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PAMP - Prevention Among Migrant People HIV and Aids - Information in multiple languages

27 aprile 2021

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What is HIV, what is AIDS?
HIV, the human immunodeficiency virus, is a virus that can only be transmitted between humans. It attacks and destroys, in particular, a type of white blood cell, CD4 lymphocytes, responsible for the body's immune response. The immune system is thus weakened until the response against other viruses, bacteria, protozoa, fungi, and tumors is canceled.
HIV may not give obvious symptoms even for several years.
When the immune system is severely compromised, the body is defenseless against internal and external pathogens that can lead to the development of opportunistic diseases that involve AIDS (Acquired Immunodeficiency Syndrome)

Is there a cure for HIV?
Today there are very effective therapies capable of controlling the virus: if an HIV-positive person takes them correctly, there’s very little chance of developing AIDS and to have a life expectancy comparable to that of an HIV-negative person.
If an HIV-positive person does not receive treatment, they still risk of getting sick today.
It is therefore very important to get tested for HIV if you believe you have had risky behaviors. Treatments are all the more effective the sooner they are administered.
Currently, the therapies keep the infection under control, but are not yet able to eliminate the virus from the body; they must therefore be taken for life.
Most of the current therapies involve taking one / two tablets a day (preferably always at the same time). Long-acting therapies will be introduced shortly, which will include a single injection once every one or two months.
Thanks to science, today most people living with HIV can work, travel, play sports and have children exactly like anyone else.

What is U = U?
U = U means Undetectable = Untrasmittable, which means that, thanks to the therapies, when an HIV-positive person's viral load is no longer detectable by laboratory tests, the person is no longer able to transmit the infection.
For this reason we can say that TASP (treatment as prevention), the fact of taking therapies, is one of the best way to prevent the spread of HIV.

How is HIV transmitted? 
HIV is transmitted only through the following liquids:blood, semen, vaginal secretions, breast milk. HIV IS NOT transmitted through: saliva, tears, sweat, urine, feces, vomit.
There is a risk of transmitting HIV whenever a fluid from a person with HIV who is unaware of is status or not under effective therapy, enters the body of an HIV-negative person through a mucous membrane (even intact), or an open wound (deep, and therefore bleeding) or by inoculation.
Then:
through unprotected sexual intercourse (homosexual or heterosexual), anal penetration, vaginal penetration, oral sex (but only for those who practice intercourse in the presence of oral cavity lesions; those who receive the stimulation run no risk).
through the exchange of syringes for injecting drug users
from an HIV positive mother to child, both during pregnancy and during childbirth or breastfeeding
Today, thanks to therapies, it is possible to give birth to perfectly healthy babies
The virus is NOT transmitted by hugging, kissing, petting, sleeping together, using the same toilet, the towels, the dishes

How do you protect yourself from HIV?
Protecting yourself during sexual intercourse with the use of a condom (from the beginning to the end of an intercourse) or with Pre-Exposure Prophylaxis.
If the person you have sex with is HIV positive but on effective therapy (U = U), it is not necessary to use a condom.
Not sharing syringes or other materials to inject drugs
If you are pregnant or planning a pregnancy, it is important to take an HIV test: knowing in time that you are positive will allow you to access treatment and to not transmit HIV to your child.

What is Pre Exposure Prophylaxis?
PrEP is a method of preventing HIV infection and consists of taking a drug. The drug can be taken every day or On-Demand, but in this case, it is necessary to follow a specific scheme that will be indicated by a doctor.
PrEP is indicated for those people who struggle using a condom. It is important to remember that PrEP protects against HIV transmission but not from other sexually transmitted infections or pregnancy.
PrEP must be prescribed by a doctor, there are PrEP clinics in Hospitals, infectious disease centers and few associations. For more info, you can consult www. prepinfo.it
PrEP is generally well tolerated and does not cause major side effects. However, it is a drug that can cause kidney function problems. It is best to take it under medical supervision.
Currently, the drug for PrEP is not available for free.

What is Post Exposure Prophylaxis?
PEP, or PPE, (post-exposure prophylaxis), is a drug therapy of limited duration (28 days of drugs followed by a final visit and follow-up examinations). PEP can be taken if there is a real risk due to exposure to HIV. Taking PEP allows you to avoid the infection, preventing the virus replication from the beginning.
In case of evident risks, such as:
-break of a condom with an HIV positive person with detectable viral load or whose HIV status is unknown
-Risk among healthcare professionals: puncture with a used needle or with cutting tools used with an HIV positive person with detectable viral load
Sexual violence
To access the PEP, it is necessary to go to an emergency room (Pronto Soccorso) as soon as possible, but no later than 48 hours after the event. You will be seen by an infectious disease specialist who will evaluate whether to prescribe PEP.

How can I know if I have HIV?
The only way to know if you have HIV is to take an HIV test. HIV infection is not diagnosed with routine blood tests.

There are different types of tests, it is important to keep in mind the times:
Generation IV tests (or Combo), can give a positive result already after 20 days, but the result is considered definitive after 40 days from the risk contact (window period). These tests are performed in most hospitals, clinics, or private analysis laboratories, they search for anti-HIV antibodies and the P24 antigen (part of the virus).
Generation III tests can give a positive result as early as 3-4 weeks but the result is considered definitive 90 days after contact at risk (window period). These tests look for HIV antibodies only
There are also rapid HIV tests, which are highly reliable, but you need to inquire about the window period, which for some (for example those you buy at the pharmacy) is 90 days.
They can be performed on a drop of blood pointed by the finger or on saliva and give the result in 20 minutes. These tests are also carried out in some associations, during prevention campaigns or can also be purchased in pharmacies (average cost, € 20).

According to Italian law, the HIV test can never be mandatory (except for reasons of absolute clinical necessity and always in the interest of the person) and cannot be carried out without the person's consent. The HIV test is free, even for foreign people without a residence permit. The HIV test can be done in total anonymity (at some public facilities it is necessary to request it first) and the results can be communicated only to the person concerned.

Can the employer request the HIV test from one of his employees?
If some professions (law enforcement and the army) are excluded, there is a law (n.135 of 1990) that expressly prohibits the employer from requesting the HIV test from one of his employees or as a condition for undertaking an employment relationship. HIV status cannot be a reason for dismissal, just as it cannot be a reason to exclude a person from school or sports activities.