What is HIV?

HIV stands for the Human Immunodeficiency Virus and is a 'Retrovirus'. Retroviruses consist of Ribonucleic Acid (RNA) and were discovered by Robert Gallo in 1978. They contain a special viral enzyme called Reverse Transcriptase, which allows the virus to convert its RNA to DNA and then integrate, and take over, a cell's own genetic material. Once taken over, the new cell - now HIV infected - begins to produce new HIV retroviruses. HIV replicates in and kills the helper T cells, which are the body’s main defense against illness.

HIV is ONLY spread through:

• Sexual contact - unprotected vaginal or anal sex. Only condoms provide 'all-in-one' protection from pregnancy and sexually transmitted infections including HIV.
• Direct innoculation of the virus - for example infection through contaminated needles
• Contaminated blood products / transplanted organs. In the US all donated blood has been tested for HIV since 1985
• An infected mother may sometimes pass the virus to her developing fetus during the birth or breast milk

In the first month to three months after a person is initially infected with the HIV virus is when that person is most infectious (i.e. meaning the amount of virus in their system is at its highest and T-cell counts are at their lowest). During the time, the body has not had time to react to the virus and produce an adequate immune response to start suppressing HIV.

More and more HIV viruses are produced and then released by a process known as budding. This means that when someone becomes infected with the HIV virus it begins to attack their immune system. This process is not visible and a person who is infected can look and feel perfectly well for many years and they may not know that they are infected. As their immune system weakens they become more vulnerable to illnesses that their immune system would normally have fought off. As time goes by they are likely to become ill more often and develop AIDS.

What is AIDS?

AIDS stands for acquired immunodeficiency syndrome. When HIV infection becomes advanced it often is referred to as AIDS. It generally occurs when the CD4 count is below 200/mL and is characterized by the appearance of opportunistic infections. These are infections that take advantage of a weakened immune system and include:

• Pneumocystis carinii pneumonia
• Toxoplasmosis
• Tuberculosis
• Extreme weight loss and wasting; exacerbated by diarrhea which can be experienced in up to 90% of HIV patients worldwide
• Meningitis and other brain infections
• Fungal infections
• Syphilis
• Malignancies such as lymphoma, cervical cancer, and
• Kaposi's Sarcoma

Today we know that Acquired Immune Deficiency Syndrome (AIDS) is a disease and not a syndrome. A syndrome is commonly used to refer to collections of symptoms that do not have an easily identifiable cause. This name was more appropriate 13 years ago, when doctors were only aware of the late stages of the disease and did not fully understand its mechanisms. A more current name for the condition, regardless of an AIDS diagnosis, is HIV Disease. This name is more accurate because it refers to the pathogen that causes AIDS and encompasses all the condition’s stages, from infection to the deterioration of the immune system and the onset of opportunistic diseases. However, AIDS is still the name that most people use to refer to the immune deficiency caused by HIV.

• Acquired — because it is a condition that has to be contracted. It cannot be inherited or transmitted through the genes.
• Immune — because it affects the body’s immune system, the part of the body that fights off diseases.
• Deficiency — because it makes the immune system stop working properly.
• Syndrome — because people with AIDS experience a number of different symptoms and opportunistic diseases.

What STDs can I get?

There are many different types of STD’s a gay man can get from having sex. The following is a listing of the major STD’s and how they can be transmitted:

