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FAQs

Basic Information

HIV (Human Immunodeficiency Virus) is a retrovirus that attacks the body's defense system, known as the immune system. A person develops HIV if the virus gets into his or her bloodstream and begins making more and more of itself, or reproducing. People living with HIV may have no symptoms for ten or more years. They may not even know they are living with the virus. An HIV test is the only way to find out if a person is living with HIV. Without treatment, most people living with HIV become unable to fight off germs and other viruses so they can become very sick.

AIDS (Acquired Immune Deficiency Syndrome) is the advanced phase of infection with HIV in which the immune system is weakened. According to the CDC, a person living with HIV has AIDS when he or she:

  • Has a very weakened defense system based on clinical criteria, OR
  • Develops a serious illness that we know can be caused by HIV.

For a list of these illnesses, visit: www.cdc.gov/mmwr/preview/mmwrhtml/rr5710a2.htm

A person of any age, sex, race, ethnic group, religion, economic background or sexual orientation can become infected with HIV. Those who are most at risk are:

  • People who have “unprotected sex” with someone who has HIV. Unprotected sex means vaginal, anal or oral sex without using a condom.
  • People who share needles, syringes, or other equipment to inject drugs, steroids, or even vitamins or medicine with someone who has HIV.
  • Babies can potentially become infected during their mothers’ pregnancy, during delivery, or after birth in the immediate post-partum period. They can also become infected through breastfeeding.
  • Health care and maintenance workers who may be exposed to blood and/or body fluids at work sometimes get infected through on-the-job exposure like needle-stick injuries.

Transmission

Sexual Transmission: HIV is spread when blood, semen or vaginal fluids from a person living with HIV who is not virally suppressed gets into the bloodstream of another person. The risk of transmission depends on the type of sexual behavior. Oral sex has a low risk of passing HIV. Vaginal intercourse is a higher risk activity for passing HIV. The sexual behavior with the highest risk is anal intercourse. If either partner is living with HIV, the virus may be transmitted, especially if blood is present during sex. The risk of transmission for any of these behaviors can be lowered in a variety of ways, including:

  • Condom use (Free condoms are available at our clinic for those over 18 years of age.)
  • Antiretroviral treatment for the person living with HIV
  • Pre-exposure prophylaxis or PrEP, a once-a-day pill HIV negative individuals can take to protect themselves. (Contact your healthcare provider or call our office to schedule an appointment for a prescription.)

A person living with HIV who is on HIV treatment and virally suppressed for 6 months or longer has effectively no risk of passing HIV to a partner through sex.

Substance Use Transmission: Sharing needles and works during injection drug use is a high-risk behavior for passing HIV from one person to another. Since blood may be present in the needle, syringe, cooker or water used during injecting, HIV can be easily passed when people share any of these equipment items. By always using sterile injection equipment and not sharing equipment can help protect people who inject drugs from HIV. To find syringe exchange programs near you, visit www.thepointny.org. People who inject drugs may also consider taking PrEP, a daily medication that can protect an HIV negative person from getting HIV. (Contact your healthcare provider or call our office to schedule an appointment for a prescription.)

Mother-to-Child Transmission: A woman who is living with HIV can pass the virus to her baby during:

  • Pregnancy
  • Delivery
  • Breastfeeding

There are medicines that a woman living with HIV should take during pregnancy, labor, and delivery to protect her health and greatly reduce the chance that she will pass the virus to her baby. Medication is also given to the infant right after birth and for the first weeks of life. It is very important for all women to know their HIV status before they become pregnant, or very early in their pregnancy, so that they can take full advantage of these medicines. A second HIV test is also recommended late in the pregnancy to identify if the woman was exposed to HIV during the pregnancy. Since HIV is also found in breast milk, women living with HIV should not breastfeed their babies.

Blood Transfusion: At the beginning of the AIDS epidemic, some people became a person with an HIV diagnosis from receiving a blood transfusion. With testing of the blood supply since 1985, there is no longer a risk of getting HIV when receiving a transfusion in the United States.

