Ask Your Family Doctor

Developed by the College of Family Physicians of Canada

What is HIV?

HIV (human immunodeficiency virus) is a virus from the retrovirus family. HIV attacks the body's immune system. A healthy immune system is what keeps you from getting sick. Once your immune system is damaged, you may develop infections or AIDs (acquired immune deficiency syndrome).

In advanced stages, people with AIDs can die from an infection or cancer.

How do people become exposed to HIV?

HIV can only be passed from person to person through body fluids, like blood, semen and vaginal fluid. The most common ways to be exposed to HIV virus are:

1. having unprotected anal, vaginal or oral sex with someone who has the virus.
2. sharing needles and syringes for injecting drugs like cocaine, heroin or steroids with someone who has the virus (or even using the same tattoo or piercing needles).

You're also at risk if you've had sex or shared needles with someone who has any of the risk factors for HIV infection listed in the box below. Children born to exposed mothers can also become infected during pregnancy, at birth or through breastfeeding.

Should I be tested for HIV?

You should think about getting tested for HIV infection if you think you're at risk or if you are pregnant. Most HIV antibody tests done by your doctor are accurate if you have them done three to six months or longer after you think you may have been infected. The blood test for HIV looks for antibodies to the virus. These antibodies are made by the body after HIV infection. So the test isn't accurate until the virus has been in the body long enough (about three to six months) for antibodies to be made.

Risk factor for HIV infection

	Have had sex with a person with known HIV infection or may be at risk for HIV.
	Those at risk of exposure.
	Newborn whose mother is known to be at risk for HIV infection.
	Have unprotected with multiple partners.
	Have a sexually transmitted disease (for example, gonorrhea, syphilis or herpes).
	Have had unprotected sex for drugs or money.
	Have shared needles to use drugs.
	Have had a blood transfusion or received blood products between 1977 and 1985.
	Born in a country where HIV infections are common.

When should I see my doctor?

Your doctor is concerned about you, your health and your privacy. If you believe that you have been exposed to HIV, you should see your doctor. He or she will help you decide if you should be tested and will give you the necessary personal support needed before and after the test. However, if you are afraid to talk with your doctor about HIV and are afraid to be tested even though you may be at risk of HIV, then going to an anonymous clinic may be a good idea. The most important thing is to be tested if you think you could have been infected. If your test is positive, you will need to see your doctor right away.

You should talk to your doctor and learn about ways to protect yourself from getting infected. If you have a positive test, this should likely be confirmed (double checked). There are now many treatments available to people who are HIV positive. People with HIV infections can lead normal lives with treatment.

What contact is safe?

HIV can't live very long outside the body, so you are not at risk of contracting HIV through casual contact. You will not be at risk for contracting the virus by touching, shaking hands, hugging, swimming in a public pool, giving blood, or using hot tubs, public toilets, telephones, doorknobs or water fountains. You are also not at risk for HIV infections from food, or mosquitoes or other insects.

How can I avoid getting an HIV infection?

The best ways to protect yourself from getting infected with HIV are to:

	Practice "safer" sex if you do have sex.
	Do not share needles and syringes.
	Ask potential sexual partners if they have an HIV infection or are at risk for such an infection.
	Always use condoms to protect yourself

You can't tell who's infected with HIV by how they look so even people who don't look or feel sick can be HIV positive, and not know it.

What is "safer" sex?

No sex is completely safe. The safest kind of sex is sex between two people who don't have HIV infection and don't use injectable drugs.
If you have any doubts about whether your partner is infected or whether he or she is having sex with anyone else at all, use latex condoms every time you have sex.

Never let someone else's blood, semen, urine, vaginal fluid or feces get into your anus, vagina or mouth. Latex condoms should be used during all sex acts, including anal, vaginal and oral sex. For oral sex on a woman, you can use a condom split lengthwise to place between her body and her partner's mouth. Condoms that have colour or flavour added to the latex are not as safe.

Even latex condoms aren't 100% effective. How well they work depends on using them correctly. Use only water-based lubricants (some examples are Gyne-Moistrin, K-Y Jelly, Replens) with condoms. Oil-based lubricants, such as petroleum jelly (an example is Vaseline), baby oil or lotions, cause the rubber in condoms to break.

How to use male latex condoms

	Use a latex condom. Condoms made from natural membranes, such as sheep gut, aren't as good because HIV is small enough to get through the tiny pores in these condoms.
	Put the condom on before any contact is made.
	Unroll the condom over an erect penis. The unrolled ring should be on the outside. Leave about a half-inch of space in the tip so semen can collect there. Squeeze the tip to get the air out. Unroll the condom to the base of the penis.
	After ejaculation ("coming"), withdraw the penis while it's still erect. Hold the condom against the base of the penis so it doesn't slip off. Wrap the condom in a tissue and throw it away. Don't reuse condoms.
	Condoms that have colour or flavour added to the latex are not as safe.

What if I share needles?

If you do share needles and syringes, clean them twice with bleach and water to help kill HIV. Draw bleach into the syringe and needle, then squirt it out. Do the same with water. Do both steps again. Ask your doctor if there is a needle exchange program in your area.

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Revised 2007 The College of Family Physicians of Canada

This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor. This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada: Dr Cathy MacLean, Halifax, NS (Scientific Editor) Dr C. Richard Fischer, Pickering, ON Dr Patrice Laplante, Fleurimont, QC Dr Richard Moffatt, Red Deer, AB Dr David Nunn, Kentville, NS Dr Cornelius Woelk, Winkler, MB The College of Family Physicians of Canada, one of the nation's largest medical groups, is committed to promoting and maintaining high standards for family physicians - the doctors who provide ongoing, comprehensive care for people of all ages. This patient education information was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians.

Support for this program has been provided by an educational grant to the Research and Education Foundation by Scotiabank.