Understanding The Connection: Breaking The Chain

So… HIV again 🙃

Currently, a major focus of management is in the breaking of the transmission chain/cycle. And yeah, we likely already know the mantra of abstinence, faithfulness in monogamy, condom use as well as medications. It’s been touted enough times as to become something of a dogma. There however are other, howbeit intertwined aspects of this whole chain breaking saga which deserve as much attention from everyone.

The HIV infection in a person is kinda like the presence of pebbles in an otherwise clear bottle of water…each pebble in this case representative of a single virus. So, if you were to take the lid off this bottle and pour out say, a table spoon of the pebble-infested water into another bottle, what are the chances of the new bottle getting a share of these pebbles? What is the ‘one great factor’ that would determine whether or not any pebble(s) is/are transferred to the new bottle?

Please take a moment…reflect a bit on the answers to these…

HIV infected persons carry a highly variable number of the virus in their blood and other bodily fluids. An established rule of thumb is…the higher the number virus in an individual, the higher the ease/risk of transmission to others… and high numbers are seen among those who are positive (aware or not) and yet to commence medication, or those on medication who may be: non-compliant, on wrong medications, carrying drug resistant viral strains, etc. Fact to remember here is… the higher the viral numbers in an infected person, the higher the chances of transmission to others.

So, it should be easy to understand the worry among HIV care providers when such persons with established/anticipated high viral numbers are encountered. We immediately are keen on asking very key questions, particularly around sexual partners and biological children as they are much more at risk of having acquired the infection from the high-viral-number-carrying partner who is more likely to have transmitted the virus.

Remember, HIV infection current has a pretty good prognosis only for those on treatment. There is no treatment if the HIV status isn’t known…and not knowing your status would most certainly not make an existing infection magically disappear; rather it would progress and escalate into full blown AIDS…an eventually which every sensible healthcare worker fights ‘tooth and nail’ to prevent from happening.

I would encourage everyone to not be offended and despair terribly if ever contacted/spoken to about having a test by reason of a contact (identified or not) who is known or strongly expected to carry high viral numbers. It is for our collective good in the short, medium and long term. It truly would be an all round win-win regardless of the test result.

Do a bit of research, speak to your health care provider and remember to seek information from the right source(s).