No. But it is important to know that you can be infected by a single exposure to HIV-infected blood, semen, or vaginal fluids. Whether a person becomes infected after being exposed to HIV depends on how the virus enters the body and the amount of virus that enters the body.

For recent potential exposures to HIV, New York State Department of Health’s HIV Clinical Guidelines recommend post exposure prophylaxis (PEP) which involves taking a combination of HIV medicines for 28 days. PEP should be started as soon as possible, ideally within 2 hours of exposure. Decisions regarding initiation of PEP beyond 36 hours but no longer than 72 hours after the exposure are made on a case by case basis, keeping in mind that the medicine is most effective the closer it can be taken to the exposure. The DOH has a fact sheet that a person who has been exposed to HIV can take to the emergency room to explain his or her special need. For PEP to work, every dose of each medicine prescribed must be taken, for the full period of time. PEP can be expensive and insurance coverage may vary, but options for payment assistance can be found on the NYSDOH website. Payment is available for sexual assault victims. Talk to your healthcare provider or an emergency room doctor right away if you think you’ve recently been exposed to HIV.

Any time you share injection equipment with someone who has HIV or whose HIV status you do not know, there is a high risk that you will get HIV. Small amounts of blood from a person living with HIV may stay in the "works" used to inject drugs (needles, syringes, cotton, cookers, water or other equipment) and can be injected into the bloodstream of the next person who uses the equipment. This includes injecting drugs, vitamins, steroids, hormones, or insulin into veins (IV), in the muscles or under the skin.

Used needles and works may also be packaged as new and sold on the street and can transmit HIV if someone with HIV used them. To find syringe exchange programs near you, visit www.thepointny.org.

No one has ever gotten HIV through casual kissing, such as between parents and children. It is possible, but extremely unlikely, for HIV to be passed during "deep kissing." There has been just one reported case of this kind: a woman became infected through deep kissing with a man with AIDS whose gums often bled after brushing and flossing his teeth and after this activity, the couple often engaged in deep kissing and protected sex. Although HIV transmission most likely occurred during deep kissing, it was probably the blood in the man's mouth, not his saliva, that transmitted HIV. Both the man and the woman had gum disease which may also have contributed to the woman becoming infected. It is important to note that in this situation, HIV is not passed through saliva, but rather through direct blood-to-blood contact.

No. AIDS cases have not been linked with any ear or body piercing or tattooing. While HIV transmission from body piercing or tattooing is highly unlikely and has not yet occurred, it is possible for the blood from an infected person to be left on the needle that is later used to pierce or tattoo another person. To guard against this possibility, all needles or equipment used for these procedures should be new or sterilized between uses, and new unused ink should be used for tattooing. However, other blood-borne illnesses, such as hepatitis B and possibly hepatitis C, can be transmitted by sharing tattooing and piercing equipment.

No. Studies have shown that mosquitoes and other insects do not pass HIV to humans.

When an insect bites a person, it does not inject its own blood or a previous victim’s blood into the new victim. It injects only saliva. Unlike the germs that cause malaria and other diseases spread by insect bites, HIV does not reproduce in insects. So, even if the virus enters a mosquito or another suckling or biting insect, the insect does not become infected and cannot pass HIV to the next human that it feeds on or bites.

No. HIV cannot live in a hot tub or swimming pool. There have been no cases of HIV transmission through swimming pools or hot tubs.

It is very unlikely that a person would get HIV from a human bite. HIV can only be passed in this manner through direct blood-to-blood contact and not by exchanging saliva. To pass the virus, the infected person would need to have blood in his or her mouth and break the skin of the other person. The break in the skin of the uninfected person could allow infected blood to enter his or her bloodstream. If a person who does not have HIV bites and breaks the skin of a person with HIV, transmission of the virus could only occur if the uninfected person has open sores or cuts in the mouth that allow for blood-to-blood contact.

Testing

For a standard HIV test, a blood or oral fluid sample is taken and sent to a laboratory. You will need to call or come back about a couple of days after the test to get your test result.

