HIV prevention

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About HIV

What is HIV?

HIV stands for Human Immunodeficiency Virus. It is a virus that attacks and weakens the immune system. If it is left untreated, HIV causes so much damage to the immune system that the body is no longer able to defend itself from infections.

There are ways to prevent HIV infection, but, as with many health conditions and illnesses, the sooner after infection someone is diagnosed, the better their outlook. This is why we encourage people to get tested regularly.

Testing is simple, quick and easy and, of course, completely confidential.

What is AIDS (or Advanced HIV Disease)?

AIDS is a term that is now being used less and less. The term more frequently used nowadays is Advanced HIV Disease (AHD).

AIDS stands for Acquired Immune Deficiency Syndrome and is seen by the appearance of the opportunistic infections that are a result of untreated HIV infection. HIV is the virus that can lead to AIDS.

If you are diagnosed with HIV early, and respond well to treatment, you are far less likely to develop AHD (AIDS).

As treatment for HIV infection has become more and more effective, most people now living with HIV are on treatment and are able to live long and healthy lives and far fewer people in the UK are now given an AHD diagnosis.

How is HIV passed on during sex?

HIV is most likely to be passed on when someone who is has HIV (HIV-positive or HIV+) who is not on HIV treatment or medication has penetrative sex without using a condom with someone who does not have HIV (HIV-negative). This means that the person without HIV is exposed to the virus.

The cum, vaginal fluids or anal mucus of a HIV+ person (who is not on effective HIV treatment*) is more likely to have a high enough quantity of HIV (a high viral load) in it to infect the HIV-negative person.

*If someone who is HIV+ is on, and responds well to, HIV treatment, and has a fully suppressed viral load (often referred to as an undetectable viral load) and has no STIs, it means that they cannot pass on HIV to another person, even if they have unprotected sex. Use of condoms, however is an effective way to prevent HIV from being passed on.

What body fluids cause HIV to spread?

Only some body fluids contain a sufficient quantity of the virus to enable HIV infection to occur.

These body fluids are:

  • Blood and blood products
  • Cum and pre-cum
  • Discharge from STIs (such as gonorrhea)
  • Vaginal fluids
  • Anal mucus (a naturally occurring fluid that lines the inside of the arse)

You cannot become infected with HIV through exposure to urine (piss) or saliva (spit).

How can HIV infection be prevented?

  • Using condoms or femidoms for anal and vaginal sex is a very effective way to prevent HIV (and other STIs) from being passed on sexually.
  • Don’t share injecting equipment if you inject drugs.
  • Methods for reducing the likelihood of transmission if you are exposed to HIV include medical preventions, such as PEPSE and PrEP which can drastically reduce the likelihood of HIV infection in other circumstances.
  • TasP: Treatment as Prevention (TasP) is a HIV prevention intervention where treating a HIV+ person with antiretroviral medication reduces the risk of transmission of the virus to a HIV-negative partner. The primary purpose of antiretroviral treatment (ART) is to treat HIV in order to improve health and extend lifespan of  HIV+ people. TasP is a secondary benefit of ART as when adhered to correctly, ART reduces the amount of HIV to undetectable levels.
  • U=U: Undetectable equals Untransmittable: HIV and people living with a HIV diagnosis are often stigmatised or feared, and there are still many myths and misconceptions about HIV infection. The truth is that people living with HIV who have access to treatment or ART are able to live long healthy lives, and successful treatment means that the HIV virus can be controlled and suppressed to undetectable levels, meaning that they are unable to pass on HIV to sexual partners. This is now being referred to as U=U (Undetectable equals Untransmittable). People living with HIV who are being successfully treated with ART who have an undetectable viral load in their blood have a negligible risk of sexual transmission of HIV. It may take up to six months for the viral load of someone living with HIV to become undetectable (depending on type of medications used). It requires proper adherence to ART to stay that way.


BHIVA (British HIV Association) endorses this statement.
 View this here.

It is our hope that this knowledge will help to end stigma and discrimination towards people living with HIV.

NB: An undetectable HIV viral load only prevents HIV transmission to sexual partners. Condoms also help prevent HIV transmission as well as other STIs and pregnancy. The choice of HIV prevention method may be different depending upon a person’s sexual practices, circumstances and relationships. For instance, if someone is having sex with multiple partners or in a non-monogamous relationship, they might consider using condoms to prevent other STIs.

