At Peech, we want to break down the taboos surrounding sex and sexuality, so in this series of articles we're discussing sexually transmitted diseases (STDs). We would like to emphasize how STDs do not make you gross or wrong or any other negative stereotype associated with STDs - it's merely infections, that in most cases can be treated easily and quickly. Give our articles about herpes, clamydia, gonorrhea and genital warts a read as well, and learn something new about STDs
HIV and AIDS are two of the most stigmatized STDs out there. In the 80s it was a death sentence to be diagnosed with HIV, as there was neither an understanding of the disease nor the people with it, nor drugs developed to treat it. But today, there are extremely effective treatment options available. In 2021, the director of the AIDS Foundation also stated that: "When you have been on medication for a short time, HIV is not contagious. We have said that a lot in the AIDS Foundation, even before my time, but it's as if it is not really clicking for people". Read more about why, and learn more about HIV and AIDS in this article.
What is the difference between HIV and AIDS?
HIV is an abbreviation for human immunodeficiency virus, which means that it's a virus that attacks and destroys the immune system. In order to survive and spread in the body, the HIV virus attaches itself to the cells responsible for alerting the immune system. The immune system is the body's defense against the bacteria and viruses that enter the body, and ensures that you don't get sick, or at least not as sick as you would without an immune system.
Once HIV has attached itself to these cells, called a CD4 cell, the cell then begins to produce new HIV cells, instead of alerting the immune system. As more and more of the CD4 cells are busy producing new HIV cells, there will be fewer and fewer "normal" cells to alert the immune system. This means that HIV has free rein when it comes to breaking down the immune system, thus increasing the risk of serious illness. It also means that bacteria that are otherwise harmless to a healthy immune system, or may just cause a small cold, can be fatal to an untreated HIV-positive person. However, these kinds of complications only arise when the HIV cells have multiplied in the body for a long time. At this point, it's termed AIDS.
So AIDS is the term for what HIV can develop into, if it's not treated. AIDS is diagnosed if, as an HIV-positive person, you get a number of infections and forms of cancers that people with a healthy immune system cannot develop. However, the effective medical treatment you can receive today means that fewer and fewer are diagnosed with AIDS.
How is HIV transmitted?
Although HIV has been detected in all bodily fluids, only blood, semen (including presperm), vaginal fluid and breast milk are infectious. Unlike STDs such as chlamydia, which are transmitted through mucous membrane contact, HIV must enter the bloodstream directly to be transmitted. This happens for example if one of the above mentioned fluids enters a small cut in the vagina or anus. This also means that HIV can be prevented very effectively, if you use barriers such as condoms or dental dams.
In the case of sexual transmission of HIV, the occurrence is higher with unprotected, penetrative anal sex than penetrative vaginal sex. This is because the anus does not have mucous membranes that can create lubrication, as the vagina does. This creates a greater risk of friction, which can cause cuts and tears and then blood. HIV can also be transmitted by sharing needles, or from mother to child during childbirth and breastfeeding.
Furthermore, HIV is most contagious in a 3 months period after initial infection or if you have developed AIDS. It is estimated that more than half of all HIV-positive people have been infected by people who have just been infected themselves.
One of the most widespread and persistent myths about HIV is that it's transmitted through physical contact such as hugging, kissing or simply holding hands. HIV cannot and has never been able to spread in this way, and the myth contributes to HIV- and AIDS positive people being ostracized, isolated and discriminated against.
What are the symptoms of HIV?
Many experience symptoms shortly after being infected with HIV, but not everyone. Most people who experience symptoms describe them as flu-like, with fever, swollen lymph nodes, fatigue and pain in the muscles and joints being common. Because the symptoms are so general, many just think it the flu.
After the initial infection, it might take a long time before you actually notice and need treatment. For some HIV-positive people it's a few years, while others live with the disease for decades before it requires any kind of treatment. However, this does not mean that you should postpone treatment or avoid seeking tests if you think you are infected. The faster you receive treatment, the more effective it is. If you are in a risk group for HIV, you also have the option of receiving PEP treatment. PEP is a preventive treatment that can prevent the development of HIV if it's taken up to 72 hours after a possible infection. The earlier you get PEP, the more effective it is. To receive PEP, you must contact a hospital that offers the treatment - here is a list of hospitals that offer PEP treatment.
The risk group is defined as people with a penis who have sex with other people with a penis, as this group remains the largest group of infected people. Statens Serum Institut (Danish CDC) estimates that there are around 6,600 people living with HIV in Denmark today – 3,600 of them are people with a penis who have sex with other people with a penis.
How to treat HIV?
HIV is currently being treated with a combination of different types of HIV medication, which either inhibit the multiplication of the virus or make it more difficult for HIV to enter the CD4 cell. While you cannot stop virus production completely, and thus be cured of HIV, you can slow it down so much that it cannot be passed on to others.
It has been 25 years since an effective treatment came along and HIV stopped being a death sentence. Modern medical treatment even means that you can live as long as everyone else if you are treated in time and take your medicine regularly. Yet almost 700,000 people die every year from AIDS-related infections and diseases, especially in the poorest parts of the world, because there is no access to treatment.
For many Western HIV-positive people, it is typically not the physical aspects of HIV that presents challenges, as the vast majority are well treated and do not experience the major complications from the disease. It is instead the psychological aspects, as HIV cannot be cured (yet), and therefore gives rise to fear and stigma. In todays society, a lack of understanding and information about HIV also helps to create stigma and isolation for HIV-positive people. Historically, HIV and AIDS are extremely demonized diseases, just as people with HIV and/or AIDS have experienced extreme discrimination. Although the understanding has improved, the extreme discrimination of the past still leaves traces, and many do not dare to speak openly about their HIV diagnosis. As with any STD, it cannot define you or your worth, and you are not wrong if you are HIV or AIDS positive. Because HIV/AIDS is not a particularly widespread disease in Denmark, many people find great security and strength in communities, where they can openly share and talk about their experiences. The AIDS Foundation is the Denmarks largest organization for prevention, testing and counseling. Apart from that there is:
- Hiv-Danmark, which is a nationwide patient association for all HIV-positive people
- Positivgruppen, which is an association for HIV-positive gay and bisexual people with a penis and their partners
- The AIDS line, which is a hotline you can call to get answers about HIV, AIDS and PEP.