HIV is the virus that causes AIDS (Acquired Immune Deficiency Syndrome) and stands for Human Immune Deficiency Virus. Someone who is infected with this virus is HIV positive. There is no risk in the normal day-to-day management of HIV-positive people.

The virus breaks down the body's immune system and can live in the body for a long time without the person being sick. A person has AIDS when HIV has affected the immune system in such a way that it can no longer protect you against diseases. The HIV virus lives in blood, semen, vaginal fluid, pre-cum and breast milk. In other bodily fluids the virus may be present, but in much too low concentrations to cause infection. For example, saliva, sweat, tear fluid, urine and stool are only dangerous if there blood is visible and if there is a risk that they can end up in the body.

AIDS is a serious disease. All over the world, men, women and children are infected with HIV, the virus that can cause AIDS, also in Suriname. To date there is no cure for HIV, but the transmission of HIV can be prevented. If one is infected, there are fortunately drugs that can suppress HIV very vigorously, so that in most cases no AIDS arises and life can almost continue.

HIV transmission

HIV is transmitted by:

• Unsafe sexual acts e.g.
  • Vaginal (penis in vagina) or anal sex (penis in anus) without a condom;
  • Oral sex, in which sperm or (menstruation) blood comes into the mouth;
  • Mutual use of sex attributes, e.g. use a dildo, without cleaning after use.

Having unsafe sex, puts you at risk of an HIV infection with HIV or other STD. Practicing  safe sex is important, because you cannot see if someone is HIV positive or not. 

• Inject with previously used needles or syringes for drug use. Only if someone injects drugs with previously used needles from someone who has HIV does he / she is at risk of an HIV infection. The HIV virus can end up in the bloodstream in this way.
• Mother to child transmission (HIV positive mother to the child) during pregnancy or delivery or through breastfeeding. After delivery, the mother can also transfer the virus via breastfeeding. The chance of transfer is reduced if the mother is treated with medication and if other precautionary measures are taken during delivery.
• Use of unsafe blood products or blood transfusion with infected blood. Blood contact: you can also become infected if your blood comes into contact with HIV-infected blood. The chance that you will get AIDS through a blood transfusion has been reduced in Suriname by testing donor blood several times for antibodies against HIV, among others. Infected blood containing these antibodies is not used.

Ways HIV cannot be transmitted

• Not through skin contact (e.g. shaking hands). HIV cannot penetrate undamaged skin. A patch on a wound offers sufficient protection from an infection
• If one does not have sex or masturbate
• If a condom is used during sex
• If you cuddle, caress or massage
• French kissing. There is too little virus in the saliva to infect someone
• HIV is not spread by touching common objects such as toilet seats or faucet handles. The virus cannot live in the open air, which means it cannot be spread by sharing drinking glasses, coffee or tea cups, cutlery, bed linen, etc.
• Not trough breathing, coughing, sneezing, etc. Therefore you can continue to interact or treat an infected person in the same way. Having physical contact and support can be very important for an HIV-infected friend, acquaintance or colleague. 

Other ways HIV cannot be transmitted. 

• First aid treatment presents no risk as long as adequate precautions or taken to protect yourself.
• Not by insects: HIV is not spread by insects. Insects do not become infected and their saliva does not contain the virus. Mosquitoes, do not inject blood into the next person they bite.
• Not via food
• Not by water in swimming pools and saunas

How to prevent HIV transmission and AIDS in a sexual relationship.
By practicing safe sex you not only protect yourself but also your partner. If you have casual sex outside of your committed relationship or if you have many different sexual relationships it is wise to: 

• Make sure you always wear a condom during sex.
• Use a condom during vaginal and anal contact,
• If you have anal sex, use special condoms with water-based lubricants,
• Do not allow sperm and (menstrual) blood to enter your mouth during oral sex. Use a condom, a dental dam or a special cloth to prevent this from happening.
• Only use your own sex attributes. If you share sex attributes always wear a condom around it every time is changes from user.
• Do not use dildos, vibrators or other attributes in the vagina first and then immediately after into the anus or vice versa. This can cause infections. After use, always clean the attributes with soap and water and if possible also with chlorine.

