WEBVTT 00:00:00.040 --> 00:00:03.240 Welcome to Prep and Play, where we have conversations 00:00:03.240 --> 00:00:06.480 about safer sexual pleasure. This podcast is 00:00:06.480 --> 00:00:09.080 dedicated to empowering listeners through open, 00:00:09.339 --> 00:00:11.679 honest discussions surrounding keeping our minds, 00:00:11.900 --> 00:00:14.779 bodies, and spirits healthy while being sexually 00:00:14.779 --> 00:00:20.399 active. My name is Danielle, and I'm the Role 00:00:20.399 --> 00:00:23.019 and Minority Outreach Specialist at AIDS Alabama 00:00:23.019 --> 00:00:26.239 South, and today I have with me My name is Caitlin 00:00:26.239 --> 00:00:28.399 Bricat. I'm the Prevention Education Outreach 00:00:28.399 --> 00:00:31.160 Coordinator at AIDS Alabama South. And today 00:00:31.160 --> 00:00:32.840 we're going to be talking to you a little bit 00:00:32.840 --> 00:00:35.500 about HIV 101, which is what we talk to people 00:00:35.500 --> 00:00:38.460 about probably most often. Almost every day. 00:00:38.780 --> 00:00:42.399 Almost every day. OK, so we're going to talk 00:00:42.399 --> 00:00:45.140 a little bit about what HIV is, the difference 00:00:45.140 --> 00:00:48.200 between HIV and AIDS, the modes of transmission. 00:00:49.559 --> 00:00:52.740 We're going to dispel a few common myths and 00:00:52.740 --> 00:00:54.979 then talk about ways to prevent and treat HIV. 00:00:55.460 --> 00:00:57.200 So first off, Caitlin, you want to kick us off. 00:00:57.240 --> 00:01:00.780 What is HIV? So HIV is the human immunodeficiency 00:01:00.780 --> 00:01:05.700 virus. It is a virus is basically sexually transmitted. 00:01:05.739 --> 00:01:07.980 There are other ways that is transmitted, but 00:01:07.980 --> 00:01:10.019 it is going to attack your body by destroying 00:01:10.019 --> 00:01:12.620 your immune system or your CD4 plus T cells. 00:01:13.280 --> 00:01:15.379 These cells are important for helping fight off 00:01:15.379 --> 00:01:20.040 other bacteria, diseases, viruses. But basically 00:01:20.040 --> 00:01:23.579 the HIV virus is going to attach to the helper 00:01:23.579 --> 00:01:26.980 T cell or your CD4 plus T cell. It's going to 00:01:26.980 --> 00:01:30.099 transmit its DNA into the nucleus of that T cell 00:01:30.099 --> 00:01:33.420 using that T cell's own DNA to replicate new 00:01:33.420 --> 00:01:36.299 copies of itself, destroying the T cell in the 00:01:36.299 --> 00:01:38.540 process and then releasing hundreds of new virus 00:01:38.540 --> 00:01:40.959 particles in your bloodstream. Yeah, you know, 00:01:41.099 --> 00:01:43.120 Caitlin really broke that down. I like to think 00:01:43.120 --> 00:01:44.599 of it, if you want to think of it super simple, 00:01:45.219 --> 00:01:47.980 human immunodeficiency virus. Immunodeficiency, 00:01:48.180 --> 00:01:50.819 it makes your immune system deficient. Virus, 00:01:51.180 --> 00:01:53.980 it's a viral mode of transmission and human means 00:01:53.980 --> 00:01:56.400 anybody in the human race is eligible for it. 00:01:56.859 --> 00:02:00.040 When people think about HIV, the term AIDS commonly 00:02:00.040 --> 00:02:03.840 comes up and AIDS stands for acquired immunodeficiency 00:02:03.840 --> 00:02:07.269 syndrome. It's actually an older term than HIV, 00:02:07.469 --> 00:02:09.169 which Chance and I will talk a little bit about 00:02:09.169 --> 00:02:15.569 in our advances in HIV care episode. But essentially, 00:02:16.270 --> 00:02:17.870 the way to understand the difference between 00:02:17.870 --> 00:02:20.509 HIV and AIDS is to look at the stages of HIV. 00:02:20.949 --> 00:02:23.370 So the first stage of an HIV infection is when 00:02:23.370 --> 00:02:26.050 a person first comes into contact with the virus, 00:02:26.430 --> 00:02:28.210 when the virus first starts entering those cells 00:02:28.210 --> 00:02:31.860 and making copies. early symptoms are going to 00:02:31.860 --> 00:02:34.120 be flu -like, occurring two to four