Division of HIV and STD Programs

• What is PrEP and PEP? What's the difference between them?

  Answer:  Both are medications that work to prevent HIV infection. PrEP (Pre-exposure Prophylaxis) is a medication you can take daily as a preventative measure against HIV infection, if you have not tested HIV-positive.

  PEP (Post-exposure Prophylaxis) is a medication you can take within 72-hours after a possible exposure to HIV (sex with or sharing needles with someone who is or may be HIV positive). It is important to seek medical attention immediately because the sooner you take PEP medication, the better chance you have of remaining HIV negative.

  Visit our Get PrEP LA website for more information and a directory of clinics that offer both PrEP and PEP.
  Links: Get PrEP in LA County

• I've just been diagnosed with an STD. Does this mean my partner has lied or cheated on me?

  Answer:  No, not necessarily. Not everyone will have symptoms of an STD even though they do have the STD. A partner can pass a disease to another without ever knowing s/he has had something. You, the unfortunate current partner, may be the one that actually ends up with symptoms. You may also have received your STD from your very first partners years ago and are just now seeing the signs of the disease.

• Where can I get free condoms?

  Answer:  Please visit our LA Condom website for information and availability of free condoms. There are various clinics and businesses that have them available or you may elect to have some mailed to your residence.
  Links: LA Condom

• What are the typical symptoms of STDs?

  Answer:  Many STDs have no noticeable symptoms. When they occur, typical STD symptoms for women may include unusual vaginal discharge (flow), sores, bumps, burning when urinating, and redness or itching around the vaginal area. Typical symptoms for men may include discharge from the penis, burning when urinating, and sores, bumps, or redness on or around the penis.

• If I get a pap smear regularly, wouldn't the doctor tell me if I had an STD?

  Answer:  No, not necessarily. A pap smear is looking for cancerous or pre-cancerous cells. STD exams are unique tests that look for specific STDs. They may take the form of a blood, culture, or urine test. Be sure and ask your doctor for the name of the test you want done (for instance, chlamydia, syphilis, or HIV).

• How can I tell if my partner has an STD?

  Answer:  In most cases, you cannot tell by looking whether someone has an STD or not. STDs often do not have visible symptoms. Some visible signs can include sores or bumps in the genital area, but those signs can also be a symptom of something else or simply irritation of the area. It's always best to practice safer sex and use a condom.

• How are STDs transmitted?

  Answer:  STDs can be transmitted through oral, anal or vaginal sex. They can be transmitted from partner to partner with or without visible signs or symptoms. Many people can pass an STD to a sex partner without knowing it. Some STDs can be passed without having intercourse; they can be passed through skin-to-skin contact in the genital area.

• What is the "window period" with regard to HIV testing?

  Answer:  It is the time period lasting up to six months following infection with HIV in which someone will test negative on a regular HIV antibody test even though they are infected. If you think you might have been exposed to HIV, it is important to test and then test again to verify any negative result.

  If it is within 72 hours of a known or possible exposure you can access Post Exposure Prophylaxis (PEP) which is treatment that may reduce your chances of becoming infected with HIV. See our PEP webpage for more information.
  Links: Post Exposure Prophylaxis

• Can herpes be passed when there are no symptoms?

  Answer:  Yes, it is possible to infect someone with herpes, even when you don't have any symptoms. Once thought to be transmitted only when sores were present, recent research has shown that herpes simplex virus (HSV) can be passed even when no visible signs are present.

• What is primary or acute HIV infection?

  Answer:  It is the first stage of HIV disease in which 50-80% of newly infected people experience an illness that is similar to a severe case of 'the flu' or 'mono' (mononucleosis). It is often accompanied by a burst in viral replication and a drop in blood T-cell numbers. If you suspect you may have contracted HIV, see a medical professional immediately and get tested for HIV.

• Can I get STDs from a towel or a toilet seat?

  Answer:  Most STDs, such as chlamydia, gonorrhea, syphilis, herpes, and genital warts, are spread only through direct sexual contact with an infected person. Crabs (pubic lice) or scabies, which are often sexually transmitted, can be passed through contact with infested items like clothes, sheets, or towels.

• What is HIV/AIDS surveillance?

  Answer:  In Public Health, surveillance has been defined as the ongoing, systematic collection, analysis, and interpretation of data (e.g., regarding agent/hazard, risk factor, exposure, health event) essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control. Simply stated, the role of surveillance is to 1)systematically track the demographic trends in the spread of a disease, such as HIV/AIDS, within a population, 2) use statistical analysis tools to clearly define these trends, and 3)and use the analyzed results to aid Public Health officials in implementing effective prevention and control programs throughout the community.

• What should I do if I think I have an STD?

  Answer:  If you think you have an STD, see a health care provider immediately. Seeking treatment early will help to minimize the long-term effects of most STDs. Avoid sexual contact until you are treated and always wear a condom to minimize exposing your partner. Make sure your sex partner(s) get tested and treated too. For STD clinic locations in Los Angeles County call the STD Hotline (800) 758-0880 or visit our clinic webpage. For all other areas, contact your local or state health department for a clinic near you.
  Links: Los Angeles County STD Clinics

• What is the law concerning confidentiality in AIDS reporting?

