I am 28. White. A Female. And a former Peace Corps Volunteer. I am HIV Positive. This is my story of how a few months, a few people, and a few events in Zambia changed me and my life forever. This is the story of how I contracted HIV and brought my Peace Corps Journey to a crashing halt... and how I am working now to pick up and put back together the pieces of my life as a newly diagnosed person living with HIV. This was not the journey I had originally planned... my path has traumatically and dramatically changed... but it is the one I am on now. There is no going back. There is only forward. I welcome you to follow along with me as I attempt to explore this new life ahead of me, whether you are someone from the Peace Corps community, or someone living with HIV. I welcome your comments, questions, suggestions, and opinions. Let us go forward together. To start from the beginning, click here He Gave Me More Than A Bracelet.

Monday, December 26, 2011

HIV 101

I would very much like to continue my story from where I left off, but I felt that I first have an obligation to get some facts and information on here to answer some of the questions that people may have about HIV. Therefore, I spent some time today getting down the basics. Please take some time to read through the questions and answers I have posted, even if you think you already have the knowledge. In addition PLEASE PLEASE contact me if you have any questions of any sort, and I will take the time to answer them the best I can. Thanks!

· What is HIV?
o       HIV stands for Human Immuno-deficiency Virus. It is a virus that can only infect human beings. HIV reproduces by taking over human cells and attacking the body’s immune system.
· What is AIDS?
o       AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is a condition that someone acquires or is infected with. AIDS makes the body’s immune system deficient (makes it not work properly). When the immune system does not work properly, people with AIDS may be vulnerable to a number of different diseases and opportunistic infections.
· What is the difference between HIV and AIDS?
o       Someone is said to have HIV or be HIV+ if they have been infected with the HIV virus. This means that the HIV virus is living in their body. People with HIV may or may not have any symptoms of the infection. HIV is the virus that causes or leads to AIDS.
o       Someone is diagnosed with AIDS when the HIV virus in their body causes their immune system to be compromised. This is measured by the CD4 Count and/or the presence of Opportunistic Infections. A person is diagnosed with AIDS when their CD4 count goes below a 200 level or if they experience one or more Opportunistic Infections.
· What is the CD4 Count?
o       CD4 Cells are a type of white blood cells that fight infection. They may also be called T-Helper Cells. HIV damages a person’s CD4 Cells. A normal CD4 count is from 500 to 1,500 cells per cubic millimeter of blood. A low or decreasing CD4 count means that the person’s immune system is weaker, and they may be more likely to get sick. A higher CD4 count means that a person’s immune system is stronger.
o       When a person’s CD4 count falls below 200, they are diagnosed with AIDS and may be more likely to develop opportunistic infections.
· What are Opportunistic Infections?
o       When a person’s immune system is compromised, they may become more vulnerable to certain infections. These are called 'opportunistic infections' because they take advantage of the opportunity offered by a weakened immune system.
o       Some of the most common HIV related opportunistic infections include: Bacterial diseases such as tuberculosis, MAC, bacterial pneumonia and septicemia (blood poisoning); Protozoal diseases such as toxoplasmosis, microsporidiosis, cryptosporidiosis, isopsoriasis and leishmaniasis; Fungal diseases such as PCP, candidiasis, cryptococcosis and penicilliosis; Viral diseases such as those caused by cytomegalovirus, herpes simplex and herpes zoster virus; and HIV-associated malignancies such as Kaposi's sarcoma, lymphoma and squamous cell carcinoma.
· What is the Viral Load?
o       Viral load is the term used to describe the amount of HIV in your blood. The result of a viral load test is described as the number of 'copies' of HIV RNA per milliliter (copies/ml). The more HIV in your blood, the faster your CD4 cells (immune system cells that fight infection) reduce, and the greater your risk of developing symptoms in the next few years.
· Is there a cure for HIV/AIDS?
o       Although there have been many advances in HIV treatments and therapies in recent years that have dramatically improved the quality of life and life expectancy of persons with HIV/AIDS in the US and other developed countries, there is, as of yet, no cure.
o       Very recently there has been one confirmed case of an HIV patient Timothy Brown being “functionally cured” of the virus.
· How is HIV transmitted/contracted/passed/spread?
o       HIV can be transmitted from an infected person to another through:
§         Blood (including menstrual blood)
§         Semen
§         Vaginal secretions
§         Breast milk
o       Blood contains the highest concentration of the virus, followed by semen, followed by vaginal fluids, followed by breast milk.
o       These specific fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the blood-stream (from a needle or syringe) for transmission to possibly occur.
