*The information in this article was developed with the support of the Positive Voice organization. You can reach the "Checkpoint" Prevention and Examination Centers in Athens and Thessaloniki. Find here details on how to make an appointment for their services, including confidential rapid testing, counselling and information in a safe, non-clinical environment, free of charge.

 

What's the difference between HIV and AIDS?

HIV infects and destroys immune system cells, making it challenging to fight other diseases. The severe weakening of the immune system by HIV can lead to acquired immunodeficiency syndrome (AIDS). AIDS is the final and most serious stage of HIV infection. AIDS patients have very low levels of certain white blood cells and a severely weakened immune system. They may have other diseases that indicate AIDS. 

 

Without treatment, HIV infection progresses to AIDS within about 10 years. The difference between HIV and AIDS is that HIV is a virus that weakens your immune system. AIDS is a condition that can result from an HIV infection when your immune system is severely weakened.

You can't get AIDS if you aren't infected with HIV.

 

What is the therapy for HIV?

Antiretroviral therapy given to people living with HIV prevents the virus from multiplying in the body. It allows them to enjoy a quality of life and life expectancy comparable to the general population's. However, the treatment must be carried out properly and under the supervision of a doctor. 

Stages of the infection

HIV infection progresses through several stages, each characterized by different clinical features and the impact on the immune system. The stages of HIV infection are as follows:

  1.  Primary infection: The symptoms are similar to severe flu, usually 2-4 weeks after exposure to the virus. They only appear in 50% of the cases.
  2. Asymptomatic:  There are no symptoms, the virus is constantly making copies, and the immune system is still healthy.
  3. Symptomatic: The symptoms include night sweats, lack of energy, skin eruptions and gum sensitivity—minor damage to the immune system.
  4.  AIDS:  The immune system has no defences; infections get control of the body.

 How is HIV transmitted?

HIV is transmitted through sexual contact, via direct contact with contaminated blood, and from mother to child during pregnancy. 

Body fluids where HIV is present are:

  • blood (including menstrual blood)
  • sperm, and possibly pre-ejaculate
  • vaginal fluids
  • breast milk

Sexual behaviours that may cause transmission of HIV are:

  • vaginal intercourse (the penis inside the vagina)
  • anal intercourse (the penis inside the anus)
  • oral intercourse (mouth on penis or vagina)

 Other transmission routes of HIV are:

  • needle sharing when taking injection drugs
  • tattoos, ear piercings, etc. 
  • accidental percutaneous needle stick 
  • transfusion of contaminated blood 
  • childbirth 
  • breastfeeding

Prevention

Prevention measures are essential in reducing the transmission of HIV. Here are some key prevention measures:

Condom: The condom is the most established way of protection, both against HIV and other STIs, but also unwanted pregnancy. However, its effectiveness is not a given if you don't know how to wear it and how and when to remove it. Proper use of a condom means:

  1. Open the wrapper by hand; do not use sharp objects - that may cut through the condom - or your teeth.
  2. Use the condom before any contact, not just before ejaculation.
  3. Do not unroll the condom before its placement, and ensure no air is left in the tip by pinching the reservoir.
  4. Check that you are using it from the correct side and that you have unrolled it completely.
  5. Use water-based lubricants and avoid oil-based products.
  6. Never use the same condom twice.
  7. Check the expiration date before use and store condoms under the conditions suggested in the instructions for use on the packaging.

U=U (Undetectable=Untransmittable):It refers to a relatively new scientific documentation that changes everything we thought we knew about HIV and how the virus is transmitted, demonstrating that a person living with HIV who receives antiretroviral therapy and has achieved an untraceable (very low) viral load in their blood for at least 6 months, can not practically transmit the virus to a sexual partner, even during unprotected sexual intercourse.

PEP (Post-Exposure Prophylaxis): Post-Exposure Prophylaxis (PEP) is a one-month treatment with antiretroviral drugs that can inhibit contamination with HIV; to be effective, it has to be administered as soon as possible – and in any case, within 3 days – after potential exposure to the virus. According to the relevant regulation in G, all hospitals must keep a stock of antiretroviral drugs for these instances. However, if you have access to a hospital with an Infectious Diseases Unit, it would be advisable to pay a visit and discuss your case with a doctor. If the doctor believes that there is reason for you to take prophylactic therapy, the hospital will provide the medicinal treatment for free.

