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AIDS Frequently Asked Questions
  1. How is the AIDS virus transmitted?
  2. How does HIV cause disease?
  3. How many persons are infected?
  4. What are the earliest symptoms of HIV infection?
  5. How reliable is the AIDS test?
  6. How do I find out if I have acute HIV infection?
  7. Who should have an AIDS test?
  8. Who should have a test for acute HIV infection?
  9. Is there an effective morning after pill?
  10. Who should stop therapy to see if the immune system is strong enough to control the virus?
  11. How many persons are long-term non-progressors and what does this mean?
  12. Can the new drug cocktails cure HIV infection?
  13. Is there an effective AIDS vaccine?
  14. What are clinical trials?
HIV infection continues to be a global health crisis. Among the frequently asked questions about HIV and AIDS are the following:

1. How is the AIDS virus transmitted?
The AIDS virus is transmitted from one person to another by three methods:
  1. Blood or blood products: Prior to 1985 HIV was frequently transmitted by blood transfusions because there was no way to test blood for the AIDS virus. Since 1985 the blood supply has been screened for HIV with an effective test. The main way the virus is transmitted by blood products now is through the sharing of needles by persons abusing drugs.

  2. Sexual contact: The virus can be passed in body fluids including sperm. Having unprotected sex (for example sex without condoms) can result in passing the infection. Oral sex can also result in transmission. The infection can be passed from men to women, women to men, men to men, and women to women.

  3. Mother to infant: The virus can be transmitted from mother to infant during pregnancy, at the time of birth, or by breast-feeding. Treating pregnant mothers with anti-HIV drugs is very effective in limiting transmission to infants, but some transmission still occurs. The risk of transmission is further diminished by Cesarean section.
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2. How does HIV cause disease?
HIV is an infection of the immune system so it destroys the body's ability to fight off infections. The illness is called AIDS, which stands for "acquired immune deficiency syndrome." It is caused by a virus, which is a microscopic organism that can only reproduce itself by entering human cells and using these to make the building blocks for new viruses. The cell that is entered eventually dies. Additionally HIV may enter a cell and then remain quiet for a prolonged time. This is a problem for drug therapy because drugs destroy the virus while it is active.
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3. How many persons are infected?
Over 30 million persons worldwide are infected. In some African countries over 20% of the population is infected. In the US there are as many as one million persons infected, and there will be an estimated 44,000 new cases of infection this year.
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4. What are the earliest symptoms of HIV infection?
Most people think of HIV infection as causing a debilitating disease called AIDS that is not apparent until years after infection. In fact, in untreated persons the average time to the development of AIDS is 10 years or more. However, HIV infection is also associated with an acute illness in most infected persons. This illness, called acute HIV infection begins within one to three weeks of exposure, and most often consists of some combination of the following symptoms: fever, sore throat, skin rash, swollen glands, ulcers in the mouth or on the genitalia. Most persons complain of severe fatigue, but in some there are very few symptoms. The symptoms usually resolve within one to three weeks, and the infected person can then remain apparently well for an average of 10 years. During this time the virus continues to slowly destroy the immune system.
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5. How reliable is the AIDS test?
The test for AIDS is a test that measures the immune response to HIV. This consists of antibodies that are generated in response to the infection. The standard AIDS test measures these antibodies. Since these take some time to develop, in the very early stages of infection there may be a negative antibody test and yet the person can be infected. The way to check for HIV infection in this circumstance is to measure the virus in the blood. This can be done with either a viral load assay or a p24 antigen test. Both of these are available through health care professionals.
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6. How do I find out if I have acute HIV infection?
The standard blood test for HIV is negative in persons with acute HIV infection, so a special blood test has to be used if this diagnosis is suspected. There are two tests that can help to diagnose acute HIV infection: HIV viral load and HIV p24 antigen test. These are available through health care professionals. The standard blood test becomes positive about four to six weeks after infection.
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7. Who should have an AIDS test?
Anyone who has had a blood transfusion before the blood was tested for AIDS (before 1985), anyone who has had unprotected sex with a person who could be infected, and the infants of infected mothers.
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8. Who should have a test for acute HIV infection?
Persons who have symptoms of acute HIV infection and who have had a known exposure to someone who is or could be HIV infected (unprotected sex or sharing needles, for example) should be considered for testing.
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9. Is there an effective morning after pill?
Physicians are trying to determine whether anti viral drugs given after exposure to HIV can prevent infection. In most large cities there are now trials going on to treat people who have been exposed to see if this can prevent infection. These trials are referred to as "post-exposure prophylaxis." In Boston, such a trial is underway at the Fenway Community Health Center.
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10. Who should stop therapy to see if the immune system is strong enough to control the virus?
This should only be done in carefully controlled experiments under the supervision of AIDS specialists. The NOVA program "Surviving AIDS" describes a new kind of experiment in which doctors are trying to determine if the body's natural defense mechanism, the immune system, can keep the virus under control after drug therapy is stopped. They have found that persons who are treated with potent anti viral drugs (often referred to as HAART for highly active antiretroviral therapy) as soon as they become infected develop strong immune responses to the virus, and now they are trying to see if this is enough to successfully control the virus. These experiments are being performed in a very select group of persons.
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11. How many persons are long-term non-progressors and what does this mean?
About 1 in 100 HIV infected persons is a so-called long-term non-progressor, meaning that they have been infected for up to 20 years and still have a normal CD4 count and low viral load. Clearly the virus has caused little damage in these persons thus far, but whether these persons will be affected by the virus in the future remains uncertain.
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12. Can the new drug cocktails cure HIV infection?
The new drug cocktail for HIV, which consists of a combination of three or more drugs, can be very effective in lowering the amount of virus in the blood, but it no longer appears that this cocktail will result in complete eradication of the virus. In fact, persons who have stopped the drug cocktail even after two years of treatment have generally had a rapid return of the virus.
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13. Is there an effective AIDS vaccine?
Attempts to make an effective AIDS vaccine have not been successful thus far. Numerous different methods are being tried, and progress is being made. Since anti viral drugs are extremely expensive, the only hope for worldwide control of HIV is to develop an effective vaccine.
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14. What are clinical trials?
Clinical trials of AIDS treatments are studies designed to answer whether new experimental treatments are more effective. Usually these trials involve comparing the effects of one treatment compared to another. Information about AIDS clinical trials in Boston can be obtained from the AIDS Clinical Trial Unit at MGB, 617-716-3819.
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Phone Numbers
Project Inform National HIV/AIDS Treatment Hotline
800-822-7422 (toll-free in the United States)
415-558-9051 (in the San Francisco Bay Area or internationally).
Hours: Monday - Friday, 9am - 5pm and Saturday, 10am - 4pm (PT).
This confidential hotline offers treatment information.