  Answer:  California Health and Safety Code, §211.5 establishes the confidential nature of records, reports, and statements obtained by the health officer. "All records of interviews, written reports and statements procured by the state department or by any other person, agency or organization acting jointly with the state department, in connection with special morbidity and mortality studies, shall be confidential insofar as the identity of the individual patient is concerned and shall be used solely for the purpose of the study..." Such reporting "shall not subject any person, hospital, sanitarium, rest home, nursing home, or other organization furnishing such information to any action for damages." Additionally, §211.5 allows for "the publishing by the state department of statistical compilations relating to morbidity and mortality studies which do not identify individual cases and sources of information or religious affiliations."
  All surveillance and seroepidemiology research studies undergo review and approval by one or more certified institutional review boards (IRB) prior to the start of the study. Procedures for maintaining the confidentiality of all study participants are critically reviewed by each IRB. Annual reapplication and approval is required, and any proposed protocol changes during the course of the study are also reviewed by the IRB.
  At the national level, the HIV/AIDS Reporting System (HARS) database (housed at the Centers for Disease Control and Prevention (CDC) is protected by a Federal Assurance of Confidentiality (Sections 306 and 308(d) of the Public Health Service Act (42 USC 242k and 242m(d)), which prohibits disclosure of any information that could be used to directly or indirectly identify patients.

• Can I get an STD more than once?

  Answer:  Yes, you are not "immune" to an STD if you have had it before. STDs caused by bacteria (chlamydia, gonorrhea, and syphilis) can be treated and cured, but you can get them again if exposed. Viral STDs, such as herpes, HPV and HIV cannot be cured and may remain in your body forever.

• Can all STDs be cured?

  Answer:  Bacterial STDs like chlamydia, gonorrhea and syphilis, can be easily treated and cured. Viral STDs like herpes, genital warts, and HIV are incurable, but there are treatments available to lessen the severity of incurable sexually transmitted diseases. In the case of HIV, early treatment can significantly reduce the chances that an individual will ever develop AIDS.

• What is the law in California governing AIDS reporting?

  Answer:  In 1983, California Administrative Code, Title 17, §2500 (a) was amended to include AIDS among the list of over 50 diseases and medical conditions which every health care provider is required to report to the local health officer. California Administrative Code, Title 17, §2500 (d) states that "disease notifications shall include, if known, the diagnosis, the name, address, telephone number, occupation, ethnic group, social security number, sex and date of birth of the patient, the date of onset, the date of diagnosis, the date of death when applicable and the name, address and telephone number of the person making the report." California Administrative Code, Title 17, §2512 allows the local health officer to investigate communicable diseases and sections 304 and 306 of the Public Health Services Act authorizes the use of the "AIDS Pediatric Confidential Case Report" and the "AIDS Adult Confidential Case Report".

• How will my confidentiality be protected?

  Answer:  In order to comply with these laws and ensure patient confidentiality, the Division of HIV and STD Programs has established comprehensive procedures to protect confidentiality and ensure data integrity. The objectives of these procedures are to:

  1. protect patient confidentiality by preventing unauthorized disclosure of information
  2. ensure the integrity of data by preventing unauthorized alteration
  3. prevent the loss of data through accidental or malicious acts, or equipment failures, and
  4. to prevent harm to DHSP functions or image through unauthorized disclosures.

  A. General procedures

  1. All new DHSP employees receive training in confidentiality and security issues and are required to read and retain a copy of this document and sign a confidentiality agreement (see Attachment B).
  2. All employees are required to attend an annual review seminar covering confidentiality and security policies and procedures. These policies/procedures are reviewed annually by the AIDS Surveillance Coordinator, and revised as necessary. All surveillance employees must sign the confidentiality agreement every twelve months. Access to the computer network is denied until an updated signature is obtained.
  3. All records are strictly confidential. Employee access to confidential records and databases which contain patient-specific identifiers is granted only to those employees who must have access to perform their assigned job duties.
  4. All materials containing patient identifying information shall be maintained in restricted access areas.
  5. All records containing patient identifiers are kept in bar-locked files at all times, unless they are in the direct possession of an employee during office hours or during necessary field work.
  6. Records containing patient identifiers are not left unattended at any time. All confidential documents in the direct possession of an employee must be placed in secured files when leaving their work space for any reason (temporary absence). All employees who work with confidential materials are required to secure these materials in bar-locked files at the end of each work day.
  7. Confidential materials are not to be stored in desks that are not equipped with bar-locks.
  8. Confidential study forms that are being processed outside of the DHSP office are maintained in secure areas and locked away during non-business hours. All procedures involving the handling of study forms are to be approved by the appropriate unit supervisor. Specific written protocols for tracking and handling study forms should be developed for each study.
  9. Keys to desks and cabinets shall not be kept in easily accessible places or unlocked desk drawers.
  10. Confidential papers are shredded horizontally using a commercial grade electronic paper shredder before they are discarded.
  11. Keys to all office suites are issued only to surviellance staff. Each key is stamped "Do Not Duplicate" and the locks on all doors to the secured suite are re-keyed annually.
  12. DHSP offices are located in a building that has a 24 hour security guard. No DHSP office suites are located on the ground floor. Entry into the building during non-business hours is permitted only to individuals who present a personalized building pass and the names of all persons entering and exiting are maintained in a log.

