AIDS Hotline 27802211

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  AIDS and STI information

A.1.i. Routes of transmission and prevention

- Sexual contact

• How does the virus get into the human body？
  
  The male and female’s reproductive organs are covered with mucous membrane which are directly in contact with semen or vaginal discharge of an infected partner during sexual contacts. Thus Human Immunodeficiency virus (HIV) can be transmitted via penetrating sex through homosexual or heterosexual contact, such as vaginal, oral or anal sex. The presence of sexually transmitted infections (STIs), ulcers and blood during sexual contact with HIV/AIDS infected partner increase risk of HIV transmission.
  
  
• Key points to note in sexual contact
  
  In Hong Kong, about 80% of HIV positive people were infected through sexual contact. HIV can be passed to another person through vaginal, anal or oral intercourse, especially when there are sexually transmitted infections, wounds, ulcers or blood.
  
  Apart from abstinence, uninfected mutually monogamous partners is the only way to guarantee risk-free from HIV. If one has doubts about partner’s sexual background, condoms should be used. Condoms can substantially reduce the risk of acquiring HIV and other STIs. Protect yourself, love your sexual partner, use condom properly and consistently.
  * Remember, use condom from the very beginning when involving in whatever types of sexual intercourse.
  
  
• Is oral sex safe?
  
  Oral sex means using the mouth to contact with the partner’s sex organ or, less commonly, anus. Such contact is also at risk of getting HIV, especially when there are wounds or ulcers in the oral cavity or genitalia. To prevent infection during oral sex, one should use the dental dam or condom. There are special condoms with various tastes such as mint, strawberries and banana.
  
  
• Is extra corporeal ejaculation safe?
  
  If condom is not used, the risk is still high even if you withdraw the penis before ejaculation.

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- Blood contact

• How is Human Immunodeficiency Virus (HIV) transmitted through blood contact?
  
  HIV thrives in blood of infected person. Hence it can be transmitted by HIV contaminated blood, blood products and needles.
  
  Blood-borne transmission of HIV usually occurs via sharing of needles or syringes by injecting drug users. It can also occur in health care setting, such as needlestick injuries, transfusion of HIV contaminated blood or blood products. HIV infection due to other forms of blood contact is very rare.
  
  
• Can one go to Red Cross Blood Transfusion Service to donate blood?
  
  During the first 3 months after being infected with HIV, that is the window period, antibody produced might not have reached a detectable level resulting in a false negative antibody screening test. Thus, you may spread the virus to the blood recipient though you are tested negative. Therefore, in order to protect others from getting HIV, you should not go to the Red Cross to donate blood if you suspect you have been at risk of HIV infection.
  
  In order to safeguard blood and blood products in Hong Kong, the Red Cross advises whomever at risk to refrain from blood donation. Also, an HIV antibody screening test will be conducted and the donor should notify the Red Cross to discard the blood donated through a confidential self-reporting system. Furthermore, the blood collection apparatus is used one-off, so there is no risk of contracting HIV through blood donation.
  
  
• What is the risk of injecting drug use?
  
  Drug users are at increased risk of acquiring HIV if they share needles or syringes during drug injection. Globally, the number of HIV infected drug users is increasing. Some of them may earn money for drug through selling sex, resulted in further spreading of HIV to non-drug users.
  
  
• To prevent HIV transmission through needles and syringes:
  
  1. Go and receive drug treatment and rehabilitation services as soon as possible.
  2. If drug abusers are not able to stop abusing drug, they should not adopt injecting method. They should join the methadone treatment programme, the maintenance or detoxification programme.
  3. If drug abusers are not able to stop injecting drug, they must not share syringe and needle and should use once-only syringe and needle.
  4. If drug abusers cannot have their own syringe, the syringe used should be cleaned twice with bleach and then twice with water properly to avoid spread of infectious disease like AIDS, hepatitis B & C, and tetanus.
     
     
• If you are worried about getting HIV infection, you can talk to our hotline counsellors. You may also seek help from the methadone clinics at telephone no：2835 1831, or other drug rehabilitation service at telephone no: 2574 3300. If you wish to know more about the methadone treatment or detoxification programme, please call the Harm Reduction Hotline at 2112 9977.

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- Mother to infant infection

• How is virus transmitted to baby from the infected mother?
  
  An HIV infected mother can transmit the virus to her infant during pregnancy, delivery or breast-feeding. The chance is 15-40%. Therefore if you are preparing to have a baby or you are pregnant but not sure about your HIV status, you should talk to your doctor or an AIDS counsellor and consider having an HIV antibody test.
  
