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HIV (human immunodeficiency virus) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. It is spread by contact with certain bodily fluids of a person with HIV, most commonly during unprotected sex (sex without a condom or HIV medicine to prevent or treat HIV), or through sharing injection drug equipment.

If left untreated, HIV can lead to the disease AIDS (acquired immunodeficiency syndrome). The human body can’t get rid of HIV and no effective HIV cure exists. So, once you have HIV, you have it for life. However, by taking HIV medicine (called antiretroviral therapy or ART), people with HIV can live long and healthy lives and prevent transmitting HIV to their sexual partners. In addition, there are effective methods to prevent getting HIV through sex or drug use, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). First identified in 1981, HIV is the cause of one of humanity’s deadliest and most persistent epidemics.

What Is AIDS?

AIDS is the late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus. In the U.S., most people with HIV do not develop AIDS because taking HIV medicine every day as prescribed stops the progression of the disease. A person with HIV is considered to have progressed to AIDS when: the number of their CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3). (In someone with a healthy immune system, CD4 counts are between 500 and 1,600 cells/mm3.) OR they develop one or more opportunistic infections regardless of their CD4 count. Without HIV medicine, people with AIDS typically survive about 3 years. Once someone has a dangerous opportunistic illness, life expectancy without treatment falls to about 1 year. HIV medicine can still help people at this stage of HIV infection, and it can even be lifesaving. But people who start ART soon after they get HIV experience more benefits—that’s why HIV testing is so important.

How Do I Know If I Have HIV?

The only way to know for sure if you have HIV is to get tested.Testing is relatively simple. You can ask your health care provider for an HIV test. Many medical clinics, substance abuse programs, community health centers, and hospitals offer them too. You can also buy a home testing kit at a pharmacy or online.

How Do You Get or Transmit HIV?

You can only get HIV by coming into direct contact with certain body fluids from a person with HIV who has a detectable viral load. These fluids are:
1.Blood
2.Semen (cum) and pre-seminal fluid
3.Rectal fluids
4.Vaginal fluids
5.Breast milk For transmission to occur, the HIV in these fluids must get into the bloodstream of an HIV-negative person through a mucous membrane (found in the rectum, vagina, mouth, or tip of the penis); open cuts or sores; or by direct injection. People with HIV who take HIV medicine daily as prescribed and get and keep an undetectable viral load have effectively no risk of sexually transmitting HIV to their HIV-negative partners.

How Is HIV Spread from Person to Person?

HIV can only be spread through specific activities. In the United States, the most common ways are:
1.Having vaginal or anal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV. Anal sex is riskier than vaginal sex.
2.Sharing injection drug equipment (“works”), such as needles, with someone who has HIV. Less common ways are:
3.From mother to child during pregnancy, birth, or breastfeeding. However, the use of HIV medicines and other strategies have helped lower the risk of mother-to-child transmission of HIV to 1% or less in the United States.
4.Getting stuck with an HIV-contaminated needle or other sharp object. This is a risk mainly for health care workers. The risk is very low. HIV is spread only in extremely rare cases by:
5.Having oral sex. But in general, the chance that an HIV-negative person will get HIV from oral sex with an HIV-positive partner is extremely low.
6.Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. The risk is extremely small these days because of rigorous testing of the U.S. blood supply and donated organs and tissues.
7.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.
8.Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids.
9.Deep, open-mouth kissing if both partners have sores or bleeding gums and blood from the HIV-positive partner gets into the bloodstream of the HIV-negative partner. HIV is not spread through saliva.
10.Eating food that has been pre-chewed by a person with HIV. The contamination occurs when infected blood from a caregiver’s mouth mixes with food while chewing. The only known cases are among infants.

Does HIV Viral Load Affect Getting or Transmitting HIV?

Yes. Viral load is the amount of HIV in the blood of someone who has HIV. Taking HIV medicine (called antiretroviral therapy or ART) daily as prescribed can make the viral load very low—so low that a test can’t detect it (this is called an undetectable viral load). People with HIV who take HIV medicine daily as prescribed and get and keep an undetectable viral load have effectively no risk of transmitting HIV to an HIV-negative partner through sex. HIV medicine is a powerful tool for preventing sexual transmission of HIV. But it works only as long as the HIV-positive partner gets and keeps an undetectable viral load. Not everyone taking HIV medicine has an undetectable viral load. To stay undetectable, people with HIV must take HIV medicine every day as prescribed and visit their healthcare provider regularly to get a viral load test. Learn more.

Ways HIV Cannot Be Spread

HIV is not spread by:

1.Air or water
2.Mosquitoes, ticks or other insects
3.Saliva, tears, or sweat that is not mixed with the blood of a person with HIV
4.Shaking hands; hugging; sharing toilets; sharing dishes, silverware, or drinking glasses; or engaging in closed-mouth or “social” kissing with a person with HIV
5.Drinking fountains
6.Other sexual activities that don’t involve the exchange of body fluids (for example, touching). HIV can’t be passed through healthy, unbroken skin.

Is the Risk of HIV Different for Different People?