o       The following are additional body fluids that may transmit the virus that health care workers may come into contact with:
§         fluid surrounding the brain and the spinal cord
§         fluid surrounding bone joints
§         fluid surrounding an unborn baby
· What activities CAN spread HIV?
o       Unprotected sexual contact (including vaginal intercourse, anal intercourse, or oral sex)
o       Direct blood contact, particularly through sharing injection drug needles.
o       Infections due to blood transfusions, accidents in health care settings or certain blood products are possible, although they are extremely rare nowadays in the United States.
o       Mother to baby (during pregnancy, during birth, or through breast milk)
o       There is a remote risk from deep, open-mouth kissing if there are sores or bleeding gums and blood is exchanged.
o       There is a remote risk of transmission by human bite. All documented cases where transmission did occur included severe trauma with extensive tissue damage and the presence of blood.
· What activities DO NOT spread HIV?
o       The following "bodily fluids" are NOT infectious:
§         Saliva
§         Tears
§         Sweat
§         Feces
§         Urine
o       HIV is not transmitted by day-to-day contact in the workplace, schools, or social settings. HIV is not transmitted through shaking hands, hugging, or a casual kiss. You cannot become infected from a toilet seat, a drinking fountain, a door knob, dishes, drinking glasses, food, insect bites, or pets.
o       HIV is not an airborne or food-borne virus, and it does not live long outside the body.
· How can transmission of HIV be prevented?
o       Abstain from sexual intercourse or be in a long-term mutually monogamous relationship with a partner who has been tested and you know is uninfected.
o       Latex condoms, when used consistently and correctly, are highly effective in preventing heterosexual sexual transmission of HIV.
o       Never reuse or "share" syringes, water, or drug preparation equipment. Do not share other tools that may come into contact with blood, such as razors.
o       Get tested and know your status. Make sure your partner(s) are tested and know their status.
o       Follow guidelines to prevent Mother to Child Transmission.
· What is Acute HIV Infection?
o       Primary or acute HIV infection occurs 2 - 4 weeks after infection with the human immunodeficiency virus (HIV). Acute HIV infection can appear like infectious mononucleosis, flu, or other viral illnesses. If symptoms occur, they are usually seen 1 - 4 weeks after becoming infected. These symptoms can last from a few days to 4 weeks, and then subside. Any of the following symptoms can occur:
§         Decreased appetite
§         Fatigue
§         Fever
§         Headache
§         Malaise
§         Muscle stiffness or aching
§         Rash
§         Sore throat
§         Swollen lymph glands
§         Ulcers of the mouth and esophagus
o       Symptoms may be subtle or non-existent in many people infected with HIV, and it is therefore uncommon for HIV to be recognized and diagnosed during the Acute Infection period.
· What is the treatment for HIV?
o       Antiretroviral therapy (ART) is the recommended treatment for HIV infection. ART involves taking a combination (regimen) of three or more anti-HIV medications daily. ART prevents HIV from multiplying and destroying infection-fighting CD4 cells. This helps the body fight off life-threatening infections and cancer. Although anti-HIV medications can’t cure HIV, people with HIV are enjoying healthy lives and living longer thanks to ART.
· Can treatment prevent HIV from advancing to AIDS?
o       Yes! Treatment with anti-HIV medications prevents HIV from multiplying and destroying the immune system. This helps the body fight off life-threatening infections and cancers and prevents HIV from advancing to AIDS.
· When should someone start on treatment?
o       Even though you have HIV, you may not need to start treatment right away. When to start anti-HIV medications (also called antiretrovirals) depends on several factors, including:
§         Your overall health
§         How well your immune system is working (CD4 count)
§         The amount of HIV in your blood (viral load)
§         Whether you’re pregnant
§         Your ability and willingness to commit to lifelong treatment
o       It’s time to start treatment if:
§         Your CD4 count is less than 500 cells/mm3
§         You have AIDS
§         You’re pregnant
§         You have HIV-related kidney disease
§         You need treatment for hepatitis B virus (HBV)
· What treatments are available?
o       The best combination of anti-HIV medications for you depends on your individual needs. Factors that you and your health care provider will consider when selecting your HIV regimen include:
§         Other diseases or conditions you may have
§         Possible side effects of anti-HIV medications
§         How anti-HIV medications may interact with other medications you take
§         Your drug-resistance testing results
§         Complexity of the regimen—how many pills to take every day and how often, and if pills must be taken with or without food
§         Any personal issues that may make following a regimen difficult (such as depression or alcohol or drug abuse)
· Are there side effects?