AIDS Action Hotline
1-800-235-2331
Hours: Mondays - Fridays 9AM - 9PM; Saturdays 9AM - 1PM (ET)
The AIDS Action Hotline provides AIDS information, such as testing and risk factors.

CDC National AIDS Hotline
(800) 342 - AIDS (2437) (English) (24 hours, 7 days a week) 
(800) 344 - SIDA (7432)  (Spanish) (8 AM - 2 AM ET) 
(800) 243 - 7889 (TTY for hearing impaired) (Monday-Friday 10 AM - 10 PM ET)
CDC National AIDS Hotline offers information on transmission and prevention of HIV.

CDC National Prevention Information Network
(800) 458-5231 (English, Spanish)
(800) 243-7012 (hearing impaired)
Hours: Mondays - Fridays, 9AM - 6PM (ET)
The CDC National Prevention Information Network provides information, publications, and technical assistance.

People With AIDS Coalition of New York (PWAC)
(800) 828-3280
Hours: Mondays - Fridays 9AM - 6PM, Tuesday 10AM - 6PM (ET)
Staffed by individuals with HIV/AIDS, People with AIDS Coalition of New York offers information and referrals.

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Web Links
AIDS HIV Aegis
http://www.aegis.com/
Described as "the largest AIDS/HIV knowledgebase in the world," this site offers a comprehensive search function and up-to-date news.