  
• How can women avoid getting AIDS
  
  Many people have wrongly assumed that HIV/AIDS is a male disease. In fact, about half of HIV infections worldwide are female. The number of female infection in HK has been increasing rapidly in recent years. Infection is not confined to commercial sex workers. Women should take an active role in the prevention of AIDS, they should:
  
  • have a mutually faithful sexual relationship with a non-infected person;
  • practise sexual contacts which do not result in the exchange of body fluid or insist on the use of condom if there is any doubt;
  • learn about the background and behaviour of your spouse or sexual partner;
  • discuss with your spouse or sexual partner about AIDS and its prevention;
  • not engage in drug use or do not share needles or syringes when injecting drug; and
  • protect against mother-to-infant transmission
    
    
• How can an infected woman make a choice on pregnancy?
  
  If you are not yet pregnant, several points have to be thought over before embarking on pregnancy. Some are：
  1. risk of transmitting the virus to your partner if he is not yet infected.
  2. risk of baby being infected.
  3. the psychosocial issues during and after pregnancy.
     
     
• If you are already pregnant, you may need to consider the following to decide about continuing pregnancy or not.
  
  1. risk of baby being infected and chance of the baby developing AIDS.
  2. your ability to care for the baby if you progress to AIDS or even die.
  3. psychological strain and impact with continuing or terminating the pregnancy.

The decision is up to you, and your partner. You are welcome to discuss it with our nurse counsellors. All calls are treated in strict confidence. You may also consult your doctor.

• How to minimize the chance of infection to the infant?
  
  An HIV infected mother can transmit the virus to her infant during pregnancy, delivery or breast-feeding. The chance is 15-40%. A study in USA has shown a reduction of maternal-infant transmission rate from 26% to 8% (i.e. two-third reduction) if the infected mother receive antiretroviral regimen during pregnancy till delivery. After birth, the newborn baby should take a course of antiretroviral therapy for six weeks. Research had revealed that Caesarean Section could also decrease the chance of maternal-infant transmission. This is however only possible if HIV diagnosis of the infected mother is made. Therefore women who have been at risk of HIV infection should talk to their doctor about further management and early treatment. Breast-feeding of the newborn should also be avoided.

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A.1.ii. What are the signs and symptoms of HIV infection?

Most infected people look healthy and have no signs or symptoms. However, even asymptomatic infected people are able to transmit the virus to others. Some infected people may have symptoms like tiredness, fever, poor appetite, weight loss, diarrhoea, night sweating and swollen glands. You are welcome to discuss it with our nurse counsellors. You may also consult your doctor.

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A.1.iii. Needlestick injury in Health Care Setting

Health care workers are susceptible to blood borne diseases such as HIV, Hepatitis B and Hepatitis C viruses through needlestick injury in health care settings. For needlestick injury, first-aid management includes squeezing out the blood, rinsing with soap and water, disinfection and proper dressing of wound. In case of mucosal contact such as spillage into the eyes, you should wash your eyes immediately and flush liberally with running water. You should report the incident to your senior and attend the accident and emergency department for further management.

The estimated risk of acquiring Hepatitis B through needlestick injury is 6-30%; while the risk of contracting HIV is 0.4% and Hepatitis C is 3-10%. The risk from mucosal exposure or non-intact skin contact is generally lower.For exposure with significant risk, Hepatitis B immunoglobulin can protect against Hepatitis B infection while, the use of antiretroviral therapy was found to be associated with a decreased risk of HIV transmission. More importantly, assessment of risk of individual’s exposure should be made. The Special Preventive Programme of the Department of Health provides post-exposure counselling and management on HIV.You should refrain from blood/organ donation and adopt safer sex before your HIV status is clear.For optimal infection control in health care settings, you should adopt universal precautions and take necessary protective measures accordingly.

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A.1.iv. Can one be infected through social contact?

HIV does not spread through air or social contact. The amount of virus in sweat and saliva is very small and insufficient to cause an infection. So shaking hands, travelling, eating together, attending school, working, sharing toilet or swimming cannot transmit HIV infection. Also, there is no evidence to suggest that mosquito and insect bites can spread HIV.

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A.1.v. Information for travel abroad

• What should I know when I travel abroad?
  
  You may travel abroad for business, visiting relatives and friends, broadening your views or just for leisure. If you want to have an enjoyable trip, make sure that you have made proper planning, have valid travel document, accident and medical insurance cover, necessary drugs and vaccination before you travel. The most important thing is not to have sex with a person with unknown sexual health background, or use a condom, and avoid sharing needles or syringes.



• Is there a possibility of contracting HIV from other countries?
  
