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HIV and AIDS

What is Human Immunodeficiency Virus (HIV)

Human Immunodeficiency Virus (HIV) is a virus that targets the body’s immune system. It is passed through blood and body fluids such as semen, pre-ejaculate, vaginal fluids, anal fluids, and breast/chest milk. HIV can be managed with antiviral medications.

Causes

HIV is passed through vaginal and anal sexual contact.  This includes both penetrative sex and sexual activities where there is an exchange of body fluids.  There is a very low chance that HIV may be passed through oral sex or when using sex toys.

HIV can also be passed through sharing drug equipment, such as needles.

HIV does not live for long outside the body. It cannot be spread by casual contact such as kissing or sharing drinking glasses with someone who has HIV.

If you have HIV, you can pass it to others even if you don’t have symptoms.

Symptoms

It is common to not notice any symptoms or to mistake HIV symptoms for a different illness.  If you do get early symptoms, they will most likely show up between 2 to 4 weeks after sexual contact. Common early symptoms of HIV infection are called seroconversion illness. These symptoms include:

  • fever
  • sore throat
  • headache
  • muscle aches and joint pain
  • swollen glands

Tests and Diagnosis

HIV testing is done with a blood sample.  Tests either look for antibodies or a small amount of the virus itself. HIV antibodies are made by the immune system to fight the virus.

There are options for how to test for HIV, including:

  • A blood sample is taken from the arm and is sent to a laboratory for testing.
  • A drop of blood is taken from the finger and results are available in a few minutes. This is called the point of care (POC) test or rapid test.  This test has a longer window period, meaning it takes longer before the results are accurate. POC testing is usually used as a screening test, so a blood sample will also need to be drawn.

Everyone should be tested for HIV at least once in their life.  Talk to your health care provider about how often you should test.  In general, it is best to get tested for HIV if you:

  • have symptoms
  • have a sexual partner who has tested positive for HIV
  • have shared drug equipment such as needles
  • are doing routine screening for STIs
  • are pregnant

In British Columbia, you can test for HIV without using your real name.  Contact your local clinic to see what options they offer.  A limited number of clinics in BC offer anonymous HIV testing.

Window Period (how long to wait before testing): There are different types of tests for HIV.  Depending on the type of test used, most test results are accurate 3 weeks after you come in contact with HIV, but it can take up to 3 months. In British Columbia, most test results should be ready in 10 days.

Find a clinic

Treatment

HIV is managed with prescription viral suppression medications called Highly Active Antiretroviral Therapy (HAART).  Taking medication has become much easier over the past few years. New treatments include two or three medicines combined in one pill. Many people living with HIV are treated with just one or two pills a day.

Sexual Partners

If you have been diagnosed with HIV, your sexual partners should be tested.  The chance of passing HIV to partners depends upon many factors, such as the level of HIV that a person has in their body (HIV viral load), the type of exposure, and whether a condom was used.

There are a few ways to tell partners. You can tell partners yourself or anonymously. Talk to your health care provider about what is right for you.

The Canadian HIV/AIDS Legal Network is a good source for up-to-date legal information about HIV

How to talk to your partners

Complications

If HIV is treated early on, you are less likely to have other health problems. Early treatment helps to keep your immune system healthy. Taking medication early will also lower the chances of passing HIV to other people.

If left untreated, HIV can lead to serious complications.

If HIV weakens your immune system, it makes it easier to get infections or cancers that rarely occur in people with healthy immune systems. Having HIV does not mean you have AIDS. AIDS occurs when your immune system has been severely weakened by HIV. Even without treatment, it takes a long time for HIV to progress to AIDS, usually 10 to 12 years.

Pregnancy:  If you are pregnant, you should be screened for HIV. You can pass HIV to your child during birth and through breast-/chest-feeding.

Prevention

To help prevent getting HIV, you can:

  • use condoms
  • consider pre exposure prophylaxis (PrEP)
  • consider post exposure prophylaxis (PEP)
  • if you use drugs, do not share drug equipment such as needles or straws
  • use new drug equipment every time you use drugs
  • get tested for other STIs, because they can increase your chance of getting (or passing) HIV

It is a good idea to regularly test for STIs, especially if you have new sexual partners or open relationships.  Talking with partners about safer sex makes sure everyone knows what to expect.  Condoms are great if they work for you – the correct use of condoms reduces your chances of getting and passing HIV.

HIV Self-Testing

On November 2, 2020 Health Canada approved the INSTI® HIV Self-Test for use and sale in Canada. HIV self-testing provides results within a few minutes, and it allows people to test where they are most comfortable, without the assistance of a healthcare provider.

How Does It Work?

