0782749118 HIV is not transmitted by day-to-day activities or by contact with objects, food or clothes. The following list includes just a few examples of questions we get from people worried about catching HIV. Most of these questions come from a combination of fear and ignorance. They come from a lack of confidence in understanding HIV transmission. You can NOT catch HIV from:

0782749118 HIV is not transmitted by day-to-day activities or by contact with objects, food or clothes.

The following list includes just a few examples of questions we get from people worried about catching HIV.

Most of these questions come from a combination of fear and ignorance. They come from a lack of confidence in understanding HIV transmission.

You can NOT catch HIV from:

• Eating any food, cooked or uncooked, with blood on it.
• From a sterile needle at a clinic or other health center.
• From a human bite.
• From an insect bite including a mosquito bite.
• From an animal.
• From living in the same house as someone who is HIV positive.
• From a sewing needle if you stab your finger.
• From blood on a bus seat that went through your underwear.
• Cleaning nail clippers.
• Using a knife/fork/spoon/cup/plate that an HIV positive person may have used.
• Getting sexual fluid on skin.
• Getting sexual fluid on a cut that has already healed over. A cut has to be open to be a risk of HIV.

Effective barriers against HIV

There are many effective barriers that prevent infection.

Skin: Skin is an excellent barrier against HIV, unless there is an open cut or open wound. Infectious fluid on skin is NOT a route for infection.

Mucous membranes in the mouth, throat and stomach: These membranes are good barriers against HIV infection, so long as there are not cuts, ulcers or sores.

Saliva: Saliva contains proteins and a low salt content that actively reduce its infectiousness. Even when HIV is detected there is too little to cause infection. HIV is not transmitted by kissing including deep kissing. Spit cannot transmit HIV.

Air: HIV is not transmitted by air.

Latex and rubber: Condoms prevent infection from HIV and many other sexually transmitted infections.

Many sexual situations have no risk of transmitting HIV.

These include masturbation (by yourself or with a partner), kissing and deep kissing, receiving oral sex and vaginal or anal sex using a condom correctly. Call us on hot line +27782749118 Email drkevin@womensclinic.za.net / info@womensclinic.za.net https://pepandpreppills.blogspot.com

0782749118 Guide to HIV testings.i-Base.info4June 2016HIV in the UK [1] • More than 110,000 people in the UK are HIV positive. 90,000 are diagnosed and 20,000 do not know they have HIV.Over 80% of people who are diagnosed are on treatment which makes HIV difficult to transmit. • 1.5 million People take an HIV test each year. Half are in a sexual health setting and half in pregnancy screening. More than 99% of all results are negative.• Of the roughly 6,500 people who test positive each year (less than 0.5% of all tests), half are heterosexual and half are gay men. • Half of diagnoses are late: i.e. in people who are likely to have been HIV positive for many years. • Late diagnosis causes half of all HIV-related deaths. These could be prevented with earlier testing

0782749118 Guide to HIV testings.i-Base.info4June 2016HIV in the UK [1] •    More than 110,000 people in the UK are HIV positive. 90,000 are diagnosed and 20,000 do not know they have HIV.Over 80% of people who are diagnosed are on treatment which makes HIV difficult to transmit. •    1.5 million People take an HIV test each year. Half are in a sexual health setting and half in pregnancy screening. More than 99% of all results are negative.•    Of the roughly 6,500 people who test positive each year (less than 0.5% of all tests), half are heterosexual and half are gay men. •    Half of diagnoses are late: i.e. in people who are likely to have been HIV positive for many years. •    Late diagnosis causes half of all HIV-related deaths. These could be prevented with earlier testing

Monday to Wednesday 12 noon to 4pmPhoneline 0808 800 60135July 2016IntroductionThis booklet is about sexual transmission of HIV and HIV testing. It includes information on: • How HIV risk is more than just about condoms. • How and when different HIV tests can be used. • What test results mean, especially in relation to the time since your last potential risk. • The importance of making your own decisions about your sexual health. This guide is written for people who want to have sex.Condoms are excellent protection against HIV. But people still become HIV positive each year for complex reasons. The main reason condoms don’t always work is because they are not used every time. This booklet doesn’t talk about safer sex. Instead, it focuses on different risks for transmission that are more than just whether or not you use a condom. But sex is complicated. Even when being careful, some people will still become HIV positive. If this happens, there is little to gain from looking back. Treatment, when used correctly, is very effective. If you do find you are HIV positive, i-Base and other organizations can help. If you are positive it does not have to stop you leading a full, active and happy life. Changes to the third edition since the previous edition there have been major advances in relation to HIV prevention. Firstly, the PARTNER study has reported no linked HIV transmissions when viral load was undetectable. This was after couples had sex more than 58,000 without condoms. Secondly, PrEP is now established as a highly effective way to protect against HIV. PrEP is when an HIV negative person uses HIV drugs to prevent infection. When used correctly PrEP reduces the risk of transmission by more than 95%. These sections have been rewritten based on this latest evidence.

