HIV dan AIDS

HIV stands for Human Immunodeficiency Virus. This virus attacks the immune system and weakens the body's ability to fight infections and diseases.

HIV can not be cured, but there are treatments that can be used to slow the progression of the disease. This treatment will also make the sufferer live longer, so that can live life normally.

With early HIV diagnosis and effective treatment, people living with HIV will not turn to AIDS. AIDS is the final stage of HIV infection. At this stage, the body's ability to fight infection is completely gone.

HIV / AIDS in Indonesia

In Indonesia, since the first incidence of HIV infection in 1987 HIV spread in 368 out of 497 districts / cities across the province. Bali Island is the first province where HIV / AIDS infection is found in Indonesia.

According to UNAIDS, in Indonesia there are about 690 thousand people with HIV until 2015. Of these, half percent are aged between 15 to 49 years. Women aged 15 years and over who live with HIV conditions about 250 thousand inhabitants. The death toll from AIDS reaches 35 thousand people. Thus there are orphans due to the deaths of parents because AIDS amounts to 110,000 children.

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The spread of HIV

HIV is a fragile type of virus. Can not last long outside the human body. HIV can be found in the body fluids of an infected person. The fluid in question is fluid sperm, vaginal fluid, anal fluid, blood, and breast milk. HIV can not spread through sweat or urine.

In Indonesia, the cause and spread of HIV / AIDS virus is divided into two main groups, namely through unsafe sex and needle-sharing syringes when using narcotics.

Here are some other ways of spreading HIV:

  1. Transmission from mother to baby during pregnancy, when giving birth or breastfeeding.
  2. Through oral sex.
  3. Use of sex aids together or alternately.
  4. Through the transfusion of blood from an infected person.
  5. Use needles, injection, and other contaminated injecting equipment, such as sponges and cleaning cloths.
HIV Infections Test
If you feel you have a risk of becoming infected with the HIV virus, the only way to find out is to have an HIV test counseled. Immediately visit the nearest health facility (VCT clinic) for HIV testing. With this test will know the results of HIV diagnosis on your body.

This HIV testing and counseling service is referred to as VCT (Voluntary Counseling and Testing) or KTS (Voluntary HIV Counseling and Testing). This test is voluntary and confidential. Before performing the test, counseling is given first. Counseling aims to determine the level of risk of infection and also the pattern of daily living. After this stage, discuss how to deal with HIV test results if proven positive.

HIV testing is usually a blood test to confirm the presence of antibodies to HIV in the blood sample. Antibodies are proteins produced by the immune system to attack certain germs or bacteria. HIV testing may be repeated one to three months after a person performs activities suspected of causing him to catch the HIV virus.

There are several places to test for HIV. You can ask the nearest hospital or health clinic. In Indonesia, there are several foundations and organizations that focus on HIV / AIDS affairs, including:

    Indonesia AIDS Community
    ODHA Indonesia
    Abiasa Set
    Spiritia Foundation
    Orbit Foundation
    AIDS Foundation Indonesia

Meanwhile, government agencies established specifically to handle HIV / AIDS is the National AIDS Commission (KPAN).

If the result is positive, you will be referred to an HIV specialist clinic or hospital. Several other blood tests may be needed. This test is to show the impact of HIV on your immune system. You can also talk about handling options that can be done.

Step Treatment For HIV Patients

Although there is no cure to completely eliminate HIV, the current HIV treatment step is quite effective. Treatment can extend the life of people with HIV and they can live a healthy lifestyle.

There are drugs that are known by the name of antiretroviral (ARV) which serves to inhibit the virus in damaging the immune system. The drugs are administered in the form of tablets consumed daily. You will be advised to do a healthy lifestyle. For example healthy food, not smoking, getting an annual flu vaccine, and five-year pneumococcal vaccine. It aims to reduce the risk of dangerous diseases.

Without treatment, people with HIV-infected immune systems will drop dramatically. And they tend to suffer life-threatening diseases such as cancer. This is known as late-stage HIV or AIDS.
How to Prevent HIV

The best way to prevent HIV is to have sex safely, and never share needles, and any injecting equipment. All who have had unprotected sex and shared needles or injections are at greater risk of HIV infection.

