HIV

HIV (Human Immunodeficiency Virus) is a blood-borne virus that affects the immune system.

HIV is not AIDS, and with treatment HIV positive people can expect to live a normal life.

AIDS (Acquired Immune Deficiency) is rare in Australia. It’s the name of a group of infections that a person can get if their immune system is severely damaged as a result of them not receiving effective HIV treatment.

Getting It

HIV is mainly passed on through cum and blood-to-blood contact with someone who has a lot of the virus in their body. High risk activities include:

  • Barebacking
  • Long sessions (more risk of damaging the lining of your arse)
  • Fucking without lube (more risk of damage to the arse)
  • Sharing injecting equipment (these rates are very low in Australia)

HIV is actually harder to pass on than you might think and four things need to be in place for transmission to occur:

  • Exist – You or one of your fuck buddies actually needs to have HIV
  • Enough – There needs to be a lot of the virus in their body (i.e. they’re not on treatment)
  • Exit – It needs to leave their body (through cuts, blood, precum, cum, and anal mucous in men)
  • Entry – It actually needs to get into a negative person’s blood (through barebacking, cuts, abrasions, etc.)

Knock out just one of those four things and HIV transmission is not possible.

HIV dies pretty quickly once it leaves the body (unlike Hep C), and not many people contract it through injecting drug use in Australia.

The majority of people in Australia who know they have HIV are on treatment meaning the virus is suppressed or undetectable. For this reason, the majority of new infections come from people fucking bareback who don’t know they have it.

Symptoms

Some guys won’t have any symptoms for years; while others go through a seroconversion illness a few weeks after contracting HIV. The symptoms of this illness can include any or all of the following:

  • Flu-like symptoms
  • Fever
  • Vomiting and diarrhoea
  • Rashes
  • Sore throat and swollen glands

The seroconversion illness varies in severity and usually lasts a couple of weeks; afterwards, a person will recover and feel as healthy as they normally do.

If HIV isn’t tested for and treated, a person’s health will start to fail over the next decade. They might notice skin problems, stomach issues or oral thrush, but as their immune system becomes more damaged they are at risk of conditions like pneumonia, brain infections, and certain cancers. It’s important to say that this is very rare in Australia, and it can be easily avoided with regular HIV testing and treatment.

Managing It

HIV treatment has come a long way, with new breakthroughs happening every year. Medication is taken daily, often just one pill a day, and includes a combination of three different antiretroviral drugs that control the virus in different ways. Today, most people with HIV will experience no short or long-term side effects from their HIV treatment.

A newly diagnosed guy can expect to start treatment early in Australia, usually suppressing their viral load to undetectable levels (UVL) in the body, meaning they will live a long and healthy life and be very unlikely to transmit the virus to others.

Treating early is recommended. The START study has shown that the earlier treatment is initiated, the better your long term health outcomes are.

Undetectable

When a HIV poz guy is taking treatment (“antiretroviral therapy” or “ART” for short) the amount of HIV in his body (known as his ‘viral load’) can be reduced to a level that is ‘undetectable’.

This means the treatment has suppressed the virus from replicating, making it almost impossible to be passed on if you’re barebacking or into higher risk play. It also means HIV is not multiplying so reduces harm to your body.

The studies that back up this information show this is true as long as a person’s meds are taken daily and after they have had an undetectable or suppressed viral load for 6 months or more.

Want to know more on what an undetectable viral loads (UVL) means? Have a look here.

Reducing Risk

Sexually adventurous men make up 35% of all new HIV diagnoses but it can be easy to avoid getting infected or passing it on, if we use some form of protection:

Undetectable viral loads in Poz guys on treatment are proven to make transmission almost impossible

PrEP, when taken daily by negative guys, is proven to make transmission almost impossible

PEP, taken 72 hours after a possible infection can help prevent catching  HIV after a potential exposure

Condoms stop cum with HIV in it getting into your body

Lube reduces the chances of damage to the arse lining

Matching HIV Statuses to only barebacking with guys with the same status as you can lower your risk (remember any current test result is only accurate for your status three months ago)

Strategic Positioning means a Neg guy only topping a Poz guy bareback (it reduces your risk, but not by much)

Relationship Agreements could be put in place, meaning a couple decide to only fuck raw with each other and use condoms with everybody else

Pulling Out before you cum reduces risk, but not by much – precum and anal mucous can contain high levels of HIV is the person’s not on treatment

Using your own, clean injecting equipment, not sharing, and using a new fit each time

Knowing Your Status

The more you fuck, the more you need to test. For us sexually adventurous guys it’s best to test every three months for HIV, a small sample of blood is taken and the doctor or nurse will probably do a syphilis test at the same time.

In NSW, some clinics, including a[TEST] peer-run services, will offer a rapid finger prick test as well, the results of these are delivered back to you within 20 minutes.

HIV testing is only accurate as of three months prior to the date you test because there’s a period of up to  90 days before HIV shows up in the blood after infection.

To find out where to get tested, click here.

HIV and Other STIs

Having an STI like chlamydia or gonorrhoea in your arse or throat can make it easier to pick up HIV. STI’s can cause inflammation of that area which increases the risk of the virus entering the body and getting  into your blood.

If you’re Poz and not on treatment  having another STI can cause a spike in your viral load, making it easier to transmit the virus to someone else. If you have UVL, a spike is unlikely.

Most Poz guys get an STI check-up at least every time they get their bloods taken by their doctor; it’s a nice, easy way of staying on top of your health and look after your partners and fuckbuddies.

HIV and Hep C

If you’re HIV positive, Hep C can cause damage to your liver faster  than in someone without HIV and have higher concentrations in your blood and cum.

Having an HIV and Hep C co-infection doesn’t mean that you can’t treat both viruses, but your doctor may have to consider which medications are best for you to take. This could mean switching your HIV treatment to a combination that is proven to be less harmful to your liver. You should always talk to your doctor about this.

Check with your doctor before taking herbal supplements, like St Johns Wort, as they can have an adverse reaction combined with your treatment. Hep C and HIV may both be treated with a class of drug called protease inhibitors and these can make taking party drugs like Ice, MDMA and Cocaine much more dangerous. The protease inhibitor affects your kidneys and liver, so the other drugs aren’t flushed out as usual; instead they build up in the body to dangerously high levels.

Talk to your doctor about your partying, or if you don’t feel comfortable, click here to get in touch with a Stimcheck health professional confidentially.

New treatments for Hep C, called DAAs (direct acting antivirals) have been available since early 2016. All people living in Australia who have a Healthcare Card can access DAA treatment, just speak with your doctor about treatment options.

More of It

For more information on HIV and other STIs check out: http://www.thedramadownunder.info/

The Multicultural HIV and Hepatitis Service (MHAHS) for HIV & Hepatitis information published in languages other than English