First up in our series on sexually transmitted infections is HIV/AIDS. We’re covering this first because it has had such a huge and devastating effect on the LGBTQIA+ community. For a lot of people, HIV/AIDS holds fear, shame, and stigma. We want to give you the tools to make sex fun, safe, and accessible. Now that we have a greater understanding of HIV/AIDS, there is more support for people who are HIV-positive. Our goal is to take the shame out of STIs and empower you to have pleasurable, healthy connections regardless of your status. 🌈✨
- What: HIV (Human Immunodeficiency Virus), which can lead to AIDS (acquired immunodeficiency syndrome) if left untreated.
- Type of infection: chronic, treatable
- Symptoms: primary HIV infection may cause flu-like symptoms including fever, headache, muscle aches, rash, sore throat, swollen lymph nodes, diarrhea, weight loss, cough, and night sweats
- Transmission: HIV is spread through bodily fluids like blood and semen and is most commonly spread through sexual contact. It can also be spread through contact with infected blood (like through sharing needles) or transmitted from a parent to a child during pregnancy or breast-feeding.
- Prevention: using condoms for penises and sex toys, using clean needles, regular testing
- Testing: Blood or saliva test at a medical office or at home
- Treatment: Anti-retroviral medication to lower viral load
What Is It?
First identified in 1981, HIV is probably the STI that is the most steeped in fear. After the HIV/AIDS epidemic of the 80s and 90s devastated the US and the queer community in particular, it’s no wonder why it still carries so much weight. A chronic illness with no current cure, HIV is a virus that attacks the white blood cells that fight infection. This leaves people who are HIV positive vulnerable to infections and some cancers. With the right medication, and particularly with early detection, people can live long, healthy lives with HIV and never progress to AIDS.
How do I know if I have it?
Depending on the stage of infection, HIV can have different types of symptoms. During early infection, Acute HIV infection that occurs 2–4 weeks after infection, around 2/3rds of people will experience flu-like symptoms, the body’s natural response to the virus. Symptoms can last anywhere from a few days to a few weeks.
It is important to get tested for HIV as soon as you think you may have been exposed, as early detection is key to lowering the viral load.
It is also important to note that most tests detect antibodies rather than the virus itself, so work with your medical provider to understand which type of test is right for you.
After the initial acute HIV infection, HIV+ people may not have any symptoms. The clinical latency period or chronic HIV infection can last for years or decades.
Stage 3 of the virus is progression to AIDS, the diagnosis of which is based on medical criteria about the number of the CD4 (a type of white blood cell key to immune function) cell count or the development of an opportunistic infection that takes advantage of a weakened immune system. Today, many HIV-positive people in the US never develop AIDS.
How is it spread?
HIV is transmitted through contact with bodily fluids like blood, semen, or vaginal fluid, most commonly through unprotected sex. Receiving unprotected anal sex puts a person at the highest risk of transmission versus other types of sex, in part due to the lack of natural lubrication. It can also be transmitted from a parent to a child through pregnancy and through contact with blood in the sharing of needles. That’s why it’s recommended that all expecting parents be tested for HIV, and why it’s so important to use sterile needles.
How can I prevent it?
Other than abstinence (which is not an effective or realistic method for most adults), the number one way to prevent the spread of HIV is through knowing your status. All sexually active adults should be tested at least once and more frequent testing (annually and ideally between each new sexual partner) is recommended for people having sex with more than one person. It is important to know your status as well as that of your sexual partners whenever possible.
The correct use of internal or external condoms during anal or vaginal sex as well as with the use of sex toys reduces the spread of HIV by up to 95%. Here’s how to use an external condom and info on internal condoms.
PrEP (pre-exposure prophylaxis) is a medication that reduces the risk of transmission for people who are HIV negative. It is recommended for people who are at a higher risk of contracting HIV, which includes men who have sex with men, transgender people, sex workers, and people who have an HIV positive partner.
PEP(post-exposure prophylaxis) is an emergency medication that must be used within 72 hours of suspected exposure to HIV to prevent transmission. You can access it through a medical provider.
How do I get tested?
There are a few different ways to get tested for HIV. All tests require a window period (typically of 14–21 days) to be accurate and cannot detect the virus immediately after exposure. In a healthcare setting, the tests available include a lab test or a rapid test and will take either a blood or oral fluid sample. Rapid test results will be available same day, in 30 minutes or less, while lab tests may take several days to become available.
There are also at home tests available for HIV, and these typically provide results within 20 minutes.
To find a testing site near you, try the HIV.gov database or contact your local health department or LGBT center.
What happens if I test positive?
For people who are positive for HIV, it is important to monitor your health and viral load with a healthcare provider. The current goal of anti-retroviral (ART) treatments is to lower the viral load (the amount of the virus in your system) of HIV so that it becomes undetectable. The earlier people are able to begin to manage an HIV infection, the better the medication works.
Even with improved treatment that provides better outcomes and fewer side effects, an HIV diagnosis can come with an array of emotions including fear and shame as well as health effects from a lowered immune system. If you are struggling with a diagnosis, you are not alone. It can be a challenge to find queer-competent, sex-positive healthcare providers, and there are resources like Queerly Health and Queer Health Access working to make this more accessible. Having a support network can be extremely helpful. In addition to your primary care team, consider joining a support group (check your local LGBT center) and seeking out counseling or therapy.