Aon Employee Benefits
Healthcare
World AIDS Day
Towards an HIV-free generation, Rise.Act.Protect
World AIDS Day is commemorated each year on the 1st of December
and is an opportunity for every community to unite in the fight against
HIV, show support for people living with HIV and remember those who
have passed away.
In an effort to create awareness and provide ongoing education we have
put together some information regarding this topic.
Global Theme
The World AIDS Campaign has set the global theme for World AIDS Day
from 2011–2015 as ‘Getting to Zero: Zero new infections, zero
discrimination, zero AIDS-related deaths’.
South Africa’s Theme for World AIDS Day 2015
Aon Resolution
Centre (ARC)
Please feel free to contact
your Aon Employee
Benefits Healthcare
Consultant if you have any
concerns.
You may also contact the
Aon Resolution Centre at
086-083-5272 or email
[email protected]
In 2011, the focus was on universal access to treatment – ‘zero AIDSrelated deaths’. In 2012, the attention shifted to HIV prevention and ‘zero
new infections’, while World AIDS Day 2014 emphasised the role of
stigma and discrimination with ‘zero discrimination’ as the theme.
The slogan for World AIDS Day is: Towards an HIV-free generation, Rise.Act.Protect
HIV and AIDS in South Africa
South Africa has the biggest and most high profile HIV epidemic in the world, with an estimated 6.3
million people living with HIV in 2013.
In the same year, there were 330,000 new infections while 200,000 South Africans died from AIDS-related
illnesses.
Risk. Reinsurance. Human Resources.
Aon Employee Benefits
Healthcare
South Africa has the largest antiretroviral treatment programme globally and these efforts have been largely
financed from its own domestic resources. The country now invests more than $1 billion annually to run its HIV
and AIDS programmes. However, HIV prevalence remains high (19.1%) among the general population,
although it varies markedly between regions. For example, HIV prevalence is almost 40% Kwazulu Natal
compared with 18% in Northern Cape and Western Cape.
HIV and AIDS Characteristics
It can be easy to confuse HIV and AIDS. While they are different diagnoses, they do go hand-in-hand and are
often used interchangeably to describe a particular disease:
HIV
AIDS
A virus and particular exposure to it can lead to
infection.
A condition or a syndrome, being infected with HIV
can lead to having AIDS.
“HIV” stands for Human Immunodeficiency Virus.
“AIDS” stands for Acquired Immunodeficiency
Syndrome
H – Human – This particular virus can only infect
human beings.
A – Acquired – AIDS is not something you inherit from
your parents. You acquire/get AIDS after birth.
I – Immunodeficiency – HIV weakens your immune
system by destroying important cells that fight
disease and infection. A "deficient" immune system
can't protect you from infections and diseases.
I – Immuno – Your body's immune system includes all
the organs and cells that work to fight off infection
or disease.
V – Virus – A virus can only reproduce itself by taking
over a cell in the body of its host.
D – Deficiency – You get AIDS when your immune
system is "deficient," or lacking, and isn't working
the way it should.
S – Syndrome – A syndrome is a collection of
symptoms and signs of disease. AIDS is a syndrome,
rather than a single disease, because it is a complex
illness with the ability to allow the body to develop
a wide range of opportunistic diseases,
complications and symptoms.
The name describes the virus: it infects humans only
and it attacks the immune system, rendering it
deficient and unable to work as effectively as it
should.
AIDS develops when HIV has caused serious damage
to the immune system. It is a complex condition with
symptoms that vary by individual.
HIV can hide for long periods of time in the cells of
your body and that it attacks a key part of your
immune system – your T-cells or CD4 cells. Your
body has to have these cells to fight infections and
disease, but HIV invades them, uses them to make
more copies of itself, and then destroys them. Unlike
many other viruses, our immune systems are unable
to attack and completely clear out HIV. That means
that once you have HIV, you have it for life
AIDS is the final stage of HIV infection, and not
everyone who has HIV advances to this stage.
Symptoms of AIDS are related to the infections a
person develops as a result of having a damaged
immune system, unable to fight infections as it would
in a healthy individual. These may include
tuberculosis, pneumonia, certain types of cancer, and
other infections.
Risk. Reinsurance. Human Resources.
Aon Employee Benefits
Healthcare
How do you get HIV
Certain body fluids from an HIV-infected person can transmit HIV.
