay man and I was afraid of HIV because of the insane “sex education” that I received that you can read about here and because of the way the people around me feared for my safety because of my “lifestyle”.

I was tested last week for HIV and the results were negative. So, I do not have HIV and cannot know what it is like to have HIV, I can only gather research and talk to those in my life who have been living with the virus. HIV is a hard disease to live with. That is indisputable. But, the stigma of the disease is arguably the most difficult part. So, here is every question you’ve ever wondered about HIV/AIDS, answered.

…well actually these were only the questions I asked first. My original edit for this post was twenty pages long. There is SO MUCH MORE information, and if you would like to know more let me know and I will follow up another post or two or three…

What is HIV?

  • HIV stands for Human Immunodeficiency Virus
  • It is a chronic virus that attacks the body’s immune system, specifically your CD4 cells (more on this later) which make the person more likely to get other infections

 

What is the difference between HIV and AIDS?

  • Nothing, AIDS is the final stage of HIV. There are more complications associated with AIDS, but it is the same virus. There is actually a lot of debate to get rid of the term AIDS entirely.
  • The reason why there are different names is easier to understand if you know more about the disease (so keep reading)

 

What does HIV do to the body?

  • From a microbiological standpoint, HIV is insane. In a way, I have a lot of respect for the virus because in a lot of ways it is genius. I know how that sounds but just listen.
    • Viruses require a host cell, HIV is no different. Viruses don’t have a cell wall or a nucleus, only a protective shell and genetic instructions on how to replicate itself
    • HIV’s host cells are called CD4 cells (also known as T-helper cells), so when the virus enters the body it heads for the lymph nodes, which is where these cells like to hang out.
    • CD4 cells are the whistle-blowers of your immune system; they send signals to activate the rest of your body’s immune response when “intruders”, like viruses or bacteria, are detected.
    • HIV hijacks these cells and turns them into HIV factories
    • Eventually, the cell will detect something is wrong, causing it to self-destruct. Which is bad.
    • This happens in other viruses as well, they attack a cell and use it until it destroys itself. Usually, that’s the end of it. But, HIV attacks CD4 cells, so when one is destroyed even more CD4 cells come to the scene of the crime and are also infected with the HIV virion.
    • It’s a massacre on a cellular level.

 

What are the stages of HIV?

  • Acute HIV Infection
    • The Earliest stage of HIV infection. Generally, develops within 2-4 weeks after a person is infected with HIV. During this time people usually experience flu-like symptoms. This is when the risk of transmission is the greatest
  • Chronic HIV Infection
    • Also called asymptomatic HIV or clinical latency. During this stage, the individual may not experience any symptoms, but they can still spread HIV. Can last for ten years or more in some case.
      • The CD4 cell count of a person who does not have HIV can be anything between 500 and 1500.
      • People living with HIV who have a CD4 count over 500 are usually in pretty good health.
      • People living with HIV who have a CD4 cell count below 200 are at high risk of developing serious illnesses. This is when HIV is considered AIDS (Auto Immunodeficiency Syndrome). It is the same disease, the only difference is your CD4 count.
  • AIDS (Auto Immune Deficiency Syndrome)
    • The final stage of HIV. The individual has a CD4 count of less than 200. At this point, the virus has done severe damage to the immune system, because of this the body cannot fight off opportunistic infections. Opportunistic infections are infections and infection-related cancers that occur more frequently or are more severe in people with weakened immune systems than in people with healthy immune systems.
    • When no one knew what the fuck was going on HIV was referred to as “Gay Cancer” during the AIDS Crisis

 

How do you get HIV?

  • In any situation in which blood or semen is transferred: sex acts, sharing intravenous needles, passing it from mother to infant during pregnancy, or receiving a blood transfusion
    • The most common way to get HIV is through Anal Sex
      • The lining of the rectum is fragile and has lots of blood vessels
      • The cells that line the rectum are more susceptible to HIV than the cells of the vagina
      • Semen and Rectal mucosa carry more HIV than vaginal fluid
    • It is NOT easy to calculate the risk of each act. And while I’m at it, let me save space for a disclaimer: JUST BECAUSE THESE ARE THE RISKS DOES NOT MEAN THAT YOU WILL BE “LUCKY” EVERYTIME BECAUSE SOMETIMES THE ODDS AREN’T ALWAYS IN YOUR FAVOR KATNISS.
    • Let’s break down the risk of each act:
      • Anal Sex:
        • (Bottoming) Receiving unprotected Anal sex – 1.4% (one transmission in every 71 acts)
        • (Topping) Inserting your penis – 0.06% (one transmission in every 1,667 acts)
      • Vaginal sex
        • Receptive ­– 0.08% (one transmission in every 1,250 acts)
        • Insertive – 0.04% (one transmission in every 2,500 exposures)
      • Oral sex
        • Giving a blow job from an HIV positive individual – 0.04% (one transmission in every 2,500 exposures)
        • Receiving a blow job to an HIV positive individual – negligible risk
      • Open mouth kissing
        • None, HIV doesn’t exist in saliva. Also, “open mouth kissing”…that’s a very polite way of saying you had your tongue down his throat, Debra.
      • Blood transfusion
        • Over 90%
        • This is very rare incident anymore because blood is tested. But is still the reason why gay men are not allowed to donate blood.
      • Sharing a needle with an HIV positive individual – .67% (one transmission in every 149 exposures)

 

Quick side note: here are a few ways that people thought you could get HIV / AIDS during the AIDS crisis:

  • Toilet Seats
  • Mosquitos
  • Kissing
  • Shaking Hands
  • Being too near someone

 

See why the stigma of HIV is so toxic?

