HIV and AIDS: Symptoms, Causes, Treatments, and More

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I'm HIV Positive. Here's What I Wish People Knew.

I never thought about death until I received my HIV diagnosis. I had made plans to get my degree, start my career, get married, and possibly have children. But I tossed all my hopes and dreams in the trash that fateful day in September 2021.

I was in the lab with a technician in a small hospital. I stared long and hard as the first stripe formed, then the shock came when I saw the slow faint formation of the second, which meant I was positive. Suddenly I was sweating; the room was too small, almost claustrophobic. I was suffocating.

"It took me a year and a half to accept that HIV could not limit me."

Until you are diagnosed with HIV, you will never understand how that first moment puts you in a state of grief: all of the enthusiasm I had previously possessed for life was suddenly gone. In its place, shame, guilt, loneliness, and shattered dreams overwhelmed me. I thought I would be dead within a few years, so why make any plans at all? Instead of grieving a lost loved one, you grieve for yourself. Denial, anger, bargaining, and depression all take over the smidgen of hope you might feel. Sadly, because of enduring stigma, society has made it so that to most people living with HIV (PLWH), acceptance remains a continuous journey that takes a much longer time than it should.

It took me a year and a half to accept that HIV could not limit me. "Your world is still vast," my counselor promised. "You can get the career you want, be in that relationship you dream of, and even have children. All you need to do is adhere to your medication." It took me some time, but eventually I learned that she was right. After my diagnosis, I started taking antiretroviral medication, which at first entailed two pills a day and now only requires one. Within eight months of my diagnosis and after I'd started taking the effective HIV drugs, my CD4 count, which is a measure of the strength of my immune system, was skyrocketing, and my viral load was already undetectable, which meant I could not pass HIV to another person.

But the realities of living with HIV are still grossly misunderstood and stigmatized by others. Before my diagnosis, I was going to travel the world — I planned to become a stewardess for an airline. And I still pursued it a year after my diagnosis. I vividly remember my interview to determine my admission to a six-month training at a local airline. I learned that I'd have to take a medical exam, but "this was just formality," I was told. I never thought my HIV status would be an issue. A month later after my interview, though, I received my rejection email. It was short and straight to the point: I was not accepted because "I failed my medical examination." Failed. Failed!? To say I was dumbstruck is an understatement.

When I was told I wouldn't get my dream job, I wanted to blame someone or something. The person who gave me HIV, these restrictive policies, even myself for getting HIV. I could feel the grief coming back to me. I was fighting the monster of bitterness.

I started digging into why this had happened. Could my HIV status affect many of my other plans of adventure? I learned that it could. Apparently, many countries can deny entry to people with HIV — including Russia, Dubai, and Australia. The internet says these places "may deny entry," as if there is a choice, but on the ground, the reality is much starker. Officials don't care if you're carrying your six-month medication, or if your viral load is Undetectable=Untransmissible. In some countries, you can be deported.

Although countries like the United States don't have such restrictions, PLWH still face stigma. Some states, for example, still have laws that treat the medical condition as a crime.

And it's not just traveling. Many countries still require people to take HIV tests to work in certain industries like hospitality, and may not offer employment to PLWH regardless of whether they are untransmissible and asymptomatic. Despite having the qualifications for my dream job, my diagnosis prohibited me from landing it.

Around the same time of getting the devastating news about the job, I was inundated with messages on social media trying to raise awareness of HIV. But the message of those postings was that PLWH are dangerous — that others should avoid interacting with them.

"The fact that it is still highly stigmatized means that HIV rates have been rising in the last decade — something that should absolutely not be happening."

And that's when I truly realized that even decades after scientists have found ways to suppress it, HIV remains highly stigmatized. The fact that it is still highly stigmatized means that HIV rates have been rising in the last decade — something that should absolutely not be happening. No country with access to antiretroviral therapy should be reporting new infections. And countries should have reached the UNAIDS 90-90-90 treatment target, which aimed, by 2020, to have 90 percent of all people living with HIV to know their status; 90 percent of all people diagnosed with HIV receiving antiretroviral therapy; and 90 percent of people receiving ARV therapy having viral suppression. But the global community failed to meet all three goals.