PrEP (Pre-Exposure Prophylaxis):This is a treatment with a pill usually taken daily and protects against HIV with a success rate of approximately 99%. It is taken by people who are HIV-negative for them to remain negative. PrEP is an antiretroviral drug of the same type that is administered to HIV-positive people as part of their treatment. If a person receiving PrEP is exposed to HIV, the drugs will inhibit the intrusion of the virus into the body cells and its reduplication. This inhibits the installation of HIV in the body, thereby preventing exposure of the person taking PrEP to HIV. It is available in several countries worldwide but not yet in Greece. 

 

Diagnosis and procedure in Greece

If you suspect that you may have had contact with someone who is HIV-positive or you know that you were diagnosed with HIV in your country, you can reach out to the Positive Voice organization which will help you to take the below steps:

  1. They will do the testing to confirm the results. 
  2. They will check your legal situation, as only those who have AMKA or PAAYPA have the right to access HIV medication in Greece.
  3. If you have PAAYPA or AMKA, they will arrange an appointment directly with the doctor's secretary in one of the hospitals in Athens with an Infectious Unit. 
  4. You will go with the social worker and the interpreter, at least for the first two appointments. They will help you navigate to the hospital and unit and accompany you during your doctor's appointment. 
  5. In this first appointment, the doctor will take your clinical record, which consists of several questions and details about how and when you were diagnosed, your relation with your family and possible genetic diseases, other possible diseases, if you already took medication in the past which one and for how long etc. 
  6. After that, the doctor will need to take a sample of your blood, also checking for other Sexually transmitted infections. After doing some other breath tests, you will leave, and the second appointment is typically 10 days later.
  7. In this second appointment, you will get the results, explained by the doctor, in case something needs clarification. The doctor might already have the medicine ready for you, so you can go to the hospital pharmacy and start taking the medication. 

In Greece, you have to visit the unit every month, get the doctor's paper description, and then go to the pharmacy to get your medicine. In the beginning, you will do this on the 1st of each month, then every three months, later every six, and finally, you will do this annually. This depends on the stage of HIV and the harshness of the therapy.

You will need to take some blood tests regularly to control the level of CD4 increasing and the one of HIV decreasing, which would mean that the medicine is working. CD4 cell level is crucial for your immune protection. 

 

Living with someone that lives with HIV

HIV is transmitted through direct contact with bodily fluids such as blood, semen, vaginal fluids, and breast milk. HIV is not transmitted through casual contact. People living with HIV do not pose a risk to those with whom they live together in the home or community and have regular non-sexual contacts. However, certain precautions should be taken to minimize the risks. 

  1. Safe sexual practices: Encourage using protective methods, such as condoms, during sexual activity. Promote open and honest communication about sexual health within your family.
  2. Regular testing: Encourage family members who are sexually active or at higher risk of HIV and other diseases to get regular testing. 
  3. Needle safety: If family members use needles for medical purposes, such as insulin injections, ensure that they follow safe practices for handling and disposing of needles properly.
  4. Blood safety: Avoid sharing personal items that may come into contact with blood, such as razors or toothbrushes.
  5. Prevention of mother-to-child transmission: If any family members are pregnant and living with HIV, it is important to receive proper medical care and adhere to the prescribed antiretroviral therapy (ART) to reduce the risk of transmitting the virus to the child.

 

Living with HIV

Living with HIV is a manageable condition with proper medical care and support. Here are some key aspects to consider if you live with HIV:

  1. Medical care and treatment: It is crucial to contact a doctor. Take your medications as directed, follow the dosing schedule, and communicate any concerns or side effects with your healthcare provider. Stay engaged in your healthcare by attending regular check-ups. This helps ensure that your treatment remains effective and that any potential complications or co-infections are promptly addressed.
  2. Support network: Building a strong support network is important for emotional and practical support. This can include friends, family, support groups, or HIV/AIDS organizations that provide resources, counselling and opportunities for connecting with others living with HIV.
  3. Healthy lifestyle: Maintaining a healthy lifestyle is beneficial for overall well-being. This includes eating a balanced diet, engaging in regular physical activity, getting sufficient rest, and managing stress. Avoiding smoking, excessive alcohol consumption and illicit drug use are also important, as they can negatively affect health and interact with HIV medications.
  4. Disclosure and relationships: Deciding when and how to disclose your HIV status is a personal decision. It's essential to consider factors such as trust, stigma, and the potential impact on relationships. Seek guidance from support networks, counsellors, or healthcare providers to help navigate disclosure and develop healthy relationships.
  5. Safer sex and prevention: While effective HIV treatment reduces the risk of transmission, it's important to practice safer sex by using condoms consistently and correctly.