HIV FAQs

AIDS (Acquired Immunodeficiency Syndrome) is the late stage of an HIV infection that occurs when the body’s immune system is badly damaged. This could be due to secondary infections or because HIV is undiagnosed in an individual.

There is currently no cure for HIV. Once a person is diagnosed with HIV, they have it for life. However, with proper treatment and medical care, HIV can be controlled. People diagnosed with HIV can live long, healthy lives.

HIV can only be transmitted by coming into direct contact with specific body fluid from a person with HIV who is undiagnosed, untreated, or has a detectable viral load. These fluids are:

• Blood
• Semen and pre-seminal fluid
• Rectal fluids
• Vaginal fluids
• Breast milk

HIV does not survive outside the human body or on surfaces; it can’t reproduce outside a human host and can’t be passed through casual contact. HIV is not transmitted by:

• Mosquitoes, ticks, or other insects.
• Through saliva, tears, or sweat.
• By hugging, shaking hands, sharing toilets, sharing dishes, or social kissing with someone HIV positive.
• Through the air.

HIV can only spread through specific activities. The most common ways are:

• Sharing injection drug equipment such as needles with someone who has HIV or getting stuck with an HIV-contaminated needle or another sharp object.
• Having vaginal or anal sex with someone who has HIV without using a condom or taking medicine to prevent or treat HIV.
• Having oral sex by putting the mouth on the penis, vagina, or anus.
• From mother to child during pregnancy, birth, or breastfeeding.

Yes, it’s possible if the person who gives someone a tattoo uses the same needle immediately after using that needle on someone who had HIV. Tattoos should be done at a reputable tattooing studio that employs only properly trained employees, is licensed with the state health department, and meets all regulations and requirements.

The risk of getting HIV varies widely depending on the type of exposure or behavior. Some exposures to HIV carry a much higher risk of transmission than other exposures. But risks do add up over time. Even relatively small risks can add up over time and lead to an increased lifetime risk of getting HIV. Those exposures in the order of risk are:

• Receptive Anal Intercourse
• Needle Sharing During Injection Drug Use
• Percutaneous Needle-Stick
• Insertive Anal intercourse
• Receptive Penile/Vaginal Intercourse
• Insertive Penile/Vaginal Intercourse
• Receptive/Insertive Oral Intercourse

Knowing your risk can help you make important decisions to prevent exposure to HIV. Overall, an American has a 1 in 99 chance of being diagnosed with HIV at some point in their lifetime. However, the lifetime risk is much greater among some populations. If current diagnosis rates continue, the lifetime risk of getting HIV is:

• 1 in 6 for gay and bisexual men overall
• 1 in 2 for African American gay and bisexual men
• 1 in 4 for Hispanic gay and bisexual men
• 1 in 11 for white gay and bisexual men
• 1 in 20 for African American men overall
• 1 in 48 for African American women overall
• 1 in 23 for women who inject drugs
• 1 in 36 for men who inject drugs

The CDC (Center for Disease Control and Prevention) recommends that everyone between 13 and 64 gets tested at least once as part of their routine health care. Individuals with higher risk factors should be tested at least once a year.

Antibody tests (Rapids - OraQuick, Insti, Chembio) look for antibodies to HIV in your blood or oral fluid. Antibody tests can take 23 to 90 days to detect HIV infection after exposure. Antibody rapid tests process results in 20 minutes or less. Nashville CARES or Nashville CARES My House Clinic currently uses the Insti Rapid HIV Test for diagnosis, and results are available in one minute or less.

Antigen/antibody (4th Generation) looks for HIV antibodies and antigens. Antibody/antigen tests are processed by a lab on blood taken from a vein and can usually detect HIV infection 18 to 45 days after exposure. Your immune system produces antibodies. Antigens are foreign substances that cause your immune system to activate.

The “window period” is when antibodies are made to fight infection. The “window period for HIV antibody testing is 90 days. Remember, if you get an HIV test after a potential HIV exposure and the result is negative, you should get tested again after the window period. You can only be sure you are HIV negative if:

Your most recent test is after the 90-day window period.

You haven’t had a potential HIV exposure during the window period. If you have potential exposure, you will need to be retested.

Founded in 1985, Nashville CARES is the premier HIV/AIDS service organization in Tennessee. Linkage to Care and wrap-around services start immediately after someone tests positive for HIV. This includes connections to:

• Case Management
• Early Intervention Services
• Day of diagnosis access to HIV medical care, including a medical provider and lab work.
• Day of diagnosis access to HIV medication.

Currently, Nashville CARES, and the Nashville CARES My House clinic is the first and only clinic to provide Rapid ART. Rapid ART (rapid antiretroviral therapy) means starting HIV treatment as soon as possible after the diagnosis of HIV infection.

• Behavioral Health referrals
• Therapeutic Support
• Nutrition Support
• Transportation Support

No HIV test can detect HIV immediately after infection. If you think you’ve been exposed to HIV in the last 72 hours, you must speak with one of Nashville CARES Sexual Health Educators or Nashville CARES My House Clinic staff about nPEP.

nPEP or PEP (post-exposure prophylaxis) is medication to prevent HIV after a possible exposure. PEP should be used only in emergencies and started within 72 hours after recent potential exposure to HIV. Exposure could be:

• during sex because the condom broke
• while sharing needles, syringes, or other equipment to inject drugs, or
• you’ve been sexually assaulted.

