What Most People Don't Know About HIV

⏰ IN A RUSH?

Today’s 30-Second Summary

If you don’t have time to read the whole email today, here are some key takeaways:

• HIV infection can lead to AIDS and death if untreated, but it’s now very preventable and treatable (but not curable, so far as we know for sure at this point).

  • Medications to avoid contracting HIV include PrEP (Pre-Exposure Prophylaxis) and PEP (Post-Exposure Prophylaxis).

  • Medications to manage HIV are generally ARVs (Anti-RetroVirals) which reduce the viral load to an undetectable level. A person with HIV but with an undetectable viral load cannot transmit HIV to someone else.

• We know that 10almonds readers like being presented with facts, and then left to make your own informed decisions.

  • Today’s sponsor 1440 has a similar view, and they specialize in presenting just the facts of the news so that you can form your own conclusions.

Read on to learn about these things and more…

👀 WATCH AND LEARN

How Old Are Your Ears? Hearing Test (2:00)

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There’s a lot of information about how this test works, including how they arrive at the numbers they do, in the description under the video.

Due to YouTube compression the maximum frequency of this video is 20KHz. For results up to 22 kHz you can visit:

https://www.arealme.com/hearing-test/en/

Additionally, do be aware that your headphones or device speakers may have their own limits (often around 15–16KHz); you can double-check by retaking the test with a different device.

Want to watch it, but not right now? Bookmark it for later 🔖

🩸 MAIN FEATURE

What To Know About HIV This World AIDS Day

Yesterday, we asked you to engage in a hypothetical thought experiment with us, and putting aside for a moment any reason you might feel the scenario wouldn’t apply for you, asked:

…and got the above-depicted, below-described, set of responses. Of those who responded…

• Just over 60% said “rush to hospital; maybe a treatment is available”

• Just under 20% said “ask them what meds they’re taking (and perhaps whether they’d like a snack)”

• Just over 10% said “despair; life is over”

• Two people said “do the most rigorous washing down there you’ve ever done in your life”

So, what does science say about it?

First, a quick note on terms

• HIV is the Human Immunodeficiency Virus. It does what it says on the tin; it gives humans immunodeficiency. Like many viruses that have become epidemic in humans, it started off in animals (called SIV, because there was no “H” involved yet), which were then eaten by humans, passing the virus to us when it one day mutated to allow that.

  • It’s technically two viruses, but that’s beyond the scope of today’s article; for our purposes they are the same. HIV-1 is more virulent and infectious than HIV-2, and is the kind more commonly found in most of the world.

• AIDS is Acquired Immunodeficiency Syndrome, and again, is what it sounds like. When a person is infected with HIV, then without treatment, they will often develop AIDS.

  • Technically AIDS itself doesn’t kill people; it just renders people near-defenseless to opportunistic infections (and immune-related diseases such as cancer), since one no longer has a properly working immune system. Common causes of death in AIDS patients include cancer, influenza, pneumonia, and tuberculosis.

People who contract HIV will usually develop AIDS if untreated. Untreated life expectancy is about 11 years.

HIV/AIDS are only a problem for gay people: True or False?

False, unequivocally. Anyone can get HIV and develop AIDS.

The reason it’s more associated with gay men, aside from homophobia, is that since penetrative sex is more likely to pass it on…

• If a man penetrates a woman and passes on HIV, that woman will probably not go on to penetrate someone else

• If a man penetrates a man and passes on HIV, that man could go on to penetrate someone else—and so on

• This means that without any difference in safety practices or promiscuity, it's going to spread more between men on average, by simple mathematics.

• This is why “men who have sex with men” is the generally-designated higher-risk category.

There is medication to cure HIV/AIDS: True or False?

False (though there have been individual case studies of gene treatments that may have cured people—time will tell).

But! There are medications that can prevent HIV from being a life-threatening problem:

• PrEP (Pre-Exposure Prophylaxis) is a medication that one can take in advance of potential exposure to HIV, to guard against it.

  • This is a common choice for people aren’t sure about their partners’ statuses, or people working in risky environments.

• PEP (Post-Exposure Prophylaxis) is a medication that one can take after potential exposure to HIV, to “nip it in the bud”.

  • Those of you who were rushing to hospital in our poll, this is what you’re rushing there for.

• ARVs (Anti-RetroVirals) are a class of medications (there are different options; we don’t have room to distinguish them) that reduce an HIV+ person’s viral load to undetectable levels.

