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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. Just walk-in Monday to Saturday (no appointment needed) or contact the sexual health team on 0121 643 0821 and book a test.
  2. 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.
  3. We will perform the simple finger prick rapid HIV test and give you your results.
  4. 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.

Just walk-in Monday to Saturday (no appointment needed) or contact the sexual health team on 0121 643 0821 and book a test.

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 the LGBT centre or 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

We provide a variety of weekly or monthly nurse or consultant led sexual health clinics from the Birmingham LGBT Centre.

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

Our current nurse or consultant led clinics are:

  • LGBT sexual health clinic every Wednesday and Thursday 9am to 5pm.

For more info on ‘Our Clinics’ click here.

Or call us on 0121 643 0821

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.

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?

PrEP stands for Pre-Exposure Prophylaxis.

PrEP is a way for people who don’t have HIV, but who are at high risk of getting it, to prevent HIV infection. This is by taking a pill containing two medicines that are also used to treat HIV at periods of high risk. If you take PrEP and are exposed to HIV through sex, these medicines can work to keep the virus from taking hold in your body.

PrEP can be combined with condoms and other prevention methods to provide even greater protection than when used alone.

There are two proven ways of using PrEP when the risk is from anal sex.  One is to take it all the time during periods of risk (the PROUD study)  and the other (the IPERGAY study) is to take a double dose 2-24 hours before you know you are going to have risky sex and then daily until 48 hours after you stop having risky sex. Both methods have been proven to work, but there is more research to support the PROUD method of daily use. For vaginal sex only, this daily method has been proven to work.  People who use PrEP must be HIV-negative and must commit to taking the drugs properly. They need regular HIV and STI testing, regular checks that the drugs have no serious side effects and regular blood and urine tests to make sure that the drugs are not affecting your kidneys.  This is because if PrEP is used after HIV infection, it can make treatment more complicated.

Who can use PrEP?

PrEP is not suitable for everyone. The aim of PrEP is for it to be used for people who are HIV-negative and at high risk of HIV infection. This may include anyone who is in an ongoing relationship with an untreated HIV+ partner, as well as for people who are having risky unprotected sex who find it difficult to consistently use condoms as a prevention method.

People who inject drugs or have shared needles might also consider using PrEP. For example, if you engage in chemsex, PrEP will not protect you against hepatitis C and it is unclear how effective it is for preventing HIV infection from injecting.

If you have a partner who is HIV+ and you are considering getting pregnant, talk to your GP about PrEP. It may be an option to protect you and your baby.

PrEP involves taking medication regularly during periods of high risk and regular visits to a GP or other clinic for urine and electrolyte tests to monitor your kidney health, plus regular HIV screening tests.

PrEP should only be used for people who are at ongoing substantial risk of HIV infection. For people who need to prevent HIV after a single high-risk event of potential HIV exposure—such as sex without a condom, needle-sharing injecting drug use, or sexual assault—there is another option called Post-Exposure Prophylaxis after Sexual Exposure, or PEPSE, where treatment must begin within 72 hours of exposure. You can read more about PEPSE here.

It’s also important to remember that taking PrEP will not prevent you from getting other STIs, such as syphilis, gonorrhoea, hepatitis C and chlamydia, nor from becoming pregnant.

How well does PrEP work?

In the recent PROUD and IPERGAY studies, PrEP has been shown to significantly reduce the risk of HIV infection in people who are at high risk from anal sex by as much as 86%, overall.  It is thought that the infections that did occur were in people who did not take their medication properly.  There has been a report of someone on PrEP who became infected by someone with an antiviral-resistant virus.

PrEP is much less effective if it is not taken properly  PrEP can be even more effective if it is combined with other ways to prevent HIV infection, such as condoms, drug treatment, and adherence to treatment for people living with HIV to further reduce the chance of HIV being passed on.

Read more about PrEP and the PROUD and IPERGAY studies here:

http://www.aidsmap.com/PrEP/cat/1623/

http://www.aidsmap.com/Pre-exposure-prophylaxis-also-stops-86-of-HIV-infections-in-Ipergay-study/page/2947854/

http://i-base.info/qa-on-prep-in-the-uk-and-changes-to-the-hiv-proud-study/

http://www.proud.mrc.ac.uk

Does PrEP have side effects?