The sooner you start PEP, the better. PEP is not a substitute for regular use of other HIV prevention, and PEP is not the right choice for people who may be exposed to HIV frequently. If you are at ongoing risk for HIV, such as repeated exposures to HIV, talk to one of Nashville CARES Sexual Health Educators or Nashville CARES My House Clinic staff about PrEP.

Depending on why you are prescribed PEP, you may qualify for free or low-cost PEP medicines. If you cannot get insurance or are underinsured, you can apply for medication assistance programs through the manufacturers. These requests for assistance can be handled urgently in many cases to avoid a delay in getting the medication, and the pharmacist can assist you with that paperwork.

If the exposure occurs on or after midnight on Sunday through Friday at noon, you can contact Nashville CARES or the Nashville CARES My House Clinic to schedule an appointment to be seen by our provider.

If the exposure occurs after noon on Friday through Sunday at midnight, proceed to Meharry Metro General at 1818 Albion Street, Nashville, TN 37208 to be seen through the emergency department.

If the exposure results from a sexual assault, proceed to/or contact the Tennessee Coalition to End Domestic & Sexual Violence located at 2 International Plaza Drive, Suite 425, Nashville, TN 37217 Hotline: (1-800) 356-6767.

Today, more tools than ever are available to prevent HIV.

• Choose sex that is less risky than anal or vaginal sex. There is little to no risk of getting HIV through oral sex.
• You can’t get HIV from sexual activities that don’t involve contact with body fluids (semen, vaginal fluid, or blood).
• Latex condoms used consistently and correctly are highly effective in preventing HIV and other sexually transmitted diseases (STDs), like gonorrhea and chlamydia.
• Use water-based or silicone-based lubricants to help prevent condoms from breaking or slipping during sex.
• PrEP (pre-exposure prophylaxis) is medicine people at risk for HIV take to prevent HIV.
• If taken as prescribed, PrEP is highly effective for preventing HIV from sex.
• Get tested for other STDs. If you have another STD, you are more likely to get HIV. Getting tested and treated for other STDs can lower your chances of getting HIV.

Truvada, Descovy, or Emtricitabine and Tenofovir Disoproxil Fumarate (generic of Truvada) are the only approved pre-exposure prophylaxis drugs. The drug regimen PrEP works by preventing HIV from replicating in the body. PrEP acts as a catalyst that helps the body produce antibodies which help diseases causing germs and viruses. After contact with the virus, the PrEP medication blocks the enzyme needed by the virus to replicate. Used correctly, PrEP eliminates the risk of contracting the virus after exposure.

Prep is highly effective for preventing HIV. PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed.

• Although there is less information about how effective PrEP is among people who inject drugs, PrEP reduces the risk of getting HIV by at least 75% when taken as prescribed.
• PrEP reaches maximum protection from HIV for receptive anal sex at about seven days of daily use.
• For receptive vaginal sex and injection drug use, PrEP reaches maximum protection at about 21 days of daily use.
• No data are available for Insertive anal sex or Insertive vaginal sex.

Nashville CARES PrEP Navigators or Nashville CARES My House Clinic staff can help you start the process of getting on PrEP.

• Before beginning PrEP, you must take an HIV test to ensure you don’t have HIV.
• While taking PrEP, you will have to visit our health care provider every three months for follow-up visits, HIV testing, lab work, and prescription refills.

How do I pay for PrEP?

Most insurance plans and state Medicaid programs cover PrEP. Other programs provide PrEP for free or at a reduced cost.

• Ready, Set, PrEP makes PrEP medication available at no cost to those who qualify.
• Co-pay assistance programs help lower the costs of PrEP medications. Income is not a factor in eligibility.
• Like PEP, manufacturers provide medication assistance programs to assist those individuals who are uninsured or underinsured.

TasP (treatment as prevention) refers to taking HIV medication to prevent the sexual transmission of HIV. It is one of the highly effective options for preventing HIV transmission. People living with HIV who take HIV medication daily as prescribed and get and keep an undetectable viral load have effectively no risk of sexually transmitting HIV to their HIV-negative partners.

TasP works when a person living with HIV takes HIV medication precisely as prescribed and has regular follow-up care, including regular viral load testing to ensure their viral load stays undetectable.

An undetectable viral load is where antiretroviral treatment (ART) has reduced your HIV to such small quantities that standard blood tests can no longer detect it.

U=U is short for undetectable = untransmittable. In recent years, an overwhelming body of clinical evidence has firmly established the HIV Undetectable=Untransmittable, or U=U, the concept as scientifically sound. U=U means that people with HIV who achieve and maintain an undetectable viral load—the amount of HIV in the blood—by taking antiretroviral therapy (ART) daily as prescribed cannot sexually transmit the virus to others. Thus, treatment for HIV is a powerful arrow in the quiver of HIV prevention tools.

Nashville CARES 24-Hour HIV Hotline (615) 761-4474.