o       Anti-HIV medications can cause side effects. Side effects vary depending on the anti-HIV medication. And people taking the same medication may not have the same side effects. Before starting treatment, discuss possible side effects with your health care provider or pharmacist.
o       Most side effects from anti-HIV medications are manageable. However, side effects that become unbearable or life threatening call for a change in medications. Side effects that may seem minor, such as fever, nausea, fatigue, or rash, can indicate serious problems. Once you start treatment, always discuss any side effects from your anti-HIV medications with your health care provider.
· What does it mean to have an Undetectable Viral Load?
o       The amount of HIV in your blood is so low that a viral load test can’t detect the virus. However, having an undetectable viral load doesn’t mean you’re cured. You still have HIV. And although having an undetectable viral load reduces the risk of HIV transmission, you can still infect another person with the virus.
· What is Adherence?
o       Treatment adherence means adhering to (following) your treatment regimen—taking the correct dose of each anti-HIV medication at the correct time and exactly as prescribed. Adherence is very important for successful HIV treatment.
· What is Drug Resistance?
o       Drug resistance develops when the virus mutates (changes form), becoming “resistant” to certain anti-HIV medications. One or more anti-HIV medications in a treatment regimen can become ineffective as a result of drug resistance.
o       Skipping medications makes it easier for drug resistance to develop. HIV can develop resistance to the anti-HIV medications in a person’s current regimen or to other, similar anti-HIV medications not yet taken, limiting options for successful HIV treatment. And drug-resistant strains of HIV can be transmitted to others, too.
· What is PEP?
o       PEP is short for Post-Exposure Prophylaxis and is the use of antiretroviral drugs as soon as possible after a high-risk exposure to HIV, to reduce (but not eliminate) the possibility of HIV infection. PEP is not the morning after pill for HIV. PEP is a four-week program of two or three antiretroviral medications, several times a day. The medications have serious side effects that can make it difficult to finish the program.
o       Treatment should be started promptly, preferably within the first several hours after an exposure. It should be administered within 48 hours of a high-risk exposure (not to exceed 72 hours). After 72 hours PEP is considerably less effective in preventing HIV infection. The sooner PEP is administered, the more effective it is.
· What is PrEP?
o       PrEP is short for PreExposure Prophylaxis and may be part of comprehensive HIV prevention services in which HIV negative people who are at high risk, take antiretroviral medication daily to try to lower their chances of becoming infected with HIV if they are exposed to it. To date, PrEP has been shown to be effective in men who have sex with men (MSM) and heterosexual men and women. A CDC study is also underway to evaluate whether it is safe and effective in reducing HIV infection among injection drug users, but those results are not yet available.
· What kind of life can a person with HIV expect to have?
o       An HIV diagnosis is not a death sentence. Treatment is highly effective and a person with HIV can expect to live an almost normal life. Just because someone is diagnosed with HIV does not mean that they will be sick, dying, or restricted from any normal activities in life that others have.
· Can someone with HIV have a relationship with someone who doesn’t have HIV?
o       Yes. HIV+ people do not have to only date other HIV+ people. Up to fifty percent of people living with HIV who are in relationships are estimated to be part of discordant couples, where one partner has HIV and the other has not.
o       Through safe sexual practices discordant couples can have healthy relationships and remain discordant.
o       Furthermore, studies have confirmed that taking antiretroviral drugs and maintaining an undetectable viral load reduces a HIV+ person’s risk of transmitting the virus to HIV- partners by 96% among heterosexual couples.
· Can someone with HIV have a baby?
o       Yes. HIV+ women can have healthy and HIV- babies without complications. There are specific regimens of drugs and guidelines that pregnant women should follow to prevent transmission to their babies. When following recommended guidelines and treatments, risk of mother to child transmission is very low.
o       An HIV+ man can have his sperm “washed” of HIV and then implanted into his HIV- negative partner in order to conceive safely.
· Can someone with HIV get a job?
o       Yes. People living with HIV can have and perform any job that others can.
o       HIV+ people are not required by law to disclose their status to employers and are protected from discrimination in the workplace and other settings by the Americans With Disabilities Act.
· Do people with HIV have to disclose their status to anyone?
o       People with HIV are not required by law to disclose their status to anyone other than their sexual partners. Each state has different laws about disclosure to sexual partners.
o       Furthermore, HIV+ people have the right to confidentiality in all settings. It is ILLEGAL for someone to disclose the status of another person without their permission.


