Understanding HIV and AIDS - HIV stands for Human Immunodeficiency Virus. This virus attacks the immune system and weakens the body's ability to fight infection and disease.
There is no cure for HIV, but there are treatments that can be used to slow the progression of the disease. This treatment will also make the sufferer live longer, so they can live a normal life.
With early HIV diagnosis and effective treatment, people with HIV will not turn into AIDS. AIDS is the final stage of HIV infection. At this stage, the body's ability to fight infection is completely lost.
HIV/AIDS in Indonesia
In Indonesia, since HIV infection was first discovered in 1987, HIV has spread to 368 out of 497 districts/cities throughout the province. The island of Bali was the first province where HIV/AIDS infection was found in Indonesia.
According to UNAIDS, there were around 690 thousand people living with HIV in Indonesia by 2015. Of this number, half of them are between 15 and 49 years old. There are about 250 thousand women aged 15 years and over who live with HIV. The death rate from AIDS has reached 35 thousand people. Thus there are 110,000 children orphaned due to the death of their parents due to AIDS.
Spread of HIV
HIV is a fragile type of virus. Cannot survive long outside the human body. HIV can be found in the body fluids of an infected person. The fluids in question are sperm fluid, vaginal fluid, anal fluid, blood, and breast milk. HIV cannot be spread through sweat or urine.
In Indonesia, the factors that cause and spread the HIV/AIDS virus are divided into two main groups, namely through unsafe sex and sharing needles when using narcotics.
The following are some other ways HIV is spread:
* Transmission from mother to baby during pregnancy, during childbirth or breastfeeding.
* Through oral sex.
* Use of sex aids together or alternately.
* Through blood transfusion from an infected person.
* Using needles, syringes, and other injecting equipment that has been contaminated, such as sponges and cleaning cloths.
HIV Infection Test
If you feel you are at risk of becoming infected with the HIV virus, the only way to find out is to have an HIV test accompanied by counseling. Immediately visit the nearest health facility (VCT clinic) for an HIV test. With this test will know the results of the diagnosis of HIV in your body.
This HIV testing and counseling service is known as VCT (Voluntary Counseling and Testing) or KTS (Voluntary HIV Counseling and Testing). This test is voluntary and confidential. Before doing the test, counseling is given first. Counseling aims to determine the level of risk of infection and also the pattern of daily life. After this stage, it is discussed how to deal with an HIV test result if it proves positive.
An HIV test is usually a blood test to confirm the presence of antibodies to HIV in a blood sample. Antibodies are proteins produced by the immune system to attack certain germs or bacteria. An HIV test may be repeated one to three months after a person engages in activities that are suspected of having infected him with the HIV virus.
There are several places to do an HIV test. You can ask the nearest hospital or health clinic. In Indonesia, there are several foundations and organizations that focus on HIV/AIDS issues, including:
* Indonesian AIDS Community
* Indonesian PLWHA
* Ordinary Sets
* Spiritia Foundation
* Orbit Foundation
* Indonesian AIDS Foundation
Meanwhile, the government agency specifically formed to deal with HIV/AIDS is the National AIDS Commission (KPAN).
If the result is positive, you will be referred to a specialist HIV clinic or hospital. Several other blood tests may be needed. This test is to show the impact of HIV on your immune system. You can also talk about possible treatment options.
Treatment Steps for HIV Patients
Although there is no cure yet to completely eliminate HIV, current HIV treatment measures are quite effective. Treatment can prolong the life of HIV sufferers and they can lead a healthy lifestyle.
There are drugs known as antiretrovirals (ARVs) which function to inhibit viruses from damaging the immune system. These drugs are given in the form of tablets that are taken every day. You will be advised to adopt a healthy lifestyle. For example, eating healthy, not smoking, getting the annual flu vaccine, and the five-year pneumococcal vaccine. It aims to reduce the risk of getting dangerous diseases.
Without treatment, people with HIV-infected immune systems will drop dramatically. And they tend to suffer from life-threatening diseases such as cancer. This is known as late-stage HIV or AIDS.