weeks after 00:02:34.120 --> 00:02:37.520 exposure. Somebody might have a fever, they might 00:02:37.520 --> 00:02:40.719 have swollen lymph nodes, things like that, and 00:02:40.719 --> 00:02:43.939 it might easily be overlooked as like a different 00:02:43.939 --> 00:02:46.280 type of, you know. Oh yeah, totally. You might 00:02:46.280 --> 00:02:47.919 think it's just a common cold that you're going 00:02:47.919 --> 00:02:51.030 to get over. Yeah, exactly. And you will because 00:02:51.030 --> 00:02:53.889 your body will fight it off, but it's the repetitive, 00:02:54.250 --> 00:02:56.789 the destroying your immune system as it continues. 00:02:57.090 --> 00:03:00.129 That's really devastating. Yeah, exactly. So 00:03:00.129 --> 00:03:02.610 your body doesn't fight the virus off, but it 00:03:02.610 --> 00:03:04.590 does fight the initial flu -like symptoms off. 00:03:04.870 --> 00:03:07.349 And that leads to the second stage, which is 00:03:07.349 --> 00:03:10.590 chronic HIV or the clinical latent stage. It's 00:03:10.590 --> 00:03:13.490 where HIV is active, but it's producing at such 00:03:13.490 --> 00:03:15.810 low levels because again, it's skyrocketed those 00:03:15.810 --> 00:03:18.319 hundreds of copies out in the beginning. And 00:03:18.319 --> 00:03:20.340 it's producing at such low levels now that you're 00:03:20.340 --> 00:03:22.800 not really having symptoms. And so during this 00:03:22.800 --> 00:03:25.960 time period, people might not know that they 00:03:25.960 --> 00:03:28.599 have HIV, but they're still definitely spreading 00:03:28.599 --> 00:03:30.800 it if they're not being treated. And then AIDS 00:03:30.800 --> 00:03:33.080 is actually what we like to think of as stage 00:03:33.080 --> 00:03:36.340 three or end stage HIV. It's the most severe 00:03:36.340 --> 00:03:39.539 phase and it's defined as a CD4 plus T cell count 00:03:39.539 --> 00:03:45.889 of below 200 cells. or the presence of opportunistic 00:03:45.889 --> 00:03:49.370 infections. So when people die of AIDS -related 00:03:49.370 --> 00:03:51.969 illness, it's not the virus itself that's killing 00:03:51.969 --> 00:03:55.069 them. It's things like rare forms of cancer and 00:03:55.069 --> 00:03:57.009 rare viruses that are attacking their immune 00:03:57.009 --> 00:04:00.990 system that would normally be fought off very 00:04:00.990 --> 00:04:02.949 easily by a healthy immune system. These things 00:04:02.949 --> 00:04:05.590 are able to kill someone living with HIV and 00:04:05.590 --> 00:04:09.080 someone suffering from AIDS. I think it's important 00:04:09.080 --> 00:04:12.180 to note too that it's less than 200 of those 00:04:12.180 --> 00:04:16.040 CD4 plus T cells per milliliter of blood. Well, 00:04:16.040 --> 00:04:19.939 your normal range is between 600 and 1200. Yeah, 00:04:19.959 --> 00:04:22.139 yeah. So that's what, like a third to a sixth? 00:04:22.459 --> 00:04:25.519 A third to a sixth. You're highly immunocompromised 00:04:25.519 --> 00:04:28.279 once you've reached AIDS. And yeah, and immunocompromised 00:04:28.279 --> 00:04:30.639 is the term that we like to use when someone's 00:04:30.639 --> 00:04:34.199 immune system has been weakened that far. And 00:04:34.199 --> 00:04:37.279 so just moving on to modes of transmission here. 00:04:37.629 --> 00:04:40.910 I like to say that HIV is spread by five and 00:04:40.910 --> 00:04:44.689 a half bodily fluids. Five and a half? Do go 00:04:44.689 --> 00:04:48.370 on. So there are five and a half bodily fluids 00:04:48.370 --> 00:04:50.870 capable of transmitting the HIV virus, as you 00:04:50.870 --> 00:04:55.410 said. Those include blood, vaginal fluids, rectal 00:04:55.410 --> 00:05:00.610 fluids, breast milk, semen, and pre -adjaculate. 