FAQS AND MYTHS

KNOWING FACT FROM MYTH HELPS REDUCE HIV-RELATED STIGMA, IMPROVING THE LIVES OF PEOPLE AFFECTED BY HIV

FAQs

No. When someone is described as living with HIV, they have the HIV virus in their body. A person is considered to have developed AIDS when the immune system is so weak it can no longer fight off a range of diseases with which it would normally cope.

Anyone can get HIV if they are sexually active, regardless of whether you're gay or straight or where you come from—but HIV rates are higher among gay and bisexual men and African communities in the UK. Everyone should ensure they take steps to protect themselves and others from HIV infection by using a condom during sex.

Although HIV is now a long-term, manageable condition and not a death sentence, it is still a serious issue in the UK.
More people than ever before are living with HIV in the UK and around 6,000 people are diagnosed every year.

Comprehensive sex and relationships education (SRE), which includes information about HIV, is not compulsory in all schools, so many young people are not being given the information they need to protect themselves from HIV infection
and other STIs.

FAQs

HIV is passed on through infected bodily fluids such as semen, vaginal fluids, blood, breast milk and rectal secretions.
The most common ways HIV is transmitted are through sex without a condom and through sharing infected needles,
syringes or other injecting drug equipment. You cannot get HIV through casual or day-to-day contact, or kissing,
spitting or sharing a cup or plate. A small number of people living with HIV in the UK acquired it before or soon after birth ('vertical' or 'mother-to-child' transmission).

The risk of HIV transmission from performing oral sex is low but it can still happen. It is best to avoid giving oral
sex if you have cuts or sores in your mouth or bleeding gums, as this increases the risk of HIV entering your body.

When used correctly, male and female condoms are effective against HIV transmission when having vaginal or anal sex. You may also want to use a condom or dental dam during oral sex, although the risk of HIV transmission is much lower. You can get free condoms from a sexual health clinic, which you can locate via the FPA website.

Pre-Exposure Prophylaxis, or PrEP, is a medication which is also highly effective at preventing HIV transmission during sex, when used as directed. Unlike condoms, PrEP does not protect against other STIs or pregnancy. PrEP is not yet available on the NHS but some people buy it privately. NAT is campaigning for PrEP to be available on the NHS to people at high risk of acquiring HIV.

Never share needles, syringes or any other injecting equipment.

If you are having sex without a condom, you could be putting yourself at risk. However, some groups in the UK carry a disproportionate burden of HIV.

For example, around 1 in 20 men who has sex with men (including gay men and bisexual men) is living with HIV compared to around 1 in 525 people in the UK population overall.  

Among heterosexuals, black African and black Caribbean women and men are disproportionately affected.

People who inject drugs are at high risk of acquiring HIV, if they share injecting equipment.

While it is important to understand the impact of HIV on specific groups, remember that 25% of people diagnosed with HIV in the UK are not in any of these groups.

Use our risk calculator to find out if you’ve put yourself at risk.

If you think you have put yourself at risk of HIV infection, you should go and get a free and confidential test
at your local sexual health clinic. You could also get a self-testing kit if you would rather
test yourself at home.

If you know you have put yourself at risk and it is within 72 hours of possible exposure to HIV, you can ask for
Post Exposure Prophylaxis (PEP) treatment from a sexual health clinic or A&E. PEP is not guaranteed to prevent
HIV infection but the sooner it is taken the more effective it can be.

No—HIV is not passed on through fingering, hand-jobs, or any form of mutual masturbation.

No—HIV can not be passed on through saliva, sweat or urine, because these bodily fluids do not contain enough
of the virus to infect another person. The only bodily fluids which can transmit HIV are semen, vaginal fluids, blood,
breast milk and rectal secretions, and only in the context of condomless sex, sharing injecting equipment, blood transfusions (outside of the UK) and vertical (mother-to-child) transmission.

During sex, it is not an automatic consequence that HIV will be transmitted. Compared with some other infectious
diseases, risk of HIV infection from a single act of sex is usually low. But of course repeated acts of sex increase
probability of transmission which is why it is important to have safer sex. Condoms are highly effective at preventing
HIV and other STIs.

