Prevention

AIDS: Ideas have a hard life
Despite some 20 years of prevention against HIV transmission, misconceptions about AIDS persist, especially among young people. 21% of them think for example that the virus can be transmitted by a kiss *.

The point with Dr. Alain Lafeuillade, AIDS specialist, and author of the book "A doctor should never say that".

Today in France, we do not get a lot of AIDS.
FALSE. Since the last decade, the figure is stable: between 6,000 and 7,000 new contaminations per year in France, according to the data of the "sentinel networks". On the other hand, the modes of transmission evolve. "We do not see any more intravenous drug addicts, thanks to" clean "syringe programs, says Dr. Alain Lafeuillade. But the epidemic continues to spread among heterosexuals, bisexuals, and especially men who have sex with men.

HIV and AIDS is the same.
FALSE and TRUE. AIDS (Acquired Immunodeficiency Syndrome) is a disease, itself caused by a virus: HIV (Human Immunodeficiency Virus), which can be HIV-positive (that is, infected with the virus) and do not have AIDS, but also be infected with HIV without feeling any symptoms for years, even decades!

"HIV is progressively destroying immune defenses (white blood cells called" CD4 cells "), says Dr. Lafeuillade. In a seronegative person, the CD4 count varies between 800 and 1200 / mm3. In a seropositive, "minor" problems (digestive fungus infections or repeated shingles) occur between 200 and 500 CD4 / mm3. The definition of AIDS by American researchers is when the rate of these white blood cells falls below 200 CD4 / mm3. It is then that the patient develops "serious opportunistic infections" or tumors that are often fatal for patients ... but also one of the final stages of AIDS: dementia, when the virus attacks the nervous system and destroys it . "

You can get AIDS by kissing or shaking hands with someone who is HIV positive.
FALSE. "HIV infection is transmissible, but not contagious. This means that it takes some practices to contract, says Dr. Alain Lafeuillade, AIDS specialist. Blood and sperm are the richest fluids in the virus. Therefore, intercourse with penetration or exchange of blood contaminated blood (scarifications) are at risk. The rest is imaginary. "

AIDS remains a disease that affects only certain populations.
FALSE. This was relatively true at the beginning of the epidemic, when homosexuals, bisexuals, drug addicts were the only ones affected. Subsequently, the epidemic spread in the heterosexual population.

With new treatments, AIDS is no longer deadly.
FALSE. No currently available treatment can "kill" HIV. There are only so-called "virostatic" drugs. These products block the multiplication of the virus in a cell and thus make it possible to obtain in a patient what is called an undetectable viral load. In other words, the virus is present, but in very small quantities, until it becomes almost non-contaminating for another person.

But beware, says Dr. Lafeuillade, HIV is still there. "It has been shown that in patients with undetectable viral load who stop their triple therapy, it becomes detectable in more than 95% of cases within 2 to 3 weeks. "

With new treatments, you do not need to protect yourself during intercourse.
FALSE. "There are" post-exposure "treatments for people who have just been exposed to a high risk of HIV transmission. They should be started ideally within 48 hours of risk taking to try to prevent contamination. "In practice, it is a triple therapy of 28 days, with surveillance for three months, says Dr. Alain Lafeuillade. If two weeks after stopping this treatment, the viral load remains undetectable, we can think that the person was not infected. "

This should not be confused with preventive treatment ("pre-exposure prophylaxis"), which is reserved for populations at high risk of HIV infection who do not routinely use condoms. When properly followed, it reduces the risk of HIV infection by up to 90%. In theory, this is part of prevention including condom use, except that some people do without it. However, this treatment does not protect against syphilis, hepatitis A, hepatitis C, gonococcal and chlamydial infections ... ", worries Dr. Lafeuillade.

In a heterosexual relationship, both men and women are at risk of being infected.
FALSE. "HIV is more concentrated in the white blood cells that accompany sperm, than in the cells of vaginal secretions. And conversely, the vagina contains many cells that may be infected with HIV. This is why the risk of transmitting HIV to a partner is more important than the risk of female-to-male transmission (although not zero). "

A spermicide alone or a contraceptive is effective in preventing contamination.
FALSE. The contraceptive has no antiviral action and never replaces a condom to protect against sexually transmitted infections "A spermicide" usual "either, says Dr. Lafeuillade, although we seek to develop spermicides containing anti-HIV molecules. But so far, their degree of prevention remains lower than that of condom use. "