00:05:01.449 --> 00:05:04.209 Blood commonly transmits HIV in cases of sharing 00:05:04.209 --> 00:05:07.360 needles or blood transfusions. Vaginal fluids 00:05:07.360 --> 00:05:09.899 can transmit HIV through unprotected vaginal 00:05:09.899 --> 00:05:13.819 sex. Rectal fluids can transmit HIV through unprotected 00:05:13.819 --> 00:05:16.920 anal sex. And breast milk can transmit HIV from 00:05:16.920 --> 00:05:19.639 mother to baby during breast milk and semen, 00:05:19.939 --> 00:05:21.800 including pre -ejaculate. That's that half there, 00:05:22.040 --> 00:05:24.819 guys. Did you catch it? It can transmit HIV through 00:05:24.819 --> 00:05:28.000 unprotected vaginal, anal, or oral sex. And I 00:05:28.000 --> 00:05:30.600 like to specifically include pre -ejaculate. 00:05:30.779 --> 00:05:32.980 Because you would be surprised how many times 00:05:32.980 --> 00:05:36.079 we get the, well, he didn't come, so there wasn't 00:05:36.079 --> 00:05:38.800 a problem, right? It's also probably important 00:05:38.800 --> 00:05:41.240 to point out that vaginal fluids are capable 00:05:41.240 --> 00:05:44.480 of transmitting the HIV virus to a baby during 00:05:44.480 --> 00:05:47.680 childbirth. Yes, if the mother is untreated. 00:05:47.879 --> 00:05:50.120 Nowadays, as we'll talk about a little bit more, 00:05:50.379 --> 00:05:53.300 we've gotten treatment down to where not necessarily 00:05:53.300 --> 00:05:58.120 always a conduit of the virus. Oh, absolutely. 00:05:58.699 --> 00:06:02.540 So how is HIV not transmitted? So HIV is not 00:06:02.540 --> 00:06:06.879 transmitted by hugging, kissing, sharing dishes, 00:06:07.579 --> 00:06:09.819 sharing toilet seats with someone who is HIV 00:06:09.819 --> 00:06:13.040 positive. It is not transmitted through the air. 00:06:13.379 --> 00:06:15.199 Yeah, it's not transmitted by any of those things 00:06:15.199 --> 00:06:18.000 that we commonly think of as casual contact. 00:06:18.480 --> 00:06:20.759 Again, like it can only be transmitted by those 00:06:20.759 --> 00:06:24.069 five and a half bodily fluids. So let's take 00:06:24.069 --> 00:06:27.509 a look here at some common myths about HIV. So 00:06:27.509 --> 00:06:30.149 myth number one, HIV is the same as AIDS. Caitlin, 00:06:30.389 --> 00:06:32.490 why isn't that true? Well, we already went over 00:06:32.490 --> 00:06:35.490 that, basically. AIDS is the end stage of HIV. 00:06:35.990 --> 00:06:38.350 It is where your immune system is most compromised, 00:06:38.569 --> 00:06:40.910 where your CD4 plus T -cell count has dipped 00:06:40.910 --> 00:06:44.689 below 200. And most of the time, it's kind of 00:06:44.689 --> 00:06:46.930 fatal at that point, although we do bring people 00:06:46.930 --> 00:06:50.610 back from AIDS diagnosis nowadays. Yeah, it's 00:06:50.610 --> 00:06:54.110 it's fatal when we find somebody in full -blown 00:06:54.110 --> 00:06:56.589 AIDS and they haven't received treatment yet 00:06:56.589 --> 00:06:59.129 People will say all the time. Oh, I want an AIDS 00:06:59.129 --> 00:07:01.730 test and the thing about that is like You want 00:07:01.730 --> 00:07:04.290 your CD4 plus T cell count check to see if it's 00:07:04.290 --> 00:07:06.389 below 200 knowing that you're living with HIV 00:07:06.389 --> 00:07:09.149 Interesting because you could just be on treatment 00:07:09.149 --> 00:07:12.689 but whatever and so yeah, that's commonly that's 00:07:12.689 --> 00:07:14.490 something we hear a lot and so that really just 00:07:14.490 --> 00:07:16.870 clarifies You know, you can get tested for HIV 00:07:16.870 --> 00:07:19.810 and if you are living with HIV if you don't get 00:07:19.810 --> 00:07:21.850 treatment, you know, that could result in AIDS 00:07:21.850 --> 00:07:25.509 later on. And so myth number two is that HIV 00:07:25.509 --> 00:07:28.550 can be transmitted through casual contact. Caitlin 00:07:28.550 --> 00:07:32.089 went over all those ways you can't get HIV, and 00:07:32.089 --> 00:07:34.529 it's really just those five and a half bodily 00:07:34.529 --> 00:07:36.569 fluids. If you would like me to repeat them, 00:07:36.730 --> 00:07:41.389 it is blood, breast milk, rectal