What symptoms might I get if infected with HIV?

Shortly after infection with HIV most people experience some symptoms, however some do not. This is known as seroconversion illness, or primary HIV infection. It usually occurs around two to six weeks after someone has been infected.

The most commonly experienced symptoms are often described as ‘flu-like’ and can include:

  • A sore throat
  • Fever
  • Body aches
  • A rash

Other common symptoms might include:

  • Mouth ulcers
  • Joint pain
  • Loss of appetite
  • Weight loss
  • Muscle pain
  • Feeling overly tired or sick

These symptoms are only linked to infection with HIV if you have put yourself at risk (such as sex without condoms) in the last six weeks. Because these symptoms are common to other illnesses, many people may not realise that they are a sign that they have become infected with HIV and may simply think that they are run down or have had the flu.

Where can I get a HIV test and what’s involved?

At Birmingham LGBT we offer rapid HIV testing which gives a result in just a few minutes.

Please call and speak to a member of the sexual health team for a test on 0121 643 0821.

A HIV test involves taking a small sample of blood which is then tested for the presence of HIV.

With our rapid HIV testing and self-sampling kits, this blood sample is taken from a simple finger prick. However, some clinics however may take the blood sample from a vein in your arm.

We are here to support you, not to judge you.

All of our services are free and confidential.

I’ve recently had unprotected sex with someone with HIV. What can I do?

If you’ve had unprotected sex with someone who may be HIV+, you can reduce your chances of HIV infection by taking post-exposure prophylaxis after sexual exposure (PEPSE) within 72 hours of exposure to the virus.

If you’ve had unprotected sex with someone who may be HIV+ within the last 72 hours, please visit Whittall Street Clinic or your nearest A&E department immediately.

Options for HIV testing

Rapid HIV Testing – With Instant Results

The whole process of rapid HIV testing is quick and simple and can be done in a few easy steps:

  1. We will take some brief details form you when you come in and give you some pre-test information about the test so that you can give your informed consent to be tested.
  2. We will perform the simple finger prick rapid HIV test and give you your results.
  3. We will give your some post-test information and offer you any further support or follow up which you may need.

The whole process usually takes 20 minutes.

Assisted STI Testing

This option is preferred by many.

Using postal STI testing kits, our sexual health staff can assist you to take the necessary samples (urine sample, swabs and finger prick blood sample) to test for:

  • HIV
  • Syphilis
  • Gonorrhoea
  • Chlamydia
  • Hepatitis B – in men who have sex with men’s kits

If you are unsure about or have difficulty using the home testing kits this is a great option. By being assisted with testing you may develop confidence to test yourself on future occasions.

This service is intended for those who do not have STI symptoms. If you have symptoms we recommend that you seek treatment. You can find details of clinics where you can get treatment on the www.umbrellahealth.co.uk website.

Self Sampling (Home Testing STI Test Kits)

Home STI Test kits

You can pick up a FREE STI testing kit from a pharmacy or clinic near you, to take your own samples at home if you prefer this option. (Skip back to the drop down menu to order a FREE STI testing kits)

About STI Self Sampling Kits

If you are aged 16 or over and living in Birmingham or Solihull, you can request a FREE sexually transmitted infection (STI) self-sampling kit. You can use the kit to take your own samples at home and then send them back to is for FREE.  We’ll test your samples and let you know the results by phone or text message for FREE.

Did we mention it’s FREE?

All kits allow testing for:

  • Chlamydia
  • Gonorrhoea
  • HIV
  • Syphilis
  • Hepatitis B is also included for men who have sex with men.

Order a Home Testing Kit

Order a home sampling kit for free here:

Nurse and Consultant led clinics

Nurse-led clinics

These clinics are suitable for people who have STI symptoms and need treatment.

These clinics are provided by our partner organisation – Umbrella Health and the nurses and consultants are NHS trained.

These clinics are all FREE OF CHARGE and Confidential.

These clinics are being held at Umbrella Health, Whittall Street, Birmingham B4 6DH while Birmingham LGBT moves to new premises. Please call 0121 237 5700 to make an appointment. If you attend without an appointment, you may have to wait to be seen.

