HIV
HIV stands for human immunodeficiency virus, a virus that directly attacks the immune system.
It is not to be confused with AIDS (acquired immunodeficiency syndrome), the last phase of an HIV infection, which occurs after years of living with the infection without receiving any treatment. People can therefore carry HIV for life without necessarily having AIDS.
The HIV crisis began in the late 1980s when the virus, known to be deadly but poorly understood and lacking a treatment, became a global pandemic. HIV has been particularly devastating in LGBTQ+ communities and has led to a wave of stigmatization of queer sexual practices. Since then, HIV has been the subject of much sexual health and STBBI prevention research and conversation. Today, thanks to medical advances, a person living with HIV who is treated and whose condition is being closely monitored has a life expectancy similar to that of a person living without the virus.
Undetectable = untransmittable
To date, there is no cure for HIV. On the other hand, with current medical advances, it is possible to live a fulfilling life (and flourish!) while limiting the risk of transmission. Scientific research has shown that, with consistent treatment and close medical monitoring, an undetectable viral load means that there is no risk of transmission.
The what load?
“Viral load” refers to the amount of virus present in a person’s blood. When we say that it is undetectable, we mean that it is below the laboratory detection threshold. Studies have shown that maintaining an undetectable viral load (below 40 copies/ml) or even a detectable viral load (below 200 copies/ml) helps prevent the sexual transmission of HIV.
What are the symptoms?
You can have an HIV infection with no symptoms, or symptoms can go unnoticed. A person can therefore be infected without knowing it.
In the absence of treatment, there are 3 phases of HIV infection.
1. Primary infection
The first symptoms may appear 2 to 4 weeks after infection and last up to 3 weeks:
2. Asymptomatic phase
Symptoms may fade or even disappear, but the virus remains in the body and can still be transmitted. If left untreated, this phase can last over 10 years in some cases.
3. Symptomatic phase
Symptoms appear as the immune system weakens:
What about AIDS?
The AIDS phase occurs after the three aforementioned phases of HIV, when opportunistic infections take advantage of the weakened immune system. The symptoms of these infections vary and are potentially fatal if treatment is not initiated. Today, most people with HIV who are adequately treated have a quality of life and life expectancy comparable to those of the general population.
How is it transmitted?
HIV is transmitted during unprotected vaginal or anal intercourse. It is also transmitted by blood when sharing equipment used for preparing, injecting, or inhaling drugs, or when using nonsterile tattooing or piercing equipment. Finally, transmission can also occur during pregnancy, childbirth, and breastfeeding.
HIV can be transmitted through oral sex, although the risk is considered extremely low compared to unprotected vaginal or anal sex. During oral sex, the risk of transmission depends on several factors, including the viral load of the infected person, the presence of other sexually transmitted infections, lesions or cuts in the mouth or on the genitals, and the sexual practice itself (fellatio or cunnilingus).
Contrary to what some people believe, HIV cannot be transmitted through everyday actions, such as using the same glass or toilet seat, sneezing, or kissing.
It is treatable?
We are still looking for a cure for HIV. On the other hand, there are drugs that can control the virus. An HIV-positive person can thus enjoy a quality of life and life expectancy similar to those of a person who does not have HIV.
HIV is treated with antiretroviral drugs (ARVs), which prevent the virus from replicating and therefore decrease the number of copies of the virus in the bloodstream (i.e., the viral load). When medication is taken properly and the condition is closely monitored, the viral load can become undetectable, thereby eliminating the risk of HIV transmission.
In Quebec, there are currently a wide range of treatments available. The choice of treatment will be made following a resistance analysis and based on the treatment’s side effects and ability to successfully block the replication of the virus. Once a treatment is selected, it is important to take it at the same time every day to maximize its effectiveness.
Tritherapy
This is currently the recommended method. It is called tritherapy because it combines the intake of three drugs used to control the virus.
Bitherapy
Rigorous research supports the effectiveness of bitherapy, which is newly available on the market. Bitherapy involves treating the virus with two drugs instead of three, which can save treatment costs and reduce short- and long-term side effects by subjecting the body to lower levels of toxicity. Only certain combinations of antiretroviral drugs have been studied and approved as effective enough to treat HIV in this way.
Cabotegravir + Injectable Rilpivirine (Cabenuva®)
Cabenuva® is a drug used to treat HIV in adults. It is made up of two drugs, cabotegravir and rilpivirine, and is administered via intramuscular injection, usually once every two months. It is the very first injectable antiretroviral therapy available in Canada.
Cabenuva® is typically prescribed to people who have already achieved an undetectable viral load through oral antiretroviral therapy and are ready to switch to a bimonthly injection treatment. It is a treatment that must be administered by a healthcare professional trained in intramuscular injection. This new type of HIV drug means that people do not have to take a treatment every day and reduces the risks associated with medical noncompliance.
If you are currently taking oral HIV medication and are interested in switching to an injectable treatment, contact us so that we can assess your situation together and contact your doctor to begin the process if desired.
The Pharmacie du Village has a dedicated injection room on site so that you can receive your injections from a qualified nurse with comfort and confidentiality.
Can I get financial support for HIV treatments?
We believe that being in a precarious financial situation should never be a barrier to obtaining your HIV medication. Did you know that many HIV drugs can be obtained with the help of financial support programs?
If your HIV medication is causing you financial stress or its costs are preventing you from accessing treatment altogether, contact us and we will discuss your options together.
What is PEP?
HIV post-exposure prophylaxis, also known as PEP, is a prevention strategy used to reduce the risk of contracting HIV after a possible exposure. It is important to know that PEP is only effective if taken soon after exposure, ideally within 72 hours. If you believe you have recently been at risk of contracting HIV, immediately go to a medical clinic or hospital emergency room, or as a last resort, call us at the pharmacy to obtain PEP.
PEP is a combination of antiretroviral drugs that must be taken every day for 28 days. The treatment can cause side effects, but they are often temporary and disappear after treatment is finished. PEP is covered by all private or public group insurance programs in Quebec.
It is important to understand that PEP should only be used in emergency situations, such as after accidental exposure to HIV through unprotected sex or shared IV drug equipment. It is recommended that you take the necessary steps to prevent contracting HIV, such as using condoms, taking PrEP, or using sterile drug injection equipment.
At the Pharmacie du Village, we can prescribe PEP in the case of an emergency, that is, in cases where you are unable to quickly see a doctor. We will guide you throughout the process.
The information on this website is presented for general information purposes only and is not intended to provide complete information on the subjects covered or to replace the advice of a healthcare professional. This information does not constitute medical consultations, diagnoses, or opinions, and should therefore not be interpreted as such. Please consult your healthcare professional if you have any questions about your medical condition, medications, or treatment.
