HIV and AIDS - Basic facts
GENERAL
1) What is HIV?
HIV stands for human
immunodeficiency virus. HIV is a
retrovirus that infects cells of the
human immune system (mainly
CD4-positive T-cells and
macrophages—key components of
the cellular immune system) and
destroys or impairs their function.
Infection with this virus results in
the progressive depletion of the
immune system, leading to
immunodeficiency.
The immune system is considered
deficient when it can no longer
fulfil its role of fighting off
infection and diseases. People
with immunodeficiency are much
more vulnerable to a wide range
of infections and cancers, most of
which are rare among people
without immunodeficiency.
Diseases associated with severe
immunodeficiency are known as
opportunistic infections because
they take advantage of a
weakened immune system.
2) What is AIDS?
AIDS stands for acquired
immunodeficiency syndrome and
describes the collection of
symptoms and infections
associated with acquired
deficiency of the immune system.
Infection with HIV has been
established as the underlying
cause of AIDS. The level of
immunodeficiency or the
appearance of certain infections
are used as indicators that HIV
infection has progressed to
AIDS (see question 4).
3) What are the symptoms of
HIV?
Most people infected with HIV do
not know that they have become
infected. Immediately after the
infection, some people have a
glandular fever-like illness (with
fever, rash, joint pains and
enlarged lymph nodes), which can
occur at the time of
seroconversion. Seroconversion
refers to the development of
antibodies to HIV and usually
takes place between one and two
months after an infection has
occurred (see question 32).
Despite the fact that HIV infection
often does not cause any
symptoms, a person newly
infected with HIV is infectious and
can transmit the virus to another
person (see question 7). The way
to determine whether HIV
infection has occurred is by taking
an HIV test (see question 31).
HIV infection causes a gradual
depletion and weakening of the
immune system. This results in an
increased susceptibility of the
body to infections and cancers
and can lead to the development
of AIDS (see questions 2 and 4).
4) When does a person have
AIDS?
The term AIDS applies to the most
advanced stages of HIV infection.
The majority of people infected
with HIV, if not treated, develop
signs of AIDS within eight to 10
years.
AIDS is identified on the basis of
certain infections. Stage 1 HIV
disease is asymptomatic and not
categorized as AIDS. Stage II
(includes minor mucocutaneous
manifestations and recurrent
upper respiratory tract infections),
III (includes unexplained chronic
diarrhoea for longer than a month,
severe bacterial infections and
pulmonary tuberculosis) or IV
(includes toxoplasmosis of the
brain, candidiasis of the
oesophagus, trachea, bronchi or
lungs and Kaposi’s sarcoma) HIV
disease are used as indicators of
AIDS. Most of these conditions are
opportunistic infections that can
be treated easily in healthy
people.
In addition, the United States
Centers for Disease Control and
Prevention defines AIDS on the
basis of a CD4-positive T-cell
count of less than 200 per mm3 of
blood
(see: [Link]
si/print/[Link]). CD4-
positive T-cells are critical in
mounting an effective immune
response to infections.
5) How quickly do people
infected with HIV develop
AIDS?
The length of time can vary widely
between individuals. The time
between infection with HIV and
becoming ill with AIDS can be 10–
15 years, sometimes longer, but
sometimes shorter. Antiretroviral
therapy can prevent progression
to AIDS by decreasing viral load in
an infected body (see question
26).
TRANSMISSION
6) Where is HIV found?
HIV can be found in body fluids,
such as blood, semen, vaginal
fluids and breast milk.
7) How can HIV be
transmitted?
HIV is transmitted through
penetrative (anal or vaginal) sex,
blood transfusion, the sharing of
contaminated needles in health-
care settings and drug injection
and between mother and infant
during pregnancy, childbirth and
breastfeeding.
Sexual transmission
HIV can be transmitted through
penetrative sex. HIV is not
transmitted very efficiently so the
risk of infection through a single
act of vaginal sex is low.
Transmission through anal sex
has been reported to be 10 times
higher than by vaginal sex. A
person with an untreated sexually
transmitted infection, particularly
involving ulcers or discharge, is,
on average, six to 10 times more
likely to pass on or acquire HIV
during sex.
Oral sex is regarded as a low-risk
sexual activity in terms of HIV
transmission.
When a person living with HIV is
taking effective antiretroviral
therapy and has a suppressed
viral load they are no longer
infectious.