I have experienced firsthand society's hatred toward PLWH, instead of the disease itself. People warn others about us, laugh at us. In most postings about HIV that I have seen online, social media users openly discuss PLWH as people to be avoided and cast out.

But amid the rejection and hatred, I can feel the fear, too: the fear that being HIV+ is a death sentence. It was the same fear I had before I ever thought I could be directly affected. It is this feeling that can keep individuals ignorant of how HIV actually works.

Despite all the stigma, I must say I am luckier than most. My partner is among the kindest individuals I have been blessed to know. He always takes the initiative to continue to learn about the virus as much as he can. I never feel any stigma coming from him; I never feel unloved. We also have plans to start a family soon. "We can," he tells me. My low viral load would not place our baby or him in any danger, thanks to the freely available ARV medication I take.

As a PLWH, I have made a decision to live — and this means taking care of myself and my partner to ensure no chances of reinfection.

I believe it will take open-mindedness, a willingness to learn, and kindness if we really want to stop the spread of HIV. Choosing to use supportive rather stigmatizing language and policies is how we begin to reach the 90-90-90 goal. My partner has shown me that it is possible to have an open conversation and take initiative to educate yourself instead of spreading fear, hate, and panic. Only then will more people be willing to disclose their HIV status, seek testing, and adhere to treatment without fear of social consequences. It is a pity we have not grasped the enormity of this yet.

HIV Positive Prostitute Had Sex With 211 Men After Learning She'd Been Infected, Cops Say

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An HIV-positive sex worker had sexual interactions with over 200 clients across multiple states, police say, prompting a health warning.

Linda Inez Leccese was charged on May 14, 2024, with soliciting after she tested positive for HIV, which is a third-degree felony, according to the Washington County Sheriff's Office.

"This case could stem anywhere from Florida up the East Coast, but there are local individuals that we will be reaching out to," Ohio's Washington County Sheriff' Office Chief Deputy Mark Warden said during the press conference, as reported by The News and Sentinel.

Linda Leccese (Washington County Sheriff's Office)

"This investigation will continue and interviews will be done, again, to protect the public's health to try to glean those other individuals who have been in contact with this individual."

Warden said the investigation found that Ms Leccese continued soliciting work even after she had tested positive for HIV in 2022.

Now, both the sheriff's office and the Marietta Police Department are in the process of contacting at least 211 people who may have been in contact with her based on the numbers were found in a phone she used used conduct business as a sex worker.

"We want the citizens out there to understand that there will be a deputy sheriff reaching out to these individuals that we have numbers for," Warden said. "They're not in trouble, this is public health awareness. This is not a scam."

Linda Inez Leccese (Washington County Sheriff's Office)

At the press conference, Health Department Nursing Director Dianna Beck told the public the issue of people coming into contact with the HIV positive sex worker may go further back than 2022 because it takes 18-90 days to detect HIV antibodies in someone's system.

Ms Beck added the incubation period for HIV is one to six weeks, so sometimes people don't know they are HIV positive. Symptoms could include a sore throat, tiredness, swollen lymph nodes and other mono-like symptoms.

Health Department Administrator Barbara Bradley with the Marietta/Belpre Health Department was on hand at the press conference to help answer questions and help those who believe they may have been infected.

"For this particular case with the Sheriff's department we're asking you to be tested, you and your family members, and to call 740-373-0611 ext. 634 … please tell the receptionist that you are part of the sheriff's case so they know where to direct your call to make an appointment or for more information," she said.

Pride, Passport Stamps, And PrEP'd With Options: One Man's Journey With HIV Prevention

Pride, passport stamps, and PrEP'd with options: One man's journey with HIV prevention

Funded and developed by ViiV Healthcare.