  B. Maintaining the security of AIDS registry files

  1. A limited number of surveillance employees are authorized to add or alter AIDS case information contained in the AIDS registry database (HARS).
  2. The secured suite which houses all AIDS registry files is a "Restricted Access" area and "Restricted Access" signs are prominently displayed. Only surveillance staff are allowed to enter the file room and field staff cubicle area. The reception area is designated for visitors. Other Department of Public Health staff, maintenance and janitorial workers may be allowed to enter restricted access areas with the supervision and permission of a unit supervisor. During such times, the suite is never left unattended and confidential data are removed from view (e.g., clearing computer screens, placing confidential documents in bar-locked file drawers).
  3. The secured suite must be locked when left unattended. The last person leaving the secured suite at any time is responsible for locking all bar-locked file cabinets, windows, and doors before leaving.
  4. Confidential AIDS Case Report Forms are stored exclusively in the secured suite.
  5. Confidential AIDS Case Report Forms are duplicated only if the case has been previously reported in an out-of-county or out-of-state jurisdiction or if the case was diagnosed in Los Angeles County but did not reside in the county at the time of AIDS diagnosis. In such cases, personal identifying information is clipped from the duplicated case report form and mailed separately to prevent improper disclosure.

• Is it true that if I get tested for HIV, I get tested for all STDs?

  Answer:  No. Each STD, including HIV has its own test. Talk to your provider to make sure you're getting the tests you need.

• Can I test myself for STDs?

  Answer:  Yes, there are home tests for some STDs. Please visit the webite listed below for more information and to order one.
  Links: STD at home test kits

• Are women at greater risk for STDs?

  Answer:  Yes, women are at greater risk for many STDs, including HIV. Women are biologically more susceptible than men to becoming infected if exposed to an STD. STDs are also less likely to produce symptoms in women, and therefore are more difficult to diagnose until serious problems develop, such as PID (Pelvic Inflammatory Disease).

• How serious are the complications of STDs?

  Answer:  If left untreated, STDs can lead to major health problems. HIV can lead to AIDS (Acquired Immunodeficiency Syndrome). Other STDs can cause infertility, tubal pregnancy, reproductive cancers, pelvic inflammatory disease, and serious complications in newborns. Complications from STDs often occur years after infection.

• How do I report a case of HIV or STDs?

  Answer:  The Division of HIV and STD Programs (DHSP) is the designated County of Los Angeles, Department of Public Health case report collection entity. Medical and health care professionals can report an HIV case by contacting DHSP. Go to our reporting webpage for instructions and contact information.
  Links: Report a Case

• What are Los Angeles County's Standards for Perinatal HIV Prevention and Care?

  Answer:  

  
  Links: What are Los Angeles County's Standards for Perinatal HIV Prevention and Care?

• What is the best protection against STDs?

  Answer:  All STDs are preventable. Abstinence (not having sex) is the only sure way to prevent any STD. If you are having sex, using condoms (latex or polyurethane) can significantly reduce the risk of getting an STD, when used correctly. Limiting your number of sex partners and staying monogamous reduces your risk of acquiring an STD. Check out the link below for information on condoms and where to find free condoms.
  Links: Condoms

• What is the link between HIV and other STDs?

  Answer:  Many STDs increase the risk of HIV transmission. Ulcerations and sores caused by many STDs can provide HIV with easy access into the bloodstream. People with an STD such as syphilis, genital herpes, chlamydia, or gonorrhea are 3 to 5 times more likely to contract HIV, if exposed, than people who are not infected with an STD.

A. General

• How common are STDs?

  Answer:  STDs are very common in the United States. With more than 12 million people in U.S. infected each year, at least 1 person in 4 will be infected with a STD at some point in his or her life. In the United States, there is approximately 4 million new chlamydia infections a year. Over 40 million people have herpes and 30 million have genital warts (HPV). These numbers surpass the 1 million cases of HIV (Human Immunodeficiency Virus).

• What are sexually transmitted diseases (STDs)?

  Answer:  The term "sexually transmitted diseases" or "STDs" represents a group of more than 25 different diseases that can be passed from one person to another through sexual contact.

• What is HIV?

  Answer:  Human Immunodeficiency Virus (HIV) is the virus that weakens the immune system and causes HIV disease and AIDS.

  • H - Human, because this virus can only infect human beings
  • I - Immuno-deficiency, because the effect of the virus is to create a deficiency, a failure in the normal function of the immune system
  • V - Virus, because the organism is a virus, which means one of its characteristics is that it is incapable of reproducing by itself. It needs a living cell to reproduce.

