HIV/AIDS awareness in Cyprus

HIV/AIDS Cyprus General Information

Learning more about HIV, AIDS, and sexual health services can help us to stay in good health

Introduction

PART ONE

    Facts about HIV

    Sexual practices; the way we have sex and HIV

    Testing for HIV

    Confidentiality

PART TWO

    Finding out that you are HIV positive

    Treatments for HIV

    Taking care about your health

    Immigration, welfare and benefit problems

DIFFICULT TERMS

WHERE ELSE TO GET HELP AND SUPPORT

OTHER USEFUL INFORMATION

Introduction

Learning more about HIV, AIDS, and sexual health services can help us to stay in good health. It can also help us to understand or to help other people who are affected by HIV. As men, we have responsibilities towards our girl friends, wives, or whomever we have sex with. This is why this booklet has been written.

Who is this booklet for?

• Μen who want to understand how they can protect themselves and others from HIV.
• Men who are HIV positive and want to know how to maintain their health and well-being.
• Professionals supporting or working with men affected by HIV.

Your comments are always welcome.

PART ONE

FACTS ABOUT HIV AND AIDS

What is HIV?

HIV stands for human immunodeficiency virus. It is a tiny germ, which attacks part of the body’s immune system. The immune system is our natural defense against diseases. When someone is infected with HIV, the person may feel well for some time, up to several years with no symptoms. However, in most cases, the immune system gets weaker and weaker. After some time, someone with HIV can go on to have AIDS.

What is AIDS?

AIDS stands for Acquired Immune Deficiency Syndrome. Doctors also call it late stage or advanced HIV infection. At this stage, the immune system is so weak, and the person can get serious illnesses that can kill. Βecause of the new medicines, fewer people get AIDS.

How can someone get HIV?

 Αround the world, most people who got HIV were infected through unprotected sex. For someone to get HIV, a sufficient amount of HIV needs to enter their bloodstream.

HIV can live in body fluids like:

• Blood
• Sperm
• Vaginal fluids
• Breast milk

These fluids can be exchanged

• During unprotected sex
• When an HIV positive woman breastfeeds a baby
• When needles are exchanged between people to inject drugs

Examples:

A person who doesn’t have HIV can get it if he (or she) doesn’t use a condom or Femidom during sex.

A man who has HIV (whether he knows it or not) can pass it on to his wife or partner if they don’t use condoms or Femidoms during sex.

Main routes of HIV transmission

Most people who have HIV have been infected through sex without protection between an HIV positive person and an HIV negative person.

There are other ways of getting HIV, but they are less common:

• Exchanging needles to inject drugs
• Blood transfusions
• From an HIV positive mother to her baby

Can you tell if someone has HIV?

People can have HIV and remain well with no symptoms for months and even years. Unless they have an HIV test, they cannot know whether they have it or not.Also you should not expect that someone with HIV would tell you about it even if you know each other very well.    

SEXUAL PRACTICES:THE WAY WE HAVE SEX AND HIV

People have sex for pleasure or to have children.

Some ways of having sex can put us, or the person we are having sex with, at risk of getting HIV or other sexually transmitted diseases.

What is the best way to avoid HIV?

You may want to protect yourself, but remember: if you don’t check your own health, you cannot assume that you are free from STIs or HIV.

Few people are able to abstain from sex for a long time. So, if you want to reduce the risk of getting HIV or passing it on, there are many things you can do:

• You can make good decisions about avoiding HIV once you are sure about yourself; whether you have HIV or not.
• If you have a wife, a girlfriend, or any other person you have sex with, don’t assume that they have HIV or an STI.
  
• Try as much as you can to discuss sex and sexual health with your partner.
• Don’t make judgments. Remember everyone who has sex without protection is at risk of getting HIV or STIs.
• If your partner brings up the subject of sex, there is nothing wrong with that. Take it as an opportunity to discuss your sexual health.
  
• As a couple, you can decide to practice safer sex.