Transmission through sharing
of needles and syringes
Re-using or sharing needles or
syringes represents a highly
efficient way of transmitting HIV.
The risk of transmission can be
lowered substantially among
people who inject drugs by always
using new needles and syringes
that are disposable or by properly
sterilizing reusable
needles/syringes before
reuse (see question 19).
Transmission in a health-care
setting can be lowered by health-
care workers adhering to
universal precautions (see
question 20).
Mother-to-child transmission
HIV can be transmitted to an
infant during pregnancy, labour,
delivery and breastfeeding.
Generally, there is a 15–30% risk
of transmission from mother to
child before and during delivery. A
number of factors influence the
risk of infection, particularly the
viral load of the mother at birth
(the higher the load, the higher
the risk). Transmission from
mother to child after birth can
also occur through
breastfeeding (see question 21).
The chances of transmission of
HIV to a child is very low if the
mother is on antiretroviral therapy
during pregnancy and when
breastfeeding.
Transmission through blood
transfusion
There is a high risk (greater than
90%) of acquiring HIV through
transfusion of infected blood and
blood products. However, the
implementation of blood safety
standards ensures the provision of
safe, adequate and good-quality
blood and blood products for all
patients requiring transfusion.
Blood safety includes screening of
all donated blood for HIV and
other blood-borne pathogens, as
well as appropriate donor
selection.
8) What is the risk of
transmitting HIV through
kissing or deep kissing?
Transmission through kissing on
the mouth carries no risk, and no
evidence has been found that the
virus is spread through saliva by
kissing.
9) What is the risk of
transmitting HIV through body
piercing or tattooing?
A risk of HIV transmission does
exist if contaminated instruments
are either not sterilized or are
shared with others. Instruments
that are intended to penetrate the
skin should be used once, then
disposed of or thoroughly cleaned
and sterilized.
10) What is the risk of
transmitting HIV through
sharing razors with an
infected person?
Any kind of cut using an
unsterilized object, such as a
razor or knife, can transmit HIV.
Sharing razors is not advisable
unless they are fully sterilized
after each use.
11) Is it safe to have sex with
a person living with HIV?
Having sex with someone living
with HIV is safe if the person’s
virus is fully suppressed by
treatment. Sex is also safe if a
condom is used properly or if you
are taking pre-exposure
prophylaxis in accordance with
your health-care provider’s
recommendations.
12) Is it safe for two people
living with HIV to engage in
unprotected sex exclusively
with each other?
It is best for someone living with
HIV to avoid becoming infected
with a different strain of the virus.
Therefore, the advice given in
question 11 should be followed,
except for the advice about pre-
exposure prophylaxis, which is
never used by people living with
HIV.
PREVENTION
13) How can HIV infection be
prevented?
Sexual transmission of HIV can be
prevented by:
Monogamous relations between
uninfected partners.
Non-penetrative sex.
Consistent and correct use of
male or female condoms
Sex between two people when
one of them is living with HIV but
in taking antiretroviral therapy
and has undetectable viral load
Pre-exposure prophylaxis taken
by people who are not infected
with HIV.
Voluntary Medical Male
Circumcision reduces the
chances of men acquiring HIV
from women.
Additional ways of avoiding
infection:
If you are an injecting drug user,
always use new needles and
syringes that are disposable or
needles and syringes that have
been properly sterilized before
reuse (see question 20) or opt for
other prevention measures such
as Opioid Substitution therapy.
Ensure that blood and blood
products are tested for HIV and
that blood safety standards are
implemented.
See questions 19–22.
14) What is safer sex?
Safer sex involves taking
precautions that decrease the
potential of transmitting or
acquiring sexually transmitted
infections, including HIV, while
having sex. Using condoms
correctly and consistently during
sex is considered safer sex, as is
oral sex and non-penetrative sex
or taking pre exposure
prophylaxis if you are at risk of
HIV infection or having
undetectable viral load if you are
living with HIV.
15) How effective are
condoms in preventing HIV?
Quality-assured condoms are the
only products currently available
to protect against sexual infection
by HIV and other sexually
transmitted infections. When used
properly, condoms are a proven
and effective means of preventing
HIV infection among women and
men.
In order to achieve the protective
effect of condoms, they must be
used correctly and consistently.
Incorrect use can lead to condom
slippage or breakage, thus
diminishing their protective effect.
16) How do you use a male
condom?
Condoms with lubrication are less
likely to tear during handling or
use. Oil-based lubricants, such as
Vaseline, should not be used, as
they can damage the condom.
