Today we’re tackling the big one: HIV/AIDS. This is the STI that is effectively in a class of its own, both in terms of impact and the way people react to it. The good news is that while it is still a brutal disease, great strides have been made in treating AIDS over the past decades, and what was once a death sentence is now closer to being a chronic (though still deadly) infection.

One of my jobs as a freelance writer involved researching and writing about the latest HIV/AIDS research. While I will be surprised if we see even a functional cure (a treatment that acts like a cure, even though the infection is still present) in the next ten years, based on the current research I do believe we will see on in the next quarter century. Given the current life expectancy of people with HIV, that means that many people in developed nations who are currently infected will benefit from such a cure. Unfortunately, the hardest hit parts of the world are also the areas where treatment and access to medical help is hardest to get.

Transmission: HIV is transmitted through the bodily fluids. This means the bodily fluid (semen, vaginal discharge, blood, mucus, etc) of someone who is infected, needs to enter the body of someone who is not infected. Now, let me put something in perspective. The common cold is spread through bodily fluids – that’s why you are supposed to wash your hands after you blow your nose. But where a common cold goes through a household like a storm, HIV doesn’t. Because despite the bogey-man reputation HIV has, it is actually hard to transmit HIV. One study estimated that it takes around 100 episodes of sexual contact for one person to get infected. Of course, this isn’t universal. Some strains are more infectious than others, and some people are more susceptible to infection. But it does mean that if you know someone who has HIV/AIDS, you can shake their hands, sleep in the same bed, even share a toothbrush, without worrying about getting infected. Of course, there are other reasons you really shouldn’t be sharing a toothbrush.

Prevention: Female and male condoms are some of the best and most widely available avenues of prevention. Getting tested regularly (and your partners getting tested regularly) is also very important. The FDA recently approved over-the-counter tests for HIV, so you can order a test online and take it in total anonymity if you are worried. (I believe similar tests are available in some other countries, hopefully the availability will spread over the next few years). Other barrier methods like diaphragms may provide some protection, though less than condoms. Research is ongoing into vaginal gels which can prevent transmission. Some of these have been successful in testing, but are not yet available on the market. PrEP (Pre-Exposure Prophylaxis) is becoming more available–this is taking anti-retroviral medicine before infection to prevent getting infected. If you or a partner are at high risk for HIV infection, speak with your doctor about whether or not PrEP may be right for you.

Symptoms: Immediately after infection, a person develops  flu-like symptoms for a week or two. Afterwards, there are no symptoms under HIV progresses to AIDS. The main early symptoms of AIDS are the development of certain illnesses which only appear in people with suppressed immune symptoms. If you are sexually active (and I don’t care if you are monogamous, do you REALLY know what your partner is doing?) try to get tested for HIV at least once a year, because catching the infection before symptoms develop is crucial to effective treatment. If you have multiple partners or new sexual partners, get tested more often.

Treatment: The main treatment for HIV/AIDS is HAART or Highly Active Anti-Retroviral Therapy, which consists of a combination of medications that interfere with the way HIV reproduces in the body. Other treatments are aimed at treating and preventing opportunist infections (OIs) which develop when the body’s immune system becomes too weak to fight them off.

(Update) I want to add a bit here, because lately I’ve been running into a lot of mis-information about HIV/AIDS, and some of it really pisses me off. I spent a year deunking AIDS cure scams and identifying legitimate alternative medical treatments that would actually help people with HIV/AIDS. Here the bottom line: To date only one person has been cured of HIV/AIDS, and that cure was a medical miracle that cannot be reliably repeated. The only reliable, life-extending treatment is HAART. Magic Johnson had to hold a press conference earlier this year to say what everyone should have known: he still has HIV. Thanks to HAART and a lot of luck, he remains largely healthy and can expect to live for a long time yet. But the best that medical science can do is to put HIV/AIDS into what I call a ‘remission’ status, and that remission lasts only as long as you keep taking HAART. If someone tries to tell you there is a secret pill that can cure HIV/AIDS, or that Magic Johnson is still alive so obviously there is a cure or anything like that, that are dangerously misinformed. Please get the facts, and spread the truth.

Diagnosis: Doctors really prefer to diagnose HIV through testing. If testing is not available, or if a person has not gotten tested, doctors can diagnose based on the presence of what are known as “AIDSindicator diseases” – diseases that are extremely rare and only occur when the immune system is severely depressed. By the time these diseases develop, the infection has already progressed from HIV to AIDS, and it is too late for treatments to be fully effective. I repeat: get tested early and often!

Complications: Mainly the obvious: suppressed immune system, opportunistic infections and eventually death. Wasting is a lesser known effect of AIDS, where the body loses muscle mass over time, regardless of eating habits. The nausea and diarrhea that frequently accompany both AIDS and HAART just worsens the effects of wasting.

Folks, please don’t treat HIV as a bogey-man. Don’t treat people with HIV like pariahs, and don’t let fear tactics trick you into thinking that you can get infected in ways that you can’t. But do be careful, do educate yourself, and do protect your partners. Further information on HIV/AIDS can be found at, and on the World Health Organization and websites.

Back to the Long List of STD/STIs.