• What is AIDS?

  Answer:  Acquired Immune Deficiency Syndrome is the life-threatening stage of HIV disease, also called Advanced HIV Disease. It is a medical diagnosis for someone whose immune system is so damaged that certain diseases (opportunistic infections) or cancers can develop. It is identified as such because:

  • A - Acquired; it is an acquired condition or infection, not something transmitted or inherited through the genes.
  • I - Immune; it affects the body's immune system, that part of the body which is responsible for protecting the body from germs such as bacteria, fungi and viruses.
  • D - Deficiency; it makes the immune system deficient (does not work properly).
  • S - Syndrome; someone with AIDS may experience a wide range of different diseases and opportunistic infections.

• What causes AIDS?

  Answer:  HIV is the virus that most researchers believe causes AIDS. However, some scientists remain unconvinced that HIV causes AIDS. These scientists believe that HIV can cause AIDS only in the presence of a cofactor, some other virus or condition which has not been found yet.

• Where did HIV come from?

  Answer:  The evidence is strong for a link between HIV and Simian Immunodeficiency Virus (SIV), which infects chimpanzees and many other species of primates. The virus was probably transmitted to humans while hunting and butchering infected chimpanzees or other primates. Evidence indicates the current epidemic probably started in the 1930s.

  The earliest known case of HIV was from a blood sample collected in 1959 from a man in the Democratic Republic of Congo. We do know that the virus has existed in the United States since at least the mid-to-late 1970s.

  From 1979-1981 doctors in Los Angeles and New York were reporting rare types of pneumonia, cancer, and other illnesses among a number of gay male patients. These were conditions not usually found in people with healthy immune systems.

• How long does it take for HIV to cause AIDS?

  Answer:  If left untreated, HIV gradually weakens the immune system and a person may develop AIDS within 10 years after becoming infected. The time it takes to develop AIDS is different for everyone and depends on genetics, general health status, levels of stress, and other contributing factors. With the development of better drug treatments since 1996, many individuals living with HIV have not and will not develop AIDS. Early treatment of HIV is a person's best chance at combating AIDS once HIV has been aquired.

• How can I tell if I'm infected with HIV?

  Answer:  HIV is diagnosed with an antibody test or other methods used by licensed medical professionals. The most common tests are antibody tests and can be administered at an HIV test site, or at a medical clinic. Many sites offer a rapid test which can give results within minutes. The only way you know if you are infected is by taking an HIV test or being diagnosed by a licensed medical professional.

• What are the symptoms of HIV?

  Answer:  The initial symptoms of HIV disease may be a flu-like illness lasting up to two weeks (fever, chills, body aches, and swollen lymph nodes). Some people do not experience any symptoms or have symptoms so mild that they may not notice them. Later (sometimes years later) people with HIV may experience night sweats, fever, fatigue, involuntary weight loss, diarrhea, swollen lymph nodes, oral candidiasis, and vaginal yeast infections.

• What is the connection between HIV and other sexually transmitted diseases (STDs)?

  Answer:  HIV is a sexually transmitted disease. You can contract HIV the same way you contract other STDs; by having unprotected sex. Also, the presence of other STDs, like syphilis, gonorrhea, or chlamydia, make it more likely to become HIV infected. By lowering your immune system, HIV can also make it easier to contract other diseases.

B. Transmission and Prevention

• How is HIV transmitted?

  Answer:  The four common means of transmission are:

  • Unprotected sexual intercourse (anal, vaginal, oral).
  • Sharing of injection drug paraphernalia - including needles, syringes, cookers, and other injection equipment.
  • From an infected woman to her fetus (vertical or perinatal transmission), or to her child through infected breast milk (neonatal transmission).
  • Through other direct exposure to infected blood or needle sticks (occupational transmission) or tattoos or piercing with non-sterile equipment.

• Can I get HIV from oral sex?

  Answer:  Oral sex carries a low risk of HIV transmission. However, other STD's are easily transmitted by oral sex, especially gonorrhea, chlamydia, syphilis, and herpes. You can use protection when engaging in oral sex. See link below and scroll down to "How to Use Dental Dams".
  Links: How to use condoms

• Can I get HIV from having vaginal sex without a condom?

  Answer:  Yes. The HIV virus can penetrate the lining of the vagina, and cuts and sores in the vagina greatly increase the risk of infection. Some of these cuts and sores are so small a woman might not know they are there. In a heterosexual encounter, HIV passes more easily from male to female than vice versa. Therefore, the woman is at greater risk of infection.

  Check out the link below for access to both free male and female condoms.
  Links: Condoms

• Can I get HIV from anal sex without a condom?

  Answer:  Yes. Anal intercourse without a condom with an infected person (man or woman) is the riskiest sexual activity for HIV transmission. The receptive partner is at risk because the anal area provides easy access to the bloodstream for HIV carried in semen. The insertive partner is also at risk because the membranes inside the urethra can provide an entry for HIV, possibly coming from the blood inside the anus of the receptive partner, into the bloodstream of the insertive partner.