At some clinics and doctors’ offices, you can get a rapid HIV test, which can give you a preliminary result that day. The test takes about 20 minutes. If your rapid HIV test is reactive (meaning HIV virus or antibodies were found), you will need additional testing that is sent to a laboratory. When you get your final test result, you will receive information about what the result means, and linkage to care as necessary.

A home HIV test kit is sold over-the-counter at pharmacies and other stores. With the home test kit, you take a finger-stick blood sample and send it to a laboratory. Later, you call to get the test result over the phone, using an anonymous code number. Follow up with a healthcare provider if have a reactive test or have any questions regarding your result.

To find out more about getting tested, call your healthcare provider or visit: www.hivtestny.org. Free anonymous HIV antibody testing with appropriate referrals is available through the New York State Health Department in Rochester. For more information: Phone: (585) 423-8081, Toll-Free: 1 (800) 962-5063, TDD: (585) 423-8120.

If you think that you may have been exposed to HIV, you should get tested as soon as possible. People should be tested if they engaged in behaviors in the past that might have placed them at risk of HIV exposure. You may have HIV and have no symptoms for many years.

Most people who have HIV will have a reactive test, meaning the test found evidence of HIV, within one month of transmission. The period of time after transmission, before the HIV test turns reactive is called the “window period.” When transmission first occurs, the virus begins to reproduce and the body makes antibodies to fight HIV. When enough virus is present or antibodies are developed, the HIV test will be reactive. Most people who have HIV will develop enough antibodies or have enough virus present to be detected by the latest testing technology two to four weeks after the exposure. Virtually all cases of HIV can be detected by three months after transmission occurs.

To find out more about getting tested, call your healthcare provider or visit: www.hivtestny.org. Free anonymous HIV antibody testing with appropriate referrals is available through the New York State Health Department in Rochester. For more information: Phone: (585) 423-8081, Toll-Free: 1 (800) 962-5063, TDD: (585) 423-8120.

Risk Reduction

There is no vaccine to prevent HIV but here are several ways a person can protect themselves from HIV:

  • If you have a partner who is living with HIV, if he or she is on effective treatment and maintains an undetectable viral load (i.e. the person is virally suppressed), for 6 months and beyond the risk of transmission through sex is negligible.
  • Using a latex condom consistently and correctly every time you have sex is extremely effective in preventing HIV. Consistent means using a new condom every time you have sex. Never reuse a condom. Correct use includes putting the condom on and taking it off correctly and using a water-based lubricant (like glycerin, K-Y™, or Astroglide®) with the male condom to prevent breakage. Oil-based lubricants such as petroleum jelly (Vaseline), cold cream, hand lotion or baby oil all can weaken the make condom, causing it to break. Female condoms can be used with water or oil-based lubricants. Male condoms made of natural lambskin are not effective protection against HIV because they allow the virus to pass through.
  • Pre-Exposure Prophylaxis (PrEP): PrEP is a once-a-day pill for HIV negative individuals to take in order to prevent HIV. When taken consistently, PrEP has been shown to reduce the risk of HIV by 92 to 99%. Many insurance plans, including Medicaid and private health insurances will cover the cost of PrEP. Visit the DOH website for information about how to pay for PrEP, including the DOH PrEP-Assistance Program (PrEP-AP) at: https://www.health.ny.gov/diseases/aids/general/prep/docs/payment_options.pdf

(If you have had a recent potential sexual exposure, you can take PEP to avoid transmission of the virus. Please see the DOH fact sheet on PEP.)

Syringe exchange programs: Risk of infection can be avoided by using a new syringe for each injection and by not sharing syringes or works. Injection drug users may obtain unused syringes by participating in one of the syringe exchange programs. Syringe exchange programs have been authorized to give syringes and needles to injection drug users without a prescription in order to prevent the spread of HIV and other bloodborne diseases. To find syringe exchange programs near you, visit www.thepointny.org.

Cleaning needles and works: Risk of infection can be reduced by always cleaning injection equipment (needles and works) immediately after use or just before reuse, even if it seems to be packaged as new.