There are other factors which can increase and reduce the risk of HIV transmission, and if someone living with HIV
is on effective treatment, with an undetectable viral load, there is no risk of them passing on HIV. However a condom
is still the safest and easiest way to prevent transmission.

There are varying degrees of risk in relation to HIV transmission, depending on the sexual activity and how much
HIV is in the body of the person with HIV (the 'viral load').  

If a person is recently infected with HIV, or has HIV and isn’t on treatment, the level of HIV in their body will be high
and the chances of passing HIV on to another person are therefore higher.  

If a person is diagnosed with HIV and is on treatment, the level of HIV in their body will be greatly reduced and in most
cases will reach what is clinically referred to as an 'undetectable viral load'. This means the chances of passing on HIV to another person are very unlikely.

HIV can be transmitted through both anal and vaginal sex. One study found that the risk of HIV transmission during anal sex may be 18 times higher than vaginal sex.

If you have an STI this may make you more vulnerable to HIV transmission since STIs can cause ulceration
and other harms to bodily tissue, which make it easier for HIV to be passed on.  

If someone with HIV also has an STI this can increase the amount of virus in their body. The more virus there is,
the greater the risk of transmission to another person, so it is a good idea for sexually active people to get regular
sexual health check-ups for both HIV and other STIs.

There is research showing male circumcision can reduce risk of HIV transmission to the circumcised male during heterosexual sex. In countries with high rates of HIV and heterosexual epidemics, such as Sub-Saharan African countries, male circumcision is recommended at a population level as an HIV prevention tool, as part of wider prevention strategies (education, promotion of safer sex practices, correct and consistent condom use). However, in the UK, male circumcision is not recommended to individuals as a method of HIV prevention as there is better access to condoms, testing and treatment, and sexual health information. There is also no evidence to suggest male circumcision prevents HIV transmission during anal sex.


MYTHS

It is true that gay men are particularly affected by HIV as a group (over 37,000 gay men in the UK have HIV) but HIV can still affect anyone and there are many heterosexuals living with HIV in the UK. The majority of new HIV diagnoses in 2010 were acquired heterosexually, while approximately a third of people with HIV in the UK are women. Anyone who has sex without a condom or shares needles when injecting drugs is at risk of HIV.

There is no risk of HIV infection from spitting and the risk of infection from biting is negligible. With over 60 million
people infected with HIV worldwide over 25 years, there have only ever been four possible reports of HIV being
transmitted through biting, all of which occurred in extremely specific and unusual circumstances.

There has never been a case of HIV infection from picking up or standing on a used needle in the UK. There have only ever been five cases of HIV infection from being pricked with a needle, and these all occurred in healthcare settings and there have been none since 1999. HIV is a very fragile virus that does not survive for long when exposed to the environment.

You can only become infected with HIV if you have sex without a condom or share a needle or injecting equipment with someone living with HIV. HIV is not spread through day-to-day contact, touching, kissing or sharing utensils. In addition, being on HIV treatment makes people with HIV far less likely to pass it on.

The most common way to be infected with HIV is through unprotected sex without a condom. When used properly and appropriately, condoms are extremely effective at protecting against HIV transmission. If you are using a lubricant as well as a condom (which is particularly recommended for anal sex) ensure it is water-based. Find out more about how to use a condom here.

HIV cannot be passed on by sharing razors or toothbrushes, even if you are sharing with an HIV positive person.
However, for general hygiene purposes it is advisable not to share these personal items as they do carry general bacteria.

HIV cannot be passed on by insect bites. Firstly the HIV virus can't survive in or on an insect. Secondly these
insects only suck blood up, they do not inject blood back in.

A small amount of HIV can be found in a man's pre-cum (pre-ejaculation), though less than there is in semen.
​Because it is harder to transmit HIV through the membranes in the mouth and throat pre-cum carries no HIV risk during oral sex. 

However, as it is easier to transmit HIV through vaginal and anal membranes, there is more of a risk of HIV transmission from pre-cum in these types of sex. In fact a number of incidents of HIV transmission have been attributed to the delay in applying a condom during sex.

FAQS

There are symptoms of very early ('primary' or 'acute') HIV infection, which 70-90% of people experience within the first three months after acquiring HIV.  At this point the viral load is particularly high.

Many of these symptoms are not unique to HIV and include: flu-like symptoms, fever, headache, mouth ulcers, night sweats, weight loss and swollen glands.  