fluid, vaginal 00:07:41.389 --> 00:07:45.089 fluid, and semen, including pre -ejaculate. I 00:07:45.089 --> 00:07:47.519 hope you're not really coming into contact with 00:07:47.519 --> 00:07:49.620 any of those things casually guys that's not 00:07:49.620 --> 00:07:51.620 just like your everyday walking around coming 00:07:51.620 --> 00:07:53.220 into contact with those i mean sometimes we come 00:07:53.220 --> 00:07:55.959 into contact with those things a lot no judgment 00:07:55.959 --> 00:07:59.100 but there usually is some intention behind coming 00:07:59.100 --> 00:08:02.899 into contact with those things so myth number 00:08:02.899 --> 00:08:06.300 three only certain groups are at risk for hiv 00:08:06.300 --> 00:08:09.379 so it is very well stigmatized that hiv began 00:08:09.379 --> 00:08:14.199 as a gay men's virus. In fact, it was called 00:08:14.199 --> 00:08:18.160 the gay cancer as the early stages of the 1980s. 00:08:18.420 --> 00:08:21.959 But that is just not true. HIV does not discriminate. 00:08:22.779 --> 00:08:24.959 It does not attack certain racial groups, does 00:08:24.959 --> 00:08:28.779 not attack just certain sexualities. Anybody 00:08:28.779 --> 00:08:32.799 is capable of contacting the HIV virus. Yeah, 00:08:32.799 --> 00:08:34.980 I like to think about this. It's not called the 00:08:34.980 --> 00:08:37.840 gay immunode. deficiency virus is that called 00:08:37.840 --> 00:08:41.080 the black immunodeficiency virus it is the human 00:08:41.080 --> 00:08:43.980 immunodeficiency virus literally anyone in the 00:08:43.980 --> 00:08:46.220 human race could come into contact with this 00:08:46.220 --> 00:08:49.460 virus especially if you are sexually active or 00:08:49.460 --> 00:08:53.159 um using injection drug needles that's a very 00:08:53.159 --> 00:08:56.700 good way of putting it for human and myth number 00:08:56.700 --> 00:08:58.899 four you can tell if someone has hiv just by 00:08:58.899 --> 00:09:02.740 looking at them that's kind of crazy um Can you 00:09:02.740 --> 00:09:04.539 tell if somebody has diabetes just by looking 00:09:04.539 --> 00:09:07.539 at them? That's another chronic illness that 00:09:07.539 --> 00:09:10.500 someone would have to manage. It comes from the 00:09:10.500 --> 00:09:14.340 early times of the virus when gay men were developing 00:09:14.340 --> 00:09:18.120 those carposy, sarcoma, cancers. They were losing 00:09:18.120 --> 00:09:22.399 rapid amounts of weight. But you don't see that 00:09:22.399 --> 00:09:24.759 very much anymore. With modern day treatments, 00:09:25.059 --> 00:09:27.639 people are staying undetected and staying healthy. 00:09:27.960 --> 00:09:29.559 And so it's important to mention, you know, when 00:09:29.559 --> 00:09:31.759 she's talking about you know, in those early 00:09:31.759 --> 00:09:35.259 days, those people clinically had AIDS. They 00:09:35.259 --> 00:09:38.179 had their CD4 plus T cell count was extremely 00:09:38.179 --> 00:09:40.460 low and they were seeing those opportunistic 00:09:40.460 --> 00:09:43.509 infections and cancers. And so I don't want to 00:09:43.509 --> 00:09:45.149 say you could tell if somebody has AIDS just 00:09:45.149 --> 00:09:48.009 by looking at them, but that is a much more serious 00:09:48.009 --> 00:09:51.429 case of illness where a person might actually 00:09:51.429 --> 00:09:53.429 be suffering the health consequences that could 00:09:53.429 --> 00:09:55.789 show up physically. Oh, yes, absolutely. You 00:09:55.789 --> 00:09:58.870 did not see those in normal healthy people. A 00:09:58.870 --> 00:10:01.629 normal healthy person's immune system would fight 00:10:01.629 --> 00:10:04.919 those off on its own. But you only see it when 00:10:04.919 --> 00:10:07.840 that immune system is extremely compromised. 