1. The story of a pregnant mother
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The story of a pregnant mother
My name is Nosi. I found out that I was HIV positive in 2001. I was pregnant and had to do the test so that I
can take safety measures for my baby.
I knew that I could be HIV positive because earlier on that same year, an ex-boyfriend of mine had come to
tell me that he is HIV positive and has been for a while and would like me to go for a test as well. We have
had sex without using any protection.
2002 I gave birth to a beautiful baby boy. He is now four years old and is the reason I am alive today. I went
through depression and thought I was going to die, but I did not. I lived because I was carrying him, I talked
to him while he was in my stomach, I apologized for bringing him to the world with such a risk at hand.
Fortunately when I tested him in this year, he tested negative. I thank God for him because I do not think I
would have been able to live with myself if he had tested positive.
It’s been a year and a few months now since I broke up with my son’s father and although I miss him but I
know that we have a relationship that was not functioning properly. My son loves him so much and I would
love us to be a family but I don’t think it’s going to happen.
The good news though is that I met a man whom I told immediately that I am positive and he was okay with
it, he is still around. He makes me so happy. He has brought so much joy in my life and I know that when I
look back at my life I can smile because he loves me and has loved me and nothing else matters because
he loves me.
I would love to get married to him but sometimes feel that it will be unfair to him to do that because we
cannot have kids, although he has a child and I have one. My dream is to marry him and become his wife.
He is a gentle soul and loves me so.
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Pablo’s story
Pablo is eighteen years old.He left his high school in Pueba, a city in Mexico. Pablo often got into trouble at
school.He used drugsand rarely went to class.His parents ?nally made him leave their house andPablo
moved into a friend’s home.His friend had recently stopped usingdrugs and he encouraged Pablo to go to a
drug treatment program for help.Pablo went to the program and stopped using drugs.Later he
attendedclasses at night and ?nished high school.
Pablo went to get an HIV test because he was worried that he might havebeen infected when he shared
needles two years before.A week later helearned that he had HIV.He went back to his friends from the drug
treatmentprogram and they helped him deal with the bad news.
After a while, Pablodecided that he wanted to help teach other young people about HIV so thatthey would
not get the virus like he did.
He comes to you for advice:
“Can youhelp me teach the students at my old high school about HIV and drugs? Howcan I reach
teenagers who do not go to school? How can I get on the radio ortelevision to tell people about HIV?”
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2. Read it with SpeakIt!
Have you been exposed to HIV?
Do you know young ones in your community how are infected with AIDS?
Is there anybody around you whose parents have died after suffering of AIDS?
Have you ever met someone with AIDS?
Can you consider yourself living with a partner who has AIDS?
Have you ever visited a clinic, which is helping people sick of AIDS?
If the answer to any of these questions – one can always put lost of other questions in the same family – is
“Yes”, you should have faced a touching situation.
In that case,
What did you?
How did you react?
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Where people move, HIV moves
More than 300 million people cross international boundaries each year. Transportation has made it easier
for HIV to spread. The virus can travel from London, England to a small village in Asia in a day.
If he has unsafe sex with another person who has HIV, he takes the virus and caries it away across the
world and gives it to another one.
This is how the virus moves. It spreads from person to person, from village to city, and from city to village.
For a virus like HIV there are no borders. Where people move, HIV moves.
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3. HIV in the world
Over 39 million people with HIV
around 22 million men
around 17 million women
Of the 39 million
around 80% got HIV during sex;ofthese,80% got HIV during sexbetween men and women
around 10% got HIV duringinjection drug use
around 5% are children infectedby mothers who have HIV
around 5% got HIV through blood
Numbers of people with HIV indifferent parts of the world
around 26 million in Africa
around 1 million in North America
around 2 million in Latin America
around 8 million in Asia(700 thousands in China)
around 2 million in Europe andCentral Asia
Because HIV is spreading so quickly,we cannot know exactly how manypeople have it.The HIV epidemic is
like a ?re that is spreading through a forest - by the time you have put out part ofit,you ?nd it has moved to
a newarea ofthe woods.
People with HIV in the world:
Year 1980 around 100,000
Year 2004 around 39,000,000
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The spread of HIV can be prevented!
There are ways to avoid, reduce contact with the bodily fluids that spread HIV (blood, sexual fluids, and
breast milk). This info sheet will explain how.