After these symptoms pass, someone with HIV may then live for many years without any indication that they have the virus.

If you experience symptoms of early HIV infection and you have had sex without a condom or shared injecting equipment in recent weeks, then you should get an HIV test as soon as possible. It could be just a bad case of flu, but there is also a risk it could it be the early signs of HIV infection so it's always best to know for sure by getting tested.

FAQS

The most common place to go to for an HIV test is a local sexual health clinic but you can also get tested in a range of other locations, such as at your GP or private doctor's surgery, in hospital or in a local community setting. HIV tests are also now available by post and over the counter at some pharmacies but will you have to pay for these. To find out more about HIV testing click here.

Generally no—all NHS services are free of charge and this includes HIV tests in a sexual health clinic, GP surgery and sometimes home testing (depending on where you live). You do have to pay if you visit a private clinic and most people have to pay for home testing.

Anywhere from 20 minutes to two weeks, depending on the type of test you have. Read more about HIV tests here.

A blood sample – either through a needle or finger-prick—is the most common way to test for HIV
but you can also now test for HIV through saliva.

HIV tests are extremely accurate and 'false positives' are very rare (although slightly more common in rapid tests where results are almost immediate). But all HIV positive test samples are sent for a second, lab-based test for confirmation—
so a person will never be incorrectly diagnosed with HIV.

HIV will also not be detected during the 'window period', the small window of time (around four weeks) straight after infection where signs of HIV cannot be picked up during screening.

If you think you have put yourself at risk, do not hang around waiting for the window period to pass—speak to your
local sexual health clinic as soon as possible to discuss the best course of action.

Finding out early if you have HIV has two vital benefits. Firstly, you will be able to start treatment as soon as you need it, which makes it more effective in helping you live a long, healthy and active life. Secondly, if you know you have HIV you can take the right steps to prevent passing it on to others by practising safer sex. Starting treatment will also dramatically reduce the risk of passing on HIV.

There are traces of HIV in saliva, which can be picked up in an HIV test, but there is not enough of the virus present to infect another person.


MYTHS

You can get an HIV test with accurate results from 4 weeks after potential infection. Results can be returned between 20 minutes and 2 weeks, depending on the test type. If you think you have exposed yourself to risk of HIV, don't wait or do nothing—it's important to seek advice from your local sexual health clinic as soon as possible.

Most HIV testing in the UK is done in a sexual health or genitourinary medicine (GUM) clinic. These clinics are legally bound not to reveal personal details and test results. GPs and private doctors also perform HIV tests, which means your HIV test and results would appear on your medical records—but these would still not be discussed with anyone else unless relevant to your treatment. If you are concerned about who else your HIV test results will be shared with, speak to your doctor about this.

If you have a blood test at a hospital or in a GP surgery they will not automatically test for HIV. You will be explicitly told if HIV is one of the conditions they plan to test for when they look at your blood. If HIV testing is not mentioned, you should not assume you have had an HIV test and it could still possibly be the case that you have undiagnosed HIV.

FAQS

It is true there are extremely effective treatments for HIV which enable people to live a long life, but there is still no cure and HIV is a condition you have to live with every day for the rest of your life. Whilst HIV needn't be feared the way it was decades ago, it remains a serious, long-term condition with potentially life-limiting consequences. Treatment must be taken everyday and can cause side effects, and sadly there is still a lot of stigma and discrimination around the condition. Everybody should take all the steps possible to avoid HIV transmission, such as using a condom during sex.

HIV treatment is provided for free on the NHS to everyone who needs it.

HIV treatment is extremely effective and an HIV positive person on treatment can now lead a full and active life and live a normal lifespan.

There may be some side effects from treatment, but these are less severe than in the past and are increasingly well managed. Some people living with HIV also experience problems which can't be helped by their HIV treatment (such as emotional and psychological difficulties) but the benefits of being on treatment are huge and ultimately HIV treatment is the difference between staying well and becoming extremely ill and possibly dying early. This is why it's always best to know your HIV status and get tested if you've put yourself at risk.

HIV treatment also has preventive benefits. Effective HIV treatment eventually reduces the level of HIV in the body to what is clinically referred to as an ‘undetectable viral load'. If someone’s viral load is undetectable, that means that they cannot pass on HIV.