00:10:08.460 --> 00:10:11.840 Exactly. So someone living with HIV whose immune 00:10:11.840 --> 00:10:15.340 system is not compromised in that way, they live 00:10:15.340 --> 00:10:18.240 a perfectly normal, healthy looking life. Yeah, 00:10:18.340 --> 00:10:20.399 you would you would never know again, since it's 00:10:20.399 --> 00:10:24.019 not something that can be that's only affecting 00:10:24.019 --> 00:10:27.539 certain groups, or it's not something that discriminates 00:10:27.539 --> 00:10:31.799 anybody could have HIV, which is why It's so 00:10:31.799 --> 00:10:33.720 important to get tested because many people don't 00:10:33.720 --> 00:10:36.899 show symptoms. As we were saying earlier, those 00:10:36.899 --> 00:10:39.559 initial flu -like symptoms occur, but after that, 00:10:40.000 --> 00:10:42.279 and especially if you think that was just a cold 00:10:42.279 --> 00:10:45.799 or flu, nobody can really tell until they get 00:10:45.799 --> 00:10:48.100 tested that they are living with HIV. That's 00:10:48.100 --> 00:10:50.600 why we recommend being tested every 90 days, 00:10:50.840 --> 00:10:54.320 testing often and frequently. Especially if you're 00:10:54.320 --> 00:10:58.259 having multiple or anonymous partners. Yes, yes. 00:10:58.360 --> 00:11:00.379 And that's one of the top ways to prevent HIV 00:11:00.379 --> 00:11:02.600 is just frequently testing if you're sexually 00:11:02.600 --> 00:11:05.519 active. And if you are in the mobile area, you 00:11:05.519 --> 00:11:07.379 can always come to AIDS Alabama South to get 00:11:07.379 --> 00:11:10.500 tested. Our clinic hours are 9 a .m. to 3 30 00:11:10.500 --> 00:11:14.179 p .m. Monday, Wednesday, and Thursday. And then 00:11:14.179 --> 00:11:16.919 on Tuesday, it's 9 a .m. to 7 p .m. And then 00:11:16.919 --> 00:11:19.820 Friday is appointment. If you are not in the 00:11:19.820 --> 00:11:22.340 mobile area, local health departments usually 00:11:22.340 --> 00:11:26.240 test for HIV and all other STIs for free or low 00:11:26.240 --> 00:11:30.519 cost. Some other methods of prevention. So one 00:11:30.519 --> 00:11:33.700 of the most common and frequent is condoms. Condoms 00:11:33.700 --> 00:11:37.679 are 99 % effective at stopping HIV virus prevention 00:11:37.679 --> 00:11:40.580 and other types of barriers including dental 00:11:40.580 --> 00:11:44.500 dams. I always find it hilarious when we go out 00:11:44.500 --> 00:11:47.440 and we have to explain what a dental dam is, 00:11:47.559 --> 00:11:49.519 and more often than not somebody's pulling one 00:11:49.519 --> 00:11:52.120 out and showing. It's usually me. It's usually 00:11:52.120 --> 00:11:54.100 me who opens the dental dam and shows them how 00:11:54.100 --> 00:11:57.279 to use it. Anyway, and then we also, so in addition 00:11:57.279 --> 00:11:59.360 to condoms and barrier methods, we also have 00:11:59.360 --> 00:12:01.940 pre -exposure prophylaxis, which is a medication 00:12:01.940 --> 00:12:05.659 taken by HIV negative individuals every day to 00:12:05.659 --> 00:12:08.580 prevent infection. It's kind of like birth control, 00:12:08.740 --> 00:12:12.690 but for HIV prevention. can be a pill taken every 00:12:12.690 --> 00:12:15.669 day or there is also a shot taken every other 00:12:15.669 --> 00:12:20.110 month. And these are over 99 .8 % effective at 00:12:20.110 --> 00:12:22.610 preventing HIV if a person does come into contact 00:12:22.610 --> 00:12:26.350 with the virus. We are very hopeful that a six 00:12:26.350 --> 00:12:30.210 month injectable is on its way. I believe they've 00:12:30.210 --> 00:12:34.210 started testing in the US now. Awesome, awesome. 