Only open the package
containing the condom when you
are ready to use it. Otherwise,
the condom will dry out. Be
careful not to tear or damage the
condom when you open the
package. If it does get torn,
throw it away and open a new
package.
Condoms come rolled up into a
flat circle. Place the rolled-up
condom, right side up, on the end
of the penis. Hold the tip of the
condom between your thumb
and first finger to squeeze the air
out of the tip. This leaves room
for the semen to collect after
ejaculation. Keep holding the top
of the condom with one hand.
With the other hand, unroll the
condom all the way down the
length of the erect penis to the
pubic hair.
If the condom is not lubricated
enough, a water-based lubricant
(such as silicone, glycerin or K-Y
jelly) can be added. Lubricants
made from oil—cooking oil or
shortening, mineral or baby oil,
petroleum jellies such as
Vaseline and most lotions—
should never be used because
they can damage the condom.
After sex, the condom needs to be
removed the right way.
Right after the man ejaculates,
he must hold onto the condom at
the base, to be sure that the
condom does not slip off.
Then, the man must pull out
while the penis is still erect.
When the penis is completely
withdrawn, remove the condom
from the penis and throw away
the condom. Do not flush it down
the toilet.
If you are going to have sex again,
use a new condom and repeat the
whole process.
17) What is a female condom?
A female condom is a female-
controlled contraceptive barrier
method. The female condom is a
strong, soft, transparent
polyurethane sheath inserted into
the vagina before sexual
intercourse. It entirely lines the
vagina and, therefore, with
correct and consistent use,
provides protection against both
pregnancy and many sexually
transmitted infections, including
HIV. The female condom has no
known side-effects or risks and
does not require a prescription or
the intervention of a health-care
provider.
18) How do you use a female
condom?
Carefully remove the condom
from its protective pouch. Add
extra lubricant, if desired, to the
inner and outer rings of the
condom.
To insert the condom, squat
down, sit with your knees apart
or stand with one foot on a stool
or low chair. Hold the condom
with the open end hanging down.
While holding the top ring of the
pouch (the closed end of the
condom) squeeze the ring
between your thumb and middle
finger.
Now place your index finger
between your thumb and middle
fingers. With your fingers in this
position, keep the top of the
condom squeezed in a flat oval.
Use your other hand to spread
the lips of your vagina and insert
the closed end of the pouch.
Once you have inserted the
closed end of the pouch, use
your index finger to push the
pouch the rest of the way up into
your vagina. Check to be certain
that the top of the pouch is up
past your pubic bone, which you
can feel by curving your index
finger upwards once it is a few
inches inside your vagina. You
can insert the pouch up to eight
hours before your have
intercourse.
Make sure that the condom is not
twisted inside your vagina: if it is,
remove it, add a drop or two of
lubricant and re-insert. Note:
about two centimetres of the
open end of the condom will
remain outside your body. If your
partner inserts his penis
underneath or alongside the
pouch, ask him to withdraw
immediately. Remove the
condom, discard it and use a new
pouch. Until you and your partner
become familiar with the female
condom, it will be helpful if you
use your hand to guide his penis
into your vagina.
After your partner ejaculates and
withdraws, squeeze and twist the
open end of the pouch to keep
the sperm inside. Pull out gently.
Dispose of the used condom (but
do not throw it down the toilet).
The re-use of female condoms is
not recommended
(see [Link]
tive-health/rtis/[Link]).
See
also: [Link]
ive-health/publications/RHR_00_8/
RHR_00_8_chapter5.[Link].
19) What is post-exposure
preventive treatment?
Post-exposure preventive (PEP)
treatment consists of medication,
laboratory tests and counselling.
PEP treatment must be initiated
within hours of possible HIV
exposure and must continue for a
period of approximately four
weeks. Research studies suggest
that, if the medication is initiated
quickly after possible HIV
exposure (ideally within two hours
and not later than 72 hours
following such exposure), it is
beneficial in preventing HIV
infection.
20) How can injecting drug
users reduce their risk of
contracting HIV?
For injecting drug users, certain
steps can be taken to reduce
personal and public health risks:
Take drugs orally (change from
injecting to non-injecting drug
use).
Never re-use or share syringes,
water or drug-preparation
equipment.
Use a new syringe (obtained from
a reliable source, e.g. a chemist
or via a needle–syringe
programme) to prepare and
inject drugs each time.
