Brittany Hanes, MSN, APRN, FNP-C

The journey of HIV in America has come a long way in 45 years. The first cases of what would be known as AIDS, later HIV, were reported in the United States in 1981. After peaking as an epidemic in the mid-1990s, research, education, prevention, and treatment have evolved, and now HIV can be well-managed. For a vast majority of people with HIV who follow their treatment plan, the virus can become undetectable with no risk of transmission, and they can live healthy, fulfilling lives.

HIV, known as the human immunodeficiency virus, weakens the immune system by attacking a type of white blood cell called CD4, making the body unable to fight infections and illnesses. Because it works backward in inserting DNA into human cells, HIV is called a retrovirus. Antiretroviral (ARV) medications are prescribed to target different phases of the HIV life cycle and keep the virus from replicating and spreading.

If not treated or managed, HIV will progress over time to AIDS, or acquired immunodeficiency syndrome, the final and most serious stage. Both HIV and AIDS increase the risk of serious infections in the brain, lungs, blood, or digestive tract, as well as certain types of cancer, including lymphoma, lung, or liver cancers.

While HIV rates are declining nationally, the overall infection rates are still too high. In 2022, research indicated approximately 32,000 people in the U.S. were newly infected with HIV, with an overall infection rate of 1.2 million people. Since HIV typically has no symptoms in its early stages, approximately 13% of those with HIV were unaware of their status and needed testing. By region, the South had the largest number, making up almost half of the new HIV infections.

People ages 25-34 accounted for the largest number of new HIV infections, with the second highest rate of infection in ages 13-24. 70% of those diagnosed were Black or Hispanic. Of the 32,000 infected, 67% of respondents were homosexual, bisexual, or reported male-to-male contact, 22% reported heterosexual contact, and 7% reported IV drug use.

Prevention

Unprotected sex or sharing needles to inject drugs are the two most common ways to contract HIV. Having safe sex, not sharing needles, and regular testing as recommended by your health care provider are the first steps in prevention.

The Centers for Disease Control recommends that everyone between the ages of 13 and 64 have an HIV test at least once. Requesting an HIV test at your provider’s office is an option, and online rapid HIV tests are available for purchase and in-home use. Free testing is also an option at many local colleges and universities in our state.

People with certain risk factors are recommended to get tested at least annually, including men who have sex with other men, having sex with a partner with known HIV, having more than one sex partner since the last HIV test, having a diagnosis of other sexually transmitted infections, and anyone sharing drug needles.

Two types of prevention strategies are also important in the fight against HIV:

PEP or Post-exposure prophylaxis – PEP is a medication regimen used to prevent HIV infection after a potential exposure to the virus. It is vital to see a health care provider within 72 hours after a possible exposure and start the antiretroviral medication to prevent HIV, with follow-up testing at 30 and 90 days. If a person utilizes PEP for unprotected sex three times or more, PrEP is recommended.

 PrEP or Pre-exposure prophylaxis – PrEP is a medicine that reduces your chance of getting HIV for those who have unprotected sex regularly, have sex with a partner with known HIV who is not undetectable, or share IV drug needles. ARV medications are prescribed with testing at regular intervals, usually every three to six months, to determine transmission. For those not on PrEP, regular condom use and testing every three to six months is recommended.

Another important prevention tip is to make safe sex a priority and use a condom. Before having sex with a new partner, discuss sexual and drug-use history, disclose your HIV status, and consider getting tested together.

Treatment

If the HIV test comes back positive, a confirmed test will be performed at your health care provider’s office before making a diagnosis.

Once a person has been diagnosed with HIV, ARV medications and regular blood work are the two mainstays of treatment. There are two primary blood tests for assessing HIV:

1. A CD4 blood test measures the amount of CD4 cells, determining the immune function level for HIV
2. An HIV viral load blood test measures the amount of HIV in a sample of blood to assess how the virus level is responding to medications and assess the risk of transmission.

People diagnosed with HIV who take their medications as prescribed can typically lower the viral load to a level at which the virus cannot be transmitted to another person. This status also keeps the immune system strong and decreases the risks of HIV-related complications.

A national awareness program called U=U or Undetectable = Untransmittable has been developed to help prevent transmission of HIV. The U=U status helps promote a higher quality of life, reduces the stigma and discrimination for those living with HIV, and promotes more access to HIV services and care.

HopeHealth started as Hope for the Pee Dee, an HIV service organization, in 1994. Now, as a community health center, we continue to provide HIV testing, education, and high-quality medical care, serving Florence, Aiken, and Orangeburg. Our case managers also help individuals with medication assistance, transportation, housing, employment, and other support to maximize the quality of life for our patients.

HIV is not a death sentence anymore, and reducing stigma means learning more about the disease and getting tested and treated. If you have questions or concerns about your HIV status, don’t delay in finding help.

For more information, visit HopeHealth online at hope-health.org or call (843) 667-9414.