The INSTI® HIV Self-Test is an HIV antibody test which detects antibodies produced in response to HIV. Antibodies to HIV can take time to develop after an exposure. It can take 3 to 12 weeks for this test to detect antibodies in the blood, which is known as the window period.

The INSTI® HIV Self-Test is the same HIV Point of Care test that has been used in clinics and health care settings for many years. Research studies have confirmed that self-testing is accurate and is able to produce the same results as Point of Care tests performed by trained healthcare providers.

It uses a finger poke to produce a few drops of bloods which are then added to the testing kit. The results from this test are ready in a few minutes. If the test is negative, it is considered very accurate for the window period. A positive test result must be confirmed with a standard laboratory test from blood taken from a vein. 

Consider reaching out for support before and/or after using the HIV self-test. The REACH team has worked with all regional health authorities in British Columbia to develop a Prevention and Care Pathway resource to help connect you with services and next steps after testing. A health care provider can also help with understanding test results or the window period, support those experiencing worry or anxiety, provide a referral for pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), and link to follow-up and care after testing if needed. You can use the clinic finder to find services in your area, contact 8-1-1 operated by HealthLink BC, or your regular health care provider if you have one. 

Cost

In Canada, the INSTI® HIV Self-Test is available to purchase online from the Biolytical website. The cost of the test kit is not covered by the BC Medical Services Plan. 

The Canadian Institute for Health Research (CIHR) for REACH 3.0 is working with community organizations across Canada to launch a telehealth program called I’m Ready for ordering, distributing, and supporting HIV self-testing.  Through REACH’s I’m Ready research study, participants are able to access up to 3 free self-test kits. The program uses a mobile app, optional Peer support, and offers resources for understanding test results and support for those who may experience worry or anxiety related to testing. The Community-Based Research Centre has also launched its Test@Home project alongside the Sex Now 2021 survey for gay, bi, trans, Two-Spirit, and queer men (GBT2Q) and non-binary people.

Highly Active Antiretroviral Therapy (HAART)

Highly active antiretroviral therapy (HAART) are medications used to treat HIV. These medications may also be called antiretroviral drugs (ART), antiretrovirals (ARVs), or anti-HIV drugs. There is currently no cure for HIV, but the availability of HAART means that HIV is manageable through lifelong treatment.

HAART prevents the HIV virus from making copies of itself and limits how much virus is in the body. The level of virus in the blood is called ‘viral load’. When the viral load is low or “undetectable”, there is less harm to the body’s immune system and fewer complications of HIV infection. Reducing the viral load to undetectable levels also greatly reduces the chance of passing HIV to partners.

Treatment as prevention (TasP) refers to the use of antiretroviral (ARV) medication to prevent HIV transmission. TasP involves prescribing ARVs to those who are living with HIV in order to reduce the amount of virus in their blood to undetectable levels so that there is effectively no risk of transmission of HIV.

There are different kinds of HAART available for treatment. Today HAART is easy to take and the number of pills needed is less than in the past.

In British Columbia, HAART is usually free and is prescribed by doctors with an expertise in HIV.

Pre-Exposure Prophylaxis (PrEP)

Pre-exposure prophylaxis (PrEP) involves the use of a daily (or on-demand) oral HIV medication (called antiretrovirals or HAART) by people who are HIV-negative to prevent HIV infection.

PrEP is different from PEP (post-exposure prophylaxis), as PrEP is taken before exposure to HIV and may be taken on a long-term basis.

How Does It Work?

PrEP usually comes as a combination tablet that contains two medications called tenofovir and emtricitabine (under the brand name Truvada®). It can be taken every day (called daily dosing) or around the time of sexual activity (called intermittent dosing). Daily dosing is recommended for PrEP, as it has been the most widely evaluated in research studies.

A number of studies have looked at the use of PrEP to see if it is effective in lowering the risk of HIV infection. Research has shown that when PrEP is used properly, it is more than 90% effective in preventing HIV.

Cost

As of January 1, 2018, PrEP is covered at no cost (free) by BC health insurance (also called BC MSP, BC Carecard, BC Services Card) for people who are at high risk of HIV infection. This includes cis- and transgender men who have sex with men and trans feminine individuals, people who inject drugs, and people who have sex with individuals living with HIV. PrEP is available through the HIV Drug Treatment program at the BC Centre for Excellence in HIV/AIDS

For any First Nations people in BC who previously had PrEP covered through the First Nations Health Authority, coverage is now only available through the HIV Drug Treatment program.

PrEP is also available free-of-charge for all Inuit people in British Columbia who are receiving benefits through the Non-Insured Healthcare Benefits (NIHB) program. For more information, contact Health Canada at 1-800-232-7301. Inuit people can also access PrEP through the HIV Drug Treatment program.

