What is HIV?

HIV stands for human immunodeficiency virus and this virus damages the cells of the human immune system. This results in a person’s immune system becoming weaker and weaker and less able to fight everyday infections and diseases once the immune system has been damaged by the virus.

The syndrome of potentially life threatening conditions that, if the virus is left untreated, is called AIDS, or acquired immune deficiency syndrome. As a syndrome, AIDS is not actually transmitted from person to person, what can be transmitted is the virus which causes AIDS, that is, HIV.

It may seem strange that symptoms of HIV in women should be different from those experienced by men but as a result of their anatomy and physiology being different from men, there are some variations. We will look into how being infected with HIV affects women specifically.

HIV transmission in women

HIV is found in the body fluids of a person who is infected, specifically: semen, vaginal and anal secretions, blood and breast milk. HIV is not carried in sweat, saliva, tears and excretions passed when sneezing. Neither is it transmitted from sharing towels, cutlery, cups or by hugging, kissing or touching.

The most common way of transmitting HIV is through unprotected anal or vaginal sex; it can also be transmitted by sharing needles with an intravenous drug user or during pregnancy, childbirth and breastfeeding.

The risk of female to female transmission is very small and there are only a handful of reported cases known to exist. An HIV positive woman who is a lesbian will have contracted the disease by sharing needles, having sex with men, sharing sex toys or being exposed to blood during sexual intercourse.

 

HIV symptoms in women

Having been exposed to HIV, between two and six weeks later, the majority of infected people will experience a short illness that closely resembles the flu and lasts 1 – 2 weeks. This is known as stage 1, acute HIV infection and the symptoms include:

  • Fever
  • Chills
  • Rash
  • Night sweats
  • Muscle aches
  • Sore throat
  • Fatigue
  • Mouth ulcers
  • Coughing
  • Sneezing
  • Headaches

This is caused by something known as seroconversion which is a period of time when the virus is replicating at great speed.

This is followed by a period known as mid-stage HIV which can last as long as ten years. This is largely a period of latency were few, if any symptoms are experienced. During this time, having swollen or painful glands would be the only indication of infection.

The third period is known as advanced HIV.

The list of symptoms above may be common to both male and females who are HIV positive but there are additional symptoms which may be experienced by women and they include:

  • Swollen lymph nodes – after the initial acute infection, swollen lymph nodes can be the earliest symptom to suggest an HIV infection is present. Swelling in the neck area, just under the jaw and behind the ears alongside having trouble swallowing all suggest the presence of swollen lymph nodes. This symptom can last from a few days to a few months.

  • Vaginal candida (yeast) infections – damage to the immune system caused by HIV can make a woman more vulnerable to candida (yeast) infections in the vagina, the symptoms of which include:

    1. Pain during sex
    2. Thick, white vaginal discharge
    3. Burning in and around the vagina and vulva
    4. Painful urination
    5. Intense itching

  • Rapid weight loss – if an HIV positive person is not receiving treatment, the virus can cause nausea, diarrhoea, loss of appetite and poor absorption of food, all of which will contribute to rapid weight loss

  • Mood changes and psychological symptoms – for some women, the strain of an HIV positive result can cause mood changes and neurological disorders. This in turn can result in increased anxiety, stress and, ultimately, depression

  • Skin changes – HIV can result in strange spots and lesions to appear on the skin. These changes can also occur on the mouth, genitals and anus

  • Menstrual changes – for some women, being HIV positive will result in menstrual changes which can mean heavier or lighter periods.  If this is accompanied by rapid weight loss it may result in their periods stopping completely. Hormonal fluctuations can lead to problems that tend to be associated with periods such as tender breasts, abdominal cramps and fatigue to change or become worse. Women with HIV may also have premenstrual symptoms which are much more severe

  • Increased outbreaks of other sexually transmitted infections (STI’s) – if a person is already infected with another sexually transmitted infection, the fact that they are HIV positive will mean that they are vulnerable to more severe and more frequent outbreaks of the disease. For instance HPV (human papillomavirus) which is the virus responsible for causing genital warts is more active in people with HIV. In addition, the normal medications that they use to treat HPV may not be as effective.