Other Services

We can offer sexual health-related support sessions with our sexual health promotion team.

Confidential, Free and Professional sessions can be offered to you if there are any issues that you would like to discuss with one of the team. Issues may be related to your sexuality, gender identity, sexual health or health status, or something else.

Through these one to one sessions we can help you to explore your issues of concern further and may be able to refer you on to other services or activities which may be of benefit.

PrEP

What is PrEP?

The information on this page is about oral PrEP (the form of PrEP that comes as pills)

PrEP stands for Pre-Exposure Prophylaxis

PrEP is a medication which stops you getting HIV. Someone who is HIV negative can take PrEP as a pill to protect themself from HIV.

PrEP is extremely effective at stopping HIV when taken correctly

PrEP is available free on the NHS. It can be prescribed confidentially without your GP or others knowing.

How does PrEP work?

When PrEP is taken correctly by someone who is HIV-negative before sex or other exposure, it blocks HIV if it gets into your body, before it has chance to multiply and take hold.

Who can use PrEP?

PrEP is for people who are HIV-negative and want to protect themselves from HIV infection.

  • PrEP is safe to take for people taking gender-affirming hormones.
  • PrEP is safe to take for people taking the contraceptive pill.
  • PrEP is safe to use if you drink alcohol or take recreational drugs
  • PrEP can be used if you inject drugs

 

What do you need to do before you take PrEP?

  • Have a HIV test to confirm that you are HIV-negative.
  • Have a kidney function test (blood sample) to check the health of your kidneys
  • Both of these tests can be done at your regular sexual health clinic

 

How do I take my oral PrEP?

  • Daily: This is how most people prefer to take their oral PrEP and is the most straightforward way and gives you the protection all of the time when taken consistently.
  • On demand: Some people prefer to take their oral PrEP on demand – only around the time they plan to have sex.

It’s important to choose the way you take your oral PrEP that is best for you to ensure that it works properly. You can talk confidentially to our sexual health outreach team to be sure that the way you take your oral PrEP is right for you and your lifestyle.

Contact Birmingham LGBT’s sexual health team by phoning  0121 643 0821 or 07549 269194

If you are considering taking oral PrEP on demand, then this  guidance may help you to decide:

  • Oral PrEP taken around the time of planned sex means taking two tablets between 2 and 24 hours before sex, followed by one tablet a day for the following two days.  If sex is continued over a longer period of time, continue taking one tablet daily, until TWO days after the last time you had sex.
  • If risk is through receptive anal sex (bottoming), oral PrEP must be started with two tablets taken between 2 and 24 hours before having sex, and continued with one tablet  daily for TWO days after the last risk.
  • If risk is through insertive neo/vaginal or anal sex (topping), oral PrEP must be started with two tablets taken between 2 and 24 hours before risk, and continued with a single dose daily for TWO days after the last risk.
  • If the risk is through receptive neo/vaginal sex, oral PrEP must be started with two tablets taken between 2 and 24 hours before risk and continued with a single dose daily for SEVEN days after the last risk.
  • If the risk is through injecting drug use, oral PrEP must be started with two tablets taken between 2 and 24 hours before risk, and continued with a single tablet daily for SEVEN days after the last risk.

 

How safe is PrEP?

The drugs used in PrEP are the same drugs used by thousands of people living with HIV. They are very safe and have no serious side-effects. A small number of people may experience nausea, headaches or tiredness, which usually passes in between a week to a month.

What about other sexually transmitted infections (STIs)?

Research has shown that PrEP is highly effective at preventing HIV as long as it is taken as directed. Unlike condoms, PrEP will not protect you from other STIs.

 

Where do I get PrEP?

PrEP is available free on the NHS. Contact Birmingham LGBT’s sexual health outreach team for more information or our partners Umbrella Health www.umbrellahealth.co.uk

Some people also order their PrEP online. You can find more information about this at: www.IwantPrEPnow.co.uk 

PEPSE

What is PEPSE?

PEPSE (Post- Exposure Prophylaxis after Sexual Exposure) is a medication that can be taken up to 72 hours after exposure to HIV to stop you becoming infected.

If you’ve had sex without a condom, or if the condom broke during sex, you may be able to use PEPSE.