For Inuit people, filling a prescription for PrEP is the same as for any other prescription. The prescription from the doctor can be filled at any pharmacy in BC. The pharmacy will fill the prescription at no cost and there is no pre-approval form or process needed. 

For the latest updates on the roll-out of publicly-funded PrEP in BC, visit the Health Initiative for Men’s GetPrEPed website or the BC Centre for Excellence website.

Things To Consider

Any doctor that is licensed to practice in BC can prescribe PrEP for you. Nurse practitioners who have taken the Treatment for HIV Prevention program at the BC Centre for Excellence in HIV/AIDS (BC CfE) can also prescribe PrEP. 

It’s important to take PrEP correctly and under the care of a health care provider. Though the medication is fairly safe, taking PrEP does require regular medical visits and blood and urine tests.

PrEP is not meant to replace other methods of HIV prevention. PrEP does not protect against other STIs. Condoms and other barrier methods are still recommended during penetrative sex to prevent HIV.

For detailed information on HIV PrEP, visit our HIV Prevention page or download our Frequently Asked Questions about HIV PrEP brochure (also available in SpanishPunjabi and Simplified Chinese).

HIV Point of Care (Rapid) Test

Point of Care (POC) HIV tests are also known as “rapid” tests and are used to screen for HIV antibodies. POC tests can be performed in clinics or other health care settings and results are available within minutes.

The INSTI test kit is the only rapid HIV test that is licenced for use in Canada. The test uses a few drops of blood, which are taken from a finger poke. People who test negative will know their result within a few minutes. If the test is positive, it is not a final result and blood is taken from the arm and sent to the lab to confirm the result. If the test is negative, it is considered very accurate for the window period.

It can take 3 to 12 weeks for this test to detect antibodies in the blood, which is known as the window period.

Use our clinic finder to find out which clinics and other locations offer POC testing in BC.

HIV Viral Load

Viral load is a test that measures how much HIV is present in a drop of blood. After being diagnosed with HIV, viral load testing is regularly done to monitor the level of virus in the body.

The goal of HIV treatment is to reach an “undetectable” viral load. This means that HIV is suppressed to such a low level that the viral load test is not able to detect any virus in the blood. “Undetectable” does not mean that there is no HIV present in the body, but it does mean that there is very little HIV in the blood.

Benefits of a Low Viral Load

Using medications to reach an undetectable viral load is important to keep HIV under control and prevent it from causing health problems.

Taking HIV medication and having an undetectable viral load also significantly lowers the chance of passing HIV to others.  Research has shown that in couples where one person has HIV and the other does not, if the HIV-positive partner is on treatment and has an undetectable viral load, HIV is not passed between partners.

Changes in Viral Load

In general, if someone is taking their HIV medication regularly, their viral load will remain suppressed.  Certain situations (like acute illness or getting vaccinations) may cause a temporary increase in a person’s viral load.

Viral load “blips” can also happen, which are unexplained temporary viral load increases in a person who normally has an undetectable viral load. These short-term increases usually do not cause any major health impacts.  However, long-term increases in the viral load may lead a health care provider to look at changing a person’s medication.

Undetectable = Untransmittable

A person with an undetectable viral load cannot pass HIV to their sexual partners. 

The Undetectable = Untransmittable (U=U) campaign is a global community of HIV advocates, activists, researchers and community partners promoting the fact that people living with HIV who are on effective treatment do not sexually pass HIV.  The U=U campaign is supported by over 500 organizations worldwide, including the BC Centre for Disease Control, the US Centers for Disease Control, the Canadian AIDS Society and the British Columbia Centre for Excellence in HIV/AIDS.

HIV anonymous testing

Anonymous HIV testing is a way to test for HIV where your name and contact information (for example, your address, phone number and email) are not collected or recorded. You are given a numbered testing code that only you know and that you must provide to get your result.

What Is Anonymous HIV Testing?

In British Columbia, there are a number of ways that you can get an HIV test.  With anonymous HIV testing your name is not attached to your result and your contact information is never collected. You are given a number code to use instead of your name.  When your HIV test result is ready, the clinic will not be able to contact you and so it is your responsibility to call or return to the clinic to get your result.  If you test anonymously and your result is positive, you still have the option of receiving confidential support from public health nurses. If you decide to get treatment for HIV, you will need to retest using your real name.

Where Is Anonymous HIV Testing Available in BC?

Use our clinic finder to find out which clinics and other locations offer anonymous HIV testing in BC. When making an appointment at any of these clinics, you do not have to give your real name, but you may be asked to provide a name to hold the appointment time.