Symptoms of HIV and AIDS

HIV infection appears in three stages. The first stage is seroconversion (The specific time period in which HIV antibodies have started to develop against the virus.). The second stage is the time when no symptoms appear. And the third stage is HIV infection turned into AIDS.

The first stage

People infected with the HIV virus will suffer from a flu-like illness. After this, HIV does not cause any symptoms for several years. Symptoms such as this flu will appear several weeks after infection. This period of time is often referred to as seroconversion.

It is estimated, about 8 out of 10 people infected with HIV experience this. The most common symptoms are:

    Sore throat
    Fever
    Rashes appear on the body, usually not itchy
    Swollen lymph smears
    Weight loss
    Diarrhea
    Fatigue
    Painful joints
    Muscle ache

The symptoms above can last for one to two months, or even longer. This is a sign of the immune system being against the virus. But, these symptoms can be caused by diseases other than HIV. This condition is not solely due to HIV infection.

Perform an HIV test if you feel you are at risk of infection or when the symptoms mentioned above appear. But keep in mind, not everyone has the same symptoms as mentioned above. If you feel you have done something that put you at risk of getting infected, visit the nearest clinic or hospital for an HIV test.

Phase Two

Once the initial symptoms disappear, HIV usually does not cause further symptoms for years. This period is called the incubation period, or the latent period. The virus continues to spread and damage the immune system. At this stage, you will feel healthy and no problem. We may not be aware of HIV, but we can transmit this infection to others. The length of this stage can run about 10 years or even more.

Third Stage or the Last Stage of HIV Infection

If left untreated, HIV will weaken the body's ability to fight infection. With this condition, you will be more susceptible to serious illness. This final stage is better known as AIDS (Acquired Immune Deficiency Syndrome). The following are symptoms that appear in the last stage of HIV infection:

    Lymph nodes or lymph nodes swell on the neck and groin.
    Fever lasting more than 10 days.
    Feeling tired almost every time.
    Sweating at night.
    Weight loss down unknown cause.
    Purple spots are not lost on the skin.
    Hard to breathe.
    Severe and sustained diarrhea.
    Fungal infections of the mouth, throat, or vagina.
    Easily bruised or bleeding for no reason.

The risk of a deadly disease will increase at this stage. For example, cancer, tuberculosis, and pneumonia. But despite this deadly disease, HIV treatment can still be done. Early treatment can help improve health.

Causes of HIV and AIDS

HIV / AIDS is divided into two main groups, namely through unsafe sex and alternately for injecting drug users (IDUs).

Whether there is a symptom or not, an HIV-infected person can pass the virus on to others. HIV positive people more easily transmit the virus a few weeks after they catch it. Treatment of HIV will reduce the risk of spreading to others.

The spread of HIV

HIV is not transmitted as easily to others. This virus does not spread through the air like cough and flu virus. HIV lives in the blood and some body fluids. But liquids such as saliva, sweat, or urine can not transmit the virus to others. This is because the content of the virus in the liquid is not enough. The fluids that can transmit HIV into other people's bodies are:

    Blood
    Anal wall
    Breast milk
    Sperm
    Vaginal fluids, including menstrual blood

HIV is not infected from kissing, saliva, bites, sneezing, sharing toiletries, towels, utensils, using the same toilet or pool, bitten by animals or mosquito-like insects. The main ways that viruses can enter the bloodstream are:

  • Through open wounds on the skin.
  • Through the thin walls of the mouth and eyes.
  • Through thin walls inside the anus or genitals.
  • Through a direct injection into a blood vessel using an infected needle or injection.

Through sex

The most prevalent viral spread is by unprotected vaginal and anal sex. Unsecured oral sex is also at risk of infection, but the risk is quite small. The spread of HIV through oral sex will increase if people who have oral sex are sores or there are cuts in the mouth. Or have sex with a person who has just been infected with HIV and has many viruses in his body.