Directions for cleaning syringes:

  • Step 1: Rinse the syringe with sterile water.
  • Step 2: Rinse the syringe with bleach.
  • Step 3: Rinse again with new sterile water.

PrEP: People who inject drugs may also consider taking PrEP, a daily medication that can prevent an HIV negative person from getting HIV. (Contact your healthcare provider or call our office to schedule an appointment for a prescription.)

Diagnosis and Treatment

The signs and symptoms of early/acute HIV can begin 2 to 4 weeks after transmission occurs with HIV. During the initial weeks after transmission, about 80% of people will develop symptoms similar to the flu. This may include things like fever, fatigue, sore throat, headaches and swollen lymph nodes. Although many of symptoms are similar, there are some differences to look for between HIV and the flu. Early HIV may cause rash or mouth sores. Flu signs that differ may be nasal congestion, cough and sneezing. Symptoms can last for just a few days or weeks, and in rare cases for several months. After that, the person may feel and look fine for some time. HIV testing is the only way to know if a person has HIV.

If HIV is left untreated, over time it will seriously damage the person’s immune system and leave him or her open to life-threatening infections and even death. Early in the epidemic, before our current treatments were available, most people living with HIV died within 12-15 years. Today, once a person has a reactive (meaning the test found evidence of HIV) test result, he or she will be linked to a health care provider who will provide care and prescribe medication they need. With treatment, people living with HIV can stay healthy and live life fully. Now people living with HIV are living as long as those who do not have HIV.

HIV is treated by taking a combination of medications. The different medications fight the virus at different stages. The health care provider will use a lab test called a genotype test or resistance test to determine the most effective treatment regimen for the patient. The good news is that pharmaceutical companies combine the different antiretroviral medications into one pill. This means that for many patients, treating HIV may be as simple as taking one pill, once a day.

It is important to seek treatment for HIV as early as possible. Getting early HIV treatment will help keep people living with HIV healthy and prevent HIV from affecting how long they live or how well they feel. The pills have either no side effects or manageable side effects. Taking the medications consistently is the most important key to staying healthy and feeling well. Once a person begins to feel well, that does not mean they should stop taking their medicine. In order for HIV medication to be the most effective, it should be taken every day even if the person feels healthy. When people living with HIV who see their healthcare provider regularly and take their medication every day, there is a very good chance that they will become virally suppressed. Viral suppression, sometimes known as being undetectable, is an important goal of treatment. Viral suppression means the amount of virus in the person’s blood is below the level the test can identify.

If a person living with HIV doesn’t take their medications regularly, the treatment won’t work as well and the amount of HIV in your body will increase. That is called having a detectable viral load. This will eventually lead to damage to the person’s immune system and greater chances of becoming ill. If people living with HIV don’t take their medication regularly, it also can lead to what is called drug resistance. This means the virus can get around the medication and the healthcare provider may have to prescribe a new treatment plan that might be more complicated to take, or possibly have a greater risk of side effects.

If a person already has health insurance, the insurance will most likely cover the cost of the medications used to treat HIV. Depending on the health care plan, the person may still have co-pays. If a person does not have health insurance, there are options to help provide the medication at no cost or at a reduced cost.

The New York State Department of Health, AIDS Institute offers five programs known as the HIV Uninsured Care Programs to provide access to health care for people with (or at risk of) HIV who are uninsured or underinsured:

  • ADAP (AIDS Drug Assistance Program) pays for medications used to treat HIV/AIDS
  • ADAP Plus (Primary Care) pays for medical visits and lab tests at enrolled clinics, hospitals, and private doctors’ offices
  • HIV Home Care Program pays for home health care
  • APIC (ADAP Plus Insurance Continuation) pays the premium for cost-effective health insurance
  • PrEP-AP (Pre-Exposure Prophylaxis Assistance Program) pays for medical and lab testing associated with the use of Pre-exposure Prophylaxis medications to prevent HIV

How to apply:

Children and Adolescents

A woman who has HIV can pass the virus to her baby during:

  • Pregnancy
  • Delivery
  • Breastfeeding

There are medicines that a woman living with HIV should take during pregnancy, labor, and delivery to protect her health and greatly reduce the chance that she will pass the virus to her baby. Medication is also given to the infant right after birth and for the first weeks of life. It is very important for all women to know their HIV status before they become pregnant, or very early in their pregnancy, so that they can take full advantage of these medicines and make informed decisions. A second HIV test is also recommended late in the pregnancy to identify if the woman was exposed to HIV during the pregnancy. Since HIV is also found in breast milk, women living with HIV should not breastfeed their babies.