  The possibility of a person contracting HIV is not determined by whether they travel abroad or stay at home. Rather it is a person’s behaviour that determines the risk. These behaviours include having unprotected sex and sharing needles or syringes. HIV cannot be transmitted through social contact such as sharing meals, using the same toilet, hugging etc. Remember you should always be alert and take necessary protection. It is possible for one to be infected in places where AIDS is not obviously prevalent. You should always use condoms properly and consistently to prevent sexually transmitted infections and AIDS.



• Does every country require visitors to take an HIV antibody test?
  
  There are countries which may require visitors, immigrants and foreign workers to take an HIV antibody test. At present, there is no such regulation in Hong Kong. To confirm which country has such a policy, you may contact respective embassies or Consulate offices.



• Is it safe to have blood transfusion or receive injection in other countries?
  
  HIV can be transmitted through HIV-contaminated blood, blood products, needles and syringes.
  There is a minimal risk of HIV transmission through transfusion of blood or blood products. But the level of risk in different places depends on factors such as prevalence of HIV infection, HIV screening of blood donors, prevalence rate of HIV infection among blood donors and measures taken to safeguard blood products. To receive a blood transfusion will depend on the medical condition and balance against its potential risk.
  If an injection is needed, you must be sure that the needles and syringes are new and sterile ones; or have been sterilized and not reused. You should clarify with the responsible medical personnel before the procedure.
  Apart from the above, you should also avoid tattooing, acupuncture, ear piercing and dental surgery unless sterile equipment will be used.

Travel safe - protect yourself. Have a nice trip!

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(A) Knowing about AIDS - 2. HIV antibody testing 

A.2.i.Should I have an HIV antibody test?

You should consider having an HIV antibody test if:
• you have unprotected sex, multiple sexual partners or sexually transmitted infections
• you have shared needles and syringes for drug injection.
• you have received HIV-contaminated blood or blood products.
• you are not sure whether your sexual partners are HIV positive or not.
• you suffer from illness that may be related to HIV.

Please talk to nurse counsellor if you have any queries.

A.2.ii.What does the test show?

When a person is infected by the Human Immunodeficiency Virus (HIV), the body responds by producing antibodies. However, these antibodies are not protective in nature. If antibodies are found in the blood, the test is positive. A positive test means the person is infected with HIV and will progress to AIDS. An HIV infected person can pose an infection risk to others.

From studies, about half of those who are HIV infected would develop AIDS within ten years. People with HIV or AIDS cannot be identified by appearance but can pass the virus onto another person.

A Negative result suggests that no HIV antibodies were detected in the blood specimen. But if the test was done within the window period, you may need to recheck after the period, as HIV antibody may take up to 3 months to reach a detectable level.

A.2.iii.What should you do if you want to have an HIV antibody test?

If you wish to have an HIV antibody test, you may make an appointment with our nurse counsellor. The service is free, anonymous and confidential. You may wish to attend one of the Social Hygiene Clinics operated by the Department of Health if you suspect you are suffering from sexually transmitted infections. Referral is not required. Of course you may also consult your family physician.

You should not go for blood donation if you have been at risk of HIV infection. During the first 3 months after infection, the HIV antibodies may not show up in the test and you will then be wrongly assumed to be HIV negative. However, the recipient is very likely to get HIV from your contaminated blood.

A.2.iv. Universal Antenatal HIV Antibody Testing

The aim of having antenatal check-up is to ensure optimal health of both mother and child HIV could be transmitted from an infected mother to her child during pregnancy, delivery and breastfeeding. The transmission rate is 15% to 40%. In Hong Kong, the Universal Antenatal HIV Testing Programme for pregnant women has been available since 2001. It aims to reduce the risk of transmitting HIV to the newborn by early detection of HIV infection in pregnant women. For the health of your baby, you, as an expectant mother, should have an early antenatal HIV screening.

A Negative result suggests that no HIV antibodies were detected in the blood specimen. But if the test was done within the window period, you may need to recheck after the period, as HIV antibody may take up to 3 months to reach a detectable level.

If the test result is positive, it means that a person is infected with HIV. Infected persons need to practise safer sex and to refrain from needle sharing to prevent the transmission of the virus to others.

By having early detection one could decrease the risk of HIV transmission from the mother to her child by two-thirds. This is achieved by the administration of antiretroviral therapy to mother during pregnancy, at delivery as well as postnatally to the baby. An HIV infected mother should not breastfeed the child after delivery, as this will increase the risk of transmission.

Special Preventive Programme of the Department of Health provides advice and support on HIV/AIDS for pregnant women and their health care providers. In case of need, you are welcome to contact us.

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A.3.i.  What is rapid test and how is it performed?

A rapid test is a preliminary test for HIV antibody. You will have the result at the same visit.

A fingertip is cleaned with alcohol and pricked with a lancet to get a small drop of blood. The blood is collected with a specimen loop and transferred to a small plastic vial containing a developing solution, into which the sample is mixed. Result of the test can be read after 20 minutes.