 

Whoa Wolfe, these seem like really low odds of transmission? Why should I even worry?

  • Well Janice, because of math that’s why.
  • HIV Spreads quickly.
    • Let’s say you are a “promiscuous” individual and have 100 sexual partners in a year
    • And about 25% of your partners are also “promiscuous”
      • That is 2500 people you were exposed to
      • 25% of those people are promiscuous
      • That means up to 62,500 people could be exposed
    • This is why calculating risk is really really difficult.

 

How to I stay clean?

  • First of all, if you are HIV negative STOP saying you are “clean”. The friends that I have who are positive are not “dirty”. It’s like saying someone has “full-blown AIDS”, it’s extremely antiquated phrasing and is harmful and disrespectful.
  • There are numerous ways to protect yourself
    • First of all, speak openly with every partner about the last time they were tested and the ways in which they protect themselves.
    • Latex condoms are 98-99% effective when used correctly
      • The most common mistake is not using a lubricant that is compatible with latex. DO NOT USE ANY SORT OF OIL FOR LUBRICANT, YOU’RE NOT MAKING A SALAD JUDITH. Oil (yes I know coconut oil is great for everything, EXCEPT LUBE) will break down the condom and make it severely less effective.
      • Trojan ENZ Lubricated condoms are the top rated across many different publications. You can get them here.
    • Use silicone based lubricants, they don’t dry out like water-based lubes and cause less irritation (
      • I like Swiss Navy, the name of the lube makes me feel butch.
      • You can get it here.
    • If someone ejaculates in your mouth, swallow or spit, don’t let it sit.
      • So, unless you’re hockin’ that load onto the carpet right away (someone did this with me, I don’t want to talk about it) swallow that load like a man/woman.
    • Take Pre-exposure Prophylaxis (PrEP)

 

What is PrEP?

  • Pre-Exposure Prophylaxis (PrEP) is a prescription medication that you take daily to reduce the risk of HIV transmission by 90% or more.
  • There are a few different medications you can take but Truvada is the most common
  • I’ll allow you to make up your own mind if PrEP is right for you
  • Information about PrEP
  • I take it and recommend it.

 

Where can I go get tested? Do I have to get blood drawn?

  • Check here for a testing center near you
  • I live in Southern California so the LGBTQ center has free oral exams to screen for HIV. It is fast, easy and the people working there are always so respectful.

 

Are oral HIV exams as accurate as blood exams?

  • Yes and no.
  • Oral exams are as accurate as a blood test for testing for HIV when it is in it’s latency period, but when in the first few weeks to few months after exposure, the body may not have made enough antibodies for the oral test to detect.

 

What does Undetectable mean?

  • – When copies of HIV cannot be detected by standard viral load tests, an HIV-positive person is said to have an “undetectable viral load.” For most tests used clinically today, this means fewer than 50 copies of HIV per milliliter of blood. Reaching an undetectable viral load is a key goal of ART (treatment for HIV).

 

Will HIV tests be positive if viral load is undetectable?

  • Yes, because HIV tests look for whether your immune system has been affected by the virus. So even if you have a viral load that is undetectable, you still have HIV.
  • Viral load tests are administered to check to see if you have achieved an undetectable status.

 

Does undetectable mean uninfectious?

 

How much does HIV treatment cost?

  • The CDC reports that the estimated lifetime cost of treating HIV is $379,000 (in 2010 dollars)
    • You can see the entirety of one man’s bill here
      • Four pills a day
      • $3,006 a month
      • $36,000 a year

 

Is there a cure?

 

What is the life expectancy of someone with HIV?

  • The life span of someone who is HIV positive still lags 13 years behind someone who has a negative status. But it is improving.

 

How long do people with HIV need to be on treatment

  • Their entire lives unfortunately
  • But, there is new information coming out that could lead to a cure.

 

Do people with HIV get sick all the time even when they’re on treatment?

  • When someone’s immune system is repressed they are more susceptible to getting sick
  • But, after being on treatment for HIV your immune system will repair itself. Some of the healthiest people I know are HIV positive.
  • Their immune system may not return to what it once was, but that doesn’t mean your body can’t do a bang up job of fighting illness.

 

Is anyone Immune to HIV?

  • Yes, about 1% of people descended from Northern Europe (White folks) are immune to HIV
  • Basically, it’s a genetic mutation that does not allow HIV to dock onto the CD4 cell.

 

I’ve just been diagnosed with HIV/AIDS what do I do now?

  • First of all, know that you’re not alone
  • Start treatment as soon as you can, but know that your positive status does not keep others from loving you.
  • Here’s a good place to start

 

Thank you all so much for reading my posts. SO much love for you.

Reach out anytime you need.

~Wolfe

 

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