When preparing drugs, use
sterile water or clean water from
a reliable source.
Using a fresh alcohol swab, clean
the injection site prior to
injection.
21) How can mother-to-child
transmission be prevented?
Transmission of HIV from a
mother living with HIV to her baby
can occur during pregnancy,
during labour or after delivery
through breastfeeding. In the
absence of any intervention, an
estimated 15–30% of mothers
living with HIV will transmit the
infection during pregnancy and
delivery. Breastfeeding increases
the risk of transmission by 10–
15%. This risk depends on clinical
factors and may vary according to
the pattern and duration of
breastfeeding.
Great progress has been made in
reducing the number of children
born with HIV. The risk of a
woman living with HIV passing the
virus on to her child can be
reduced to 5% or less with
effective antiretroviral therapy
during pregnancy, delivery and
breastfeeding. Primary prevention
of new HIV infections among
women of childbearing age,
coupled with early access to
prenatal care and HIV testing, are
key to the strategy, with women
living with HIV also encouraged to
remain on lifelong treatment for
their own health (the Option B+
strategy).
Early infant diagnosis is essential
to identify the HIV status of
infants and to improve prevention
and treatment programmes, as
peak mortality occurs between six
weeks to four months of age for
children who have acquired HIV
infection.
22) What procedures should
health-care workers follow to
prevent transmission in
health-care settings?
Health-care workers should follow
universal precautions. Universal
precautions are infection-control
guidelines developed to protect
health workers and their patients
from exposure to diseases spread
by blood and certain body fluids.
Universal precautions include:
Careful handling and disposal of
“sharps” (items that could cause
cuts or puncture wounds,
including needles, hypodermic
needles, scalpels and other
blades, knives, infusion sets,
saws, broken glass and nails).
Hand-washing with soap and
water before and after all
procedures.
Use of protective barriers, such
as gloves, gowns, aprons, masks
and goggles, when in direct
contact with blood and other
body fluids.
Safe disposal of waste
contaminated with blood or other
body fluids.
Proper disinfection of instruments
and other contaminated
equipment.
Proper handling of soiled linen.
In addition, it is recommended
that all health-care workers take
precautions to prevent injuries
caused by needles, scalpels and
other sharp instruments or
devices. In accordance with
universal precautions, blood and
other body fluids from all people
are considered as infected with
HIV and other possible viruses,
regardless of the known or
supposed status of the person.
For more information,
see [Link]
precautions/universal/en/.
23) Is there a cure for HIV?
There is no cure for HIV. However,
there is effective treatment,
which, if started promptly and
taken regularly, results in a
quality and length of life for
someone living with HIV that is
similar to that expected in the
absence of infection.
24) What treatment is
available?
Antiretroviral medicines are used
in the treatment of HIV infection.
They work against HIV infection
by blocking the reproduction of
HIV in the body (see question
4). When a person living with HIV
is on effective antiretroviral
therapy, they are no longer
infectious.
25) How do antiretroviral
medicines work?
Inside an infected cell, HIV
produces new copies of itself,
which can then go on to infect
other healthy cells within the
body. The more cells HIV infects,
the greater its impact on the
immune system
(immunodeficiency). Antiretroviral
medicines slow down the
replication and, therefore, the
spread of the virus within the
body by interfering with its
replication process in different
ways.
Nucleoside reverse
transcriptase inhibitors: HIV
needs an enzyme called reverse
transcriptase to generate new
copies of itself. This group of
medicines inhibits reverse
transcriptase by preventing the
process that replicates the virus’s
genetic material.
Non-nucleoside reverse
transcriptase inhibitors: this
group of medicines also interferes
with the replication of HIV by
binding to the reverse
transcriptase enzyme itself. This
prevents the enzyme from
working and stops the production
of new virus particles in the
infected cells.
Protease inhibitors: protease is
a digestive enzyme that is needed
in the replication of HIV to
generate new virus particles. It
breaks down proteins and
enzymes in the infected cells,
which can then go on to infect
other cells. The protease inhibitors
prevent this breakdown of
proteins and therefore slows down
the production of new virus
particles.
Other medicines that inhibit other
stages in the virus’s cycle (such
as entry of the virus and fusion
with an uninfected cell) are
currently being tested in clinical
trials.
26) Are antiretroviral
medicines effective?