You can French kiss, cuddle, caress, massage or masturbate without any risk of getting infected. And of course you can also decide to delay having sex / sexual intercourse. The duration of your relationship is not a measure to decide whether to have sex with or without a condom! This decision only depends on the risks that you and your partner have taken in the past.

When entering into a new relationship, it is recommended for both partners get tested first for HIV. If both partners are aware of their HIV status, the risk of an HIV transmission can be reduced.

Wait with sex until you are ready and always use a condom when you decide to have sex.

Practice safe sex or abstinence, because HIV does not discriminate. 

HIV TESTING
How does one know if one is infected? To know your HIV status, you should get tested. The HIV test shows whether there are HIV antibodies in the blood. If that is the case, you are HIV infected or HIV-positive. If there are no HIV antibodies in the blood, the test result is negative.

When to test?
If your sexual behavior has put you at risk for HIV, you should get tested. If the test is negative, it must be repeated after a three month waiting period (window period). The window period is time between potential exposure to HIV infection and the point when the test will give an accurate result. During the window period a person can be infected with HIV and be very infectious but still test HIV negative. 

How does the test work?
Before the HIV test, you receive counseling during which the following is being discussed:

• The reason and the advantages and disadvantages of the test.
• Ways of HIV transmission and how to reduce the risk of HIV infection. 

You will not be forced to have the test. The decision to test is completely voluntary. 

The test
Rapid test are used to look for HIV antibodies in your blood. The results are available within ± 15-20 minutes after the test.  The test is done by means of a finger prick.

Two of these Rapid tests are done simultaneously. If both tests indicate the same result, then this result will be communicated to the client. If one (1) test is positive and one (1) test is negative, a third test will be done for confirmation. 

Quality control is performed every day on every test site.

The test result
The test result can be "seronegative" or "seropositive". Seronegative means that no antibodies have been found in the blood and the person being examined is not infected with HIV, provided that there has been no new risk of infection during the three months prior to the test.

Seropositive means that antibodies have been found and that the person is infected with HIV, which means the person carries the virus and can transfer it to others and has a great chance of getting AIDS over time.

There known cure for HIV. However, treatment, prevention options have a positive impact on the lives of many infected people.  

Please note!
Your partner’s HIV status does not determine your own HIV status. It may be possible that your partner test is negative and yours positive or vice versa. So if want to know your status, you should always get tested yourself. 

TREATMENT WITH AIDS BLOCKING DRUGS (ANTI RETROVIRAL THERAPY, ART)
Due to scientific efforts, over the years, an HIV infection can be treated. There are medications that delay the development of HIV infection, also known as AIDS inhibitors.

People with HIV don’t usually have symptoms right away, so an infection may go unnoticed. It takes year before HIV makes you feel sick. However, in the long or short term, you may experience flu like symptoms, persistent fatigue, weight loss, persistent fever (above 38 ° C), severe night sweats, persistent diarrhea, swollen lymph nodes in the neck and armpits, muscle aches and fungal infections.

Don’t assume that you are infected if you have one or more of the aforementioned symptoms. Any of these symptoms can be related to other diseases. The only way to know is to get tested for HIV.

Being HIV positive does not mean AIDS.

Without treatment, HIV will affect the immune system in such a way that it can no longer protect the body against certain serious infections or tumors. These infections are called opportunistic infections and only occur when the individual's resistance is lowered. The HIV infection has progressed into AIDS, the final stage of HIV infection. AIDS stands for Acquired Immune Deficiency Syndrome (acquired immunodeficiency syndrome).

Without the use of HIV inhibitors, it takes an average of 10 years for people to develop symptoms of AIDS. In some people it may take more than 20 years and maybe the diagnosis of AIDS will never made. This only occurs in very small percentage. But with some, AIDS develops much faster, sometimes within a year and sometimes within a few months.

In Suriname, AIDS inhibitors are provided free of charge through pharmacies on prescription of the treating physician. Payment of administrative costs may be required. Since February 2005, AIDS inhibitors are being purchased by the Ministry of Health (VGZ) with financial aid, from the Global Fund.

Anti-retroviral therapy does not protect against re-infection:
Safe handling of blood and other bodily fluids, as well as safe sexual behavior remain important in the prevention of (re) contamination. Practicing safe sex also protects of your sexual partner against an HIV infection.

HIV counseling and testing is available at Stichting Lobi, since 2006.