• Chlamydia - Chlamydia is a sexually transmitted disease (STD) caused by a bacteria called Chlamydia trachomatis. It can spread from person to person during sexual intercourse (vaginal and anal) when a person's mucous membranes come into contact with the vaginal secretions or semen of an infected person. It can be transmitted without complete insertion of a penis into the vagina or anus. It is less likely, although possible, to be transmitted to the throat during oral sex. It can also be passed from mother to newborn during childbirth. Chlamydia infections are treatable and curable with antibiotics.
• Gonorrhea - Gonorrhea is a sexually transmitted disease (STD) caused by a type of bacteria called Neisseria gonorrhoea. Gonorrhea can be transmitted to both male and female partners during vaginal, anal and oral sex from a partner infected in his or her throat, vagina, urethra or anus. Gonorrheal infections are completely curable with antibiotics.
• Hepatitis - Hepatitis is the name for inflammation of the liver caused by several different viruses. The viruses are classified by letters of the alphabet -- with types A, B, and C being the most common. Each of these viruses can be transmitted in a number of ways, some sexually. Hepatitis B and C viruses can cause inflammation of the liver, liver failure, liver cancer, and death. Hepatitis B is the most common cause of liver cancer in the world. Chronic Hepatitis C (HCV) is the leading cause for liver transplants.
• Herpes - Herpes is a sexually transmitted disease caused by the herpes simplex virus (HSV) and transmitted via direct skin-to-skin contact during oral, anal and vaginal sex. HSV I usually causes fever blisters and cold sores on the mouth, but can also cause sores on the genitals. HSV II usually causes sores on the genitals (vagina, penis, anus) and the skin around those areas. The majority of oral herpes cases are caused by HSV I and the majority of genital herpes cases are caused by HSV II; however, since so many people are now having oral sex, type-I is often appearing in the genitals. HSV is different from other common viral infections because once it is introduced into your system, it lives there forever, often with periodic symptoms or without symptoms at all.
• HPV - HPV is the virus that causes genital and anal warts, also sometimes called condyloma. The virus may cause wart-like bumps to form on the penis, in and around the vagina, on the cervix (opening to the uterus), and/or around the rectum. The virus is passed via skin-to-skin contact from one person to another during anal or vaginal sex. Warts caused by HPV are not the same warts commonly found on hands and feet, and one type of wart can not be passed from one body part (hands and feet) to another (genital area).
• Syphilis - Syphilis is a sexually transmitted disease (STD) caused by a type of bacteria called T. Pallidum. It can spread from person to person by physical contact during vaginal, anal, or oral sex. Syphilis infections are treatable and curable with antibiotics.
• Crabs and Scabies - Crabs are very small bugs that attach themselves to pubic hair and bite the surrounding skin. Scabies are mites (bugs) that dig under the skin where they lay their eggs, often in the genital area. Both cause extreme itching in men and women. Both are usually passed from one person to another during sex, but can also be transmitted by having contact with clothes, bedding, and towels that have been used by an infected person. There are both over-the-counter and prescription creams available to get rid of crabs and scabies. Use as directed by your medical provider. You must also wash your clothing, bedding, and towels in hot water to avoid re-infection.
• Molluscum Contagiosum - Molluscum or m. contagiosum is a skin affliction caused by a virus that can be passed from one person to another during sex or, more commonly, other close skin-to-skin contact. It is also possible for molluscum to be passed by sharing towels. It's commonly found in people that exercise in gyms and people who ride bicycles frequently. Symptoms include several smooth, firm, rounded bumps with a dip in the center that appear on the thighs, sex organs, buttocks, below the waist, and/or in the pubic hair. The bumps may be tan, yellow, grey or pink. Molluscum will go away on its own without any treatment or complications, but if you choose, the bumps can be frozen off by a medical provider with liquid nitrogen.
• Shigella - This is a bacterial infection that causes serious stomach cramps and diarrhea. Shigella can easily be spread from one person to another through rimming (oral-anal contact) and from oral contact with contaminated skin including skin in the groin area, the testicles and the penis. Shigella can also be spread via fecally contaminated food and water. People with HIV are more likely to have serious complications from Shigella infections.. Shigella can be treated with antibiotics. Very thorough washing of your genitals and hands before and after sex can help prevent shigella and other infections, as well as using a barrier (cut-up condoms, dental dams, or household plastic wrap) for oral-anal sexual activities.
• Non-Gonoccochal Urethritis (NGU) - Also called non-specific urethritis, this is an infection in the male urethra caused by bacteria such as chlamydia, mycoplasma, ureaplasma or trichomoniasis. NGU is passed from one person to another during anal, vaginal and possibly oral sex. Symptoms may include a mild discharge from the head of the penis that goes away after a few days and pain or burning upon urination. Antibiotics are used to cure NGU.
• Trichomoniasis - Also known as trich, this is an infection caused by a protozoa that is passed from person to person during vaginal sex. Women have more symptoms than men, in fact most men have no symptoms. A prescription drug called metronidazole will cure trichomoniasis.