  Always wear condoms to protect yourself against STDs. Click on the link below to get more information on condoms and where to find free condoms.
  Links: Condoms

• Can I get HIV from open mouth kissing?

  Answer:  Not likely. Open mouth kissing is not known to pose any risk for HIV infection. Saliva does not transmit HIV.

• Can I get HIV from tattoos or through body piercing?

  Answer:  Yes. Any instrument designed to penetrate the skin can transmit disease from person to person. Always ensure that the person doing the tattooing or piercing is using properly sterilized equipment.

• Can I get HIV from casual contact? What is casual contact?

  Answer:  No. HIV is not transmitted through casual, everyday contact. Casual contact includes, but is not limited to shaking hands, hugging, sharing a phone, trying on clothes, kissing someone on the mouth or cheek, sharing pens or pencils, sharing food, eating from the same plate, drinking from the same glass, and sharing toilet seats.

• Can I get HIV from mosquitoes and/or other insects?

  Answer:  No. Mosquitoes draw blood out of the human body and do not inject blood into the human body. HIV cannot live in the gut of or on any part of a mosquito. No other insect or bug has the ability to carry HIV from human to human.

• Can I get HIV from donating blood?

  Answer:  No. When blood is donated, sterilized needles are always used and are not reused. In you are concerned, ask the health worker if they are using new, sterilized needles and equipment to draw blood.

• Can I get HIV from blood transfusions?

  Answer:  Not likely. Early in the epidemic, there were cases of HIV contracted through transfusions. Arthur Ashe, the tennis player, was infected this way. Beginning in 1985, the blood supply was tested for HIV. Tests for HIV have come a long way since then so the chances of getting infected by transfusion are very, very small, something like 1 in 600,000. It is recommended that people who will need to get blood for medical procedures bank their own blood in advance to eliminate any risk from blood transfusions.

• Are patients in a dentist or doctor's office at risk of getting HIV?

  Answer:  Not likely. All doctors, dentists, chiropractors, acupuncturists etc., who treat patients with invasive procedures are required to use sterilized instruments or disposable, single use devices. If you have any doubt about whether someone is reusing equipment or needles, let them know your concerns. You have a right to refuse treatment and see another professional.

• Should I be concerned about getting infected with HIV while playing sports?

  Answer:  No. There are no known cases of HIV transmitted while playing sports. If someone is bleeding, they should immediately stop participating until the wound stops bleeding, is cleaned and covered by a bandage.

• Why does injecting drugs put a person at risk for HIV?

  Answer:  HIV is a blood borne virus. Direct blood-to-blood contact through sharing needles is very risky because even small amounts of blood may have enough HIV to be infectious. When a person with HIV shares a needle with another person, the HIV from the infected person goes directly into the next person's blood stream. HIV can also be present in water, cookers, cottons or other equipment used to prepare injection drugs.

• How can people who use injection drugs reduce their risk for HIV infection?

  Answer:  It is recommended that people who inject drugs be regularly counseled to stop using drugs and/or enter and complete substance abuse treatment. Injection drug users who cannot or will not stop injecting drugs should:

  • Never reuse or share syringes, water, or drug preparation equipment.
  • Only use syringes obtained from a reliable source (such as pharmacies or needle exchange programs).
  • Use a new, sterile syringe to prepare and inject drugs.
  • Use a new or disinfected container (cooker) and new cotton to prepare drugs.
  • Safely dispose syringes after one use.

  Many local pharmacies will sell up to 10 syringes at a time to customers without a prescription. Needle exchange programs are also operated in some parts of Los Angeles County.

• Can a mother pass HIV to her baby?

  Answer:  It is possible for an HIV infected mother to pass the virus on to her baby during pregnancy, while giving birth, and through breast milk. If a woman living with HIV who is pregnant does not seek treatment, the chances are as high as 25% that her baby will be born with HIV.

  If you are pregnant it is important that you get tested for HIV. If you are infected with HIV, there are treatments available that greatly reduce the chances that your baby will be born with HIV.

• Is there a way to reduce mother-to-child transmission?

  Answer:  By taking medications (anti-retroviral therapy) used to treat HIV infection, women living with HIV can reduce the risk of transmission to their unborn child to less than 2%. Sometimes a caesarian section is recommended as well, to further reduce the risks to the unborn child.

• Are health care workers at risk of getting HIV?

  Answer:  The risks of health care workers contracting HIV on the job are very low, especially if they practice universal precautions and use personal protective equipment.

  The main workplace HIV transmission risk for health care workers is through needle sticks and accidental injuries from other sharp instruments that may be contaminated with the virus. Even this risk is small.

  Scientists estimate that the risk of infection from a needle jab is less than 1 percent, a figure based on the findings of several studies of health care workers who received punctures from HIV-contaminated needles or were otherwise exposed to HIV-contaminated blood. It is important to remember that casual, everyday contact with an HIV-infected person does not expose healthcare workers or anyone else to HIV.