It is vital that this medication is given within 72 hours of the potential exposure to HIV as the medication is not effective after this time. The earlier PEPSE can be given the better.

If you’ve had condomless sex and you think you may have been exposed to HIV (if you are not on PrEP) within the last 72 hours, it’s important to get help straight away. Please don’t leave it until the 72 hours are up or nearly up.

What you need to know before starting PEPSE

  • PEPSE medication needs to be taken for one month after the initial dose to be effective
  • It can have unpleasant side effects (e.g. nausea and diarrhoea)
  • PEPSE medication is not 100% guaranteed to work
  • You will need to be monitored during the month when you take PEPSE and then for another three months afterwards

What happens if I need to have PEPSE?

  • If you’ve had condomless sex and you think you may have been exposed to HIV (if you are not on PrEP) within the last 72 hours, it’s important to get help straight away. Please go to Whittall Street Clinic (if it’s open) or your local A&E department straight away
  • The doctor you see will take some blood tests from you, to check for liver function, kidney function, blood count and may test for hepatitis B and syphilis
  • You will have a HIV test prior to starting treatment, as if you are already HIV+, giving PEPSE may reduce the types of HIV medication which could be used to treat you in the future
  • The doctor will explain how to take the medication and ask you to sign to say you are happy to take it
  • You will be asked to attend a further appointment to ensure you are not having any problems with the medication
  • Once you have finished the month’s course you will have an appointment for blood tests to check your kidney and liver function
  • After three months you will be asked to come back in for a final HIV test

PEPSE should never be thought of as a substitute for using condoms.

Where do I get PEPSE?

PEPSE must be prescribed by a qualified clinician.

  • PEPSE is available from Whittall Street Clinic during their opening hours. Call them on 0121 237 5700.
  • PEPSE is available at the nurse-led clinics at the Birmingham LGBT Centre on Wednesdays and Thursdays  from 9am-5pm. Call us on 0121 643 0821.
  • Outside of clinic hours, PEPSE can be obtained from hospital A&E departments. Find an A&E department here.

Umbrella Health PEPSE Leaflet

You can read Umbrella Health’s PEPSE Leaflet here.

HIV Support

Here to Support You – Not to Judge You.

Support for people living with or affected by HIV

Birmingham LGBT Wellbeing Service

Bacterial vaginosis (BV) is a common condition in which the balance of bacteria inside the vagina becomes disrupted.

Chlamydia is a Sexually Transmitted Infection (STI) caused by bacteria. It is the most common sexually transmitted infection in the UK.

Genital Warts (sometimes called anogenital warts) are a curable sexually transmitted infection (STI) caused by human papillomaviruses or HPVs.

Gonorrhoea is a Sexually Transmitted Infection (STI) caused by bacteria. It is the second most common bacterial sexually transmitted infection in the UK.

Hepatitis A is a viral infection which affects the liver. It can be passed on in various ways including sexually from some sex acts.

Hepatitis B is an infection of the liver and is caused by the hepatitis B virus which can be passed on sexually.

Hepatitis C is a viral infection affecting the liver. It has usually been associated with injecting drug use but we now know that it can be passed on sexually, particularly with certain sex practices.

Genital herpes is a common infection caused by the herpes simplex virus (HSV). It can cause painful blisters on the genitals and the surrounding areas.

Lymphogranuloma venereum, or LGV, is a curable sexually transmitted infection (STI) caused by a bacterium (a type of germ) from the chlamydia family.

NGU is inflammation of the male urethra (water pipe) which can occur due to various causes hence the condition sometimes being called Non-Gonococcal Urethritis (NGU).

PID is the name given to inflammation of female reproductive organs: the womb (or uterus) fallopian tubes, ovaries and surrounding tissues.

Pubic lice are tiny parasitic insects that live on coarse human body hair, such as pubic hair.

Scabies is a common and very itchy skin condition caused by a tiny mite called Sarcoptes Scabiei.

Shigella is an infectious bacterial infection. It is often a cause of food poisoning but can easily be passed on during sex.

Syphilis is a sexually transmitted infection (STI) caused by a bacteria.

TV is a curable sexually transmitted infection (STI) caused by a protozoon called Trichomonas vaginalis, or ‘TV’. Protozoa are tiny germs similar to bacteria.

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