A.3.ii. What does the test show?

A Negative result suggests that no HIV antibodies are detected. But if the test was done within the window period, you may need to recheck after the period, as HIV antibody may take up to 3 months to reach a detectable level.

A Preliminary Positive result suggests that HIV antibodies may be present. Therefore, you need to undergo a confirmatory test.

A.3.iii.How well does the test work?

The test is very accurate (> 99%), but additional testing is necessary to confirm a Preliminary Positive result.

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A.4.i.  Disease monitoring and medical treatment

• Medical management of HIV infection

HIV destroys the white blood cells and impairs the body’s defence mechanism, making one susceptible to various opportunistic infections and cancers which rarely affect healthy individuals.

Although there is as yet no cure for AIDS, significant advances and progresses in the treatment of AIDS have been made.

The treatments available to an HIV-infected individual can be divided into two main types:

1. The adoption of antiretroviral drugs, which can suppress the activities of the virus, restore immunity function, and thus minimize its harmful effects.
2. Treatment and prophylaxis for the opportunistic infections due to immunodeficiency.

Timely institution of these treatments makes a significant contribution towards improving the quality of life and survival in people infected with HIV.

It is therefore advisable for an HIV infected person to have regular medical follow-up for disease monitoring. The ultimate aim is to have early detection of complications and appropriate intervention. Similar to that for other diseases, early diagnosis and management of HIV/AIDS improves the chance of survival.

• Should one be hospitalized after being infected with HIV?

It depends on the physical condition of the infected person. Often, hospitalisation is required only when the HIV infected person has major illness. With better treatment nowadays, they remain well and only need to attend outpatient clinic for follow-up. They can continue their work as the medical condition allows.

• How does one get to know of the disease’s progression?

People infected with HIV need to have regular follow up and blood checking in order to monitor the disease progression. HIV gradually destroys CD4 T-lymphocyte, one important type of white blood cell which plays a vital role in the body immune defence system. The CD4 count correlates closely with the immune defence status, and falls as the disease progresses. A test is also available to measure the amount of virus in the blood (viral load). Apart from the medical condition, CD4 count and viral load provide useful information on the HIV disease progression status and its response to treatment.

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A.4.ii.  Antiretroviral therapy

• What is the use of antiretroviral drugs?

The antiretroviral drugs attack HIV at different stages of its life cycle to inhibit HIV replication and thus bring the viral load down. As a result, the immune function can be improved and disease progression delayed. Highly active anti-retroviral therapy (HAART) has now become the standard treatment of HIV infection in Hong Kong. It refers to very potent regimen in which almost invariably inhibits viral replication to an undetectable level in the blood. An example of HAART is the use of two or more different classes of antiretroviral drugs.

• What is the benefit of antiretroviral treatment?

Recent advances in antiretroviral therapy can benefit HIV infected patients in several aspects, including better well-being, weight gain, improvement in HIV related symptoms, fewer opportunistic infections, improving survival, increase in immune (CD4) cells and the drop in viral load.

• Are there any side effects of antiretroviral drugs?

Antiretroviral therapy can improve the immune function of the patients, but it may also cause side effects or toxicities. However, most of the side effects are usually transient and mild. The most common side effects are nausea, diarrhoea and gastrointestinal upset. Other side effects may occur such as anaemia, neutropenia and abnormal liver function. Some drugs-produced side effects are peripheral neuropathy, pancreatitis and kidney stone. It is uncommon that patients need to withdraw from treatment because of major toxicity.

• Why is drug adherence so important?

The most important element in the success of antiretroviral treatment is to strictly adhere to the drug regimen. Good drug adherence can prevent treatment failure and emergence of resistance. Otherwise, poor drug adherence will lead to the development of drug resistance, limiting the effectiveness of therapy.

You may obtain more drug information about the antiretroviral drugs that are currently used in Hong Kong from the Virtual AIDS Office website: http://www.aids.gov.hk or contact our nurse counsellor.

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A.4.iii.  Complications

• How does the disease progress after HIV infection?

HIV results in a disease spectrum, with varying clinical presentations and rate of progression among infected individuals. On average, 50% of HIV infected adults progress to AIDS in 10 years’ time. After acute primary infection, HIV disease enters into its chronic phase. The patient generally remains well for a few years before symptoms manifest. When the infection progresses, there is a continuous decline of immunity of the body. A patient may have symptoms arising from opportunistic infections or from HIV itself. When the HIV disease worsens further, there could be malignancies such as Kaposi’s sarcoma and lymphoma or major life-threatening opportunistic infections, such as pneumocystis carinii pneumonia. Effective treatment has altered the disease course.