  • Highly low risk of HIV transmission varies, depending on the type of sex that is done.
  • Doing oral sex in a man who is HIV positive, and the man ejaculates in the mouth.
  • HIV transmission can occur when we do oral sex in women who are HIV positive, especially when the woman is menstruating, although the risk is small.
  • Receiving oral sex from people with HIV is very low, because HIV is not transmitted through saliva.

In addition to sex, HIV can be transmitted through:

  • Blood transfusion.
  • From mother to baby, whether during pregnancy, childbirth, or when breastfeeding.
  • Sharing needles, whether for piercing or tattooing.
  • Share the injections, especially for the heated (injecting drug users).
  • Share sex aids with people living with HIV.

The Effects Of HIV In The Human Body

The immune system is in charge of protecting us from attacking diseases. One important element of the immune system is the CD4 cell (one type of white blood cell). These cells protect against a variety of bacteria, viruses, and other germs.

HIV infects the immune system. The virus enters the immune system in CD4 cells. This virus utilizes CD4 cells to multiply itself thousands of times. This self-replicating virus will leave the CD4 cell and kill it at the same time. The more CD4 cells die, the immune system will be lower. Until finally, the immune system does not work.

When this process occurs, the body will still feel healthy and no problem. This condition can last for 10 years or even more. And patients can spread the virus in this period.

People at Risk for HIV Infection

Remember that everyone is at risk of HIV infection, regardless of age limit. But there are some groups of people who are at higher risk of HIV infection. They are:

  • Users of injecting narcotics.
  • People who make tattoos or do piercings.
  • People who have unprotected sex either sex, or heterosexual.
  • People who live or travel frequently to areas with high HIV rates, such as Africa, Eastern Europe, Asia, and southern America.
  • People who perform blood transfusions in areas with high HIV rates.
  • People affected by other sexually transmitted infections.
  • People who have sex with injecting drug users.

Diagnosis of HIV and AIDS

People who have recently become infected with HIV will experience symptoms like flu. This occurs for approximately one month to two months after infection. Early symptoms that appear such as fever, sore throat, and the appearance of a rash. But, some people who suffer from HIV do not feel the signs and symptoms for years.

Just by having an HIV test, we can know for sure whether we are infected or not. The faster the HIV is detected, the treatment success rate will be higher. If you feel you are at risk of HIV infection, consult your nearest doctor or health clinic.

Do not delay treatment after you know you have been infected with HIV. If it's too late, the virus can quickly spread into the immune system. This can interfere with your health. You can also avoid spreading the virus to people closest or to others.

Conducting HIV / AIDS Test

To test whether we are infected with HIV, one of the most common tests is a blood test. Blood will be checked in the laboratory. This test serves to find antibodies against HIV in the blood. But, this blood test can only be trusted if done at least a month after HIV infection, because antibodies to HIV do not form immediately after the initial infection. Antibodies to HIV take about two weeks to six months, before finally appearing in the blood.

The period between HIV infection and the formation of antibodies sufficient to show positive test results is referred to as the "window time". At this time, an HIV-infected person can transmit the virus, although blood tests do not show any antibodies to HIV in the blood.

One way to diagnose HIV other than a blood test is the "Point of Care" test. In this test, a sample of saliva from the mouth or a little drop of blood from a finger will be taken, and the results will come out in just a few minutes.

Before a person is given a definitive diagnosis, it is necessary to do several tests to be sure. This is because the window of HIV is long enough. So, the first test results are not necessarily reliable. Take the test several times if you feel you are at risk of HIV infection.

If tested positive for HIV, some tests should be done to monitor the development of the infection. After that, then can be known when to start treatment of HIV.

Where to Test HIV / AIDS

There are several places to perform HIV blood tests. In fact, some puskesmas have also provided services for HIV testing. Click this link to see some hospitals in Indonesia that provide HIV testing facilities and services for people living with HIV and AIDS.

In Indonesia, there are several foundations and organizations that focus on HIV / AIDS affairs, including:

    Indonesia AIDS Community
    ODHA Indonesia
    Abiasa Set
    Spiritia Foundation
    Orbit Foundation
    AIDS Foundation Indonesia

Meanwhile, government agencies established specifically to handle HIV / AIDS is the National AIDS Commission (KPAN). You can consult them on everything related to HIV / AIDS.