"Sex wasn't something that was talked about in my family," Dino says. "I had a cousin who died at the start of the AIDS epidemic, so I was always very cautious and wanted to protect myself against HIV in the best ways that I could. My mother was concerned for me, but her idea of protection was to sprinkle holy water on me as I was walking out the door for a date!"

Dino has traveled a long road from the West Virginia steel mill town of his youth, where he was raised in a traditional Catholic household. Growing up, homosexuality was a taboo topic, and sexual health was a source of silence and stress.

His lifelong wanderlust was sparked during childhood when his parents took him to visit Disney's Magic Kingdom just after the original theme park opened in Florida. Now 55 years old, Dino's life story unfolds like a map of adventures, from his days as a competitive bodybuilder and tennis player to his current quest to visit every Disney theme park worldwide. Amidst these travels, he found love in the most unexpected of places – Maui – where he met his husband of eight years, Craig.

"I knew from the start that this was the man that I was going to marry someday," Dino says. "He disclosed that he was living with HIV to me, so we always used protection. His diagnosis was never a concern because I loved him. Being in a polyamorous relationship, I knew about HIV prevention options including PrEP, and talked to my doctor about it."

Pre-exposure prophylaxis, commonly known as PrEP, is a medication taken by individuals who do not have HIV but may have reasons for wanting to help prevent HIV. When adherently taken as prescribed, PrEP can significantly reduce the chance of HIV transmission as part of a comprehensive risk management strategy used in conjunction with other safe-sex practices. PrEP can be taken as a daily oral pill or a long-acting injectable.1 For many years, PrEP was only available in pill form, and Dino started out by taking it as a daily tablet to help him stay HIV negative.

Pride, passport stamps, and PrEP\u2019d with options: One man\u2019s journey with HIV prevention

But, as an avid traveler, Dino admits he always had apprehension about taking his PrEP pills with him when on the go. Between lost luggage, negative social stigmas associated with PrEP and sex, and distractions that occur when he is away from his regular routine at home, the daily pill regimen could be a source of stress when traveling.

"I worried about having a bottle that someone might accidentally see during my travels, and I may get questioned about it," he says. "You never know where that stigma might come from, especially when traveling to new places that may have different societal attitudes."

Then in 2021, the U.S. Food and Drug Administration approved APRETUDE (cabotegravir), a prescription medicine used for HIV-1 PrEP to reduce the risk of getting HIV-1 infection in adults and adolescents who weigh at least 77 pounds (at least 35 kg).2

It is important for people who receive APRETUDE for PrEP to help reduce their risk of getting human immunodeficiency virus-1 (HIV-1) infection to know that you must be HIV-1 negative to start APRETUDE.2 Do not receive APRETUDE unless you are tested and confirmed to be HIV-1 negative. APRETUDE does not prevent other sexually transmitted infections (STIs). Practice safer sex by using a latex or polyurethane condom to reduce the risk of getting STIs. You must stay HIV-1 negative to keep receiving APRETUDE for HIV-1 PrEP.

You must stay HIV-1 negative to keep receiving APRETUDE for HIV-1 PrEP.2 Know your HIV-1 status and the HIV-1 status of your partners. If you think you were exposed to HIV-1, tell your healthcare provider right away. Your risk of getting HIV-1 is lower if your partners with HIV-1 are taking effective treatment. Get tested for HIV-1 with each APRETUDE injection or when your healthcare provider tells you. You should not miss any HIV-1 tests. If you become HIV-1 infected and continue receiving APRETUDE because you do not know you are HIV-1 infected, the HIV-1 infection may become harder to treat. Get tested for other STIs. These infections make it easier for HIV-1 to infect you. Talk to your healthcare provider about ways to reduce your HIV-1 risk. Do not miss any injections of APRETUDE. Missing injections increases your risk of getting HIV-1 infection.