• What is opportunistic infection?

HIV destroys the immune defence function of an infected person. As a result, AIDS patients will develop complications of infections and cancers that normally do not affect healthy persons. They are called opportunistic infections as they ‘seize’ the opportunity to cause problem. These infections can affect any organ and pose significant morbidity and mortality to the patients.

The common infections include respiratory complications such as pneumocystis carinii pneumonia (PCP), tuberculosis and mycobacterium avium intracellulare (MAI). The neurological system and gastrointestinal tracts are also commonly affected. e.g. cytomegalovirus infection of the retina and cryptococcus infection of the meninges.

• Can opportunistic infections be treated?

Many of the opportunistic infections can be prevented and treated. Recurrence of opportunistic infections is however common due to the immunodeficiency state of the patient. Besides antiretroviral therapy, the HIV /AIDS patient generally need long term maintenance treatment to prevent the relapse of opportunistic infections.

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A.4.iv.  Support services

• Emotional and psychological support

Emotions are natural. Everyone will have positive and negative emotions. In general, the emotional state with no big fluctuation is considered favorable to our physical and psychosocial developments. However, while facing life adversities, our emotions will inevitably be upset. Thus, it is common if one has range of negative feelings: fear, uncertainty, guilt, anxiety, anger, depression, while facing the illness of HIV/AIDS and its impacts. Most probably, one will also experience deterioration of health, stress from life-long treatment, change of life-style and social discrimination.

Don’t deny your feelings. Ventilation of feelings is crucial in resolving the emotional distress you faced. Sharing your feelings and concerns with others is considered as one of the effective ways. You can talk to our nurse counsellors. Our medical social worker can also help you. You can also gain counselling support from some AIDS non-government organisations (NGOs).

Certainly, relieving those distress emotions doesn’t mean that all the problems you are facing are solved. However, with the relief of emotional distress, you can regain energy to face and even resolve those problems.

Actually, utilizing our community resources can solve some problems like financial hardship and caring problems. We will try our best to help if you need assistance from us.

• Facing emotional distress, what can I do?

Facing with the diagnosis of HIV infection or AIDS, you may feel uncertain, angry, sad, guilty, helpless or hopeless. These emotional reactions are not uncommon among the infected individuals, but truly, they are distressing for you.

In coping with emotional distress, it is important for you not to deny those negative feelings or emotions, but to ventilate them whenever possible. To cry or to write them down may help. But one of the effective ways of ventilation is to share your feelings and concerns with someone who knows your diagnosis and whom you trust. Their concern and support can definitely help you to tide over this hard time.

Though you should spend sufficient time to rest in order to stabilize your mood and resume physical strength, it is important for you to keep on your daily (normal) functioning. It is because any sudden change of daily life is not favorable; e.g. excessive rest may lead to a sense of “idleness”. Besides, you can arrange some amusement to make yourself relaxed. You can also seek spiritual comfort and support from your religion.

Remember, “time” is a good cure of pain.

• Hospital services

According to current policy, all patients can obtain medical services from outpatient clinics and hospitals, no matter what disease you are suffering from. A patient’s information will be kept confidential and will only be disclosed to related health care workers on a need-to-know basis. All hospitals should be able to provide care for HIV/AIDS patients. Generally, an HIV/AIDS patient needs no isolation unless indicated; e.g. having active infectious tuberculosis that poses a risk of transmission to others.

Upon discharge, an HIV infected patient will be referred to specialist clinic for follow-up. They may continue their usual work if their condition is stable.

• AIDS organizations

At present, there are two designated HIV clinics providing clinical and support services for HIV/AIDS patients. They are the Special Preventive Programme run by the Department of Health and the Special Medical Consultation Clinic run by Queen Elizabeth Hospital of the Hospital Authority.

There are some AIDS-related non-government organizations (NGOs) providing direct support services to HIV infected patients.

Special Preventive Programme also runs information and counselling hotlines:- the AIDS Hotline Tel.: 2780 2211 and the Gay Man HIV Testing Hotline 2117 1069. There are other organisations providing information on HIV/AIDS, for more information, you can talk to our nurse counsellors.

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A.4.v.  Tips on maintaining health

• How to keep up my health?

A healthy (and ‘fit’) lifestyle is most desirable. Have an optimal balance between work, rest and play. Take adequate rest especially when you are tired. Regular exercise e.g. walking, jogging or swimming can keep you fit. But do begin exercising slowly, don’t over strain yourself and try to choose exercise that you like and easy to cope with.

Stop smoking or cut down your cigarette consumption. A small amount of alcohol does not seem to have any adverse effect, but excessive amount may damage one's health. Illicit drugs should be avoided.