  1. Jessica, thank you for posting such good and relevant information. People are terrified by what they don't know. I do not know you personally, but feel like I do through Stephanie and through reading about your journey. We all were praying for you when you were sick; and will continue to pray that God uses this situation in your life and the lives of those around you for a greater purpose...and I can see that He is already doing that. Thank you for your transparency and your bravery. From the comments and visitors to your site, I can already see you impacting others for the better. God bless in this journey; like most of life I am sure it will have its ups and downs, but it is all about perspective. He's got this. Hugs from Florida, Clara

  2. Excellent post, and way to stay informed and let others know! My dad was HIV+ for over 20 years... (he did die from AIDS, but I believe that was due to him not adhering to his meds and continuing in a risky lifestyle). I admire your candid and frank way of sharing. Thanks for your transparency and honesty! Praying for you :)

  3. Thanks for being so transparent here, Jessica. I don't think we've ever met, but I was friends with Stephanie in high school and have stayed in touch with her. My husband and I have been praying about adopting a child who is HIV+, so learning about your journey is helping to educate us as well. We're praying for you, and we're thankful for you!

  4. Good Job. Sorry about not calling sooner but I've been to busy to do anythiung else. I'll call in a day or two, but tell Nancy (Mother nature) we said hellop and ask if she has an extra bed for two lovely people.

    Love you.
    Grandpa Jack.

    grandpa jack

  5. Spend your holidays abroad with HIV. Travel restrictions and retreats here: www.plwha.org

  6. Hi. I worked for an NGO in West Africa that focuses on HIV and AIDS. I found your blog through a friend's Facebook post. I admire your bravery and transparency. Thank you so much for providing others with relevant HIV information. More people need to be informed.

  7. I just wanted to say thank you for being brave enough to create this blog and put it out there for everyone to see. My sister is currently in the PC in Africa and although your blog made me pretty scared for her, I am happy that she, and her fellow PC Volunteers had the chance to see this. I know for a fact that this blog will be what saves someone else from getting HIV. This will be in the back of everyone's mind (if not in the front), and people will definitely think twice before just trusting the person they're with that they were tested. I'm hoping this will teach everyone to go get tested with their partner and see the results before taking the next step in their relationship.

    My heart goes out to you, and again, I am so grateful for you sharing your story with the world.

  8. "Furthermore, HIV+ people have the right to confidentiality in all settings. It is ILLEGAL for someone to disclose the status of another person without their permission."

    Unless there's yet another law I haven't read of, this isn't true in the United States. Free speech and all that. It would apply to medical professionals who have knowledge of HIV status as part of their job, but generally speaking, there would be no such restriction or expectation of confidentiality.

    Great blog.