Some people in clinical studies of PrEP had early side effects such as an upset stomach or loss of appetite and headache, but these are usually mild and go away within the first month. Some people had some kidney disturbance, but this did not lead to serious long-term kidney problems.

The medication used in PrEP has been used to treat people living with HIV for many years and has been shown to be at low risk of serious side effects. However, if  you experience side effects of using PrEP, you should discuss this with the GP or clinic where you have your regular checkups.  Ideally, you have a kidney function blood test and a urine test before you start and may need to repeat them if you remain on PrEP.

PrEP on the NHS (in Birmingham and Solihull)

From 5 October 2020, PrEP is available on the NHS in Birmingham and Solihull via Umbrella Health.  Please note that this is with tenofovir disoproxil fumarate, and not the newer tenofovir alfenamide.

If you would like access PrEP on the NHS, please call Umbrella Health on 0121 237 5700. You may then be booked into a telephone clinic initially. You will need sexual health tests, and in particular a negative HIV test before you start PrEP.

If you have any other queries, please call Birmingham LGBT on 0121 643 0821 and ask to speak to a member of the sexual health team.

Can’t get PrEP on the NHS right now? Where can I get PrEP in the UK?

PrEP is now available on the NHS in the UK. Some people still choose, for various reasons, to purchase PrEP online.

NB: The NHS will only supply tenofovir disoproxil fumarate and not tenofovir alfenamide. 

There are always risks in buying anything online, but we have included the following links for you to obtain more information if you are considering buying or acquiring PrEP:

Can I get PrEP privately in the UK?:

http://i-base.info/qa/10696

Where can I buy PrEP online and is it legal in the UK?:

http://i-base.info/qa/10734

https://www.iwantprepnow.co.uk/ 

How can I check that PrEP I buy from the internet is genuine?: http://i-base.info/qa/10695

How do I safely use PrEP if I buy it online?:

http://i-base.info/qa/10528

Recommended reading if considering buying PrEP online: www.iwantprepnow.co.uk and http://prepster.info/

What is the medication used in PrEP?

The pill used by people using PrEP for daily use who are at  high risk of getting HIV infection is called Truvada®.

Truvada® is a combination of two HIV medications (tenofovir and emtricitabine). In other parts of the world it is available as a cheaper generic (non patented) product.  Most commonly this is from an Indian company called Cipla.  These medicines work by blocking important pathways that HIV uses to set up an infection. If you take PrEP daily, the presence of the medicine in your bloodstream can stop HIV from taking hold and infecting you with the virus.

Dosage is very important: If you do not take PrEP properly there may not be enough medicine in your bloodstream to block the HIV virus. If you become infected with HIV, the virus may then have some resistance to Truvada and may affect your later treatment.

Read more about PrEP and the PROUD and IPERGAY studies here:

http://www.aidsmap.com/PrEP/cat/1623/

http://i-base.info/qa-on-prep-in-the-uk-and-changes-to-the-hiv-proud-study/

http://www.proud.mrc.ac.uk

http://www.ipergaymtl.com/en/about-us.html

http://www.aidsmap.com/Pre-exposure-prophylaxis-also-stops-86-of-HIV-infections-in-Ipergay-study/page/2947854/

PrEP Clinics

Pleas see the ‘Our Clinics’ page or click here

PrEP information videos

Informational videos by iwantprepnow.co.uk click here

PrEP 4 Trans (Trans Men) information video here.

PrEP 4 Trans (Trans Women) information video here.

Umbrella Health PrEP information leaflet & website

To read the Umbrella Health ‘Pre-Exposure Prophylaxis (PrEP)’ leaflet click here.

To be directed to Umbrella Health’s PrEP website information click here.

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

Peer Mentor Support: Our trained volunteer peer mentors are able to offer informal peer support with a range of issues to support you in making choices to support your well-being.

Swanswell (for those living with HIV residing in Birmingham): facebook.com/swanswelluk

Positive West Midlands (PWM): Positive West Midlands is a support group for people living with HIV & their supporters. Providing social support and sign-posting to other agencies. https://www.facebook.com/positivewestmidlands/

Useful Information

If you have any enquiries, questions, or if we can help in any way, we’d love to hear from you 

  • 0121 643 0821
  • hello@blgbt.org

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