How to Prevent HIV
The best way to prevent HIV is to have safe sex, and never share needles and injecting equipment of any kind. All who have had unprotected sex and share needles or injections are at greater risk of becoming infected with HIV.
HIV infection occurs in three stages. The first stage is seroconversion (a certain period of time during which HIV antibodies have started to develop to fight the virus.). The second stage is the time when no symptoms appear. And the third stage is HIV infection turns into AIDS.
The first stage
People infected with the HIV virus will suffer from a flu-like illness. After this, HIV does not cause any symptoms for several years. Flu-like symptoms will appear several weeks after infection. This period of time is often referred to as seroconversion.
It is estimated that about 8 out of 10 people infected with HIV experience this. The most common symptoms are:
* Sore throat
* Fever
* A rash appears on the body, usually not itchy
* Swollen lymph nodes
* Weight loss
* Diarrhea
* Fatigue
* Joint pain
* Muscle ache
The above symptoms can last for one to two months, or even longer. This is a sign that the immune system is fighting the virus. However, these symptoms can be caused by diseases other than HIV. This condition is not solely due to HIV infection.
Get tested for HIV if you feel you are at risk of infection or when the symptoms listed above appear. But keep in mind, not everyone experiences the same symptoms as those mentioned above. If you think you have done something that puts you at risk of infection, visit the nearest clinic or hospital for an HIV test.
Second Stage
After the initial symptoms disappear, HIV usually causes no further symptoms for years. This period is referred to as the incubation period, or the latency period. The virus continues to spread and damage the immune system. At this stage, you will feel healthy and there are no problems. We may not realize that we have HIV, but we can pass this infection on to other people. The duration of this stage can last about 10 years or even more.
Third or Final Stage of HIV Infection
If left untreated, HIV will weaken the body's ability to fight infection. With this condition, you will be more susceptible to serious illness. This final stage is better known as AIDS (Acquired Immune Deficiency Syndrome). The following are the symptoms that appear in the last stage of HIV infection:
* Swollen lymph nodes or lymph nodes in the neck and groin.
* Fever that lasts more than 10 days.
*Feeling tired most of the time.
* Sweating at night.
* Weight loss without known cause.
* Purple spots that don't go away on the skin.
* Hard to breathe.
* Severe and persistent diarrhea.
* Fungal infections of the mouth, throat, or vagina.
* Easy bruising or bleeding for no reason.
The risk of contracting a deadly disease will increase at this stage. For example cancer, TB, and pneumonia. But even though this is a deadly disease, HIV treatment can still be done. Early treatment can help improve health.
In Indonesia, the spread of the HIV/AIDS virus is divided into two main groups, namely through unsafe sex and taking turns for injecting drug users (IDUs).
Whether symptoms occur or not, a person infected with HIV can transmit the virus to others. People who are HIV positive are more likely to transmit the virus a few weeks after they are infected. Treatment for HIV will reduce the risk of spreading it to others.
Spread of HIV
HIV is not transmitted that easily to other people. This virus does not spread through the air like cough and flu viruses. HIV lives in blood and some body fluids. But fluids such as saliva, sweat, or urine cannot transmit the virus to other people. This is because the virus content in the liquid is not enough. Fluids that can transmit HIV into another person's body are:
HIV is not contracted from kissing, saliva, biting, sneezing, sharing toiletries, towels, eating utensils, using the same toilet or swimming pool, being bitten by animals or insects such as mosquitoes.
The main ways that the virus can enter the bloodstream are:
* Through open wounds in the skin.
* Through the thin walls of the mouth and eyes.
* Through the thin wall inside the anus or genitals.
* By injection directly into a vein using an infected needle or injection.
Through sex
The main spread of the virus is through unprotected vaginal and anal sex. Unprotected oral sex is also a risk of infection, but the risk is quite small. The spread of HIV through oral sex will increase if the person who has oral sex has canker sores or there are sores in the mouth. Or have sex with people who have recently been infected with HIV and have a lot of the virus in their bodies.