How HIV spreads?
There is still misunderstanding about how HIV is transmitted from one person to another. Knowing the
basics helps you avoid getting the virus if you are HIV-. You can also avoid passing it on if you are HIV+.
HIV is spread through the following body fluids:
Blood (including menstrual blood)
Semen and other male sexual fluids ("pre-cum")
Vaginal fluids
Breast milk
HIV cannot spread through:
Sweat
Tears
Saliva (spit)
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4. Blood products
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Blood products
In the past, HIV was spread in blood products. Many people were infected this way. The blood supply is
now much more strictly tested and controlled. The chances of being infected from receiving blood in lots of
countries are extremely low.
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Unclean needles AVOID them!
Drug users
Many HIV infections happen when people share needles to inject heroin, methamphetamine, or other
drugs. Using fresh needles each time can eliminate the risk. Many cities now offer free needle exchange
programs.
Drug injectors can give HIV not only to other drug users,but also to theirsexual partners and through them
to the poor babies.
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5. Tattooists
When getting a tattoo or body piercing, always go to a licensed professional and make sure the equipment
is sterilized not just with alcohol but rather through using of heat, chemicals, high pressure or filtration.
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Not protected sex
Every sexual act that involves sexual fluids of some kind has at least some risk. Barriers, such as condoms
(male and female), rubber gloves and even plastic food wrap, help reduce risk to a large extent.
Unsafe sex (without condoms or barriers) puts you and your partner at risk for HIV or other sexually
transmitted diseases. Safer sex (using condoms or other barriers correctly and consistently) protects you
and your partner.
Assault
Sexual assault can result in infection if the assailant is HIV+. The risk increases when rape involves anal
penetration, force, and/or multiple assailants. Some forced sexual acts involving wounds can place a victim
at very high risk.
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6. Read it with SpeakIt!
Talking about sex
Many people have sex but do not talk about it.Because of HIV and AIDS. We need to talk about sex.Sexual
partners have to talk about what they are doing.Talkingabout HIV before having sex is much better than
talking about it afterward(or during!).
Often people have thought about HIV but feel uncomfortabletalking about it with their sexual
partners.Those who ?nally talk about HIVusually feel pleased.This is especially true in places where
anxiety aboutinfection is common.
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How to say NO
Here are some ways some people have said “NO”when they did notwant to have sex.You can use these or
think of other ways.
Get the other person’s attention:
Use his ?rst name
Look into his eyes
Say “Listen to me”
Say “no”
Use the words “I said no”
Use a ?rm voice
Hold your body in a way that says no
If pressured to have sex anyway:
Say no again
Suggest doing something else
Leave
Other ways to say no:
Use humor
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7. Ask him why he cares so much about having sex; this puts the pressureon him
Keep repeating what you want
Tell your partner you need to think about it more
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How to avoid spreading HIV through sex
There are some general ways to make sex safer.These are:
1. Choose carefully and limit the number ofsexual partners.
2. Get tested and treated for sexually transmitted diseases,and ask partners toget tested and treated
too.
3. Have safer types ofsex.
4. Use condoms or other barriers during sex.
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Mother-to-child transmission
Mothers with HIV virus can pass the virus to their babies while pregnant, during birth, or by breastfeeding.
New medical techniques have almost eliminated the risk of a baby getting HIV from its mother when safety
measures are taken.
Infected mothers should not breastfeed their babies.
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8. Reduce the risk of transmission
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Reduce the risk of transmission by:
Avoiding contact with sexual fluids by always practicing safer sex
Don’t have sex unless you and your partner are both HIV- and in a long-term, relationship only with
each other
Not using injection drugs, or if you do, always using new or clean needles
Do the HIV test if you are planning to get pregnant and working with a knowledgeable doctor and
obstetrician if you are HIV+
If you protect yourself in these ways, you do not need to be afraid of getting or passing HIV by casual
contact.
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HIV is NOT moved by:
Hugs
Dancing
Sharing food or drinks
Using a shower, bath, or bed used by an HIV+ person
Kissing (between people with no major dental problems)
Sharing exercise equipment
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9. Myths and Misunderstandings
WHY ARE THERE SO MANY AIDS MYTHS?