00:12:35.070 --> 00:12:38.090 PEP or post exposure prophylaxis is basically 00:12:38.090 --> 00:12:40.509 the same thing as pre exposure prophylaxis, but 00:12:40.509 --> 00:12:43.570 used in emergency circumstances. So it involves 00:12:43.570 --> 00:12:48.610 taking one pill for 28 days. It is the same antiviral 00:12:48.610 --> 00:12:51.889 medications that we used to treat HIV, but as 00:12:51.889 --> 00:12:55.070 a post exposure. So you have a 72 hour window 00:12:55.070 --> 00:12:58.090 or three days to come down to our clinic or any 00:12:58.090 --> 00:12:59.990 of your other health professionals to get on 00:12:59.990 --> 00:13:02.629 PEP if you think you might have been exposed 00:13:02.629 --> 00:13:05.769 to the HIV virus. You do not have to know for 00:13:05.769 --> 00:13:07.690 certain that you were exposed to the virus to 00:13:07.690 --> 00:13:09.929 get on PEP. If you think there's a possibility, 00:13:09.970 --> 00:13:12.370 if you wake up in the next morning and you don't 00:13:12.370 --> 00:13:14.289 know who you slept with and they're already gone, 00:13:14.710 --> 00:13:16.929 hey, come on down. We could just start on a round 00:13:16.929 --> 00:13:20.789 of PEP, post -exposure prophylaxis. Yep, yep. 00:13:20.929 --> 00:13:23.230 And that also comes in super handy in cases of 00:13:23.230 --> 00:13:26.690 assault. If a person just wants to feel safe 00:13:26.690 --> 00:13:30.269 and secure that even though their physical body 00:13:30.269 --> 00:13:32.429 was violated, their health doesn't have to be, 00:13:32.509 --> 00:13:35.649 PEP works great. And we mentioned testing already, 00:13:35.750 --> 00:13:39.590 last but not least, certainly not least, we have 00:13:39.590 --> 00:13:43.230 safe needle practices. So I would love it if 00:13:43.230 --> 00:13:45.490 everybody could avoid doing injection drugs in 00:13:45.490 --> 00:13:47.149 the first place. Like I would seriously love 00:13:47.149 --> 00:13:49.149 that, but I do know that we don't live in a perfect 00:13:49.149 --> 00:13:52.190 world. So avoiding sharing needles is a huge 00:13:52.190 --> 00:13:54.529 way that people can lower their risk of contracting 00:13:54.529 --> 00:13:57.149 HIV. Because again, you can't tell if someone 00:13:57.149 --> 00:13:58.970 has HIV just by looking at them. You don't know 00:13:58.970 --> 00:14:00.629 if your buddy next to you is living with the 00:14:00.629 --> 00:14:03.129 virus. They might not even know. So avoiding 00:14:03.129 --> 00:14:05.990 sharing needles. It's not just sharing needles 00:14:05.990 --> 00:14:08.970 too, using the same spoon or something to draw 00:14:08.970 --> 00:14:11.909 from as somebody else, you know, there's transmission 00:14:11.909 --> 00:14:15.309 that occurs in that as well. So just sharing 00:14:15.309 --> 00:14:19.070 any kind of equipment used to prepare or inject 00:14:19.070 --> 00:14:21.509 drugs is probably not in your best interest. 00:14:21.889 --> 00:14:24.090 That's a really good point. And then also there 00:14:24.090 --> 00:14:27.470 are harm reduction services, you know, that apply 00:14:27.470 --> 00:14:29.490 there. And Caitlin was talking a little bit about 00:14:29.490 --> 00:14:31.549 personal protective equipment. If you're working 00:14:31.549 --> 00:14:35.470 in the healthcare field at all, you know, using 00:14:35.470 --> 00:14:38.549 gloves, using protection when handling bodily 00:14:38.549 --> 00:14:41.649 fluids is super important. It also went hard 00:14:41.649 --> 00:14:45.110 to get on PrEP too. So I got on it just because 00:14:45.110 --> 00:14:47.450 of this job being in the constant going out and 00:14:47.450 --> 00:14:50.750 trying to find HIV and get those people that 00:14:50.750 --> 00:14:52.789 are, you know, living with HIV and not knowing 00:14:52.789 --> 00:14:56.269 it at risk for being exposed to it myself. So 00:14:56.269 --> 00:14:58.309 getting on PrEP was something that I chose to 00:14:58.309 --> 00:15:02.950 do. And then also, HIV is more treatable than 00:15:02.950 --> 00:15:07.549 it has ever been. So antiretroviral therapy is 00:15:07.549 --> 00:15:10.149 the treatment that we are using to control HIV. 00:15:10.549 --> 00:15:12.610 There are a couple different types of medication 00:15:12.610 --> 00:15:15.090 that are used. Caitlin was explaining earlier 00:15:15.090 --> 00:15:18.470 about how HIV attaches to a cell, enters into 00:15:18.470 --> 00:15:21.629 that