Do not take APRETUDE if you already have HIV-1 or do not know your HIV-1 status, are allergic to cabotegravir, or are taking certain medicines containing carbamazepine, oxcarbazepine, phenobarbital, phenytoin, rifampin, or rifapentine.2 If you are HIV-1 positive, you need to take other medicines to treat HIV-1. APRETUDE can only help reduce your risk of getting HIV-infection before you are infected. If you have HIV-1 and receive only APRETUDE, over time, your HIV-1 may become harder to treat. Please see the Important Safety Information below, and visit www.Apretude.Com to learn more about APRETUDE.

Pride, passport stamps, and PrEP\u2019d with options: One man\u2019s journey with HIV prevention

After learning about the different treatment options, Dino approached his doctor about a PrEP option that didn't require a daily oral pill. They discussed the pros and cons and agreed to change his prescription to APRETUDE.

"As a gay man in a polyamorous relationship, I try to stay in the know about HIV, PrEP, and sexually transmitted infections," Dino says. "I have a good rapport with my doctor and asked him what he thought about APRETUDE. After talking with him about how I would have to be tested before every injection, I liked knowing that I was taking an extra step in helping to protect myself against HIV. I decided to give it a try and have been taking it ever since. I feel like I'm on the right form of PrEP for me."

"I refuse to let anything hinder my exploration of incredible destinations in the U.S. To cities like Atlanta and Orlando, and to cities in other countries, like Dubai and Hong Kong. It is nice to fully immerse myself in every experience, embracing each moment with gusto! It is also nice to not think about someone discovering my pill bottle when I'm traveling," he says.

Dino says his next big trip with his husband, Craig, will be to Japan. He says after long days of food and adventure, he'll appreciate knowing he doesn't have to remember to pack or take a daily PrEP pill. "I encourage everyone with reasons for HIV prevention to speak to their provider about different PrEP options available."

Considering the unique experiences of individuals like Dino, it's important to understand and explore the different PrEP options that best fit an individual's needs and preferences. Have you experienced any of these challenges when taking a daily oral PrEP:

Do you struggle to fit a PrEP pill into your daily routine?

Do you occasionally forget to take your daily PrEP pill?

Are you concerned that people may see your PrEP pill and ask you about it?

If you experience any of these challenges – you are not alone! Talk to your doctor about whether APRETUDE may be right for you.

IMPORTANT SAFETY INFORMATION

What is the most important thing I should know about APRETUDE?

Important information for people who receive APRETUDE for pre-exposure prophylaxis (PrEP) to help reduce their risk of getting human immunodeficiency virus-1 (HIV-1) infection:

Before receiving APRETUDE to reduce your risk of getting HIV-1, you must be HIV-1 negative to start APRETUDE. Do not receive APRETUDE unless you are tested and confirmed to be HIV-1 negative.

Some HIV-1 tests can miss HIV-1 infection in a person who has recently become infected. Tell your healthcare provider if you had a flu-like illness within the last month before starting or at any time while receiving APRETUDE. Symptoms of new HIV-1 infection include: tiredness; joint or muscle aches; sore throat; rash; enlarged lymph nodes in the neck or groin; fever; headache; vomiting or diarrhea; or night sweats

While you are receiving APRETUDE for HIV-1 PrEP:

APRETUDE does not prevent other sexually transmitted infections (STIs). Practice safer sex by using a latex or polyurethane condom to reduce the risk of getting STIs

You must stay HIV-1 negative to keep receiving APRETUDE for HIV-1 PrEP

Get tested for HIV-1 with each APRETUDE injection or when your healthcare provider tells you. You should not miss any HIV-1 tests. If you become HIV-1 infected and continue receiving APRETUDE because you do not know you are HIV-1 infected, the HIV-1 infection may become harder to treat

Who should not receive APRETUDE?

