HIV stands for Human Immunodeficiency Virus and is the virus known to cause AIDS (Acquired Immune Deficiency Syndrome).
HIV kills or damages cells of the body's immune system, progressively destroying its ability to fight infections and certain cancers.
A person infected with HIV is only said to have AIDS either when the immune system damage has reached a certain severity or they have developed one or more of a list of 26 otherwise rare illnesses as a result of the immune system breakdown. It can take from a few months to over 10 years for an infected person to develop symptoms.
There is no vaccine or cure yet available for HIV infection but there is treatment which dramatically slows the progress of the disease. More information about HIV/AIDS is available from NHS Direct Wales Online.
Who gets it and how serious is it?
HIV is passed on from an infected person through the transfer of body fluids such as blood, semen, vaginal fluid and breast milk.
There are four main ways to catch HIV:
Anyone can become infected with the virus through the routes described above. HIV is not spread through everyday social contact with an infected person. Touching, shaking hands, hugging, coughing or sneezing can not pass on the virus.
There are certain groups whose activities may put them at higher risk of infection than others. These include; men who have sex with men (MSM), injecting drug users (IDU), people who have lived as adults in countries where heterosexual transmission of HIV is common (notably South, East and Central Africa) and babies born to infected mothers.
HIV is a serious infection. Without treatment most people are expected to die from their infection.
HIV testing and self testing
It is estimated that 1 in 4 people living with HIV in Wales is currently unaware that they have the infection contributing to ongoing transmission to others in the population and poorer health outcomes for themselves.
New treatment regimes for HIV infection are extremely effective and all those who perceive themselves to be at risk should have a HIV test.
Free HIV testing is available at your GP surgery or in any of the integrated sexual health services.
Information on where your local integrated sexual health services is can be found on the NHS Direct Wales website at http://www.nhsdirect.wales.nhs.uk/localservices/searchlocalservices.aspx?s=SexualHealth
In addition, it is expected that HIV self-testing kits will be available during 2014.
The document HIV Testing and Self Testing Frequently Asked Questions produced by Public Health England, provides information on how and when to get tested to allow individuals to make these informed decisions.
Treatment
Currently, there is no cure or vaccine for HIV but there is now treatment called highly active antiretroviral treatment (HAART). The treatment suppresses the HIV virus and can reverse the damage to the immune system for some time, prolonging the lives of those infected. However, it is not a cure.
HAART regimes also requires a high level of commitment and compliance from the patient to be effective. Treatment with antiviral drugs is offered to all pregnant HIV-positive women as it can greatly reduce the risk of the baby becoming infected.
How common is it?
To date around 65 million people have been infected with HIV globally and 25 million people have died of AIDS since it was first recognised in 1981.
Over two-thirds of all people infected with HIV live in sub-Saharan Africa although there are growing epidemics in Eastern Europe and Central Asia.
In 2011, the Health Protection Agency (HPA) estimated there were about 96,000 people of all ages with HIV living in the UK. Approximately one quarter of these are undiagnosed and thus are unaware they are infected with HIV.
In Wales up until the end of June 2013, there have been 2245 individuals diagnosed with HIV infection.
More information about the surveillance of HIV infection in Wales is available from the Public Health Wales Health Protection Division microsite by following the link: rates and surveillance of HIV in Wales
Prevention
Sexually active men and women can reduce their risk of HIV by adopting 'safe sex' practices which include; the avoidance of unprotected sex, the correct and consistent use of condoms, monogamous relationships with uninfected partners and the reduction in the number of sexual partners.
To help prevent infection, injecting drug users should not share needles, syringes and other injecting equipment with anyone else and dispose of used equipment safely. HIV-positive mothers are advised not to breast feed as the virus can be transmitted to their baby via breast milk.
Since 1985 all blood donations in the UK have been screened for HIV, meaning that there is minimal risk of being infected through a hospital blood transfusion. This is true for many developed countries. In developing countries especially in those where HIV infection is much more prevalent, there can be a significant risk of contracting HIV via medical procedures.
Anyone who suspects that they have HIV or believe that certain behaviours may have put them more at risk of contracting the virus are advised to have an HIV test. Early detection of HIV infection can be of benefit as the health of a person who is HIV positive will be monitored closely and treatment can be offered when necessary. Also, measures can be taken by the individual to prevent the transmission of the virus to others.
Individuals can request an HIV test, either from their GP or from a genitourinary medicine (GUM) clinic, lists of which are available from the FPA website. GUM clinics are completely confidential, can be attended at any age and will not inform GPs of results unless requested to do so by the patient. Some HIV/AIDS charities, such as the Terrence Higgins Trust also offer confidential screening.
Minimising impact in Wales
Public Health Wales has established the Sexual Health Programme which collects and collates data on the levels of sexually transmitted infections, including HIV, in the Welsh population. Such data allows significant trends and any particular groups of the population affected to be identified, and will enable effective delivery of high quality, accessible and appropriate specialist public health services, both in partnership and support of other national and local bodies.
As part of this programme, a campaign to remind people that HIV infection is still a health risk was launched in Wales on World Aids Day 2012. Campaign advertisements with the strapline “Thinking about sex? You are now!” are placed across Wales on buses, inside buses and trains, on billboards and at nightclubs, sports clubs, colleges and universities.
These advertisements, as well as Bluetooth messaging at train stations in Cardiff, direct people to the website www.friskywales.org / www.cymruchwareus.org where they can assess their risk of infection. They can also find out how to protect themselves in future, and where to go for testing.
Public Health Wales also manages the All-Wales Sexual Health Network which was established in 2000 as part of the action plan to implement the Welsh Sexual Health Strategy. The Network is intended to provide a discussion forum for a range of agencies involved in promoting better sexual health, and to be a means of promoting best practice and increasing public understanding of sexual health issues. The network currently has approximately 800 members, and is being expanded to include a role in promoting and strengthening local sexual health service networks. More about the Network is available from their website at: http://www.shncymru.org.uk/home.cfm?orgid=485
Additionally, an All Wales HIV Network, run by Public Health Wales, has also been established. This is intended to be a resource for practitioners and people living with HIV; a 'one-stop' site for all news, events, information, guidance and publications related to living with HIV in Wales. This network is available from: http://www.wales.nhs.uk/sites3/home.cfm?orgid=895.