A well balanced diet and good food hygiene may help to maintain optimal health and reduce the risk of infection.

Mental health is equally important. Avoid stress and anxiety. Talk to someone you trust about your feelings and worries. Keep yourself up to live with HIV.

People infected with HIV need to have regular follow-ups in order to monitor the disease progression and get early treatment.

• How to select food?

It is especially important for an HIV infected person to maintain a well balanced diet with reasonable carbohydrate, protein, fibre and appropriate calorie intake. Rice, bread, meat, fish, vegetables and fruit are good choices. Adequate fluid intake is also important

No ‘special’ diet is needed. Vitamins and mineral supplements are generally not necessary if one takes a balanced diet. Food has to be cleaned and properly cooked. Avoid raw food as it may harbour germs which may attack your body.

• Can I still have sex?

Yes, but safer sex is a must. That means always use condom or have sex without body fluids exchange such as caress or body massage.

You should use a condom even if your partner is also HIV infected. You are at risk of contracting other sexually transmitted infections through unsafe sex, which may affect the disease progression.

• Should I make known my HIV status to anyone?

Only tell people who need to know is the principle. However, being HIV positive is not something that must be kept secret. Having someone to talk to is important for many people.

Tell someone that you can trust and turn to for help when problems arise.

As your partner may be infected too, he or she should be informed and consider taking an HIV antibody test.

Moreover, please be honest about your HIV status to the health care workers who take care of you. This will facilitate the diagnosis and prompt treatment of complications.

• Would I infect my family?

HIV is not transmitted through social contact like eating together or sharing a toilet. Do not share toothbrush or razor, as they may be contaminated with blood.

Open wounds, skin lesions, abrasions should be covered with waterproof dressings.

Wash the articles that have bloodstains or body fluid stains with diluted bleach before cleaning them in the usual manner.

Wear gloves before contacting blood or body fluids; avoid being bare-handed.

If someone accidentally contacts blood or body fluids, he or she should immediately wash the affected area with soapy water.

If you currently have a contagious infection e.g. active tuberculosis, you have to avoid close contact with others for the time being and adequate ventilation should be maintained.

• Tips on travelling

People infected with HIV can travel if their health permits. It is important to maintain good hygiene practices in other countries. Food should be cleaned and adequately cooked before consumption. Raw food or unboiled water should be avoided. If you have any questions concerning immunization, you need to consult your doctor. You also need to take along enough medications with you. For frequent travellers, it is important to understand the policies on AIDS in different countries. Some countries may require visitors or foreign workers to take HIV antibody tests. At present, there is no such regulation in Hong Kong.

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A.4.iv.  Rights of people with HIV/AIDS

• How does the Disability Discrimination Ordinance (DDO) protect people infected with HIV/AIDS and their families?

Under the DDO, people with HIV/AIDS are protected against discrimination, harassment or vilification in the areas of employment, education, services and facilities, and clubs and sporting activities etc. This protection includes their families and associates.

• The following are the rights for people with HIV/AIDS:


1. Hospitals or Clinics cannot refuse to treat people on the ground of having HIV/AIDS.
2. People with HIV/AIDS and their families have an equal right to access to welfare services under the same set of eligibility requirement, like any other citizen.
3. It is unlawful if people with HIV/AIDS are singled out to take an HIV antibody test by the employer who wants to confirm their HIV status.
4. People with HIV/AIDS can perform the inherent requirement of most jobs as far as his or her health condition allows.
5. It is unlawful for the employer to dismiss people with HIV/AIDS on the ground of their HIV status.
6. It is unlawful for colleagues to avoid, harass, or vilify him because of his HIV status.


• In conditions where people with HIV/AIDS feel discriminated, harassed or vilified, either directly or indirectly, they may seek assistance from the Equal Opportunities Commission (EOC) or take the case to court. Upon request, the EOC will assist people with HIV/AIDS in respect of the legal proceedings. Strict confidentiality is observed by the EOC. The telephone number of EOC is 2511 8211.



• Apart from EOC, you can contact the local AIDS Organizations for their advice and assistance.

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1. How do sexually transmitted infections link with AIDS?
2. Common Sexually Transmitted Infections
3. What should I do if I have whitish or abnormal discharge from the genitalia?
4. What should I do if I have a sore or a growth on my genital organ?
5. Where do I go for a sexually transmitted infection checkup?

• Sexually transmitted infections and HIV/AIDS are closely related in the following ways:
  
  1. According to local figures, about 80% of all HIV infection were acquired through sexual contact, thus we can say AIDS is one kind of Sexually Transmitted Infections (STIs).
  2. The chance of contracting HIV will be much higher if a person already has signs and symptoms of sexually transmitted infection like sore, inflammation or discharge from the genitalia.
  3. STIs may worsen the disease progression of HIV.
  4. The sexually transmitted infection contracted by the HIV infected person usually takes a longer time to treat and the relapse rate is higher.
     