  • Those of you who were asking what meds your partner was taking, these will be those meds. Also, most of them are to be taken in the morning with food, so that’s what the snack was for.

If someone is HIV+, the risk of transmission in unprotected sex is high: True or False?

True or False, with false being the far more likely. It depends on their medications, and this is why you were asking. If someone is on ARVs and their viral load is undetectable (as is usual once someone has been on ARVs for 6 months), they cannot transmit HIV to you.

U=U is not a fancy new emoticon, it means “undetectable = untransmittable”, which is a mathematically true statement in the case of HIV viral loads.

See: NIH | HIV Undetectable=Untransmittable (U=U)

If you’re thinking “still sounds risky to me”, then consider this:

You are safer having unprotected sex with someone who is HIV+ and on ARVs with an undetectable viral load, than you are with someone you are merely assuming is HIV- (perhaps you assume it because “surely this polite blushing young virgin of a straight man won’t give me cooties” etc)

If you’re concerned about potential stigma associated with HIV testing, you can get kits online:

CDC | How do I find an HIV self-test?

(these are usually fingerprick blood tests, and you can either see the results yourself at home immediately, or send it in for analysis, depending on the kit)

If I get HIV, I will get AIDS and die: True or False?

False, assuming you get treatment promptly and keep taking it. So those of you who were at “despair; life is over” can breathe a sigh of relief now.

However, if you get HIV, it does mean you will have to take those meds every day for the rest of your (no reason it shouldn’t be long and happy) life.

So, HIV is definitely still something to avoid, because it’s not great to have to take a life-saving medication every day. For a little insight as to what that might be like:

HIV.gov | Taking HIV Medication Every Day: Tips & Challenges

(as you’ll see there, there are also longer-lasting injections available instead of daily pulls, but those are much less widely available)

Summary

Some quick take-away notes-in-a-nutshell:

• Getting HIV may have been a death sentence in the 1980s, but nowadays it’s been relegated to the level of “serious inconvenience”.

• Happily, it is very preventable, with PrEP, PEP, and viral loads so low that they can't transmit HIV, thanks to ARVs.

• Washing will not help, by the way. Safe sex will, though!

  • As will celibacy and/or monogamy in seroconcordant relationships, e.g. you both have the same (known! That means actually tested recently! Not just assumed!) HIV status.

• If you do get it, it is very manageable with ARVs, but prevention is better than treatment

• There is no certain cure—yet. Some people (small number of case studies) may have been cured already with gene therapy, but we can't know for sure yet.

Want to know more? Check out:

CDC | Let’s Stop HIV Together

Take care!

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🌍 AROUND THE WEB

What’s happening in the health world…

• Black patients face delays in Alzheimer's diagnosis, research finds

• A novel lightweight wearable device for performing balance exercises at home

• Swine flu: UK detects first human case of new strain

• Researchers identify a new small molecule inhibitor for use against Alzheimer's disease

• Natural products used in Ayurvedic treatments alleviate symptoms of depression in fruit flies

• Urban environments linked to higher breast cancer incidence

• Study suggests changing to a healthier diet could add ten years to your life

More to come tomorrow!

📖 ONE-MINUTE BOOK REVIEW

Encyclopedia Of Herbal Medicine: 550 Herbs and Remedies for Common Ailments – by Andrew Chevallier

A common problem with a lot of herbal medicine is it's "based on traditional use only", while on the other hand, learning about the actual science of it can mean poring through stacks of Randomized Clinical Trials, half of which are paywalled.

This beautifully and clearly-illustrated book bridges that gap. It gives not just the history, but also the science, of the use of many medicinal herbs (spotlight on 100 key ones; details on 450 more).

It gives advice on growing, harvesting, processing, and using the herbs, as well as what not to do (with regard to safety). And in case you don't fancy yourself a gardener, you'll also find advice on places one can buy herbs, and what you'll need to know to choose them well (controlling for quality etc).

You can read it cover-to-cover, or look up what you need by plant in its general index, or by ailment (200 common ailments listed). As for its bibliography, it does list many textbooks, but not individual papers—though it does cite 12 popular scientific journals too.

Bottom line: if you want a good, science-based, one-stop book for herbal medicine, this is a top-tier choice.

Click here to check out the Encyclopedia of Herbal Medicine, and expand your home remedy repertoire!

Wishing you a wonderful month ahead,

The 10almonds Team