If you and your sexual partner are HIV negative, being faithful to each other helps reduce chances of getting HIV.

What does safer sex involve?

You can continue to enjoy sex in many ways, as long as you remember:

• Using condoms or Femidoms every time you have sex with penetration is the only way to reduce the risk of getting or passing on HIV.
• Having many sexual partners puts everyone in the relationship at risk

Sex with penetration is not the only way to enjoy sex. Many people also enjoy safer practices like:

• Oral sex (sucking or licking other’s sexual organs)
• Masturbation including mutual masturbation (so long as you don’t exchange each other’s body fluids).

It is a good thing to check your sexual health checks at least every 6 months.

I have been with my wife for many years. We have never used condoms; why should we start using condoms?

Even if you love and trust your wife, it is still difficult to be sure that both of you are clear from HIV and other STIs. The only way to be sure that one of you has HIV or not is to take the test. You may find it difficult to bring up HIV with your wife in a discussion. Health advisors in sexual health or GUM clinics can help you to do it.

USING CONDOMS

Using condoms is the best way to protect yourself and others when you are having penetrative sex. Condoms can stop HIV but also other sexually transmitted diseases. It is important that you know how to use condoms properly:

• Ensure that the condom or Femidom you are using is of good quality; check for the expiry date or  the CE. These are the signs of good quality to look for on the condom pack:
• Check that the condom fits well during sex.
• If you are not comfortable, use some water based lubricant like KY jelly. You can use the jelly inside the condom or outside. Don’t use too much lubricant; it can make the condom slip off.
• Don’t use Vaseline or body cream; they can make the condom become weak and break.

Where can I find condoms?

Condoms are available free of charge from:

• Gregorios Clinic
• Other HIV and AIDS organizations
• The Cyprus Family Planning Association

You can also buy them from kiosks, chemists and supermarkets.

You can find water-based lubricants in most chemists and supermarkets.

 TESTING FOR HIV

What is an HIV test?

To do the test, doctors will take a small amount of your blood. The HIV test does not look for the virus itself, it looks for antibodies. Antibodies are chemicals, which appear in the blood after HIV has entered the body. If HIV antibodies are found in the blood, the person is said to be HIV positive.

If antibodies are not found, the person is said to be HIV negative. However, if someone gets HIV, antibodies might not show up in the blood for up to three months. It is called the “window period.” This is why, even if you are HIV negative, you may be asked to take another test at least three months later to be sure that you are truly HIV negative.

What is the advantage of taking an HIV test?

Taking an HIV test helps you to know of your status. If you know whether you have HIV or not, it helps you to

• Decide how to take care of your health from now on.
• Think about how to protect yourself but also your wife, your girl friends, or anyone you have sex with.
• Decide about having children (or more children).If you find that you are HIV positive, you can get help to stay in good health:
• There are now treatments that can help you live longer in good health. These treatments work better if you know about HIV early.
• You can learn to make more efforts to live a healthy lifestyle.
  

Why should I have an HIV test?

HIV passes on from person to person. This means that if we want to protect our wives, girlfriends, or our children, we can do something about it. If you are sure that you don’t have HIV, you can decide to protect yourself from getting it.  People who are found HIV positive may benefit from new medicines. These medicines may work better if you know you are HIV positive early enough.

Antenatal testing

All pregnant women must be  offered an HIV test. If your wife or girlfriend is pregnant, it is possible that she may agree to take the test. This is an opportunity for you to ask her about the test and how it happens at the clinic. By doing so, you will be able to support her during the test. It is also a chance to take the test yourself. Your wife’s result does not tell much about you. You and your wife can have two very different results.

Where can I go for an HIV test?

The best place to go for a test is a sexual health clinic; or a General Hospital. The test is confidential and anonymous. This means that:

• You don’t have to give your real name.
• You will be given a number, which will be your identification.
• Your results will not be given to anybody without your agreement.
• You do not need to be referred by a GP or anyone.