Post-Exposure Prophylaxis (PEP)

Post-exposure prophylaxis (PEP) is a 4-week course of medications that you can take if you are HIV negative and think that you have been recently exposed to HIV. The medications are called antiretroviral drugs (or HAART), and are the same drugs used to treat HIV infection.

In most cases, PEP stops HIV from establishing itself in the body and will prevent you from becoming HIV positive. To be effective, the treatment needs to be started as soon as possible in the first 72 hours after exposure. The treatment needs to be taken correctly and daily over the next 28 days.

PEP is different from PrEP, or ‘pre-exposure prophylaxis’, as PEP is taken after a potential exposure to HIV and PrEP is taken before a potential exposure.

How Does It Work?

PrEP usually comes as a combination tablet that contains two medications called tenofovir and emtricitabine (under the brand name Truvada®). It can be taken every day (called daily dosing) or around the time of sexual activity (called intermittent dosing). Daily dosing is recommended for PrEP, as it has been the most widely evaluated in research studies.

A number of studies have looked at the use of PrEP to see if it is effective in lowering the risk of HIV infection. Research has shown that when PrEP is used properly, it is more than 90% effective in preventing HIV.

Cost

As of January 1, 2018, PrEP is covered at no cost (free) by BC health insurance (also called BC MSP, BC Carecard, BC Services Card) for people who are at high risk of HIV infection. This includes cis- and transgender men who have sex with men and trans feminine individuals, people who inject drugs, and people who have sex with individuals living with HIV. PrEP is available through the HIV Drug Treatment program at the BC Centre for Excellence in HIV/AIDS

For any First Nations people in BC who previously had PrEP covered through the First Nations Health Authority, coverage is now only available through the HIV Drug Treatment program.

PrEP is also available free-of-charge for all Inuit people in British Columbia who are receiving benefits through the Non-Insured Healthcare Benefits (NIHB) program. For more information, contact Health Canada at 1-800-232-7301. Inuit people can also access PrEP through the HIV Drug Treatment program.

For Inuit people, filling a prescription for PrEP is the same as for any other prescription. The prescription from the doctor can be filled at any pharmacy in BC. The pharmacy will fill the prescription at no cost and there is no pre-approval form or process needed. 

For the latest updates on the roll-out of publicly-funded PrEP in BC, visit the Health Initiative for Men’s GetPrEPed website or the BC Centre for Excellence website.

Things to consider

Any doctor that is licensed to practice in BC can prescribe PrEP for you. Nurse practitioners who have taken the Treatment for HIV Prevention program at the BC Centre for Excellence in HIV/AIDS (BC CfE) can also prescribe PrEP. 

It’s important to take PrEP correctly and under the care of a health care provider. Though the medication is fairly safe, taking PrEP does require regular medical visits and blood and urine tests.

PrEP is not meant to replace other methods of HIV prevention. PrEP does not protect against other STIs. Condoms and other barrier methods are still recommended during penetrative sex to prevent HIV.

For detailed information on HIV PrEP, visit our HIV Prevention page or download our Frequently Asked Questions about HIV PrEP brochure (also available in SpanishPunjabi and Simplified Chinese).

HIV Seroconversion Illness

HIV seroconversion is the name given to a group of symptoms that can happen when someone first gets HIV.

During this time, there are very high levels of HIV in the body. This is known as a high viral load. When a person has a high viral load, they can easily pass HIV to others.

Symptoms

During the early stage of new HIV infection, up to 90% of people will experience flu-like symptoms. This usually happens about two to four weeks after they come in contact with HIV. The symptoms may last for one or two weeks and include:

  • Fever
  • Rash
  • Swollen glands
  • Feeling tired
  • Joint or muscle pain

Other less common symptoms include: loss of appetite, weight loss, headache, stiff neck, mouth ulcers, sore throat, nausea/vomiting, diarrhea and abdominal pain.

If you are worried about symptoms, see a health care provider for testing.

Causes

When a person gets HIV, the virus makes copies called CD4 lymphocytes. The immune system responds and the body begins to make antibodies to HIV. This immune response causes the symptoms of the seroconversion illness.

Tests & Diagnosis

The only way to know for sure if you have HIV is to get a blood test. Tests either look for antibodies or a small amount of the virus itself.

Treatment

There are health care providers in British Columbia with HIV care, treatment, and support. For more about HIV, see HIV and AIDS and visit the links to other websites.

Downloadable Guides

HIV and AIDS Information Sheet

A PDF version of the HIV and AIDS topic page on SmartSexResource.

Download

HIV/AIDS Information Sheet (Spanish) (VIH y sida)

Download

HIV/AIDS Information Sheet (Punjabi)

Download

HIV/AIDS Information Sheet (Simplified Chinese) (HIV及艾滋病)

Download

Resources and Related Pages