Today, home HIV-testing kits are also available free to buy at pharmacies, health clinics, or via the internet. But, to be more clear in understanding this virus, it is advisable to consult a doctor.

If interested in HIV testing, before will be given counseling or counseling. HIV testing can not be done without the consent of the person concerned.

Treatment of HIV and AIDS

There is no cure for HIV infection, but there are treatments that can slow the progression of the disease. This treatment can make an infected person to live longer and can lead a healthy lifestyle. There are various types of drugs that are combined to control the virus.

Early HIV Emergency Drugs

If you feel or suspect you have just been exposed to the virus in a 3x24 hour timeframe, anti-HIV drugs can prevent infection. This drug called post-exposure prophylaxis (PEP) or in Indonesia is known as post-exposure prophylaxis. Prophylaxis is a health procedure that aims to prevent rather than cure.

This treatment should be started up to three days after exposure (exposure) to the virus. Ideally, this drug can be taken immediately after exposure. The faster the treatment, the better.

Treatment using PEP lasts for a month. The side effects of this drug are serious and there is no guarantee that this treatment will work. PEP involves the same drugs as people who have tested positive for HIV.

This medicine you can get in a specialist sexually transmitted infectious disease (STI) or in the hospital.

HIV Positive Test Results

If a positive or reactive test result means we are infected with HIV. The results of this test should be delivered by counselor (counselor) or doctor. They will tell the impact on everyday life and how to deal with the situation that happened at the time.

Blood tests will be done regularly to monitor the development of the virus before starting treatment. Treatment is done after the virus begins to weaken the human immune system. This can be determined by measuring the level of CD4 cells (cells that fight infection) in the blood.

Treatment is usually recommended after a CD4 cell count below 350, whether symptomatic or not. If the CD4 is near 350, it is advisable to take treatment as soon as possible. The goal of treatment is to reduce the level of the HIV virus in the blood. It is also to prevent or delay HIV-related illnesses. The possibility to spread it also becomes smaller.

Involvement of Other Illnesses

For people with hepatitis B and hepatitis C who are also infected with HIV, treatment is recommended when the CD4 cell count is below 500. If the HIV patient is undergoing radiotherapy or chemotherapy that will suppress the immune system, treatment is done with any CD4 cell count. Or when you also suffer from other diseases such as tuberculosis, kidney disease, and brain diseases.

Antiretroviral Drugs

Antiretroviral (ARV) are some of the drugs used to treat HIV infection. These drugs do not kill the virus, but slow the growth of the virus. HIV can be adaptable and immune to one class of ARVs. Therefore, a combination of ARV classes will be given to the patient. Some classes of ARVs are:
  • NNRTIs (Non-nucleoside reverse transcriptase inhibitors). This type of antiretroviral drugs will work by removing the proteins that the HIV virus needs to replicate.
  • NRTI (Nucleoside reverse transcriptase inhibitors). This class of antiretrovirals inhibits the development of HIV in the cells of the body.
  • Protease inhibitors. This type of antiretroviral drugs will eliminate the protease, a type of protein that HIV also needs to multiply.
  • Entry inhibitors. This type of HIV will prevent HIV from entering CD4 cells.
  • Integrase inhibitors. This type of antiretroviral drugs will eliminate the integrase, the proteins that HIV uses to enter the genetic material into the CD4 cells.

This combination treatment is better known as antiretroviral therapy (ART). Usually patients will be given three classes of ARV drugs. The combination of antiretroviral drugs is different for each person, so this type of treatment is personal or special.

Some ARV drugs have been combined into one pill. As soon as HIV treatment begins, it may have to be taken for life. If one ARV combination does not work, it may be necessary to switch to another ARV combination.