• The HIV test in GUM clinics is entirely confidential. This means that:
  
• You do not need to give your real name; you may be given a number instead.
• No one else apart from some staff at the clinic will know your HIV test result.
• The staff at the clinic cannot give your HIV test result to anyone without your consent.

What happens in GUM clinics?

If you decide to go to a GUM clinic, you may have to book an appointment. At the clinic, the staff will ask you some questions about your address and age. They may ask for your name, but you don’t have to give a real name.You will be asked to see a health adviser. They can help you decide about the HIV test, and other tests that you may want to take.

• Before the HIV test, you will be offered to see a health adviser for pre test counseling. The adviser will ask you some questions about your lifestyle. You can ask any questions you want about the test. You can also ask all the questions you want to. After the counseling, if you don’t feel ready to take the test, you do not have to do it.
• You will also have post test counseling with the adviser after you have taken the test. Whether you get tested positive or negative, the adviser will give you information about how to stay healthy.
• The test involves taking a small amount of your blood.

HIV testing facts:

• HIV tests are very reliable medical tests.
• At HIV clinics, testing is free and anonymous for everyone.
• In many clinics you can have the test and get results on the same day.

You may be offered to get checked for other sexually transmitted diseases.

*Gregorios is the only clinic that is specialized in HIV/AIDS matters in Cyprus.

CONFIDENTIALITY

“I am not sure about going to a GUM clinic. If someone sees me there, they will think I have HIV.”

You should not worry about that; people go to GUM clinics for many reasons not just HIV. You cannot assume anything about other people you will see in the clinic.

How can I be sure that no one will know about my results?

If you want to be sure about confidentiality, have your test in a sexual health or a GUM clinic.

The staff at the clinic is professionals. By law they have to keep strict confidentiality rules.

In most clinics, your file will be kept safely in a computer and few people will have the password.

Your name will be replaced by a number, so even the people who have your password would not know your name.

You don’t even have to give your real name, but make sure you always remember it.

If you feel that confidentiality was broken and you wish to make a complaint, you can get support from many volunteer organizations in Cyprus.

PART TWO

FINDING OUT THAT YOU ARE HIV POSITIVE

“I was diagnosed with HIV after my girl friend died of pneumonia. I never thought about it before. It was devastating.”

Men who found out that they were HIV positive in Cyprus had to go through difficult times:   

• Some found out after being admitted themselves in a hospital for an AIDS related illness.   
  
• Some found out because their wife or girlfriend fell ill.   
  
• Some found out when their baby fell ill.   
  
• Others found out when they felt at risk and wanted to be sure by going for a voluntary HIV test.

Whichever way you find out about HIV, the best thing to do is to get as much information as you can about:

• How and where to get help
• How to stay in good health

How do I deal with an HIV positive result?

Soon after you have an HIV positive result, health advisers are available to answer some of your questions. They can give you information that can help you get back to a normal life.

Most HIV positive people have gone through the hard time of finding out they were positive. However, with time and support most people find a way of dealing with it.

Health checks and monitoring

Once doctors have found out about your HIV, you will be referred to a specialist doctor. You will be asked to do more tests and examinations. There are two important tests to know:

The CD4 count; it helps to know how your body is coping.

The viral load; it shows how much virus there is in your blood.

You will be given appointments to come to the clinic every three months or more often. It is important not to miss your appointments. If you don’t feel confident about going alone to the clinic, say so to a health adviser or call a volunteer organization. You may get help with an advocate or translator.

Getting support from health professionals

Within the hospitals and clinics, you can get help from a lot of the staff. These can be doctors, nurses, social workers, counselors, or health advisers. They may not have a lot of time to spend with you.

Make sure that every time you have an appointment with a health professional, you ask all the questions that you need. If you have any health problem, your doctor will be able to advise you or refer you to another specialist. It may be a good idea to write them down.

If you don’t feel confident on your own, you can go to your appointments with an advocacy worker or a translator. Talk to your health advisor about it.

