What are HIV and AIDS?
AIDS stands for Acquired Immune Deficiency Syndrome and is a group of health problems caused by a virus called HIV, the Human Immunodeficiency Virus. HIV is transmitted from person to person via exchange of bodily fluids - semen, blood, and vaginal fluids - during anal, vaginal, and possibly oral sex, or when sharing needles during intravenous drug use.

People who test positive for HIV do not necessarily have AIDS. Many people are HIV+ but don't show symptoms of illness for years, if at all. People who do get AIDS can get very ill and die from infectious diseases and cancers that usually don't cause problems for other people. There is currently no cure for AIDS.

How many people have it?
As of December 2003, there were a total of 29,056 people with AIDS in San Francisco. San Francisco ranks third nationwide in the number of cases of AIDS in major metropolitan cities. The people who have AIDS in San Francisco overwhelmingly are white men who have sex with other men, including men who also use intravenous drugs.

From 1999 to 2003, AIDS incidence has leveled off in San Francisco. In contrast, rectal gonorrhea and syphilis rates have increased among men who have sex with men. These rises are paralleled by an overall increase in unprotected anal sex.

Why worry about HIV/AIDS?
People with HIV show signs of AIDS when their immune system is seriously damaged. People with AIDS can suffer from what are called opportunistic infections, such as Kaposi's sarcoma (a skin cancer), PCP (a lung infection), CMV (a virus that infects the eyes), and candida (a fungal infection). AIDS-related diseases also include severe weight loss, brain tumors, and a myriad of other health problems.

AIDS shows up differently in every infected person. Some people die soon after getting infected, while others live fairly normal lives for many years after they are diagnosed with AIDS.

There are now treatments available that can slow down the replication of HIV in your body, along with any immune system damage. The treatment is called anti-retroviral therapy. However, there is currently no cure for AIDS.

What are the symptoms?
You might not know if you are infected with HIV. Some people get flu-like symptoms such as fever, headache, sore muscles and joints, stomach ache, swollen lymph glands, or a skin rash four to six weeks after exposure to the virus. Most people have no symptoms at all.

What is an HIV test like?
If you get infected with HIV, your body tries to fight the infection. It makes antibodies, special molecules that are supposed to fight HIV. The most common HIV test is a blood test which looks for these antibodies. If you have them in your blood, it means that you are HIV positive.

If you become infected with HIV, it usually takes between three weeks and two to three months for your immune system to produce antibodies to HIV. If you think you were exposed to HIV, you should get tested. During your visit, speak to your doctor about the possibility of taking post-exposure prophylaxis or PEP.

Newer tests can detect HIV antibodies in saliva, a scraping from inside the cheek, or urine. A rapid HIV test was approved by the FDA in November 2002. Rapid test results are available within a half an hour after a blood sample is taken. The home test kits on the market are designed to help you collect your own blood sample. The sample is then sent to a lab where it is tested for HIV.

Clinics and medical providers will offer either confidential or anonymous HIV testing services. Confidential antibody testing means that you and the health care provider know your results, which may be recorded in your medical file. The health care provider and any other staff in the clinic or office are bound by confidentiality not to disclose the results of your test to anyone without your permission. City Clinic provides free confidential HIV testing to people considered by clinicians to be at high-risk for HIV.

Anonymous testing means that your name is  never associated with your test results. As of April 17, 2006, current California law requires all positive HIV tests to be reported to the local health department using a name-based method, unless you test at an anonymous site. City Clinic is a confidential testing site. When you test at a confidential site, or with a medical provider, your name and social security number will be sent to the health department. Anonymous sites do not have to report new cases of HIV. If you would like to test at an anonymous setting, your counselor or clinician can provide you with a list of anonymous testing sites in San Francisco. Currently, a person who gets either type of HIV test is asked to participate in pre- and post-test counseling.

When you come to City Clinic, you will have an opportunity to talk to your clinician and/or HIV test counselor about the benefits and risks of HIV testing, and choose the type of test that will best meet your needs.

How is HIV/AIDS treated?
As mentioned earlier, there is no cure for AIDS. There are anti-retroviral drugs now available that can slow down the virus, and slow down the damage to your immune system. These drugs have also helped reduce the overall rates of opportunistic infections in people with AIDS. The drug regime is severe however - many expensive pills have to be taken regularly on a daily basis - and there can be side effects when the pills are taken for a long period of time. Many people who are able to, though, choose to go on anti-retroviral therapy once they are diagnosed HIV+ to stem any potential illness and keep their quality of life high as long as possible. For more detailed and current information about treatment, visit www.hivinsite.org.

What can I do if I have HIV/AIDS?
The best thing you can do is to stay healthy -- keep your stress levels low, eat well, exercise regularly, get lots of rest, and if you're sexually active, have protected sex with your partners. You also need to work closely with a medical provider to monitor your health and determine the best course of continued treatment over time. There are resources available to help HIV+ people in the U.S. get treatment and regular medical services, sometimes at low-cost or reduced fees.

In order to avoid transmission of the virus to your sex partners, as well as to protect yourself from getting other bacterial and viral STDs, we advise discussing your HIV status with a prospective partner before having sex. Communication is one of the keys to keeping our community sexually healthy.

How do I avoid getting HIV/AIDS?
The only way to be 100% sure you won't get HIV/AIDS is to abstain from sex and intravenous drug use. If you're sexually active, using condoms correctly each and every time you have anal or vaginal sex provides the best protection against HIV transmission. While there is not enough scientific evidence available yet to be certain, there are many individuals who also state that they have gotten HIV from participating in oral sex (as givers to infected men). It is advisable to consider using condoms for oral sex as well, especially because other STDs like syphilis and gonorrhea, which can increase your risk of getting HIV, can be transmitted via oral sex.