* The high and low risk of HIV transmission varies, depending on the type of sexual intercourse performed.
* Perform oral sex on a man who is HIV positive, and the man ejaculates in the mouth.
* HIV transmission can occur when we perform oral sex on HIV-positive women, especially when the woman is menstruating, although the risk is small.
* Receiving oral sex from a person who has HIV is very low risk, because HIV is not transmitted through saliva.
In addition to sex, HIV can be transmitted through:
* Blood transfusion.
* From mother to baby, whether during pregnancy, childbirth, or while breastfeeding.
* Sharing needles, whether for piercing or tattooing.
* Sharing injections, especially for heaths (injecting drug users).
* Sharing sex aids with people with HIV.
Effect of HIV on the Human Body
The immune system is in charge of protecting us from invading diseases. One of the most important elements of the immune system is CD4 cells (a type of white blood cell). These cells protect against various bacteria, viruses, and other germs.
HIV infects the immune system. The virus enters the immune system on CD4 cells. This virus uses CD4 cells to multiply itself thousands of times. This self-replicating virus will leave the CD4 cells and kill them at the same time. The more CD4 cells that die, the lower the immune system will be. Until finally, the immune system does not function.
When this process occurs, the body will still feel healthy and there are no problems. This condition can last for 10 years or even more. And sufferers can spread the virus during this period.
People at Risk of HIV Infection
Remember that everyone is at risk for HIV infection, regardless of age. But there are some groups of people who are more at risk of becoming infected with HIV. They are:
* Injecting narcotics users (Pasun).
* People who make tattoos or do piercing.
* People who have unprotected sex, both same sex and heterosexual.
* People who live or travel frequently to areas with high HIV rates, such as Africa, Eastern Europe, Asia, and southern America.
* People who do blood transfusions in areas with high HIV rates.
* People who are infected with other sexually transmitted diseases.
* People who have sex with injecting drug users.
People who have recently been infected with HIV will experience flu-like symptoms. This occurs for approximately one month to two months after infection. Early symptoms that appear include fever, sore throat, and the appearance of a rash. However, some people with HIV do not experience signs and symptoms for years.
Only by taking an HIV test, we can know for sure whether we are infected or not. The sooner HIV is detected, the higher the treatment success rate will be. If you feel you are at risk of becoming infected with HIV, consult your doctor or the nearest health clinic.
Do not delay treatment after you know you have been infected with HIV. If it's too late, the virus can quickly spread into the immune system. This can interfere with your health. You can also avoid spreading the virus to those closest to you or to other people.
Doing HIV/AIDS Test
To test whether you are infected with HIV, one of the most common tests is a blood test. The blood will be checked in the laboratory. This test is used to find antibodies to HIV in the blood. However, this blood test can only be trusted if it is done at least a month after being infected with HIV, because antibodies to HIV are not formed immediately after the initial infection. Antibodies to HIV take about two weeks to six months, before they finally appear in the blood.
The period between HIV infection and the formation of sufficient antibodies to show a positive test result is referred to as the “window period”. At this time, a person who is infected with HIV can already transmit this virus, although blood tests do not show any antibodies to HIV in the blood.
One way to diagnose HIV apart from a blood test is the "Point of care" test. In this test, a sample of saliva from the mouth or a small drop of blood from a finger will be taken, and the results will come out in just a few minutes.
Before a person is given a definite diagnosis, it is necessary to carry out several tests to be sure. This is because the HIV window period is quite long. So, the results of the first test performed are not necessarily reliable. Get tested several times if you feel you are at risk of HIV infection.
If tested positive for HIV, several tests should be done to watch for progress of the infection. Only then can it be known when to start treatment for HIV.
Where to do an HIV/AIDS test
There are several places to do an HIV blood test. In fact, several puskesmas have also provided services for HIV testing.
In Indonesia, there are several foundations and organizations that focus on HIV/AIDS issues, including:
* Indonesian AIDS Community
* Indonesian PLWHA
* Ordinary Sets
* Spiritia Foundation
* Orbit Foundation
* Indonesian AIDS Foundation
Meanwhile, the government agency specifically formed to deal with HIV/AIDS is the National AIDS Commission (KPAN). You can consult them about everything related to HIV/AIDS.