When AIDS first became known, it was a very mysterious disease. It caused the death of many people.
There are still many unanswered questions about the disease. Many people reacted with fear and came up
with stories to back up their fear. Most of these had to do with how easy it was to become infected with HIV.
Most of these are not true.
TRANSMISSION MYTHS
Many people believed that HIV and AIDS could be transmitted by a mosquito bite, by sharing a drinking
glass with someone with AIDS, by being around someone with AIDS who was coughing, by hugging or
kissing someone with AIDS, and so on. Transmission can only occur if someone is exposed to blood,
semen, vaginal fluid or mother’s milk from an infected person. There is no documentation of transmission
from the tears or saliva of an infected person.
• Myth: A woman with HIV infection can’t have children without infecting them.
• Reality: Without any treatment, HIV-infected mothers pass HIV to their newborns about 25% of the time.
However, with modern treatments, this rate has dropped to only about 2%. See Fact Sheet 611 for more
information about HIV and pregnancy.
• Myth: Needles left in theater seats or vending machine coin returns are spreading HIV.
• Reality: There is no documented case of this type of transmission.
MYTHS ABOUT A CURE
It can be very scary to have HIV infection or AIDS. The course of the disease is not very predictable. Some
people get very sick in just a few months. Others live healthy lives for 20 years or more. The treatments
can be difficult to take, with serious side effects. Not everyone can afford the medications. It’s not surprising
that scam artists have come up with several “cures” for AIDS that involve a variety of substances.
Unfortunately, none of these “cures” work. A very unfortunate myth in some parts of the world is that having
sex with a virgin will cure AIDS. As a result, many young girls have been exposed to HIV and have
developed AIDS. There is no evidence to support this belief.
• Myth: Current medications can cure AIDS. It’s no big deal if you get infected.
• Reality: today’s medications have cut the death rate from AIDS by about 80%. They are also easier to
take than they used to be. However, they still have side effects, are very expensive, and have to be taken
every day for the rest of your life. If you miss too many doses, HIV can develop resistance to the drugs you
are taking and they’ll stop working.
THE GOVERNMENT DEVELOPED AIDS TO REDUCE MINORITY POPULATIONS
The world’s best researchers in government and in private pharmaceutical companies are working hard to
try to stop AIDS. The government doesn’t have the capability to create a virus.
Many minorities do not trust the government, especially regarding health care. A recent study in Texas
found that as many as 30% of Latinos and African Americans believed that HIV is a government conspiracy
to kill minorities. However, it seems that minorities receive a lower level of health care due to the same
factors as anyone else: low income, inconvenient health care offices, and so on. Attitudes about health
care and health care providers were much less important.
MYTHS ABOUT MEDICATIONS
It has been very challenging for doctors to choose the best anti-HIV medications (ARVs) for their patients.
When the first drugs were developed, they had to be taken as many as three times a day. Some drugs had
complicated requirements about storage, or what kind of food they had to be taken with (or how long you
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10. had to wait after eating before taking a dose.) The reality of ARVs has changed dramatically. However,
there are still some myths:
• Myth: You have to take your doses exactly 12 (or 8, or 24) hours apart.
• Reality: Medications today are fairly forgiving. Although you will have the most consistent blood levels of
your drugs if they are taken at even intervals through the day, they won’t stop working if you’re off by an
hour or two.
• Myth: You have to take 100% of your doses on time or else they’ll stop working.
• Reality: It’s very important to take AIDS medications correctly. In fact, if you miss more than about 5% of
your doses, HIV has an easier time developing resistance and possibly being able to multiply even when
you’re taking ARVs. However, 100% observance is not realistic for just about anyone. Do the best you can
and be sure to let your health care provider what’s going on.
• Myth: Current drugs are so strong that you can stop taking them (take a drug holiday) with no
problem.
• Reality: Ever since the first AIDS drugs were developed, patients have wanted to stop taking them due to
side effects or just being reminded that they had AIDS. There have been many studies of “treatment
interruptions” and all of them have shown that stopping your ARVs is very likely to cause problems. You
could give the virus a chance to multiply or your count of CD4 cells could drop, a sign of immune damage.
• Myth: AIDS drugs are poison and are more dangerous than the HIV virus.
• Reality: When the first AIDS drugs became available, they weren’t as good as current medications.