    1. Thank you for your comment. It actually caused me to go back and research this further.

      I was told by doctors (I believe in DC) that it was illegal for others to disclose your status without permission. Upon further research, I have found that the laws vary from state to state, and it may or may not be illegal. It was difficult to find a clear answer, and I didn't really have time to search and read through legal jargo all night, but here is some of what I found:
      HIV Status: It is difficult to keep someone from telling others about your HIV status. Unlike HIV test results, HIV status is any reference that you are living with HIV/AIDS – it does not have to be a piece of paper listing your HIV-positive test result. Your rights may be violated if another person discloses your HIV/AIDS status to other people without your permission, although it may be very difficult to prove.

      The legal protections you have available to you are only remedial; they may help you to punish a person, but they cannot prevent the disclosure of your status in the first place. You must be very careful before you decide to disclose your HIV status to another person.

      If someone discloses your HIV/AIDS status or HIV test results, you may be able to sue for damages, including psychological harm, depression, and damage to your reputation. You may also be entitled to damages, including relief to prevent and restrain the invasion of your privacy, compensatory monetary damages, and attorney fees. Each case is different. (See Wis. Stat. § 252.15(8), (9) (2007)) A person who is proven to give publicity to the details of one’s private life without any legitimate public purpose may be liable for the damages listed above (see Wis. Stat. § 995.50 (2007)).

      If you know someone who is telling other people that you have HIV/AIDS or disclosing your HIV test results without your consent, it is best to consult with an attorney (see the Resources chapter). http://www.legalexplorer.com/legal/legal-QA.asp?PositionPoint=&Sid=2&Qid=2#quest

      1) My boyfriend and I had a big fight. Now he's threatening to tell my family and neighbors that I'm HIV positive. Can he do that?

      Legally, he cannot. The Illinois AIDS Confidentiality Act states that no person can disclose your HIV result without permission from you. So if your boyfriend starts telling people that you are HIV positive, and you have not given him permission to do so, he is breaking the law.

      2) What can I do to stop someone from telling other people I'm HIV positive?

      One thing you can do is make it very clear to that person that any unauthorized disclosure of your HIV status is a violation of the law. The Illinois AIDS Confidentiality Act says that each time someone intentionally discloses your HIV status, that person can be fined $10,000 by the courts. If this person is threatening to tell five people about your HIV status, he might be liable for $50,000 in damages! http://www.aidslegal.com/Publications/Confidentiality_English.pdf

      HIV status is confidential and disclosure by an uninvolved third party can lead to civil suits, penalties, and damages. http://ph.lacounty.gov/phcommon/public/faqs/faqdisplist.cfm?ou=ph&prog=pho&unit=aids

  9. hi Jessica,
    Thank you for everything you have done so far and everything you will do to bring HIV out of the whispers and shadows it hides in. i have one question about transmission maybe you know the answer to. i am wondering if there is any difference in the risk of getting hiv from oral sex if u swallow the semen versus not since that is where the hiv remains. thank you. i will continue to follow you on your journey. are you attending the international aids conference in july?

    1. As far as I know, swallowing the semen is not a bigger risk than not swallowing, because the acids in our stomach kill the virus. Therefore, it is not likely that transmission would happen from the virus being in one's stomach. It is more likely that transmission happens when the semen is in the mouth, and somehow passes into the bloodstream (this can be through tiny cuts from flossing/brushing, cold sores, etc.). I did read somewhere that if a person has a sore throat or some sort of infection in the throat, that this could make it easier for the virus to be transmitted while swallowing. Big Key Picture here: Once semen enters your mouth, whether swallowed or not, you are at risk of getting it. (Just an additional note to remember: Pre-cum can also contain HIV, so it is also not totally safe to have pre-cum in your mouth)

  10. Thank you for sharing your story ... I know it took lots of courage to do so young lady. I found your blog after searching for the "Angels in the Dust" movie...I do have a question...How did you get sick so quickly if it is HIV and not AIDS?

    Thank you

    1. Acute Infection- it happens within the first few weeks of contracting, as your body has not yet recognized and adjusted to or built up antibodies to combat the virus. Most people just get mildly sick. For some reason (maybe due to poor diet or other things?), I got very sick.