The use of antiretroviral
medicines in a combination of
three medicines has been shown
to dramatically reduce AIDS-
related illness and death. While
not a cure for AIDS, combination
antiretroviral therapy has enabled
people living with HIV to live
longer, healthier, more productive
lives by reducing viraemia (the
amount of HIV in the blood) and
increasing the number of CD4-
positive cells (white blood cells
that are central to the effective
functioning of the immune
system).
For antiretroviral treatment to be
effective for a long time, different
antiretroviral medicines need to
be combined. This is what is
known as combination therapy.
The term highly active
antiretroviral therapy (HAART) is
used to describe a combination of
three or more anti-HIV medicines.
If one medicine is taken on its
own, it has been found that, over
a period of time, changes in the
virus enable it to build up
resistance to the medicine. The
medicine is then no longer
effective and the virus starts to
reproduce to the same extent as
before. If two or more
antiretroviral medicines are taken
together, the rate at which
resistance develops can be
reduced substantially.
Effective antiretroviral therapy
also prevents the transmission of
HIV. When a person living with HIV
is taking effective antiretroviral
therapy and has a suppressed
viral load HIV can no longer be
transmitted through sex.
Antiretroviral medicines should
only be taken as prescribed by a
health-care professional.
TESTING
27) What is an HIV test?
An HIV test is a test that reveals
whether a person has been
infected with HIV. Commonly used
HIV tests detect the antibodies
produced by the immune system
in response to HIV, as they are
much easier (and cheaper) to
detect than the virus itself.
Antibodies are produced by the
immune system in response to an
infection.
For most people, it takes a month
for these antibodies to develop.
Antibodies can be found in blood
or oral fluid.
28) How long after possible
exposure should I wait to be
tested for HIV?
Generally, it is recommended that
you wait three months after
possible exposure before being
tested for HIV. Although HIV
antibody tests are very sensitive,
there is a window period of up to
two months, depending on the
specific test being used, which is
the period between infection with
HIV and the appearance of
detectable antibodies to the virus.
In the case of the most sensitive
anti-HIV tests currently
recommended, the window period
is about three weeks. This period
may be longer if less-sensitive
tests are used.
During the window period, people
infected with HIV have no
antibodies in their blood that can
be detected by an HIV test.
However, the person may already
have high levels of HIV in their
body fluids, such as blood, semen,
vaginal fluids and breast milk. HIV
can be passed on to another
person during the window period
even though an HIV test may not
show that they are infected with
HIV.
29) Why should I get an HIV
test?
Knowing your HIV status has two
vital benefits. Firstly, if you are
HIV-infected, you can start
treatment promptly, thereby
potentially prolonging your life for
many years (see question 36).
Secondly, if you know you are
infected, you can take all the
necessary precautions to prevent
the spread of HIV to others (see
question 13). If you are not
infected with HIV, you can learn
how to protect yourself from HIV
in the future
30) Where can I get tested?
There are many places where you
can be tested for HIV: in the
offices of a private doctor, a local
health department, hospitals,
family planning clinics and sites
specifically set up for HIV testing.
Always try to find testing at a
place where counselling is
provided about HIV. You can also
take an HIV test in privacy by
using an HIV self-test kit. However
you should go and see your
health-care provider in the event
of a positive test result for
confirmation and seeking
appropriate treatment.
31) Are my test results
confidential?
All people taking an HIV test must
give informed consent prior to
being tested. The results of the
test must be kept absolutely
confidential.
There are different types of
testing available:
Confidential HIV test: the
medical professionals handling
the HIV test keep the result of the
test confidential within the
medical records. Results cannot
be shared with another individual
unless written permission is
provided by the person tested.
Anonymous HIV test: the tested
person’s name is not used in
connection with the test. Instead,
a code or number is assigned to
the test, which allows the
individual being tested to receive
the results of the test. No records
are kept that would link the
person to the test.
Shared confidentiality is
encouraged and refers to
confidentiality that is shared with
others, who might include family
members, loved ones, caregivers
and trusted friends. However, care
should be taken when revealing
the results as it can lead to
discrimination in health-care and
professional and social settings.
Shared confidentiality is therefore
at the discretion of the person
who will be tested. Although the
result of the HIV test should be
kept confidential, other
professionals, such as counsellors
and health and social service
workers, might also need to be
aware of the person’s HIV-positive
status in order to provide
appropriate care.
32) What do I do if I have HIV?
Thanks to new treatments, people
living with HIV can now live long,
healthy lives. It is very important
to make sure you have a doctor
who knows how to treat HIV. A
health-care professional or trained
HIV counsellor can provide
counselling and help you to find
an appropriate doctor.