These body fluids are:
•
Blood
•
Rectal fluids
•
Semen
•
Vaginal fluids
•
Pre-seminal fluid
•
Breast milk
These body fluids must come into contact with a mucous membrane or damaged tissue or be directly injected
into your bloodstream (by a needle or syringe) for transmission to possibly occur.
Mucous membranes are the soft, moist areas just inside the openings to your body. They can be found inside
the rectum, the vagina or the opening of the penis, and the mouth.
Symptoms of HIV
The symptoms of HIV vary, depending on the individual and what stage of the disease you are in.
Early stage
(2-4 Weeks after
contracting)
•Fever
•Swollen glands
•Sore throat
•Rash
•Fatigue
•Muscle and joint aches and
pains
•Headache
Clinical Latency
stage
•No HIV-related symptoms,
or only mild ones.
Sometimes called
“asymptomatic HIV
infection” or “chronic HIV
infection.”)
•People in this symptom-free
period are still able to
transmit HIV to others
How is HIV spread
HIV is mainly spread by:
•
•
Having sex with someone who has HIV. In general:
o
Anal sex (penis in the anus of a man or woman) is the highest-risk sexual behavior. Receptive
anal sex (“bottoming”) is riskier than insertive anal sex (“topping”).
o
Vaginal sex (penis in the vagina) is the second highest-risk sexual behavior.
o
Having multiple sex partners or having sexually transmitted infections can increase the risk of
HIV infection through sex.
Sharing needles, syringes, water for rinsing needles or other equipment used to prepare injection
drugs with someone who has HIV.
Risk. Reinsurance. Human Resources.
Aon Employee Benefits
Healthcare
Less commonly, HIV may be spread by:
•
Being born to an infected mother. HIV can be passed from mother to child during pregnancy, birth, or
breastfeeding.
•
Needle stick injuries - being stuck/pricked with an HIV-contaminated needle or other sharp object. This
is a risk mainly for health care workers.
•
Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with
HIV. This risk is extremely small because of rigorous testing of the donated blood supply and organs
and tissues.
•
Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when
infected blood from a caregiver’s mouth mixes with food while chewing. Transmission in this way is
very rare.
•
Being bitten by a person with HIV. Each of the very small number of documented cases has involved
severe trauma with extensive tissue damage and the presence of blood. There is no risk of
transmission if the skin is not broken.
•
Oral sex—using the mouth to stimulate the penis, vagina, or anus (fellatio, cunnilingus, and rimming).
Giving fellatio (mouth to penis oral sex) and having the person ejaculate in your mouth is riskier than
other types of oral sex.
•
Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or bloodcontaminated body fluids. These reports have also been extremely rare.
•
Deep, open-mouth kissing if the person with HIV has sores or bleeding gums and blood is exchanged.
HIV is not spread through saliva. Transmission through kissing alone is extremely rare.
HIV is NOT spread by:
•
Air or water
•
Insects, including mosquitoes or ticks
•
Saliva, tears, or sweat
•
Casual contact, like shaking hands, hugging or sharing dishes/drinking glasses
•
Using common drinking fountains
•
Toilet seats
HIV is not spread through the air and it does not live long outside the human body.
Having an undetectable viral load greatly lowers the chance that a person living with HIV can transmit the virus
to a partner, but there is still some risk. “Viral load” refers to the amount of HIV in an infected person’s blood.
An “undetectable viral load” is when the amount of HIV in a person’s blood is so low that it can’t be
measured. Antiretroviral therapy (ART) reduces a person’s viral load, ideally to an undetectable level, when
taken consistently and correctly. However, a person with HIV can still potentially transmit HIV to a partner
even if they have an undetectable viral load, because:
Risk. Reinsurance. Human Resources.
Aon Employee Benefits
Healthcare
•
HIV may still be found in a person’s genital fluids (e.g., semen, vaginal fluids). The viral load test only
measures virus in a person’s blood.
•
A person’s viral load may go up between tests. When this happens, they may be more likely to
transmit HIV to partners.
•
Sexually transmitted diseases (STDs) increase viral load in a person’s genital fluids.
How do you get AIDS
The terms “HIV” and “AIDS” can be confusing because both terms refer to the same disease. However, “HIV”
refers to the virus itself, and “AIDS” refers to the late stage of HIV infection, when an HIV-infected person’s
immune system is severely damaged and has difficulty fighting diseases and certain cancers.