Now, home HIV test kits are also freely available to buy at pharmacies, health clinics, or via the internet. But, for a clearer understanding of this virus, it is advisable to consult a doctor.
If you are interested in taking an HIV test, you will be given counseling or counseling beforehand. HIV testing cannot be done without the consent of the person concerned.
There is no cure for HIV infection yet, but there are treatments that can slow the progression of the disease. This treatment can make people who are infected to live longer and can lead a healthy lifestyle. There are various types of drugs that are combined to control the virus.
Early HIV Emergency Medicines
If you feel or suspect that you have just been exposed to the virus within 3x24 hours, anti-HIV drugs can prevent infection. This drug is called post-exposure prophylaxis (PEP) or in Indonesia known as post-exposure prophylaxis. Prophylaxis is a medical procedure that aims to prevent rather than cure.
This treatment should be started a maximum of three days after exposure (exposure) to the virus. Ideally, this drug can be taken immediately after exposure. The sooner the treatment, the better.
Treatment using PEP lasts for a month. The side effects of this drug are serious and there is no guarantee that this treatment will work. PEP involves the same drugs as in people who have tested positive for HIV.
You can get this drug at a doctor who specializes in sexually transmitted infections (STIs) or at a hospital.
HIV Positive Test Results
If the test result is positive or reactive, it means we are infected with HIV. The results of this test should be submitted by an extension worker (counselor) or doctor. They will tell the impact on everyday life and how to deal with the situation that occurred at that time.
Blood tests will be done regularly to monitor the progress of the virus before starting treatment. Treatment is carried out after the virus begins to weaken the human immune system. This can be determined by measuring the level of CD4 cells (cells that fight infection) in the blood.
Treatment is usually recommended once the CD4 is below 350, whether symptoms occur or not. If the CD4 is close to 350, it is advisable to do treatment as soon as possible. The goal of treatment is to lower the level of the HIV virus in the blood. It is also to prevent or delay HIV-related diseases. The possibility of deploying it also becomes smaller.
Involvement of Other Diseases
For people with hepatitis B and hepatitis C who are also infected with HIV, treatment is recommended when the CD4 count is below 500. If the HIV patient is undergoing radiotherapy or chemotherapy that suppresses the immune system, treatment is carried out with any CD4 count. Or when you also suffer from other diseases such as TB, kidney disease, and brain disease.
Antiretroviral Drugs
Antiretrovirals (ARVs) are several drugs used to treat HIV infection. These drugs do not kill the virus, but slow the growth of the virus. HIV is adaptable and resistant to one class of ARVs. Therefore, a combination of ARV groups will be given to patients. Some classes of ARVs are:
* NNRTIs (Non-nucleoside reverse transcriptase inhibitors). This type of ARV will work by removing a protein that the HIV virus needs to multiply.
* NRTIs (Nucleoside reverse transcriptase inhibitors). This group of ARVs inhibits the development of HIV in the body's cells.
* Protease inhibitors. This type of ARV will eliminate proteases, a type of protein that HIV also needs to reproduce.
* Entry inhibitors. This type of ARV will prevent HIV from entering CD4 cells.
* Integration inhibitors. This type of ARV will eliminate integrase, a protein that HIV uses to insert genetic material into CD4 cells.
This combination treatment is better known as antiretroviral therapy (ART). Usually the patient will be given three classes of ARV drugs. The combination of ARV drugs given is different for each person, so this type of treatment is personal or special.
Several ARV drugs have been combined into one pill. Once HIV treatment is started, it may be necessary to take this drug for life. If one ARV combination doesn't work, it may be necessary to switch to another ARV combination.
Combining several types of treatment to treat HIV infection can cause unexpected reactions and side effects. Always consult a doctor before taking other drugs.