UNAIDS
http://www.unaids.org/
As the main advocate for global action on HIV/AIDS, UNAIDS leads, strengthens, and supports an expanded response aimed at preventing the transmission of HIV, providing care and support, reducing the vulnerability of individuals and communities to HIV/AIDS, and alleviating the impact of the epidemic.

World Health Organization
http://www.who.int/
The Web site of the World Health Organization offers news, information, resources and reports on health-related issues.

National Institute of Allergies and Infectious Diseases
http://www.niaid.nih.gov/
NIAID's web site offers cutting-edge news on the development of an AIDS vaccine, as well as other possible solutions to major health crises.

AIDS Vaccine Site
http://www.niaid.nih.gov/daids/vaccine/default.htm
Presented by NIAID, this thorough, well-organized site offers information on the latest efforts to find an AIDS vaccine. The site includes news, general information, science, resources, and a bulletin board.

Project Inform
http://www.projinf.org/
Since 1985, Project Inform has been an active advocate for the HIV/AIDS community, working to provide information on the diagnosis and treatment of HIV to HIV-infected individuals, their caregivers, and healthcare providers. Their Web site offers educational information, a hotline number, resources and literature on the foundation.

The Names Project Foundation: AIDS Memorial Quilt
http://www.aidsquilt.org/
The site of the Names Project Foundation provides information on AIDS and the mission of the Foundation. Other features include the Quilt display schedule and a searchable image database of over 78,000 names and over 41,000 viewable images of panels in the AIDS Memorial Quilt.

Elizabeth Glaser Pediatric AIDS Foundation
http://www.pedaids.org/
A strong advocate and pioneer in research for AIDS in children, the Pediatric AIDS Foundation is one of the most well-known organizations for the research of HIV/AIDS. Their Web site offers information on what the PAF is currently doing and what it hopes to do.

The Body: An AIDS and HIV Information Resource
http://www.thebody.com/index.shtml
This user-friendly site offers information on AIDS Basics, treatment, conferences, quality of life, and links to chat groups.

CDC-NCHSTP-Division of HIV/AIDS Prevention (DHAP)
http://www.cdc.gov/hiv/dhap.htm
CDC's HIV mission is to prevent HIV infection and reduce the incidence of HIV-related illness and death, in collaboration with community, state, national, and international partners. The site offers a variety of information, including FAQs, publications, brochures, and fact sheets.

Johns Hopkins AIDS Service
http://www.hopkins-aids.edu/
This site offers expert advice and FAQs on AIDS/HIV including prevention, treatment, publications, resources and a section on the use of telecommunications to facilitate health care.

UNICEF Virtual Exhibit Online
http://www.unicef.org/aids/
This site presents a multimedia exhibition produced for UNAIDS by UNICEF that illustrates the impact of HIV/AIDS on children.

University of Iowa Department of Pharmacology
http://www.medicine.uiowa.edu/pharmacology/
The Web site of the University of Iowa offers information and interactive products that utilize the new computer-generated images of HIV produced by Dr. Jose Assouline's lab (See "See HIV in Action").

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Books
Big Shot: Passion, Politics, and the Struggle for an AIDS Vaccine, by Patricia Thomas. New York: Public Affairs, 2001

In this important chronicle of the race to develop an antidote, veteran medical journalist Patricia Thomas tackles the question: Why is there yet no AIDS vaccine a full two decades after the pandemic began? Thomas tells her story with passion, humanity, and uncommon intelligence.

And the Band Played on: Politics, People, and the AIDS Epidemic, by Randy Shilts. Penguin, 1995 (Reissue edition).

In the first major book on AIDS, San Francisco Chronicle reporter Randy Shilts examines the first days of the AIDS epidemic and is critical of the initial response of the medical and political communities.


Special Thanks
Betsey Arledge
Dr. José Assouline
Dr. Bruce Walker
Lakshmi Govid
David FitzSimons


Credits
Lauren Aguirre, Senior Producer
Christine Chan, Intern
Kim Ducharme, Senior Designer
Rick Groleau, Hot Science Developer
Tyler Howe, Assistant Designer
Brenden Kootsey, Technologist
Rob Meyer, Production Assistant
Peter Tyson, Producer


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