  • Pelvic inflammatory disease – this is otherwise known as PID and is an infection of the reproductive system including the uterus, fallopian tubes, fallopian tubes and ovaries. PID in HIV positive women may be more difficult to treat with outbreaks being more frequent and more severe.

 

How is HIV diagnosed?

Early diagnosis of HIV is crucial when it comes to the prognosis because there are now good forms of medication that can help a person manage HIV without having to face complications.

There are different types of tests that can detect HIV although some tests will not be able to detect the virus in the early stages of infection.

The available tests include:

  • Antibody tests – these tests can detect HIV antibodies which the immune system produces to attack the virus. The rapid testing for use at home are usually looking for antibodies and are unable to detect HIV early in the process

  • Antigen/antibody tests – these tests detect HIV antibodies and antigens or components of the virus in the bloodstream; These tests are also unable to detect HIV at an early stage

  • Nucleic acid tests – these tests are looking to detect HIV genetic material in the bloodstream and these tests can give an early result. As a result of this, if you believe you have been exposed this is the most reliable test to have.

 

Treating HIV

There is no actual cure available at this time for HIV. There are prophylactic treatments that can be given to protect against contracting the disease as well as treatments known as antiretrovirals which are designed to prevent or reduce the rate at which the virus replicates which gives the body’s own immune system the opportunity to fight the virus.

 

Prophylactics for HIV

  • Pre-exposure prophylaxis (or PrEP) – this is a way for people who do not have HIV but who are at very high risk of getting HIV to prevent being infected. The pill (brand name Truvada) is taken daily and contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV.

  • Post exposure prophylaxis (PEP) – PEP is a course of anti-HIV medication. You must start the treatment as soon as possible after you’ve been exposed to HIV, ideally within a few hours. The medicines must be taken every day for 28 days (4 weeks).

PEP is unlikely to work if it’s started after 3 days (72 hours) and it won’t usually be prescribed after this time. It is best to start taking PEP within 1 day (24 hours) of being exposed to HIV. PEP will reduce the chances of contracting HIV but it is not a cure for HIV and it does not work in all cases.

 

Antiretroviral therapies for treating HIV

This type of medication is designed to either prevent the virus from replicating completely or reduce the rate at which this is happening; this will allow the immune system to repair itself as well as preventing the virus from causing further damage.  

These antiretroviral drugs are usually given as a combination of different medications. The point of this is that the virus can develop resistance to any one medication and so giving them in combination makes this far less likely. In an ideal world and if the correct combination of antiretrovirals is given, the virus will stop replicating completely and the immune system can then regenerate and fight off what virus is left. 

Eventually, the level of virus in the system will be undetectable and that is the aim of these drugs. However, there will be some level of HIV in the body and if the medication is stopped, it will begin to replicate again.

 

Preventing HIV

It is important to remember that HIV is transmitted by sharing bodily fluids with an infected person; sexual intercourse or intravenous drug use are the biggest risk areas.

Key ways to reduce the risk of contracting HIV include:

  • Do not share needles during intravenous drug use
  • Take pre exposure prophylaxis (PrEP).  This is particularly recommended for use by people who have known risk factors for contracting HIV such as:
    1. Men who have sex with men
    2. If your partner is from a part of the world where HIV incidence is high
    3. If you have a partner who is HIV positive with an undetectable load
    4. People who do not use condoms during sex
    5. Men who have had sex with men who have recently had a sexually transmitted disease
    6. People who have used post exposure prophylaxis following a sexual risk situation
    7. People who have chemsex
  • Do not douche after sex as this can upset the natural balance of bacterial and yeast in the vagina which will aggravate an existing infection as well as making you more vulnerable to contracting HIV or other sexually transmitted illnesses.
  • Use a condom in the correct way unless you are in a monogamous relationship with an HIV negative partner

 

Conclusion

Many HIV symptoms resemble those of other illnesses, such as the initial stage where the symptoms resemble those of flu and many other symptoms which occur as a result of the damage to the immune system can appear unconnected to HIV but are part of the syndrome known as AIDS (acquired immune deficiency syndrome).

If a person at any time suspects they may have been exposed to HIV it is vital that they are tested for the virus. Only by doing this can they get the treatment which is available and so look forward to a relatively long and healthy future.