Some groups of people in the United States are more likely to get HIV than others because of many factors, including the status of their sex partners, their risk behaviors, and where they live. When you live in a community where many people have HIV infection, the chances of having sex or sharing needles or other injection equipment with someone who has HIV are higher. You can use CDC’s HIV, STD, hepatitis, and tuberculosis Atlas Plus to see the percentage of people with HIV (“prevalence”) in different US communities. Within any community, the prevalence of HIV can vary among different populations. Gay and bisexual men have the largest number of new diagnoses in the United States. Blacks/African Americans and Hispanics/Latinos are disproportionately affected by HIV compared to other racial and ethnic groups. Also, transgender women who have sex with men are among the groups at highest risk for HIV infection, and injection drug users remain at significant risk for getting HIV. Risky behaviors, like having anal or vaginal sex without using a condom or taking medicines to prevent or treat HIV, and sharing needles or syringes play a big role in HIV transmission. Anal sex is the highest-risk sexual behavior. If you don’t have HIV, being a receptive partner (or bottom) for anal sex is the highest-risk sexual activity for getting HIV. If you do have HIV, being the insertive partner (or top) for anal sex is the highest-risk sexual activity for transmitting HIV. But there are more tools available today to prevent HIV than ever before. Choosing less risky sexual behaviors, taking medicines to prevent and treat HIV, and using condoms with lubricants are all highly effective ways to reduce the risk of getting or transmitting HIV. Learn more about these and other strategies to prevent HIV.

How Can You Tell If You Have HIV?

The only way to know for sure if you have HIV is to get tested. You can’t rely on symptoms to tell whether you have HIV. Knowing your HIV status gives you powerful information so you can take steps to keep yourself and your partner(s) healthy:
If you test positive, you can take medicine to treat HIV. People with HIV who take HIV medicine daily as prescribed can live a long and healthy life and prevent transmission to others. Without HIV medicine (called antiretroviral therapy or ART), the virus replicates in the body and damages the immune system. This is why people need to start treatment as soon as possible after testing positive.
If you test negative, there are several ways to prevent getting HIV.
If you are pregnant, you should be tested for HIV so that you can begin treatment if you're HIV-positive. If an HIV-positive woman is treated for HIV early in her pregnancy, the risk of transmitting HIV to her baby can be very low.

What Are the Symptoms of HIV?

There are several symptoms of HIV. Not everyone will have the same symptoms. It depends on the person and what stage of the disease they are in. Below are the three stages of HIV and some of the symptoms people may experience.
Stage 1: Acute HIV Infection
Within 2 to 4 weeks after infection with HIV, about two-thirds of people will have a flu-like illness. This is the body’s natural response to HIV infection.
Flu-like symptoms can include:
Fever
Chills
Rash
Night sweats
Muscle aches
Sore throat
Fatigue
Swollen lymph nodes
Mouth ulcers These symptoms can last anywhere from a few days to several weeks. But some people do not have any symptoms at all during this early stage of HIV. Don’t assume you have HIV just because you have any of these symptoms—they can be similar to those caused by other illnesses. But if you think you may have been exposed to HIV, get an HIV test.
Request an HIV test for recent infection—Most HIV tests detect antibodies (proteins your body makes as a reaction to HIV), not HIV itself. But it can take a few weeks after you’re infected for your body to produce them. There are other types of tests that can detect HIV infection sooner. Tell your doctor or clinic if you think you were recently exposed to HIV, and ask if their tests can detect early infection.
Know your status—After you get tested, be sure to learn your test results. If you’re HIV-positive, see a doctor as soon as possible so you can start treatment with HIV medicine. And be aware: when you are in the early stage of infection, you are at very high risk of transmitting HIV to others. It is important to take steps to reduce your risk of transmission. If you are HIV-negative, there are prevention options like pre-exposure prophylaxis (PrEP) that can help you stay negative.
Stage 2: Clinical Latency
In this stage, the virus still multiplies, but at very low levels. People in this stage may not feel sick or have any symptoms. This stage is also called chronic HIV infection. Without HIV treatment, people can stay in this stage for 10 or 15 years, but some move through this stage faster. If you take HIV treatment every day, exactly as prescribed and get and keep an undetectable viral load, you can protect your health and prevent transmission to others. But if your viral load is detectable, you can transmit HIV during this stage, even when you have no symptoms. It’s important to see your health care provider regularly to get your level checked.
Stage 3: AIDS
If you have HIV and you are not on HIV treatment, eventually the virus will weaken your body’s immune system and you will progress to AIDS (acquired immunodeficiency syndrome). This is the late stage of HIV infection. Symptoms of AIDS can include:
Rapid weight loss
Recurring fever or profuse night sweats
Extreme and unexplained tiredness
Prolonged swelling of the lymph glands in the armpits, groin, or neck
Diarrhea that lasts for more than a week
Sores of the mouth, anus, or genitals
Pneumonia
Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
Memory loss, depression, and other neurologic disorders Each of these symptoms can also be related to other illnesses. The only way to know for sure if you have 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. See your health care provider if you are experiencing any of these symptoms.

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