Do not receive APRETUDE if you:

already have HIV-1 or do not know your HIV-1 status. If you are HIV-1 positive, you need to take other medicines to treat HIV-1. APRETUDE can only help reduce your risk of getting HIV-1 infection before you are infected. If you have HIV-1 and receive only APRETUDE, over time, your HIV-1 may become harder to treat

are allergic to cabotegravir

are taking certain medicines: carbamazepine; oxcarbazepine; phenobarbital; phenytoin; rifampin; or rifapentine

What are the possible side effects of APRETUDE?

APRETUDE may cause serious side effects:

Allergic reactions. Call your healthcare provider right away if you develop a rash with APRETUDE. Stop receiving APRETUDE and get medical help right away if you develop a rash with any of the following signs or symptoms: fever; generally ill feeling; tiredness; muscle or joint aches; trouble breathing; blisters or sores in mouth; blisters; redness or swelling of the eyes; swelling of the mouth, face, lips, or tongue

Liver problems. Liver problems have happened in people with or without a history of liver problems or other risk factors. Call your healthcare provider right away if you have any of the following symptoms: your skin or the white part of your eyes turns yellow; dark or "tea-colored" urine; light-colored stools; nausea or vomiting; loss of appetite; pain, aching, or tenderness on the right side of your stomach area; or itching

Depression or mood changes. Call your healthcare provider or get emergency medical help right away if you develop any of the following symptoms: feeling sad or hopeless; feeling anxious or restless; have thoughts of hurting yourself (suicide) or have tried to hurt yourself

The most common side effects of APRETUDE include:

Pain, tenderness, hardened mass or lump, swelling, bruising, redness, itching, warmth, loss of sensation at the injection site, abscess, and discoloration; diarrhea; headache; fever; tiredness; sleep problems; nausea; dizziness; passing gas; stomach pain; vomiting; muscle pain; rash; loss of appetite; drowsiness; back pain; or upper respiratory infection

These are not all the possible side effects of APRETUDE. Call your healthcare provider for medical advice about side effects

Before receiving APRETUDE, tell your healthcare provider about all your medical conditions, including if you:

have ever had a skin rash or an allergic reaction to medicines that contain cabotegravir

have or have had liver problems

have ever had mental health problems

have or ever had kidney problems

are pregnant or plan to become pregnant. It is not known if APRETUDE will harm your unborn baby. APRETUDE can remain in your body for up to 12 months or longer after the last injection. Tell your healthcare provider if you become pregnant while or after receiving APRETUDE

are breastfeeding or plan to breastfeed. APRETUDE may pass into your breast milk. Talk with your healthcare provider about the best way to feed your baby while or after receiving APRETUDE

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

How will I receive APRETUDE?

APRETUDE will be given to you as an injection by your healthcare provider

APRETUDE is initially given as an injection into the muscle of your buttock 1 time every month for the first 2 months, then as an injection 1 time every 2 months

Before receiving your first APRETUDE injection, your healthcare provider may have you take 1 oral cabotegravir tablet 1 time a day for 1 month (at least 28 days) to assess how well you tolerate cabotegravir

APRETUDE is a long-acting medicine and may stay in your body for 12 months or longer after your last injection

Stay under the care of a healthcare provider while receiving APRETUDE. It is important that you receive APRETUDE as scheduled

If you miss or plan to miss a scheduled injection of APRETUDE by more than 7 days, call your healthcare provider right away to discuss your PrEP options

If you stop receiving APRETUDE, talk to your healthcare provider about other options to reduce the risk of getting HIV-1 infection

What is APRETUDE?APRETUDE is a prescription medicine used for HIV-1 PrEP to reduce the risk of getting HIV-1 infection in adults and adolescents who weigh at least 77 pounds (at least 35 kg).

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.Fda.Gov/medwatch, or call 1-800-FDA-1088.

Please read the Patient Information, including an Important Warning, for APRETUDE and discuss it with your healthcare provider.

References

1. Pre-Exposure Prophylaxis. HIV.Gov. Updated March 22, 2024. Accessed April 22, 2024. Https://www.Hiv.Gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis

2. APRETUDE [package insert]. Durham, NC: ViiV Healthcare; December 2023.

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