People still died of AIDS-related conditions. It’s true that some people get serious side effects from AIDS
medications, but the death rate in the US has dropped by about 80%. Researchers are working hard to
make HIV treatments easier and safer to use.
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11. Immune system
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Immune system
Immune means safe and protected. The body’s immune system works to keep out invaders such as viruses
(like the one that causes polio), bacteria (like the one that causes tuberculosis), parasites (like the one that
causes malaria), and fungi (like the one that causes yeast infections).
These organisms can infect people and cause disease and death. The immune system is made of different
types of cells. Cells are tiny parts of a person’s body that are too small to see without a microscope. The
body is made up of billions of cells. Each type of cell plays a different role; some cells make up bone,
others muscle, others the immune system.
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HIV
HIV is:Human Immunodeficiency Virus. It is a virus, such as the other viruses that causes the flu or cold.
HIV is a virus that takes over certain immune system cells to make many copies of itself. Some people
think the virus makes a billion copies of itself every day.HIV causes slow but constant damage to the
immune system.
Normally, the human immune system is the body’s protection against bacteria, viruses, etc. It is like a cover
of shield for the body. When HIV enters the body, it starts making holes in the shield.
In the end, the shield becomes very weak and unable to protect the body. Once the armor is very weak or
is gone, the person is said to have AIDS. If people do not get any treatment for HIV disease, it takes an
average of 8-10 years to advance from HIV to AIDS.
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The four stages of HIV infection
1. The ?rst few weeks after infection,when many people have symptoms likethe ?u.
2. The quiet period,when there are few signs of HIV disease.
3. Early HIV disease.
4. Advanced HIV disease (AIDS),when a person is very ill.
Over time,one stage leads to the next.
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AIDS
AIDS is Acquired Immune Deficiency Syndrome. It is the disease caused by HIV. This virus, as stated
earlier, attacks the immune system, the body's "security force" that fights against infections.
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12. Acquired – means that the disease is not hereditary but develops after birth from contact with a
disease-causing agent (in this case, HIV).
Immunodeficiency – means that the disease is described by a weakening of the immune system.
Syndrome – refers to a group of warning signs that together show or a disease. In the case of AIDS
this can include the development of certain infections and/or cancers, as well as a decrease in the
number of certain cells in a person’s immune system.
A damaged immune system is not only more open to to HIV, but also to the attacks of other infections. It
won't always have the strength to fight off things that wouldn't have bothered it before.
As time goes by, a person who has been infected with HIV is likely to become ill more and more often until,
usually several years after infection, they become ill with one of a number of particularly severe illnesses. It
is at this point in the stages of HIV infection that they are said to have AIDS.
AIDS is an extremely serious condition, and at this stage the body has very little defense against any sort
of infection.
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HIV types, worldwide
There are two types of this virus:HIV-1 and HIV-2. Like sister and brother,they have similarities and
differences.HIV-1 is found in all parts ofthe world.HIV-2 is found mostly in West Africa.
The spread ofboth viruses can be prevented in the same ways.
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13. Are you infected?
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How does a person know that he or she has HIV?
Most people can’t tell that they have been exposed or infected. It can take up to 12 weeks for an HIV test to
come back positive. However most people respond much faster. Within two to four weeks of exposure to
HIV, one might have flu-like symptoms such as fever, swollen glands, muscle aches, or rash.
Take a test
The only way to know for sure if a person is infected is taking an HIV test. If there is a possibility that you
have been exposed to HIV, then a test is always the best option.
Why should I be tested? - The benefits of knowing
Immune system monitoring and early treatment can greatly improve your long-term health.
Knowing you are positive may help you change behaviors that would put yourself and others at risk.
You will know whether or not you can infect others.
Women and their partners considering pregnancy can take advantage of treatments that potentially
prevent transmission of HIV to the baby.
If you test negative, you may feel less anxious after testing.
Test results in two weeks
The most common test for HIV is the antibody test (called ELISA). It can be done on blood, saliva, or urine,
which is more than 99% accurate. Results are generally available within two weeks.
If you are waiting to take an HIV test, it is most important that you do not put yourself at risk through further
contacts to HIV during this time period. This means you should practice safe sex and not share needles.
A positive result means your body has developed antibodies for HIV, so you are infected with the virus. To
be completely certain, positive results are confirmed with a more sensitive test.
