Last week, I started the story of the pregnant woman who tested positive to HIV while her husband was negative. The question remains “did the woman cheat or not?” There are different sides to this story since the woman claims she didn’t have the virus before marriage.
First, let’s talk about different ways one can get the HIV virus;
Sexual intercourse: This is the most frequent mode of transmission of HIV world wide. Unprotected sexual intercourse (anal or vaginal) with someone infected with HIV and not taking medicines to prevent transmission of HIV exposes one to HIV infection. When a person has other STDs, especially the kinds that cause ulcers, the areas of the body exposed to HIV infection is increased and in turn increases the chances of getting infected with HIV.
Blood transfusion: Transfusion of blood, blood products, and organ/tissue transplant contaminated with HIV used to be one of the most common means of HIV transmission. The risk is now extremely reduced because of rigorous testing of blood products and donated organs/tissues.
Injecting equipments: Sharing needles, syringes, or skin-piercing equipments, contaminated with HIV can expose non-infected individuals to the virus. HIV survival on a used needle can be up to 42 days depending on various factors (e.g. Temperature).
Mother to infant transmission: This can occur during pregnancy, delivery, or as a result of breast feeding. The risk is high for mothers living with HIV and not taking recommended medications. WHO recommends that all pregnant women be tested for HIV and immediate treatment should be commenced for the infected mothers in order to lower the prevalence of babies born with HIV.
Health care setting: Infection might result from splash from contaminated body fluids or being accidentally stuck with an HIV-contaminated needle or other sharp objects. Any contact between broken skin, wounds, or mucous membranes and HIV-infected blood or contaminated body fluids may lead to infection.
Oral sex: This involves putting the mouth on the vagina, penis, or anus. Although, transmission of HIV through oral sex is extremely rare, it is theoretically possible if an HIV-positive man ejaculates in his partner’s mouth during oral sex.
Pre-chewed food: Food that has been pre-chewed by a person with HIV gets contaminated when infected blood from the mouth mixes with food while chewing. The only known cases are among infants.
Human Bite: Being bitten by a person with HIV poses a risk of infection when there is severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken.
Deep, open-mouth kissing: During deep kissing, there is risk of infection if both partners have sores or bleeding gums and blood from the HIV-positive partner gets into the bloodstream of the HIV-negative partner. HIV is not spread through saliva
HIV can NOT be transmitted by:
• Coughing or sneezing
• Hand shakes
• Kissing
• Water or food
• Touching or hugging
• Public baths
• Insect bites
• Sharing cups, plates and other utensils
• Swimming pools
Relationship between HIV virus window period and immunity
When a person contracts HIV, the body’s defence system gets to work. The body produces antibodies against the HIV antigens. This period is called seroconversion (defined as a period when a recently infected person first tests positive to HIV) and can be between 6 weeks to 3 months and unusually, up to 6months. It varies across individuals because people make antibodies at different rates based on their immune system. Everyone’s immune system is different. This makes it difficult to predict how long each of the stages last.
Before seroconversion, the level of HIV antibodies in the blood is not detectable by tests and this can lead to a false negative result. The timeframe between HIV contraction and when tests can detect the infection (seroconversion) is known as the “window period.” During this window period, an individual is highly infectious but infection cannot be detected by testing. Although tests have become more accurate recently, none of them can still detect an HIV infection immediately after it’s contracted. In the case of the most sensitive anti-HIV tests currently recommended, the window period is about three weeks.
Back to the story…
After disclosing the news to the man, the PMTCT (Prevention of Mother to Child Transmission) nurses counselled him and his wife. The man looked calm but kept asking lots of questions which the nurses patiently listened and tried to answer as much as possible. He was let in on the probability that he might have transmitted the virus to his wife, but his probably hasn’t shown on testing yet because he might have a stronger immunity (different seroconversion times) than his pregnant wife. However, there’s still the possibility that the woman might have cheated, or gotten it through other sources. He was told to come back after three months for another HIV test. His wife was referred to the HIV clinic for subsequent follow up and management.
Stay safe!
Maureen.
Medtrix 