33) What does it mean if I test
negative for HIV?
A negative test result means that
no HIV antibodies were found in
your blood at the time of testing.
If you are negative, make sure
you stay that way: learn the facts
about HIV transmission and avoid
engaging in unsafe behaviour.
However, there is still a possibility
of being infected, since it can take
up to three months for your
immune system to produce
enough antibodies to show
infection in a blood test. It is
advisable to be retested at a later
date and to take appropriate
precautions in the meantime.
During the window period, a
person is highly infectious, and
should therefore take measures to
prevent any possible
transmission.
MYTHS
34) Are mosquito bites a risk
of infection with HIV?
HIV is not spread by mosquitoes
or other biting insects. Even if the
virus enters a mosquito or another
sucking or biting insect, it cannot
reproduce in the insect. Since the
insect cannot be infected with
HIV, it cannot transmit HIV to the
next human it feeds on or bites.
35) Should I be concerned
about being infected with HIV
while playing a sport?
There is no evidence that HIV can
be transmitted while playing a
sport.
36) Can I get HIV from casual
contact (shaking hands,
hugging, using a toilet,
drinking from the same glass
as someone who is living with
HIV or being close to an
infected person who is
sneezing or coughing)?
HIV is not transmitted by day-to-
day contact in social settings,
schools or the workplace. You
cannot be infected by shaking
someone’s hand, by hugging
someone, by using the same toilet
or drinking from the same glass as
someone living with HIV or by
being exposed to coughing or
sneezing by an infected
person (see question 7).
37) Does HIV only affect
homosexuals and drug users?
No. Anyone who has condom-less
sex, shares injecting equipment or
has a transfusion with
contaminated blood can become
infected with HIV. Infants can be
infected with HIV from their
mothers during pregnancy, during
labour or after delivery through
breastfeeding.
38) Can you tell if someone
has HIV just by looking at
them?
You cannot tell if someone has
HIV by just looking at them. A
person infected with HIV may look
healthy and feel good, but they
can still pass the virus to you. An
HIV test is the only way a person
can find out if he or she is infected
with HIV.
39) Can I have more than one
sexually transmitted infection
at a time?
Yes, you can have more than one
sexually transmitted infection at
the same time. Each infection
requires its own treatment. You
cannot become immune to
sexually transmitted infections.
You can catch the same infection
over and over again. Many men
and women do not see or feel any
early symptoms when they first
become infected with a sexually
transmitted infection; however,
they can still infect their sexual
partner.
40) When you are on
antiretroviral therapy, can you
transmit HIV to others?
If the antiretroviral therapy is
effective and the virus is fully
suppressed, you cannot transmit
HIV to others. For this reason,
monitoring of the suppression of
the viral load is recommended as
part of ongoing care for people
living with HIV.
HIV AND COVID-19
41) I’m living with HIV. What
should I know about COVID-
19?
COVID-19 is a serious disease and
all people living with HIV should
take all recommended preventive
measures to minimize exposure
to, and prevent infection by, the
virus that causes COVID-19.
As in the general population, older
people living with HIV or people
living with HIV with heart or lung
problems may be at a higher risk
of becoming infected with the
virus and of suffering more
serious symptoms.
We will actively learn more about
how HIV and COVID-19 together
impact on people living with HIV
from countries and communities
responding to both epidemics.
Lessons in rolling out innovations
or adapting service delivery to
minimize the impact on people
living with HIV will be shared and
replicated as they become
available. Until more is known,
people living with HIV—especially
those with advanced or poorly
controlled HIV disease—should be
cautious and pay attention to the
prevention measures and
recommendations.
42) How should people living
with HIV protect themselves
from the virus that causes
COVID-19?
People living with HIV should
protect themselves and others
from the virus that causes COVID-
19 in the same way that all people
are advised to reduce exposure:
Regular and thorough hand
washing with soap and water or
alcohol-based hand rub.
Maintain at least 1 metre
distance between yourself and
anyone who is coughing or
sneezing.
Avoid touching your eyes, nose
and mouth.
Make sure that you, and the
people around you, follow good
respiratory hygiene—cover your
mouth and nose with your bent
elbow or tissue when you cough
or sneeze and dispose of the
used tissue immediately.
Follow local health service advice
on social distancing measures
regarding staying at home
except for essential business,
health needs and exercise.