A negative result means your body is probably not infected. To get truly accurate results, wait three to six
months after your last possible exposure to the virus before being tested. That is because the immune
system can take three to twelve weeks to show antibodies.
Antibodies are the body's response to an infection. So if a person has specific antibodies against HIV in
their blood, it means they have been infected with HIV.
To get medication
If you test HIV+ there are effective medications to help you stay well. But you cannot get the health care
and treatment you need if you do not know your HIV status. Being unaware of your status also makes it
more likely to unknowingly pass HIV to others.
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14. Someone you are close to has HIV
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Someone close to you has HIV
The following list describes some emotions families or friends may feel whensomeone they care about tells
them that he has HIV.Health workers can talkabout some of these possible reactions with people who have
a positive test.Itwill help them prepare for difficult situations. If the health worker has HIV herself,talking
about some of her personal experiences can be especially helpful.
Shock
Family members may be shocked and ask,“Why us?”They may be surprised to ?nd out about the situation
that put their loved one at risk;forexample,a husband or wife may not have known that the other was
havingsex outside the marriage.
Anger
Families and sexual partners may be angry with a person who has HIV.They may feel betrayed if the
person had sex outside the relationship,or theymay feel abandoned because the person they love will
become ill.The angermay get worse as the person with HIV becomes ill and health workers do nothave
much medical help to offer.The family or partner may become frustrated.Try to help them understand some
of the reasons they might be angry,and let them know that it is natural to be frustrated in the face of these
issues.
Fear of infection
Family members and sexual partners may think that theygave HIV to their loved one,or they may worry that
their loved one will infectthem in the future.It is important to talk with family members about how thevirus is
and is not spread.HIV is not spread by casual contact,so they do nothave to worry about living with
someone with HIV or being friends with him,but they should think about changing their sexual behavior to
lower thechance that the virus will spread.Sexual partners should think about beingtested for HIV
themselves.
Fear of being alone
Families and friends may worry about being left alone orisolated from the rest of the community.A serious
illness often causes thecommunity to withdraw.Health workers can offer support and let families andfriends
know that they are not alone.If there are support groups in the community for families and friends of people
with HIV,tell people about them.
Guilt
People who are close to others with HIV but don’t have the virus themselves may feel guilty about the fact
that they do not have the virus.Somepeople react to this by taking more risks because they care less about
theirown lives.Other people may think that they or someone in their family didbad things in the past,and
that their gods or spirits are now punishing themby giving them HIV.
Shame
Some families or friends may feel ashamed that a person has HIV.They may think that HIV brings dishonor
to the family.Families may have lesscontact with the community because they fear rejection.Explain that no
oneshould feel ashamed to have someone with HIV in the family.
Helplessness
Family and friends may feel helpless in the face of disease.Learning more about HIV and volunteering for
an HIV organization can givethem a sense that they can help other people and help slow the spread of
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15. HIVand AIDS.
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Keeping the spirits high
No one - neither modern medicine nor traditional healers - has a cure for AIDS. Most people with HIV
can be healthy for many years, especially with the right care and treatment.
During this time it can help to:
make the best of every moment of your life.
spend time with friends and family.
try to keep active by doing your daily work.
be sexual if you want to. Enjoying sexual touch can help you stay healthier longer.
Support groups
Try joining or starting a group of people with HIV and AIDS. Some people with HIV and AIDS work together
to educate the community, to provide home care to those who are sick with AIDS, and to support the rights
of people with HIV and AIDS.
Mental health
Good mental health is very important for staying healthy and avoiding illness. AIDS places a heavy stress
on the mind and the emotions. It is very common for people living with AIDS to feel very afraid and tense
(fear), or to feel sadness or have no feelings at all (hopelessness). Fear and hopelessness can weaken
the body and make a person more likely to get sick.
It is important to try to tell the difference between signs of illness that are caused by physical problems, and
signs that are caused by fear or hopelessness. Knowing the cause of a problem may make it easier to
treat. It is also important to try and overcome these feelings so that they do not make a person with AIDS
become sicker. See a counselor or join a support group to get help.