Before the development of certain medications, people with HIV could progress to AIDS in just a few years.
But today, most people who are HIV-positive do not progress to AIDS. That’s because if you have HIV and
you take antiretroviral therapy (ART) consistently, you can keep the level of HIV in your body low.
This will help keep your body strong and healthy and reduce the likelihood that you will ever progress to AIDS.
It will also help lower your risk of transmitting HIV to others.
Progression to AIDS
If you have HIV and you are not taking HIV medication (antiretroviral therapy), eventually the HIV virus will
weaken and destroy your body’s immune system. The onset of symptoms signals the transition from the
clinical latency stage to AIDS (Acquired Immunodeficiency Syndrome).
During this late stage of HIV infection, people infected with HIV may have the following symptoms:
•
Rapid weight loss
•
Sores of the mouth, anus, or genitals
•
Recurring fever or profuse night sweats
•
Pneumonia
•
Extreme and unexplained tiredness
•
•
Prolonged swelling of the lymph glands in
the armpits, groin, or neck
Red, brown, pink, or purplish blotches on
or under the skin or inside the mouth,
nose, or eyelids
•
•
Diarrhoea that lasts for more than a week
Memory loss, depression, and other
neurologic disorders.
Each of these symptoms can be related to other illnesses. The only way to know for sure if you are infected
with HIV is to get tested.
Many of the severe symptoms and illnesses of HIV disease come from the opportunistic infections that occur
because your body’s immune system has been damaged. You cannot rely on symptoms to know whether you
have HIV. The only way to know for sure if you are infected with HIV is to get tested.
TB and HIV
At least one-third of people living with HIV worldwide in 2014 were infected with TB bacteria. People living with
HIV are 20 to 30 times more likely to develop active TB disease than people without HIV.
Risk. Reinsurance. Human Resources.
Aon Employee Benefits
Healthcare
HIV and TB form a lethal combination, each speeding the other's progress. In 2014 about 0.4 million people
died of HIV-associated TB. Approximately one third of deaths among HIV-positive people were due to TB in
2014. In 2014 there were an estimated 1.2 million new cases of TB amongst people who were HIV-positive,
74% of whom were living in Africa.
Source: Avert, the Council for Medical Schemes (CMS), South African National AIDS Council (SANAC), World
AIDS Campaign, World Health Organisation (WHO).
In conclusion
The information contained in this clinical awareness communication is for educational purposes only, and is
not intended as medical advice, diagnosis or treatment. If you are experiencing symptoms or need health
advice, please consult a healthcare professional.
All medical care for any exposure to HIV and AIDS is covered under the Prescribed Minimum Benefits (PMBs)
and protected in the Medical Schemes Act. ‘PMBs allow for the testing, prevention, and treatment of HIV to be
covered by medical schemes. The regulations also cover the treatment of complications arising from HIV
infection.’
HIV is a prevailing factor by law. This means that if you have HIV and any other PMB condition/s, the
entitlements that HIV present are overridden by that of HIV.
Should a member require treatment or medical care relating to HIV / AIDS it is important that they understand
the benefits offered by their specific medical scheme option as well as the benefits allowed in terms of PMB’s.
Many medical schemes have Designated Service Providers (DSPs) who are appointed to treat their HIVpositive members. Knowing who the medical scheme DSP is and making use of them prevents co-payments
for using a non-DSP.
Most schemes run HIV management programmes and require their members to register on the programmes
to access the benefits available to them. If members don’t register then they may only have access to the PMB
entitlement or in some instances a limited rand amount. These programmes focus on education and ensuring
that treatment and the management of a condition is effective and efficient.
At one time in history, a diagnosis of HIV or AIDS was considered a death sentence. Thanks to research and
the development of new treatments, today, people diagnosed with HIV and AIDS are living long, productive
lives.
If you do not get satisfactory assistance from your medical scheme please do not hesitate to contact your
allocated Aon Employee Benefits Healthcare Consultant or the Aon Resolution Centre (ARC) on 0860
835 272.
For more information from Aon Employee Benefits on this topic and other healthcare industry news go
to aon.co.za. You can also follow us on:
http://www.facebook.com/Aonhealthcare
Click “Like” on our page (Aon healthcare)
http://twitter.com/Aonhealthcare
Click “follow” on our profile
Aon Employee Benefits - Healthcare
Risk. Reinsurance. Human Resources.