Guide to HIV testings.i-Base.info6July 2016HIV basics Fear of HIV testing HIV is not an easy virus to catch sexually. Compared to the numbers of people who have sex each year, only a tiny percentage of people will become HIV positive. The chance of not getting HIV is always much higher than getting HIV. This is the case even when one partner is HIV positive and the other is HIV negative. However, it also only takes one exposure for an infection to occur. An exposure is any situation where there would be a risk of transmission if one partner was HIV positive. Many new infections, perhaps most, come from people who do not know their HIV status. Someone who is very recently infected (within the last month or two) is likely to think they are still HIV negative. But this is the time when someone is also at their most infectious because in the first few months the amount of virus is at its highest. In nearly every country, 25-50% of HIV positive people have not been diagnosed. This percentage will only be reduced when HIV testing becomes a normal, routine part of health care. HIV, sex and risk this book is about sexual transmission of HIV.  Although most people know what is high or low risk there is less confidence about the middle ground in between these extremes. If one person has sex without a condom they are unlikely to become HIV positive. But if 10,000 people have sex without condoms, it is very likely that some will become HIV positive. Even if they all have exactly the same type of sexual risk. A low single risk can end up affecting a lot of people if the group is large. A lot of people have sex and the majority of times this doesn’t involve condoms. Understanding risk is also not always easy and is something that is not really taught in school. So we might worry most about things that are never likely to affect us, such as plane crashes and bird flu. On the one hand we convince ourselves that things we enjoy are low risk (“it will never happen to me”).On the other hand, some very low risk things are so scary that we can worry out of all proportion to the likelihood that it will happen (“I’m sure I am HIV positive”).This is how our brains work. No wonder HIV is so tricky to get your head around.

Monday to Wednesday 12 noon to 4pmPhoneline 0808 800 60137July 2016Which body fluids are infectious? The risk of HIV transmission is related to different factors. These include:•  Which body fluids are infectious.• How infection occurs - often called the ‘routes of infection’.• Other risk factors including viral load, type of sex, genetics etc. Only some bodily fluids have the potential to be infectious. These include: •    Sexual fluids (semen and vaginal fluid).• Mucus from the vagina and anus.•    Blood.• Breast milk is infectious to a baby but is unlikely to be infectious to an adult.•  Tears may be infectious but this is more a theoretical caution than a likely route of actual transmission. Saliva, spit, urine and faces are not infectious for HIV. What are the routes of infection? Common routes include: • Contact with the mucous membranes of genital or anal tissue. A mucous membrane is a type of tissue that is a less effective barrier than skin. The inner foreskin is also a mucous membrane. • Ulcers, sores, tears or tiny abrasions (i.e. that are too small to see) on genital tissue (to the vagina, penis or anal lining). • Any direct route into the bloodstream including cuts in your mouth. Sharing needles and injecting equipment has one of the highest risks of transmitting HIV. This is because there is a direct blood-to-blood route. The section on skin, mucous membranes and HIV transmission on pages 46 to 47 shows the different types of cell structure for skin and mucous membranes. These drawings show the different biology for penile, vaginal and anal sex. They show why some risks are higher than others and why anal sex has an especially high risk. They show why an uncircumcised man has higher risk for some activities compared to a circumcised man.