The incorporation of several types of treatment to treat HIV infection can lead to unexpected reactions and side effects. Always consult a doctor before taking any other medications.
HIV Treatment In Pregnant Women

For pregnant women who are HIV-positive, there are special antiretroviral drugs for pregnant women. This medicine is to prevent mother from HIV transmission to her baby. Without treatment, there is a comparison of 25 out of 100 infants infected with HIV. Risk can be lowered by less than one in 100 if treated early.

With earlier treatment, the risk of transmitting the virus through normal delivery does not increase. But for some women, it is advisable to give birth by caesarean section.

For HIV-infected women, it is advisable not to breast-feed their babies. Viruses can be transmitted through the breastfeeding process. If you are a HIV-infected partner, talk to your doctor as there is an option to stay pregnant without risk of contracting HIV.

Regular Drug Consumption

You should schedule a routine to include HIV treatment into your daily lifestyle. HIV treatment can work if you take medication regularly (at the same time every time you take the medicine). If you miss a single dose, the effect may increase the risk of failure.

Side Effects of HIV Treatment

All treatments for HIV have unpleasant side effects. If abnormal side effects occur, you may need to try a combination of other ARV drugs. Here are examples of common side effects:

     Fatigue
     Nausea
     Rash on the skin
     Diarrhea
     One part of the body is fattening, the other is thin
     Mood swings

HIV and AIDS Prevention

There is no vaccine to prevent HIV and no cure for AIDS, but you can protect yourself from getting infected. The only way to prevent HIV infection is to avoid activities that increase the risk of contracting HIV. Basically, prevention is always better than cure.

The most common ways to become infected with HIV are having unprotected sex, and sharing needles or other syringes. If you are infected with HIV, you can pass it on in such ways. If both partners are infected, still have safe sex. You can catch other types of HIV virus that may not be controlled by the drugs you consume.

Through Sex Relationships

The highest risk of HIV infection is transmitted through unprotected sex through vaginal as well as anal. The risk of contracting through oral sex is quite low, but it does not mean zero. Oral sex can transmit other sexually transmitted infections such as syphilis. Toys and sex aids are also at risk in spreading HIV if one of these toys and sex aids is positively infected with HIV.

The best way to prevent HIV and other sexually transmitted infections (STIs) is to use condoms for all types of sex penetration. And use a dental dam to perform oral sex. Dental dam is a sheet of latex fabric. This fabric serves as a barrier between the mouth and the vagina or anus. It aims to reduce the spread of STIs during oral sex.

Take Truvada medication

For people at high risk of HIV infection, taking emtricitabine-tenofovir (Truvada) drugs may reduce the risk of HIV infection through sexual intercourse. Truvada is also used in HIV care along with other medications.

Condom use

If you do not know your partner's HIV infection status, always use a new condom every time you have anal or vaginal sex. Condoms are available in different shapes, colors, textures, materials, and taste. Condoms are available for both men and women.

Condoms are the most effective form of protection against HIV and other sexually transmitted infections. Condoms can be used for any sexual intercourse. It is important to wear condoms before any sexual contact that arises between the penis, vagina, mouth, or anus. HIV can be spread before ejaculation. This occurs when the discharge of the initial fluid from the genitals and from the anus.

Use condoms made from latex or polyurethane (latex and polyurethane) when having sex. Use a condom once you or your partner has an erection, not before ejaculation.

Use of lubricants

Lubricants are used to increase the comfort and safety of sex with the aim of adding moisture to the vagina and anus during sex. Lubricants will reduce the risk of skin sores (tears) in the vagina or anus. The lubricant also prevents the condom from tearing.

Use only water-based lubricants instead of oils. Oil-based lubricants can weaken the power of condoms and can even tear condoms.

Through Needles and Injection

If you use a needle to inject medicine, make sure the needle is sterile. Do not share needles, injections, or injecting equipment again like sponges and fabrics. Sharing needles may increase the risk of being infected with HIV and other viruses in the blood, such as hepatitis C.

If you want to make a tattoo or piercing, make sure always use a sterile needle and clean. Do not do this activity in place carelessly. Make sure you check the needles used.

Doing circumcision for men

Male circumcision is a surgical procedure to cut the skin at the tip of the penis. Circumcision is done on male genitals can reduce the risk of men affected by HIV.