Advances in HIV Prevention and Treatment
Living a Healthy Life With HIV
Human immunodeficiency virus (HIV) weakens your immune system and makes you vulnerable to illness. Left untreated, HIV can lead to acquired immune deficiency syndrome (AIDS). While it is estimated that more than 1.2 million people in the U.S. are living with HIV, around 14 percent of them do not know they are infected.
When HIV was first discovered in the early 1980s, it carried a devastating stigma that kept patients from seeking information, care and support. Fear and shame led to further spread of the virus and more lives lost. More than 30 years later, there is still no cure for HIV, and HIV stigma persists.
However, the medical community now has a much greater understanding of the virus and how it’s transmitted. Advances in medicine are helping people reduce their risk of becoming infected with HIV and enabling those who are infected to live healthy, longer and more active lives.
“Every decade, we’ve made a huge leap in what we can offer to patients with HIV,” states Michael P. Angarone, DO, associate professor within the Division of Infectious Diseases at Northwestern University Feinberg School of Medicine. “While the Holy Grail is getting rid of the virus, advancements in prevention and treatment have transformed how providers are able to care for their patients with HIV. The conversation has shifted from end-of-life care to daily medication for HIV management.”
HIV can be transmitted through blood, semen, vaginal secretions, rectal fluids and breast milk. It cannot be spread through casual contact, such as sharing towels or bedding, saliva, sweat or toilet seats. Condoms remain an effective choice to reduce the risk of transmitting or acquiring HIV through sexual contact. Now, medication is also available to reduce your risk of HIV infection.
One type of medication, taken before exposure, is pre-exposure prophylaxis (PrEP). The medication doesn’t protect against other sexually transmitted infections (STI) or pregnancy, but it has been shown to reduce the risk of HIV infection through sex by more than 90 percent for gay and bisexual men, transgender women, and heterosexual men and women. For people who inject drugs, PrEP has been shown to reduce the risk of HIV infection by more than 70 percent, according to the Centers for Disease Control and Prevention (CDC). The medication is generally well-tolerated with minimal side effects.
“Since initial studies about 10 years back, we’ve seen how beneficial preventive medicine like PrEP can be for individuals who are at risk for HIV infection,” Dr. Angarone says.
If you believe you may have already been exposed to HIV, another medication option, post-exposure prophylaxis (PEP), can be pursued. It must be started within 72 hours of a possible exposure, such as through sex, sexual assault or the sharing of needles. If you’ve had a very recent exposure, talk to your physician or healthcare provider immediately to see if PEP is an option for you.
Early Detection and Treatment
If you think you may have been exposed to HIV, get tested immediately. Early detection offers more choices for treatment, lowers your risk for complications and helps you manage your symptoms. According to the CDC, all adults between the ages of 13 and 64 should get tested at least once during routine health care, and those at high risk for HIV infection should get tested at least annually.
If you test positive, immediate treatment is recommended. “By treating the infected individual, you can also decrease the spread of HIV,” says Dr. Angarone.
The Path to Treatment
If you believe you have been exposed to HIV, immediately notify your physician or healthcare provider. They can order testing to confirm your HIV diagnosis, and then will be your advocate as your care team develops a treatment plan.
The cornerstone of HIV treatment is antiretroviral therapy (ART), which can prevent the virus from damaging your immune system further and reduce your chances of transmitting HIV to sexual partners. In some cases, ART can even reverse damage that has been done. There are a number of antiretroviral drugs used in ART, and the treatment is recommended for all people living with HIV, regardless of how long they’ve had the virus.
Monthly or bimonthly injectables are now being evaluated to replace daily medication. Before this treatment is available to patients, further data is needed to support its safety and effectiveness.
Getting the Right Support
Receiving an HIV diagnosis is life-changing, both for you and for those you love. Proper guidance and support from a trusted healthcare team will help ensure that your unique physical, emotional and spiritual needs are being met. Northwestern Medicine HIV Center and Specialty Clinics offer comprehensive services for people living with HIV, including infusion therapy services, inpatient consultation, care coordination and access to clinical research studies.
Research shows that communication between partners is associated with a reduction in transmission and increase in testing, so it is important to talk openly about the disease with your loved ones and your care team. Know that you are not alone. With today’s medical advances and the right support, you can continue to live a long and active life with an HIV diagnosis.