  It is clear that one should take precaution against sexually transmitted infections and AIDS – use condoms properly and consistently for safer sex. If you think you might have got a sexually transmitted infection, please go to a Social Hygiene Clinic of the Department of Health for check up, treatment and counselling. Your sexual partner should also receive examination, treatment and counselling to avoid cross-infection and reinfection.

This service is confidential. You don’t even need a doctor’s referral.

For more information on sexually transmitted infections such as the routes of transmission, symptoms and treatment, please phone the Dr Sex Hotline at 2337 2121 to listen to the pre-recorded messages.

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B. 2.  Common Sexually Transmitted Infections

Common Sexually Transmitted Infections in Hong Kong include Syphilis, Gonorrhoea, Non-Gonococcal Urethritis, Non Specific Genital Infection, Genital Warts, Genital Herpes type II Infection, Pubic Lice and HIV Infection.

The incubation period of each sexually transmitted infection varies, the symptoms may differ also. Some common symptoms are ulcers, growth, blisters, itchiness, painful sore, frequent urination or stabbing pain on voiding and whitish discharge from the genital organ. For anal or oral sex, the symptoms will appear around the anus, the mouth or in the throat. Sometimes symptoms of sexually transmitted infections are not easy to detect. In particular, women may show no symptoms at all.

Remember, Sexually Transmitted Infections can be serious, they affect genital organs and cause complications or even death; the children of the patient may be affected as well. Thus, if you suspect that you are infected, please go to a Social Hygiene Clinic of the Department of Health for a check up, treatment and counselling. This service is confidential, you don’t even need a doctor’s referral. Once the diagnosis is confirmed, you must attend regular follow up in order to obtain the best treatment. Your sexual partner should also receive examination, treatment and counselling to avoid cross-infection and reinfection.

Prevention of sexually transmitted infections and AIDS – Use condoms properly and consistently.

For more information on sexually transmitted infections such as the routes of transmission, symptoms and treatment, please call the Dr Sex Hotline at 2337 2121 to listen to the pre-recorded messages.

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B. 3.  What should I do if I have whitish or abnormal discharge from the genitalia?

It is likely that you have contracted Gonorrhoea, Non-Gonococcal Urethritis or Non- specific Genital Infection.

Gonorrhoea is caused by the bacteria gonococcus, while Non-Gonococcal Urethritis (NGU) and Non-Specific Genital Infection (NSGI) may be caused by multiple organisms, NGU and NSGI are more difficult to treat. The incubation period of Gonorrhoea is usually 2-3days after exposure.
In males the symptoms are usually obvious with purulent urethral discharge, frequent and painful urination. In females the symptoms are usually not obvious or minimal, although a minority may have purulent vaginal discharge, frequent and painful urination.

In case of oral sex, the person may experience sore throat. Gonorrhoea, non-gonococcal urethritis and Non-Specific Genital Infection can lead to serious complications if untreated. In men, it may cause urethral stricture, prostatitis, semino-vesiculitis and epididymo-orchitis. In women, it may cause salpingitis, pelvic infection, ectopic pregnancy and sterility. In pregnant mother, the disease may affect the eyes of the newborn that may lead to blindness.

If you suspect you have a sexually transmitted infection, please go to a Social Hygiene Clinic of Department of Health for a check-up, treatment and counselling. The clinic provides effective treatment and the service is confidential. Your sexual partner should also receive examination, treatment and counselling to avoid cross-infection and reinfection.

Prevention of sexually transmitted infections and AIDS – Use condoms properly and consistently.

For more information on sexually transmitted infections such as the routes of transmission, symptoms and treatment, please call the Dr Sex Hotline at 2337 2121 to listen to the pre-recorded messages.

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B. 4.  What should I do if I have a sore or a growth on my genital organ?

It is likely that you have contracted Syphilis, Genital Warts or Genital Herpes type II infection. Let us explain them one by one.

Syphilis : Syphilis can be divided into 4 stages. Primary Syphilis presents a painless sore on or around the genitalia 2 to 4 weeks after the sexual contact. Symptoms can be inconspicuous in women. The painless sore usually disappears spontaneously within a few weeks and the disease enters into its second stage, then latent and late stages. Late syphilis can seriously affect the body organs. If untreated, an infected pregnant woman may pass the disease to her offspring resulting in blindness, deafness, physical disability or even death.