nucleus, replicates and spits back out copies 00:15:21.629 --> 00:15:25.009 of itself. So yeah, today there are six different 00:15:25.009 --> 00:15:27.649 types of medications. I can't tell you exactly 00:15:27.649 --> 00:15:29.649 what they are, but I know each of them does a 00:15:29.649 --> 00:15:32.289 specific different thing for the body. Some of 00:15:32.289 --> 00:15:35.470 those medications will stop the HIV virus from 00:15:35.470 --> 00:15:39.210 being able to attach to the T cells. Some of 00:15:39.210 --> 00:15:41.289 them will strengthen the cell wall so that it 00:15:41.289 --> 00:15:43.389 prevents the virus from being able to pass its 00:15:43.389 --> 00:15:46.350 DNA into the virus. And some of them will even 00:15:46.350 --> 00:15:49.610 stop the virus from being able to come out of 00:15:49.610 --> 00:15:52.590 an infected T cell. So our gold standard today 00:15:52.590 --> 00:15:55.610 is three different medications from two or more 00:15:55.610 --> 00:15:59.779 classes of drugs. and in all that you know an 00:15:59.779 --> 00:16:01.539 important thing to remember is like it is through 00:16:01.539 --> 00:16:04.200 different medications but most regimens today 00:16:04.200 --> 00:16:07.580 are one pill a day regimens absolutely back in 00:16:07.580 --> 00:16:10.000 the day people were on cocktails of medications 00:16:10.000 --> 00:16:14.220 taking 12 20 pills different times of the day 00:16:14.220 --> 00:16:17.960 yeah but today it's one pill a day or there's 00:16:17.960 --> 00:16:21.990 also a bimonthly injection as well And this is 00:16:21.990 --> 00:16:24.250 super important because with treatment today, 00:16:24.389 --> 00:16:26.309 people can go on to live long and happy lives. 00:16:26.470 --> 00:16:28.850 And by long and happy, I mean that they can reach 00:16:28.850 --> 00:16:33.269 a level of viral suppression where they are no 00:16:33.269 --> 00:16:36.169 longer able to transmit the virus to another 00:16:36.169 --> 00:16:39.029 person. And we call that U equals U, undetectable 00:16:39.029 --> 00:16:42.169 equals untransmittable. So undetectable equals 00:16:42.169 --> 00:16:45.340 untransmittable. Basically, we perform a laboratory 00:16:45.340 --> 00:16:48.700 test, a viral load test, which is a lab test 00:16:48.700 --> 00:16:51.240 that measures the number of HIV virus particles 00:16:51.240 --> 00:16:54.379 in a milliliter of your blood. Our modern medical 00:16:54.379 --> 00:16:57.879 tests are capable of detecting as few as 20 copies 00:16:57.879 --> 00:17:00.799 of the HIV virus in a milliliter of blood. Where 00:17:00.799 --> 00:17:03.600 at peak infection, you're going to have over 00:17:03.600 --> 00:17:06.559 100 ,000 copies of the HIV virus in that same 00:17:06.559 --> 00:17:10.440 amount of blood. But if we can't find it, if 00:17:10.440 --> 00:17:14.200 it's less than that 20, that we can detect, you're 00:17:14.200 --> 00:17:16.420 considered undetectable at that point. And you 00:17:16.420 --> 00:17:20.140 cannot, I repeat, cannot transmit the HIV virus 00:17:20.140 --> 00:17:23.220 to another person. Yes, when someone is undetectable, 00:17:23.259 --> 00:17:25.180 they are untransmittable. And it's important 00:17:25.180 --> 00:17:29.079 to note that as medical tests have gotten better 00:17:29.079 --> 00:17:31.660 and better, we've been able to detect fewer and 00:17:31.660 --> 00:17:35.839 fewer copies. But the standard for being untransmittable 00:17:35.839 --> 00:17:39.220 is actually the standard for viral suppression, 00:17:39.440 --> 00:17:42.579 which is a bit older based on tests that were 00:17:42.579 --> 00:17:45.339 not able to pick up as many copies. So the standard 00:17:45.339 --> 00:17:49.400 for viral suppression is, I believe, 200 copies 00:17:49.400 --> 00:17:51.220 per milliliter of blood, even though the test 00:17:51.220 --> 00:17:53.480 might be able to pick up a little bit more. If 00:17:53.480 --> 00:17:55.759 somebody is under that 200, they are not able 00:17:55.759 --> 00:17:57.819 to transmit the virus to another human being. 