Guide to HIV testings.i-Base.info8July 2016Ways that HIV is not transmitted HIV is not transmitted by day-to-day activities or by contact with objects, food or clothes. The following list includes just a few examples of questions we get from people worried about catching HIV. Most of these questions come from a combination of fear and ignorance. They come from a lack of confidence in understanding HIV transmission. You can NOT catch HIV from:• Eating any food, cooked or uncooked, with blood on it.• From a sterile needle at a clinic or other health centre.• From a human bite.• From an insect bite including a mosquito bite.• From an animal.• From living in the same house as someone who is HIV positive.• From a sewing needle if you stab your finger.• From blood on a bus seat that went through your underwear.• Cleaning nail clippers.• Using a knife/fork/spoon/cup/plate that an HIV positive person may have used.•  Getting sexual fluid on skin.• Getting sexual fluid on a cut that has already healed over. A cut has to be open to be a risk of HIV. Effective barriers against HIV There are many effective barriers that prevent infection. Skin: Skin is an excellent barrier against HIV, unless there is an open cut or open wound. Infectious fluid on skin is NOT a route for infection. Mucous membranes in the mouth, throat and stomach: These membranes are good barriers against HIV infection, so long as there are not cuts, ulcers or sores. Saliva: Saliva contains proteins and a low salt content that actively reduce its infectiousness. Even when HIV is detected there is too little to cause infection. HIV is not transmitted by kissing including deep kissing. Spit cannot transmit HIV. Air: HIV is not transmitted by air. Latex and rubber: Condoms prevent infection from HIV and many other sexually transmitted infections. Many sexual situations have no risk of transmitting HIV. These include masturbation (by yourself or with a partner), kissing and deep kissing, receiving oral sex and vaginal or anal sex using a condom correctly. Call us on hot line +27782749118 Email drkevin@womensclinic.za.net / info@womensclinic.za.net https://pepandpreppills.blogspot.com

0782749118 How HIV risk is more than just about condoms. How and when different HIV tests can be used. What test results mean, especially in relation to the time since your last potential risk. The importance of making your own decisions about your sexual health PEP PILLS, PEPSE PILLS, PREPS PILLS, PEP PREVENTION PILLS

0782749118 How HIV risk is more than just about condoms.

    How and when different HIV tests can be used.

    What test results mean, especially in relation to the time since your last potential risk.

    The importance of making your own decisions about your sexual health.

This guide is written for people who want to have sex.

Condoms are excellent protection against HIV. But people still become HIV positive each year for complex reasons. The main reason condoms don’t always work is because they are not used every time.

This booklet doesn’t talk about safer sex. Instead, it focuses on different risks for transmission that are more than just whether or not you use a condom.

But sex is complicated. Even when being careful, some people will still become HIV positive.

If this happens, there is little to gain from looking back. Treatment, when used correctly, is very effective.

If you do find you are HIV positive, i-Base and other organisations can help.

If you are positive it does not have to stop you leading a full, active and happy life.

Changes to the third edition

Since the previous edition there have been major advances in relation to HIV prevention.

Firstly, the PARTNER study has reported no linked HIV transmissions when viral load was undetectable. This was after couples had sex more than 58,000 without condoms.

Secondly, PrEP is now established as a highly effective way to protect against HIV. PrEP is when an HIV negative person uses HIV drugs to prevent infection. When used correctly PrEP reduces the risk of transmission by more than 95%.

These sections have been rewritten based on this latest evidence. Call us on hot line +27782749118 Email drkevin@womensclinic.za.net / info@womensclinic.za.net https://pepandpreppills.blogspot.com

Preventing HIV by Taking One Pill Once a Day: Pre-exposure Prophylaxis (PrEP) 72HOURS PREVENTION PILLS, HIV AIDS PILLS, HIV PREVENTION, HIV PREVENTION PILLS, PEP TABLETS, PEP PILLS, PEPSE PILLS, PREP PILLS, PREP TABLETS, WOMENS CLINIC,

Unfortunately, PEP needs to be taken as soon after exposure as possible. This is preferably within hours rather than days. Most guidelines have a cut off for PEP of 48 hours after exposure.

Even though in the UK you can get PEP for up to 72 hours it is much less likely to work when it is used this late.

If, after testing and confirmation, you’re HIV negative, is PrEP available to you where you live?

What is PrEP?

PrEP stands for Pre Exposure Prophylaxis.

It is a way for an HIV negative person to use HIV drugs to protect against catching HIV.

PrEP uses two HIV drugs (tenofovir DF and FTC) in one pill. For highest levels of protection PrEP needs to be taken before and after sex.

Most PrEP studies – including the UK PROUD study – involved taking one pill every day, even when not having sex. In studies where people were good at not missing doses, there was close to 100% protection.

Other ways of using PrEP have also been studied, which only use PrEP when someone thinks they are likely to have sex. This is called event based dosing (EBD).