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A good example
Rosa has AIDS
When Rosa was in bed because of AIDS difficulties, her mother kept a cheerful attitude. Every day she
bathed her daughter, dressed her with nice clothes, and put a little flower next to her bed. Rosa was not
hungry but her mother arranged the food in a way that could make her want to eat. The family would talk to
Rosa about daily life, and their work and community. With their good humor and positive comments, Rosa
felt that she was not cast aside.
Close to the family
Even though Rosa was often tired or didn’t feel well, the family arranged for her friends to visit her in the
moments she felt better. Music, conversation, and good spirit kept the house full of life. Rosa felt that she
was loved and needed, and that AIDS could not ruin her closeness and her time with her family.
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Teaching the others
Education changes how people see themselves.It also affects a person’s health.Often,the more educated a
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16. mother is,the healthier she is because she knowshow to take care ofherself.The healthier a mother is,the
healthier her childwill be.
The level ofa person’s education can help or hurt your efforts to advisesomeone.For example,a person who
is able to read may have read newspapers and billboards about AIDS.He may already know something
aboutHIV.You could teach him using written materials.The ability to read andwrite may mean that a person
feels comfortable learning in a school setting.
A person who does not read or write relies on other sources of information,such as radio,television,and
friends.She often thinks more in terms ofreal-life situations.In this case,telling stories about other people
with AIDSmay teach more than listing facts about the number ofpeople in the countrywith HIV.
Using visual aids such as posters,drawings, and videos can be especially helpful.People who cannot read
often learn better from their own experience than from information given in a student-and-teacher
setting.Whenadvising such a person,it is also better to ask more concrete (exact) questions;for
example,ask, “When you last had sex,did you use a condom?”ratherthan “Should condoms always be used
for sex?”Written materials such as pamphlets can help with your counseling.
People may have questions afteryou have spoken with them,andthe written information can helpanswer
these.It can also remindpeople offacts they have forgotten.They can share the pamphlet withothers.People
who have difficultyreading can still be given writtenmaterials;their friends or familycan read the materials to
them.
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East Palo Alto AIDS Project
Some years ago,a few people in East Palo Alto decided that they wanted tostop the spread of HIV.They did
not have much money but they had a lot ofpride.They decided to teach drug users about how HIV was
spread and howthey could protect themselves.They knew that they needed to bring the message to where
people were:on the streets.
Martin
The best person to do this was aman named Martin.Martin had used drugs but then stopped;at the time
theproject started,he had not used drugs for over a year.He felt strong enough tobe around people using
drugs and not start using them again himself.Martinwas known in the community and had many friends.He
had a strong desire tohelp his community and he knew the ways of the streets.Most important,heknew how
to talk with people on the streets about HIV.
“Bleach Kits”
Martin set up an office in a trailer parked near a place where people useddrugs.He got pamphlets about
HIV from the state government,had condomsdonated by a local clinic, and made “Bleach kits”for cleaning
needles.On eachof the pocket-sized bottles ?lled with bleach,he and his partner Atieno pastedinstructions
on how to clean needles and a telephone number people couldcall for more information on HIV.They
explained the project to the police inadvance so that the police would not think they were selling drugs.
Teaching on the streets
Martin put the materials in a backpack and went out onto the streets.Hestarted talking to people about HIV
and how it is spread.He gave bleach kitsto anyone who would take one. Soon he became known as “the
bleach Man”and people would look for him on the street and call out his name.Beforelong most of the drug
users in the community knew about cleaning needlesand about using condoms during sex.
Cookies - Condoms
Men and women who traded sex formoney also learned from Martin.Soon Martin had so much work that
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17. heneeded help.He went to a local medical school and asked students to helphim teach people on the
street.They set up a table in a parking lot and passedout condoms,pamphlets,and bleach kits to people
passing by.They also triedto give out cookies and bananas so that people would feel comfortable coming
by the table - sometimes it is easier to ask for a free cookie than it is to askfor information on HIV.
Martin and the students set up a regular schedule and people began torely on them for AIDS information
and supplies of condoms and bleach.Atieno answered phones at the office and coordinated the project.She
talkedwith church leaders and got donations of supplies.
With the help of a localclinic,Martin and Atieno set up a pre- and post-test counseling service forpeople who
wanted to be tested for HIV.The project grew and Martin andAtieno were able to get small salaries from the
government for their work.
They found it was surprisingly easy to get support for the project once theyproved it worked.
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