• How effective are latex condoms in preventing HIV infection?

  Answer:  Latex condoms have been proven effective in preventing the transmission of HIV and other sexually transmitted diseases. Studies show that when used correctly and consistently, male condoms are 98-100 percent effective against infection. Latex is a very resilient and strong material that does not allow HIV to pass through it.

  According to the National Centers for Disease Control and Prevention (CDC), the female condom also offers protection against HIV and may be used when a male condom can not be used appropriately.

  Remember, all condoms should be stored in a dry cool place.

• What lubricants can I use with condoms?

  Answer:   Water based lubricants are recommended. If you are not sure, check the label.

  Lubricants that should never be used with condoms include petroleum jelly, baby oil, cooking oil, hand lotion, massage oil, or face creams. Condoms should also be stored in a dry cool place.

• What are dental dams?

  Answer:  Dental dams or latex dams are latex squares that dentists use to isolate the tooth on which they are working. The dams are recommended as a protective barrier for oral sex, either mouth to vagina or mouth to anus. Because they were not originally designed for sex, they tend to be thicker than condoms. Plastic wrap may be used where dental dams are not available.

• What does it mean to have safer sex?

  Answer:  Any sexual practice that does not let someone else's semen, blood, or vaginal fluids get into someone else's body. Safer sex often involves use of latex condoms, latex dental dams, plastic wrap, latex gloves, and finger cots as barriers between the infectious fluids and mucous membranes or open cuts. Other ways to practice safer sex might include mutual masturbation, massage, body rubbing, and limiting sexual partners.

C. Testing for HIV

• Where can I get an HIV/AIDS test?

  Answer:  Many places provide HIV testing. Common testing locations include offices of private doctors, hospitals, Health Maintenance Organizations (HMOs) and sites specifically set up to provide HIV antibody testing. The County of Los Angeles Department of Public Health offers free or low cost HIV testing. For a clinic close to you call the HIV/AIDS hotline number (1-800-367-AIDS) or visit www.erasedoubt.org.

• What does it mean to give informed consent?

  Answer:  Informed consent means that before an HIV test is given the nature of the test is discussed with the patient, the possible results of the test are explained and the alternatives to the test are listed for the benefit of the patient. Once the patient has been informed either verbally or in writing, then the patient gives consent to take the test.

• Can I be tested for HIV without my consent?

  Answer:  No. HIV testing cannot be done without consent from the patient, except under very specific conditions.

  In California, persons accused of or incarcerated for certain crimes may be tested for HIV without giving consent. Courts may order an HIV test in which a crime has been committed where victims may have been exposed to HIV infected blood.

  People applying for a new or renewal of a license as a professional boxer or martial artist must present evidence of HIV negative status within 30 days of application for the license.

  People who apply for immigrant visas to the U.S. are also required to document HIV negative status.

  Finally, the U.S. military, Peace Corps and other government agencies require that people wanting to join these agencies produce proof of HIV status before the applicant will be hired or enlisted.

• What is an anonymous test?

  Answer:  An anonymous test means that absolutely no one has access to your test result since your name is never associated with the test or the test results. In anonymous settings, the client gives consent for testing verbally. This may be a good option for you if absolute privacy is of concern.

• What is confidential testing?

  Answer:  Confidential testing means that only you and your health care provider know your test results. Your HIV status will only be shared when you give your written permission to share that information. Some reasons for confidential testing include:

  • Any time a written copy of test results with identifying information is needed;
  • for immigration reasons;
  • and to obtain treatment for HIV disease.

• What are rapid HIV tests?

  Answer:  Rapid tests for detecting antibodies for HIV are screening tests that produces very quick results, usually in 10 to 30 minutes. Rapid tests can use oral, blood draw, or finger-stick methods to collect samples for testing. Standards of care in the United States say that a positive result with a rapid test (an initial positive) must be confirmed by another test before an HIV diagnosis can be given. People who receive an initial positive result from the rapid test will be asked to undergo another test before they are confirmed as HIV positive. The confirmatory test may take up to two weeks to process.

• What is OraSure HIV test?

  Answer:  OraSure is the name of a collection device for standard antibody testing which is inserted into the mouth. OraSure absorbs oral mucosal transudate*, rather than saliva, for testing. OraSure collects antibodies, not HIV itself. There is not enough HIV in saliva to be infectious.

  *Transudate is a fluid that passes through a membrane which filters out much of the protein and cellular elements to yield a watery solution. A transudate is due to increased pressure in the veins and capillaries forcing fluid through the vessel walls. It is a filtrate of blood. The transudated fluid accumulates in tissues outside the blood vessels.

• How accurate are the HIV tests?

  Answer:  HIV tests are extremely accurate. The CDC states that the combined accuracy of the ELISA plus either the Western Blot or IFA (indirect immunofluorescence assay) is greater than 99%. If anitibodies to HIV are present in a person's body, the tests will detect it.

• How long after a possible exposure should I wait to get tested for HIV?