One of these studies, called IPERGAY, used a double-dose 24 to 2 hours before sex, with two post-sex single doses 24 and 48 hours after the first dose.

EBD only provides protection for anal sex whereas daily dosing works for both anal and vaginal sex.

PrEP was approved in the US in 2012 and was quickly included as a key recommendation in World Health Organization (WHO) guidelines. PrEP was only approved in Europe in July 2016.

NHS England decided to block access in June 2016. However, many people in the UK buy generic PrEP online. This is just as effective as the brand name drug but much cheaper. It is legal and safe to buy online meds.

PrEP is currently available on the NHS in Scotland, Wales and Northern Ireland. It is only available free in England by joining the PrEP Impact Study.

For more information see:

    How to access PrEP in the UK

    i-base Guide to PrEP

    IwantPrEPnow.org.uk

    prepster.info

    i-base Q&As on PrEP

What is PEP and PEPSE?

PEP stands for Post Exposure Prophylaxis.

This involves using a combination of three HIV drugs after sex if there has been a significant risk – and taking them for a month. The word PEPSE is sometimes used – it stands for PEP after Sexual Exposure.

PEP needs to be taken as soon after exposure as possible. This is preferably within hours rather than days. Most guidelines have a cut off for PEP of 48 hours after exposure.

Even though in the UK you can get PEP for up to 72 hours it is much less likely to work when it is used this late.

The longer the delay the less the chance that PEP will work.

Before getting PEP you will need to talk about your risk. This involves talking about the type of sex and whether you know the HIV status of your partner.

You also need to have a rapid HIV test which gives the result within 30 minutes. This test only tells you whether you were HIV positive three months ago. It tells you nothing about the recent risk.

You need an HIV test because if you are HIV positive without knowing it, a short-course of treatment could cause drug resistance.

You can get PEP at any accident and emergency (A&E) department of a hospital 24 hours a day. You can also access PEP from a GUM clinic during working hours.

After a course of PEP you need to wait 28 days before testing for HIV. This is because PEP can delay infection.

Can I use my partner’s meds as PEP?

Using someone else’s meds is not recommended. Some HIV drugs should never be used as PEP.

However, two HIV drugs have been studied for preventing HIV. These are tenofovir and FTC (in one pill called Truvada). A single dose of Truvada would provide more rapid cover while you get to a clinic and wait to be seen.

Several studies have shown that daily Truvada reduces the chance of HIV transmission when taken by HIV negative people. These studies also showed Truvada to be safe.

This would only be recommended as a single dose while you are waiting to get to HIV clinic for PEP.

However, if the HIV positive person is already on treatment and has an undetectable viral load, they will also be much less infectious. In these circumstances some guidelines think the risk is so low as to not recommend PEP.

HIV meds that must NOT be used as PEP include:

   Any type of NNRTI (nevirapine, efavirenz, etravirine or rilpivirine).

    Atripla or Eviplera (which both contain an NNRTI)

    Abacavir (or Kivexa or Trizivir that contain abacavir).

This is because these drugs have low risk very serious side effects, including hypersensitivity reactions and severe skin rash. With some NNRTIs the risk can be higher for someone with a stronger immune system that when they are used for treatment in someone who is HIV positive.

TasP

What is TasP?

TasP stands for Treatment as Prevention. (See Viral Load).

It refers to the impact of HIV treatment – when taken by an HIV positive person – on reducing the risk of transmitting HIV.

This is because treatment reduces HIV to levels that are too low to be infectious.

This was known in 2001 for heterosexual couples. In 2008, a group of Swiss doctors said that they believed this risk to be zero in a paper called the Swiss Statement. The doctors were sufficiently sure that they said it was safe to have a baby this way, if the man was positive and on treatment and the women was HIV negative.

In 2012, another heterosexual study called HPTN-052 showed treatment reduced the risk of HIV by 96%.

Then in 2014, the PARTNER study reported no linked HIV transmission in over 900 couples and after more than 44,000 times when people had sex without a condom. PARTNER included both gay and straight couples and included anal and vaginal sex. See page 16 for more details.

In the UK, every HIV positive person can access HIV treatment if they want to be less infectious to partners.

Call us on hot line +27782749118 Email drkevin@womensclinic.za.net / info@womensclinic.za.net https://pepandpreppills.blogspot.com