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HIV/AIDS

Description

What is HIV/AIDS
 ​​​​​​
​HIV/AIDS is Human Immunodeficiency Virus (HIV). The virus is mainly transmitted through sexual intercourse but can also be passed down from mother to child during pregnancy, childbirth and breastfeeding, or acquired via blood transfusion with infected blood, the sharing of needles (e.g. during drug use) or through needle-stick injuries (if you’re a healthcare worker, for example).


Signs and symptoms    
       
The symptoms of HIV vary depending on the stage of infection. Though people living with HIV tend to be most infectious in the first few months, many are unaware of their status until later stages. The first few weeks after initial infection, indivi​​duals may experience no symptoms or an influenza-like illness including fever, headache, rash, or sore throat.

As the infection progressively weakens the immune system, an individual can develop other signs and symptoms, such as swollen lymph nodes, weight loss, fever, diarrhoea and cough. Without treatment, they could also develop severe illnesses such as tuberculosis, cryptococcal meningitis, severe bacterial infections and cancers such as lymphomas and Kaposi's sarcoma, among others.   

 
Prevention 
       
Individuals can reduce the risk of HIV infection by limiting exposure to risk factors. Key approaches for HIV prevention, which are often used in combination, are listed below.



Male and female condom use    
       
Correct and consistent use of male and female condoms during vaginal or anal penetration can protect against the spread of sexually transmitted infections, including HIV. Evidence shows that male latest condoms have an 85% or greater protective effect against HIV and other sexually transmitted infections (STIs).



Testing and counselling for HIV and STIs    
       
Testing for HIV and other STIs is strongly advised for all people exposed to any of the risk factors. This way people learn of their own infection status and access necessary prevention and treatment services without delay. The department also recommends offering testing for partners or couples.



Testing and counselling, linkages to tuberculosis care

Tuberculosis (TB) is the most common presenting illness and cause of death among people with HIV. It is fatal if undetected or untreated and is the leading cause of death among people with HIV, responsible for more than 1 of 3 HIV-associated deaths.

Early detection of TB and prompt linkage to TB treatment and ART can prevent these deaths. TB screening are offered routinely at healthcare facilities in Gauteng and routine HIV testing are also offered to all patients with presumptive and diagnosed TB. 

Individuals who are diagnosed with HIV and active TB should urgently start effective TB treatment (including for multidrug resistant TB) and ART. TB preventive therapy is offered to all people with HIV who do not have active TB.



Voluntary medical male circumcision (VMMC)

Medical male circumcision, reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. This is a key prevention intervention supported in 15 countries in Eastern and Southern Africa (ESA) with high HIV prevalence and low male circumcision rates. VMMC is also regarded as a good approach to reach men and adolescent boys who do not often seek health care services.



Pre-exposure prophylaxis (PrEP) for HIV-negative partner

Oral PrEP of HIV is the daily use of ARV drugs by HIV-negative people to block the acquisition of HIV. More than 10 randomised controlled studies have demonstrated the effectiveness of PrEP in reducing HIV transmission among a range of populations including serodiscordant heterosexual couples (where one partner is infected and the other is not), men who have sex with men, transgender women, high-risk heterosexual couples, and people who inject drugs.

PrEP is recommended as a prevention choice for people at substantial risk of HIV infection as part of a combination of prevention approaches. The World Health Organisation has also expanded these recommendations to HIV-negative women who are pregnant or breastfeeding.



Post-exposure prophylaxis for HIV (PEP)

Post-exposure prophylaxis (PEP) is the use of ARV drugs within 72 hours of exposure to HIV in order to prevent infection. PEP includes counselling, first aid care, HIV testing, and administration of a 28-day course of ARV drugs with follow-up care. PEP use is recommended for both occupational and non-occupational exposures and for adults and children.



Treatment for HIV/​AIDS    
HIV can be suppressed by combination ART consisting of 3 or more ARV drugs. ART does not cure HIV infection but suppresses viral replication within a person's body and allows an individual's immune system to strengthen and regain the capacity to fight off infections​
 

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