According to New York State Public Health Law, individuals may consent to an HIV test without regard to age. Parents or legal guardians generally have the authority to consent to HIV testing for infants and young children who do not have the ability to understand and make an informed decision about testing. Care is taken to assure that young persons seeking HIV testing are able to make informed decisions about the test and are capable of understanding all information provided. Once a person has the capacity to consent—no matter what age—she or he can have an HIV test without parental knowledge or consent.

You can find out about places that offer HIV testing at www.hivtestny.org. Free anonymous HIV antibody testing with appropriate referrals is available through the New York State Health Department in Rochester. For more information: Phone: (585) 423-8081, Toll-Free: 1 (800) 962-5063, TDD: (585) 423-8120.

Parents or guardians will not be told the test result if the adolescent being tested shows capacity to consent to the HIV test. The laws that protect confidentiality of HIV-related information apply, no matter what the person’s age or whether the person has parental consent or parental involvement.

There are certain times when a parent or guardian of an adolescent who gave informed consent can be told confidential HIV-related information—for example, if the adolescent is being abused or needs urgent care. If it is best for the adolescent, HIV-related information should be kept strictly confidential.

Human Rights

New York State Public Health Law (Article 27F) protects the confidentiality and privacy of anyone who has been:

  • Tested for HIV
  • Exposed to HIV
  • Diagnosed with HIV or HIV/AIDS-related illness
  • Treated for HIV/AIDS-related illness

Discrimination against persons living with HIV in the areas of employment, housing, public accommodation, health care, and social services is prohibited by law.

The Americans with Disabilities Act (ADA) gives Federal civil rights protections to individuals with disabilities similar to those provided to individuals on the basis of race, color, sex, national origin, age, and religion. People living with HIV, both symptomatic and asymptomatic, are protected by the ADA because HIV is considered a disability. The ADA also protects persons who are discriminated against because they have a record of or are regarded as having HIV, or they have a known association or relationship with an individual who has HIV. Persons who are discriminated against because they are regarded as being a person living with HIV are also protected. For example, the ADA would protect a person who is denied an occupational license or admission to a school on the basis of a rumor or assumption that he or she has HIV or AIDS, even if he or she does not, as protected by law.

The Fair Housing Act (FHA) prohibits discrimination against individuals with disabilities, including HIV or AIDS. The FHA prohibits discrimination in the sale or rental of housing (such as apartments, houses, mobile homes, nursing homes, assisted living centers, group homes, student housing, and homeless shelters), and in other residential real estate transactions.

No. Under the federal nondiscrimination laws, an employer cannot require a job applicant to disclose his or her HIV status or to have an HIV test to get or keep a job.

No. It is a violation of the New York State Human Rights Law to restrict an employee's duties or fire them solely because of HIV infection or AIDS. In addition, the federal Americans with Disabilities Act (ADA) requires employers to provide reasonable accommodations to the known physical or mental limitations of employees with disabilities, including HIV infection or illness.

Yes. New York State Code, Rules and Regulations, Title X-Part 63, requires that confidential HIV-related information be recorded in the medical record and be easily accessible to provide proper care and treatment.

No. Hospital and emergency medical services workers have a legal responsibility to care for the sick and to employ staff capable of carrying out that mission. Health care workers who refuse to care for a person living with HIV or AIDS may be fired or disciplined. Ongoing education is required for all health care workers to ensure that they understand the ways in which HIV is spread and follow recommended safety precautions.