Avoid gatherings of more than a
few people.
Stay home if you feel unwell. If
you have a fever, cough and
difficulty breathing, seek medical
attention and call in advance.
Follow the directions of your local
health authority.
UNAIDS recognizes, however, that
in many countries, owing to
weaker health-care systems,
informal settlements,
overcrowded cities and public
transportation and a lack of clean
water and sanitation, the current
approaches to self-protection,
social distancing and containment
may not be viable.
43) Does UNAIDS have any
specific recommendations for
people living with HIV during
the COVID-19 pandemic?
UNAIDS recommends that people
living with HIV should have a
supply of necessary medical
supplies on hand—ideally for 30
days or more. This includes both
antiretroviral therapy and other
regular medicines, such as
tuberculosis treatment,
contraceptives and other ongoing
treatment for noncommunicable
diseases and mental health.
The World Health Organization
HIV treatment guidelines now
recommend multimonth
dispensing of three months or
more of HIV medicines for most
people at routine visits. Although
this has not yet been widely
implemented in all countries,
UNAIDS calls on all countries to
provide such multimonth
dispensing.
Know how to contact your clinic
by telephone in the event that you
need advice. Know how to access
treatment and other support
within your community. This
treatment could include
antiretroviral therapy,
tuberculosis medication (if on
tuberculosis treatment) and any
other medication for other
illnesses that you may have.
Remember that other illnesses
continue despite the COVID-19
pandemic. Do not hesitate to seek
medical advice for new or
worsening symptoms, sexual and
reproductive health services,
mental health challenges or
injuries. The risks of poor or
inadequate medical treatment are
usually greater than the risks of
contracting COVID-19 in a health
centre.
44) How should key
populations protect
themselves against HIV during
the COVID-19 pandemic?
Key populations, including people
who use drugs, sex workers, gay
men and other men who have sex
with men, transgender people and
prisoners, should continue to
ensure that they have essential
means to prevent HIV infection,
such as sterile needles and
syringes and/or opioid substitution
therapy, condoms and pre-
exposure prophylaxis (PrEP).
45) How do we ensure that
human rights are respected
and reduce stigma and
discrimination during the
COVID-19 pandemic?
UNAIDS urges all countries to
ensure an appropriate balance
between protecting health,
preventing economic and social
disruption and respecting human
rights.
UNAIDS and partners are working
to ensure that human rights are
not eroded in the response to
COVID-19 and to ensure that
people living with or affected by
HIV are offered the same access
to services as others and to
ensure that HIV-related services
continue without disruption.
In the light of overcrowding in
many prisons and other places of
detention, which undermines
hygiene, health, safety and
human dignity, a health response
alone to COVID-19 in closed
settings alone is insufficient.
UNAIDS urges political leaders to
ensure that COVID-19
preparedness and responses in
closed settings are identified and
implemented in line with
fundamental human rights.
46) What should I do if I am
worried about gender-based
violence during the COVID-19
pandemic?
If you are experiencing violence, it
may be helpful to reach out to
family, friends and neighbours, to
seek support from a hotline or, if
safe, from an online service for
survivors of violence. Find out if
local services (e.g. shelters,
counselling) are open and reach
out to them if available.
Make a safety plan in case the
violence against you or your
children escalates. This includes:
Identifying a neighbour, friend,
relative, colleague or shelter to
go to in case you need to leave
the house immediately for safety.
Have a plan for how you will exit
the house safely and how you will
reach there (e.g. transport).
Keep a few essential items (e.g.
identification documents, phone,
money, medicines, and clothes)
available, and a list of telephone
numbers in case of an
emergency.
If possible, develop a code with a
trusted neighbour so they can
come to your aid in case of an
emergency.
47) What should I do if I am
concerned about my mental
health during the COVID-19
pandemic?
Pay particular attention to your
mental health by:
Avoiding excessive exposure to
media coverage of COVID-19.
Only read information from
trusted sources.
Taking care of your body. Take
deep breaths, stretch or
meditate. Try to eat healthy,
well-balanced meals, exercise
regularly, get plenty of sleep and,
where possible, avoid alcohol and
drugs.
Making time to unwind and
reminding yourself that negative
feelings will fade. Take breaks
from watching, reading or
listening to news stories—it can
be upsetting to hear about the
crisis repeatedly. Try to do some
other activities you enjoy in order
to return to your normal life.
Connecting with others. Share
your concerns and how you are
feeling with a friend or family
member.