  Answer:  The tests commonly used to detect HIV infection look for antibodies produced by your body to fight HIV. Most people will develop detectable antibodies within two weeks to three months after infection. In rare cases, it can take up to 6 months. This is called the window period. For this reason, the Office of AIDS Programs and Policy testing sites recommend that clients get an HIV test between three to six months from the date of their last possible exposure to HIV. It is also important to remember that every time you expose yourself to HIV, you open up another window period.

• What does a negative HIV test mean?

  Answer:  A negative HIV test means that HIV antibodies have not been found in your blood at this time. If you were exposed to HIV more than six moths ago then you are not infected and do not need to repeat the test.

  If your exposure was less than six months ago, then you are in the window period and you should take the test again at the six month mark after that exposure.

  A negative test result does not mean you are immune to HIV, that you have resistance to the virus, or that you will never get HIV or AIDS. You should go in for an HIV test any time you have a possible exposure to HIV (between three to six months after each possible exposure).

• What is the window period?

  Answer:  The window period is the time it takes for a person who has been infected with HIV to develop antibodies that can be detected by an HIV test. See the question, "How long after possible exposure should I wait to get tested for HIV?"

• If I test HIV negative, does that mean that my partner is also HIV negatve?

  Answer:  No. Your HIV test result reveals only your HIV status. Your negative test result does not tell you whether your partner has HIV. HIV is not necessarily transmitted every time there is an exposure. Therefore, taking an HIV test should not be seen as a method to find out if your partner is infected. If you belive that your partner is at risk for HIV, encourage them to get their own HIV test. Testing should never take the place of protecting yourself from HIV infection.

• What does a positive HIV test mean?

  Answer:  A positive test result means that you have HIV antibodies and you have been infected with the virus at some point in time. People with a positive result should assume that they have the virus and can infect others, or become re-infected. They should not donate blood, organs, tissue, and must stop breastfeeding. They must practice safer behaviors and inform sex and/or needle sharing partners about their status.

  A positive test result does not mean:

  • You have AIDS.
  • You will necessarily get AIDS.
  • You are immune to AIDS, even though you have antibodies.

• Why should I test for HIV?

  Answer:  Benefits of testing for HIV include:

  • If you know you are HIV-positive, you can take advantage of immune system monitoring and early treatment and intervention.
  • By taking the test, you can find out whether or not you can infect others.
  • Regardless of the result, testing often increases your commitment to overall good health habits.
  • If you test negative, you may feel less anxious after testing.
  • Women and their partners considering pregnancy can take advantage of treatments that potentially prevent transmission of HIV to the baby.
  • Counseling can provide a critical opportunity to assist you in identifying your risk of acquiring or transmitting HIV.
  • Counseling also provides an opportunity to negotiate and reinforce a plan to reduce or eliminate HIV risk.

• What are the risks of testing for HIV?

  Answer:  Risk of testing for HIV includes the following:

  • Taking the HIV antibody test is a stressful event, regardless of the results.
  • Disclosures of an antibody test result, or sometimes the disclosure that a person even took the test, may lead to discrimination, stigmatization and violence.

• If I am HIV positive, where can I get information about treatment?

  Answer:  It is recommended that you be in the care of a doctor or medical service, ideally one with experience treating people living with HIV. Your doctor can provide information and guidance.

  For further information click here: http://www.publichealth.lacounty.gov/dhsp/ThinkYouMayHave.htm
  Links: HIV and STD Treatment

• Can a poor and uninsured person have access to treatment?

  Answer:  Everyone who is diagosed with HIV has access to treatment and medications regardless of their income. An individual who tests positive for HIV and is subsquently diagnosed with AIDS, and is unable to work, is considered disabled. Where such a person is eligible, Medi-Cal pays for the treatment. A federal program called AIDS Drug Assistance Program (ADAP) pays for the medicines. To get more information on free treatment and medications for Los Angeles County residents, you can visit www.HIVLA.org or call 1-800-367-AIDS.

• Can an illegal immigrant receive treatment without being reported to the United States Citizenship and Immigration Services (USCIS)?

  Answer:  Treatment is confidential and health care providers are not required to report the residency status of their clients to the USCIS.

• Why is CDC recommending that all pregnant women be tested for HIV?

  Answer:  Pregnant women who test positive for HIV should be given the best possible prenatal care to assure the best possible outcome for both mother and child. There are now medical therapies available to lower the chance of an HIV-infected pregnant woman passing HIV to her infant before, during, or after birth. Antiretroviral drugs administered to the mother before, during and after birth and to the child after birth can dramatically reduce the risk of transmitting the virus from mother to child.

  HIV testing and counseling provides an opportunity for HIV positive women to find out they are infected and to gain access to medical treatment that may help to delay disease progression. For women that are not infected, HIV counseling provides an opportunity to learn important prevention information to reduce the possibility of future exposures.

D. Legal and Ethical Considerations

• Is it mandatory for all pregnant women to be tested for HIV?