00:17:58.119 --> 00:18:01.720 And that's huge. When I first started in HIV 00:18:01.720 --> 00:18:04.420 a little over a year ago, I was told that it 00:18:04.420 --> 00:18:07.019 was at 50 copies, but I have since learned that 00:18:07.019 --> 00:18:09.500 we've gotten better and it's down to 20. Yeah, 00:18:09.700 --> 00:18:11.920 and so the test just keeps getting better and 00:18:11.920 --> 00:18:14.440 better. But, you know, as long as somebody is 00:18:14.440 --> 00:18:16.500 under that 200, they cannot transmit to another 00:18:16.500 --> 00:18:19.579 person. And that's easily achieved, usually within 00:18:19.579 --> 00:18:22.799 the course of one to three months of being on 00:18:22.799 --> 00:18:26.420 antiretroviral therapy. So not only is somebody 00:18:26.420 --> 00:18:29.279 who is virally suppressed unable to transmit 00:18:29.279 --> 00:18:32.039 the virus to another human being, but it also 00:18:32.440 --> 00:18:34.799 kind of helps a lot with some of that stigma, 00:18:35.059 --> 00:18:37.339 stigma that was surrounding HIV. Because when 00:18:37.339 --> 00:18:41.339 you think about it, 20, 30 years ago, HIV was 00:18:41.339 --> 00:18:43.420 still something that could be a death sentence 00:18:43.420 --> 00:18:47.980 to many people. And so, to take away some of 00:18:47.980 --> 00:18:51.039 that fear, if you contract HIV today and you 00:18:51.039 --> 00:18:53.359 discover it before it hits that age stage and 00:18:53.359 --> 00:18:56.140 you are suffering from a rare type of cancer 00:18:56.140 --> 00:18:57.960 that nobody knows how to treat, if you discover 00:18:57.960 --> 00:19:00.349 it before then and get on treatment, there's 00:19:00.349 --> 00:19:03.509 no reason that you should ever suffer detrimental 00:19:03.509 --> 00:19:05.490 health consequences because of living with the 00:19:05.490 --> 00:19:09.369 virus. In fact, our patients typically lead healthier 00:19:09.369 --> 00:19:12.049 lives than most other people because they come 00:19:12.049 --> 00:19:14.710 see the doctor so often to get tests to make 00:19:14.710 --> 00:19:17.549 sure their medications doing what it's supposed 00:19:17.549 --> 00:19:20.650 to be doing, that they're catching other things 00:19:20.650 --> 00:19:23.609 earlier and quicker. Yeah, and that's truly awesome. 00:19:23.650 --> 00:19:25.990 So it's even promoting health at this stage. 00:19:27.059 --> 00:19:29.819 And so we've talked to you a little bit about 00:19:29.819 --> 00:19:32.799 the basics of HIV, what it is, how it's transmitted, 00:19:33.240 --> 00:19:36.099 those different stages. We've dispelled a few 00:19:36.099 --> 00:19:38.380 myths and explained how you can both prevent 00:19:38.380 --> 00:19:41.299 and treat HIV. I just want to remind everybody 00:19:41.299 --> 00:19:43.440 how important it is to get tested, you know, 00:19:43.900 --> 00:19:48.079 every 90 to 180 days, every 36 months. And if 00:19:48.079 --> 00:19:51.490 you do frequently come into contact with with 00:19:51.490 --> 00:19:54.529 any of those five and a half bodily fluids, the 00:19:54.529 --> 00:19:56.789 importance of pre -exposure prophylaxis, which 00:19:56.789 --> 00:19:59.230 is readily available for anybody who wants it, 00:19:59.869 --> 00:20:01.690 and adherence to treatment if you are living 00:20:01.690 --> 00:20:05.849 with HIV. You can find more resources and support 00:20:05.849 --> 00:20:08.250 at AIDSAlabamaSouth .org or you're always welcome 00:20:08.250 --> 00:20:11.569 to come into our clinic. We give out free condoms. 00:20:11.809 --> 00:20:14.930 We do give out free condoms. Thank you so much 00:20:14.930 --> 00:20:17.269 for joining me, Caitlin. It's been my pleasure. 00:20:17.809 --> 00:20:20.789 And on our next episode, I'll be with Chance 00:20:20.789 --> 00:20:23.829 talking about advances in HIV care. Thank you.