The reduction of infectiousness as a result of HIV treatment is also how mother-to-child HIV transmission is prevented—in the UK today, most women with HIV will give birth to HIV negative babies because of interventions with HIV treatment.

PEP or Post Exposure Prophylaxis is a medical treatment that can prevent HIV infection after the virus has
entered the body.

If you have put yourself at risk of HIV infection you can go to a sexual health clinic or hospital A&E department
and they can usually prescribe a course of PEP drugs. You need to start PEP ideally within 24 hours of the risk occurring and no later than 72 hours. The longer you wait the less chance there is of PEP working.

It is not guaranteed you will get PEP if you ask for it. The doctor you see will advise you whether they recommend
it based on the level of risk involved. They will also ask you to have an HIV test before and after taking PEP. PEP
won't be offered if you refuse to be tested.

PrEP or Pre Exposure Prophylaxis is a medical treatment taken before you have sex, to prevent HIV. Clinical trials have shown that taking PrEP is a very reliable way of preventing HIV infection in people who are at high risk of getting HIV.

PrEP is not currently available on the NHS, but can be prescribed privately by a doctor for a fee and purchased from specialist pharmacies or online. Buying PrEP online tends to be much cheaper than buying it from a pharmacy. However if you are considering getting PrEP it’s important that you first seek advice from a sexual health clinic.

The drugs used for PrEP are the same as those used for the treatment of people living with HIV and are very safe, with serious side effects occurring very rarely. However, unlike condoms, PrEP will not protect you from other sexually transmitted infections or pregnancy.

For more information on accessing PrEP online, the risks and how to protect yourself, click here.

In the past few years there have been significant steps towards learning how we might one day cure HIV.

The closest we have come to a complete cure is the Berlin Patient, who was living with HIV and had a bone marrow transplant from someone with a rare genetic immunity to HIV. This appeared to have eradicated the Berlin Patient’s HIV infection, though he may still have some of the virus present in his body.

The reason people living with HIV currently have to take their treatment everyday is a key piece in the cure puzzle. Even if medication can stop HIV replicating in immune cells that are currently active, our body holds reservoirs of ‘sleeping’ immune cells, which wake up unpredictably. If someone is living with HIV, they will have HIV-infected immune cells sleeping in their reservoir. If these wake up, the HIV will return.

In 2013 it was reported that the ‘Mississippi Baby’ had been cured of her HIV infection, however in 2014 we learned that her HIV had returned. The baby acquired HIV from her mother, who was not diagnosed prior to the delivery. In an attempt to prevent infection, the baby was given antiretroviral treatment, which she continued to take after she was diagnosed as HIV positive. The treating clinic lost contact with the Mississippi Baby at 18 months of age. Yet even without taking medication, her HIV did not re-emerge for more than two years.

There is also a lot of interest in the VISCONTI cohort of adults living with HIV. This was a group who were given treatment very early in their infection. They then had this treatment stopped, but still managed to control their viral load without medication for at least four years.

Each of these studies takes us closer to a cure, but we are still some years off the final solution.


MYTHS

If someone living with HIV decides to have a baby, there are options available and steps they can take to ensure HIV is not passed on to their partner during conception (if the partner is HIV negative) or to their child. In the UK today there is less than a 1% chance of an HIV positive mother passing HIV on to her child if the right steps are taken.

Although there isn't a cure for HIV, treatment is so advanced that it is no longer considered a death sentence. People diagnosed with HIV in the UK today can expect to have a normal life expectancy and live a healthy and active life. Early diagnosis is particularly important as the longer HIV goes undiagnosed the more damage it can do to the body.

It is not always easy to tell someone you have HIV. In addition, over a quarter of people with HIV are undiagnosed. It is dangerous to assume that your partner would automatically tell you if they had HIV—either because they may struggle to confide in you or because they don’t know they have it! Your sexual health is your responsibility—always using a condom is the safest way to protect against HIV transmission.

Despite sometimes being talked about in the media, there is no evidence for this myth—commonly referred to as HIV-related ‘health-tourism’. In fact, the evidence shows that most migrants with HIV who come to the UK do not know
they have it before they arrive (and are not diagnosed for a number of years) so are definitely not coming over here seeking treatment.