Getting support and learning from people like you

Learning from people who have gone through the same experiences as you can be a good thing. You can do this by:

• Attending support groups of HIV positive people.
• Reading the HIV press; many newsletters and magazines are available. You can get some at Gregorios clinic, Family Planning Association and other volunteer organizations.
• Phoning help lines and information lines.

Getting support from HIV and AIDS organizations

There are many organizations. You can make your choice depending on your needs.

Who to tell?

This will probably be one of the most important questions you will have to ask yourself when you are diagnosed with HIV. Deciding whom to tell is your own choice. Many people are still ignorant about HIV and some people may reject you or discriminate against you because of HIV..

TREATMENTS FOR HIV

There are now new medicines that have helped people with HIV to live longer and better. These medicines can reduce the amount of HIV in your blood. They can also help to maintain or improve your immune system. They cannot cure HIV.

Combination therapy

If you are diagnosed with HIV, doctors will ask you to do more tests to see how the virus is damaging your immune system. Once the test results are all out, doctors may offer you to start treatment. They may also offer you to wait until you are ready to start or until your immune system gets damaged by HIV.

What you should know about HIV treatments

• They cannot cure HIV.
• They can help HIV positive people to live longer in good health.
• They have to be used in combination and they need to be taken every day.
• Once you start combination therapy, you may have to take it for the rest of your life.
• Anti-HIV drugs can have side effects.

For the treatment to work, doctors have to use several drugs together. This is called combination therapy. There are many different types of drugs and every year they are getting better. It is important to learn about anti-HIV drugs and combination therapy even if you have not started treatments.

TAKING CARE OF YOUR HEALTH

Being HIV positive means that you will have to make more efforts and look after your health. 

Living with HIV

Some people choose to keep themselves busy by working, sports, reading, and socializing. Others get involved in religious activities, helping other people with HIV, volunteering, or studying.

Other treatments

Because of HIV, you may be at risk of getting opportunistic infections or other diseases. Every time you see your doctor, he will be checking that things are alright. If you have an opportunistic infection, doctors might prescribe you other types of drugs like antibiotics. Sometimes doctors will also advise you to take antibiotics to stop you from getting diseases like PCP or toxoplasmosis.

Nutrition

When you have HIV, what you eat and how you eat becomes even more important.If you are taking HIV treatments, you will have to organize the time of your meals because of the medication. HIV drugs work better when you learn how to organize your meals properly.

Can I still eat my favorite meals?

Yes of course, you can continue eating your favorite meals. The best way to get good advice is to talk to a specialist HIV dietician. You can find one by asking the health adviser at your clinic.

Safer sex

Using condoms is the only way to avoid other sexually transmitted diseases. It is also the best way to avoid passing on HIV to someone else.

I am HIV positive, but I want to have children. How can I get help?

Many of us want to have children or more children. But before having a baby, it might be useful to ask yourself:

• Can I take the risk of infecting or re-infecting my partner?
• Who will take care of my children when I will not be able to cope?
• Will my wife or my family be able to cope?

Being HIV positive, using condoms is the only way to avoid re-infection through sex.

Doctors may soon find ways of doing sperm washing. This means that some clinics may be able in the future to remove HIV from the man’s sperm and use the sperm to make women pregnant. When this will be available, it means that HIV positive men will be able to have children without taking the risk of passing on HIV to a woman.

IMMIGRATION, WELFARE, AND BENEFIT PROBLEMS

I found out that I am HIV positive, and I have already made an application to stay in the country

You need to get good advice from a qualified lawyer.

You can ask to speak to an immigration adviser.

I hear that lawyers are expensive. I don’t have the money!

There are many lawyers who will ask for lots of money to help you. It is not necessary. If you have no money, you can still get good legal advice.

Ask your local Citizen’s Advice Bureau or Law Center. You can find their address in the phone book or through directory enquiries.

DIFFICULT TERMS

PCP

SymptomsToxoplasmosis

Sexually transmitted diseases

Side effects

STIs