HIV Treatment in Pregnant Women
For pregnant women who are HIV positive, there are special ARV drugs for pregnant women. This drug is to prevent the transmission of HIV from mother to baby. Without treatment, there is a ratio of 25 out of 100 babies will be infected with HIV. The risk can be lowered to less than one in 100 if treated early.
With earlier treatment, the risk of transmitting the virus through vaginal birth does not increase. But for some women, it is still advisable to give birth by caesarean section.
For women infected with HIV, it is advisable not to breastfeed their babies. The virus can be transmitted through breastfeeding. If you are a partner who has HIV, talk to your doctor about options for staying pregnant without risking getting HIV.
Regular Medication Consumption
You should create a regular schedule to incorporate HIV treatment into your daily lifestyle. HIV treatment can work if you take your medication regularly (at the same time each time you take your medication). If you miss even one dose, the effect can increase the risk of failure.
Side Effects of HIV Treatment
All treatments for HIV have unpleasant side effects. If abnormal side effects occur, you may need to try another combination of ARV drugs. The following are examples of common side effects:
* Fatigue
* Nauseous
* Rash on the skin
* Diarrhea
* One body part is fat, the other is thin
* Mood swings
There is no vaccine to prevent HIV and no cure for AIDS, but you can protect yourself from getting infected. The only way to prevent HIV infection is to avoid activities that increase the risk of contracting HIV. Basically, prevention is always better than cure.
The most common ways to become infected with HIV are having sex without a condom, and sharing needles or other injecting equipment. If you are infected with HIV, you can transmit it in these ways. If both partners are infected, continue to practice safe sex. You can be infected with other types of HIV virus that may not be controlled by the drugs you are taking.
Through Sex
The highest risk of HIV infection is transmitted through unprotected vaginal or anal sex. The risk of contracting it through oral sex is quite low, but by no means zero. Oral sex can transmit other sexually transmitted infections such as syphilis. Toys and sex aids are also at risk of spreading HIV if one of the users of these toys and sex aids is HIV positive.
The best way to prevent HIV and other sexually transmitted infections (STIs) is to use condoms for any type of sexual penetration. And use a dental dam to perform oral sex. A dental dam is a piece of cloth made of latex. This cloth serves as a barrier between the mouth and the vagina or anus. This aims to reduce the spread of STIs during oral sex.
Taking Truvada
For people who are at high risk of HIV infection, taking the drug emtricitabine-tenofovir (Truvada) can reduce the risk of HIV infection through sexual intercourse. Truvada is also used in HIV treatment along with other medicines.
Condom use
If you do not know your partner's HIV infection status, always use a new condom every time you have anal or vaginal sex. Condoms are available in many different shapes, colors, textures, materials, and flavors. Condoms are available for both men and women.
Condoms are the most effective form of protection against HIV and other sexually transmitted infections. Condoms can be used for any kind of sex. It is very important to wear a condom before any sexual contact that occurs between the penis, vagina, mouth, or anus. HIV can be transmitted before ejaculation. This occurs when the initial discharge is from the genitals and from the anus.
Use condoms made of latex or polyurethane (latex and polyurethane) when having sex. Use condoms once you or your partner has an erection, not before ejaculation.
Use of lubricants
Lubricants are used to increase the comfort and safety of sex with the aim of adding moisture to the vagina and anus during sex. Lubricants will reduce the risk of skin sores (tears) in the vagina or anus. The lubricant also prevents the condom from tearing.
Only use water-based lubricants, not oil-based ones. Oil-based lubricants can weaken the strength of the condom and can even tear the condom.
Through Needle and Injection
If you use a needle to inject medication, make sure the needle is sterile. Do not share needles, syringes, or injecting equipment again such as sponges and cloths. Sharing needles can increase the risk of infection with HIV and other viruses in the blood, such as hepatitis C.
If you want to get a tattoo or piercing, be sure to always use a clean, sterile needle. Do not do this activity in random places. Make sure you check the needle used.
Performing male circumcision
Male circumcision is a surgical procedure to cut the skin at the tip of the penis. Male genital circumcision can reduce a man's risk of getting HIV.