FAQS

Today there are more people than ever before living with HIV in the UK, but fewer people report knowing someone with HIV. More than one in six people with HIV are unaware they have it. Many HIV positive people do not find it easy to tell other people about their condition, so you may not realise if someone you know is HIV positive.

Not everyone wants to talk about their personal health information, and that includes some people with HIV. Unfortunately in today's society there is still a lot of stigma around HIV and many people hold myths and misconceptions about HIV and how it is transmitted. Some people also hold prejudicial views about people living with HIV. This means many HIV positive people find it difficult to tell others about their HIV because they have fears about how people will react and think it will be easier if they kept it to themselves.

Effective HIV treatment means most people diagnosed nowadays with HIV are able to work just like everyone else and it is in fact illegal to discriminate against someone in recruitment or employment because they are living with HIV.

People living with HIV can do almost any job, though you cannot join the army, navy or airforce and it can still be difficult to become a pilot if you have HIV.

There is no reason why an HIV positive person cannot have a relationship with an HIV negative person. However if you are the HIV positive person in a relationship it is vital that you disclose your HIV status before engaging in any sexual activity, so that your partner is fully aware of the possible risk.

It is also important that both partners take measures to ensure that the HIV negative partner remains uninfected. Firstly, if you are the HIV positive partner you should start and stay on antiretroviral therapy, which can reduce your viral load to an undetectable level, eliminating the risk of you transmitting HIV to your partner.

Secondly, you should use a condom during sex to prevent HIV transmission, as well as the transmission of any other sexually transmitted infections (STIs), which could greatly increase the risk of HIV transmission.

Thirdly, you should both have a sexual health check-up at the beginning of the relationship and at regular intervals to ensure that the HIV negative partner has not been infected with HIV and that neither partner has any other STI.

Finally, if you are the HIV negative partner and you are planning to have unprotected sex with your HIV positive partner, you should consider taking PrEP to stop you being infected with HIV. You should also consider taking PEP as soon as possible if you have had unprotected sex with your HIV positive partner in the last 72 hours.

If someone living with HIV decides to have a baby, there are options available and steps they can take to ensure HIV is not passed on to their partner during conception (if the partner is HIV negative) or to their child. In the UK today there is less than a 1% chance of an HIV positive mother passing HIV on to her child if the right steps are taken.

It is true that in the UK a person can go to prison for recklessly or intentionally passing on HIV to another person. There has never been a case of anyone being convicted for intentionally passing on HIV but there have been several convictions for reckless HIV transmission, which involves a person knowing they were HIV positive but not taking the necessary steps to protect their sexual partner. Find out more about criminal prosecutions for HIV transmission here.

Because HIV affects the immune system, people living with HIV can be susceptible to certain illnesses—particularly if they haven't yet been diagnosed and aren't accessing treatment. These include bacterial diseases such as tuberculosis (TB), pneumonia and blood poisoning, fungal diseases such as oral thrush, and viral diseases. Some of these conditions are considered 'AIDS-defining', which means if they are diagnosed alongside HIV the person is considered to have AIDS.

There are also certain illnesses which HIV positive people are prone to being co-infected with, and these include hepatitis B and C. There is a vaccination against hepatitis B which all HIV positive people should receive but there is no vaccination against hepatitis C. Having both conditions at the same time can have severe health implications and liver disease caused by hepatitis B and/or C is a leading cause of serious illness and death in people with HIV.

Unfortunately even in today's society some people hold prejudiced views about HIV.

This means people living with HIV can find it difficult to tell others about their status because they have fears about how people will react. If they tell you they are placing a huge amount of trust in you and it is important not to abuse that trust.

Firstly it is important you keep the information to yourself and try to handle the situation as sensitively as you can. Often people living with HIV find questions about how they acquired their status difficult. Wait to see what level of information they want to share.

For some people, particularly if they have been living with HIV for a while, it may not be something they particularly struggle with, however for some, especially if they are recently diagnosed, they may be upset and looking for support.

And most importantly try not to worry if somebody you care about has HIV. In most cases, and with the right support, people living with HIV can lead normal lives, be able to work, have relationships and children. And if they are diagnosed early and are on effective treatment they are also likely to have a normal lifespan.