Genital warts : genital warts are caused by a human papilloma virus. The incubation period ranges from a few weeks to more than a few months. The infected person usually shows cauliflower-like growth over external genitalia or around the anus, these will then increase in size. The lesions are delicate and can be easily traumatized causing bleeding and secondary infection. For female patients, this can increase the risk of having cervical cancer.

Genital Herpes type II infection: It is caused by herpes simplex virus type II. The average incubation period is about 2 to 6 days. The affected area has a burning or tingling sensation followed by the appearance of characteristic grouped small blisters in pin-point to green bean size. The blisters rupture spontaneously and heal within 10 days. The discharge from the blisters is highly contagious at this stage. Some patients may also suffer from generalized symptoms like fever, malaise, joint pain and appearance of lymph glands in the groin that persist and disappear in 2 to 3 weeks time. Genital Herpes may relapse when the affected person has emotional stress, malnutrition or a decrease in body immunity. A newborn baby may contract the virus by passing through the birth canal of the infected mother during delivery, causing brain infection or even death.

Syphilis, Genital Warts and Genital Herpes type II infection are serious infections, they may cause complications or even death. The off springs of the infected person may be affected as well. Thus, if you suspect you have a sexually transmitted infection, please go to a Social Hygiene Clinic of the Department of Health for a medical check up, effective treatment and counselling. This service is confidential, you don’t even need a doctor’s referral. Once the diagnosis is confirmed, you must attend regular follow-ups in order to obtain the best treatment. Your sexual partner should also receive examination, treatment and counselling to avoid cross-infection and reinfection.

To prevent sexually transmitted infections and AIDS – Use condoms properly and consistently.

For more information on sexually transmitted infections such as the routes of transmission, symptoms and treatment, please call the Dr Sex Hotline at 2337 2121 to listen to the pre-recorded messages.

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B. 5.  Where do I go for a sexually transmitted infection checkup?

• If you suspect you have a sexually transmitted infection, please go to a Social Hygiene Clinic of the Department of Health a medical check up, treatment and counselling, as soon as possible. Self-medication will delay effective treatment resulting in deterioration of the disease.

Sexually transmitted infections are serious infection, they can cause complications or even death. The offspring of the infected person may be affected as well.

Remember, once the diagnosis is confirmed, you should have regular follow up in order to obtain the best treatment. Your sexual partner should also receive examination, treatment and counselling to avoid cross-infection and reinfection.

An HIV antibody blood test is available for those who attend the Social Hygiene Clinic. The service is confidential. No doctor’s referral is required.

You can obtain the addresses and consultation hours of Social Hygiene Clinics through our Virtual AIDS Office website www.aids.gov.hk or press 0 to contact nurse counsellors for further information.

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C. 1.  Choices of condoms

Proper use of condoms can reduce chances of pregnancy and also lower the risk of contracting sexually transmitted infections and AIDS. There are condoms for both males and females; consumers can choose according to their individual needs.

Condoms are usually made of latex. Try to select and use a quality condom whenever possible.

Condoms will age as time goes by, resulting in impairment of the tenacity. Exposure to intense heat and light will also accelerate aging of the rubber, thus weakening the pulling force and affecting its overall function. Do not buy condoms displayed under sunlight or decorative light in the shop. Condoms should be stored in a cool place. They should not be stored in places where they may be exposed to frequent pressure and friction, for example, the wallet or the back pocket of trousers.

Do not buy condoms in damaged or old packages, expired or without the imprinted date of manufacture or validity. Condoms stored for too long, damaged, sticky or no longer elastic, should not be used.

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C. 2.  Using a condom properly

A number of infectious diseases can be transmitted through sexual contacts, e.g. syphilis, gonorrhoea, herpes and HIV. An infected partner may not show any signs or symptoms at all. Therefore condoms should be used for sexual contacts if uncertain.

Please note the following steps for correct use of condom:

• Use a new, good quality latex condom and check the expiry date before use.
• Don’t store condoms near heat sources because they might perish.
• Open the individual packet carefully. Do not use sharp cutters such as scissors.
• Put on the condom before you enter your partner.
• Hold the tip of the condom to squeeze out the air. This leaves room for the semen when you ejaculate. Put the condom on the end of your erect penis.
• Keep holding the tip of the condom, unroll it onto your erect penis all the way down to the hair.
• You can use a water-based lubricant. Oil-based lubricant like vaseline or grease should not be used because they can cause the condom to break.
• After you ejaculate, hold onto the rim of the condom and pull out while your penis is still hard.

Besides the male condom, there is the female condom with the similar function. Proper and consistent use of condoms can substantially reduce the risk of acquiring HIV and other STIs. There are different colours and tastes of condoms which can increase the romance of the sexual activity.

As condoms can protect you and your sex partner, using a condom means mutual love of each other.

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