  Answer:  No. California law requires that all pregnant women seeking perinatal care must be offered an HIV test. As of January 1, 2008, this test will be offered on an opt out basis, meaning the test will be performed unless the patient specifically refuses. The health care provider must still explain the nature of the test and the meaning of possible results to the patient before a test can be performed.

• Are there any federal and state laws that protect people infected with HIV?

  Answer:  Yes. The Federal Rehabilitation Act of 1973 offers protection against discrimination for persons with disabilities in federally funded programs. The American with Disabilities Act (ADA) of 1990 extends federal protection against discrimination for person with disabilities, including persons with HIV infection, in the private and public sector. Employers must accommodate the needs of an otherwise qualified disabled employee in the performance the essential functions of his/her job (reasonable accommodations). Similarly, the ADA requires all businesses and public services to reasonably accommodate the needs of otherwise qualified disabled persons in the provision of services.

  The Fair Housing Act prohibits discrimination in housing accommodations based on disability. California law further guarantees equal access to housing accommodations offered for rent, lease, or compensation. In addition, it provides that when transferring real property, owners or their agents need not disclose that an occupant had HIV.

• Can I be denied employment because of my HIV status?

  Answer:  No. You cannot be turned down for a position because of your status, nor can you be fired. Likewise you cannot be passed over for a promotion or demoted because you are HIV positive or have AIDS.

  The Americans with Disabilities Act (ADA) also requires that your employer make reasonable accommodations for you because of your HIV status. The only way an employer can be exempted from providing you with reasonable accommodations for your disability is if he/she can show that to do so would impose an undue hardship on his/her business.

  Fair Employment and Housing Commission regulations establish that disabled persons include individuals with HIV infection or AIDS, or who are perceived as having AIDS. In addition, the regulation prohibits use of public health records pertaining to AIDS to determine employability.

  The ADA is the most significant piece of civil rights legislation in the past 20 years and was developed specifically to include HIV discrimination in the workplace. It states that no covered employer can discriminate against you because of your HIV status, as long as you are able to perform the essential functions of your job.

• Can a physician disclose my HIV status?

  Answer:  No. Laws in California prohibit disclosure of medical information without the written authorization of the patient. In the absence of written authorization, the information may be disclosed only under very specific circumstances such as pursuant to a court order, or to health care providers for purposes of diagnosis and treatment.

• Do I have the right to know if my coworker is infected?

  Answer:  No. Since HIV is not casually transmitted, a person with HIV poses no threat to his or her coworkers.

• Do home care workers have the right to know if their patients are infected with HIV?

  Answer:  No. HIV status is confidential and no personal information can be disclosed. Every home care worker should treat all body fluids as if they are infected and practice universal precautions to protect themselves from all infections.

• What do I do if I know someone is HIV positive and is having unprotected sex and/or sharing needles?

  Answer:  There is no way the partner(s) can be notified by anyone except by the person who is HIV positive and having unprotected sex or sharing needles. HIV status is confidential and disclosure by an uninvolved third party can lead to civil suits, penalties, and damages.

  However there are laws which make it a felony for persons infected with HIV to transmit HIV to others if 1) they know they are infected 2) have unprotected anal or vaginal intercourse and/or share needles 3) fail to disclose their status to their partner and 4) have the intent to infect their partner with HIV.

• At what age can a person give informed consent for HIV testing?

  Answer:  In California the legal age to give consent for HIV testing is 12 years of age or older.

• Are there any exceptions to HIV testing without consent?

  Answer:  Individuals convicted of sexual crime and/or persons in custody of the justice system can be tested by court order. The courts may provide written consent for minors who are wards of the court.

  In the case of an incompetent person, the person's parents, guardian, conservators or other persons legally authorized to make health care decisions can give written consent for an HIV test.

  U.S military service enlistees and new legal immigrants to the United States are tested without consent, however, it could be argued that joining the military and applying to be a citizen of the U.S. is a voluntary activity.

• Can I bring a third party with me when collecting my HIV results?

  Answer:  As a matter of policy, third parties (anyone who is not a staff member of the test site) may not be present during the actual disclosure of test results at Office of AIDS Programs and Policy funded testing sites. This policy is consistent with laws of the California Health and Safety Code that prohibit disclosure of HIV test results without the signed, written consent of the client. However, a partner or friend may join you afterward during post-test counseling.

E. Epidemiology

• How many people worldwide have HIV and AIDS?

  Answer:  According to UNAIDS : There were approximately 36.7 million people worldwide living with HIV/AIDS at the end of 2016. Of these, 2.1 million were children (<15 years old). An estimated 1.8 million individuals worldwide became newly infected with HIV in 2016 – about 5,000 new infections per day.

• How many people in the United States are living with HIV/AIDS?

  Answer:  The Centers for Disease Control and Prevention (CDC) estimates that there were approximately 1.1 million cases of HIV in the United States at the end of 2015.

• How many people in Los Angeles County are living with HIV?

  Answer:  Visit lacounty.hiv for the latest stats on HIV in Los Angeles County.

  
  Links: Los Angeles County HIV/AIDS Strategy