Wednesday, February 08, 2017

Triangle of Self-Care: The ESSEntials of HIV Transmission

By Mark de Castro

There are many ways to keep ourselves from forgetting simple but essential things. For instance, we use an alarm clock to help us wake up early and be on time for work; we use a bookmark to remind us where we are on a book we’re reading; we bring a grocery list to make our visit to the marketplace quick and easy - the list goes on. Well, this checklist we’re about to share with you may sound new, but it may help answer some of your questions about the essential conditions or factors regarding HIV (Human Immunodeficiency Virus) infection.The crossword above contains words that are important for us to learn about HIV transmission. These simple terms, however, are not enough for us to understand what these words mean. They only lend themselves visible and meaningful to people who have undergone “HIV 101” trainings or seminars and those who have had HIV counseling. (If you’ve noticed, the same principles are used by counselors whenever conducting risk assessment.) This is why we thought: Why not share this secret around?
Yes, we know you’re busy, but this won’t take much of your time. We promise it’s shorter than an episode of Team Magazine’s Hanging Out.
The ESSE Mnemonic
Highlighted in the crossword are: Exit, Sufficient, Survive, Entry (ESSE), which are four necessary conditions for HIV to be transmitted from a Person Living with HIV (PLHIV)  to another person who is uninfected, someone with an unknown status, or another PLHIV.
The infection process starts when the virus exits the body through body fluids like: blood, breast milk, rectal fluid, semen, and vaginal fluid. These body fluids allow HIV to survive outside the body, but they need to immediately enter the other person’s body for a new infection or a co-infection to occur.  
Exit and Sufficiency
HIV can only be transmitted among humans, and contrary to popular belief, mosquitoes are not part of our family tree. Going back, the first essential step for an infection to start is for the virus (embedded in body fluids) to exit the body in sufficient numbers. You might ask: How much of these body fluids is enough?
A quick answer is that you don’t need to measure them.
The amount of virus that exists in the body is known as the viral load. Among the different body fluids, only blood, seminal fluid, vaginal fluid, rectal fluid, and breastmilk are the reported means of HIV transmission. Other body fluids like saliva, tears, sweat, or urine contain negligible traces of the virus, which are not enough to successfully transmit infection.
By knowing which body fluids have the sufficient amount of the virus, we now know which behaviors or incidents could expose us to HIV. For instance, unprotected penetrative anal sex exposes someone to semen, rectal fluid, or even blood if one gets a laceration. Simply put, having anal sex without a condom exposes a person to higher risks, especially if it is done with someone (a stranger or your current partner) with an unknown serostatus.
Survival and Entry
Viruses are infectious agents that can only replicate themselves inside the living cells of other organisms. This is why HIV does not survive for long outside the human body. Conversely, this is the reason it is not possible to get infected with the virus by mere contact with infected body fluids. Our skin is our first line of defense from pathogens (disease-causing organisms). An intact skin and mucosa provide us optimum protection. However, cuts and/or wounds would limit the protection they provide.
In airtight syringes and needles, the absence of oxygen allows the virus to live longer. And during sex (particularly during penetration), there is an immediate contact between the fluids and the possible route of entry of the virus. This is a major factor why unprotected penetrative sex poses a high risk for HIV transmission.
Infection can be prevented if one engages in safe and satisfying sex practices, which include using condoms and lubes for penetrative sex, and performing less risky sexual practices such as frottage (a.k.a. dry humping or kiskisan), kissing and hugging, or oral sex (suck, tsupa [Tagalog], bona [Bekinese] ) -- behaviors with minimal chance of transmitting the virus. Avoiding sharing of needles or taking care so as not to get pricked by used needles are also measures in preventing HIV infection.
In all cases, wearing condoms and making sure sterilized equipment are used at all time are major prerequisites in mitigating risks of getting infected with HIV.
MESSED Up Information
There are numerous sources of information about HIV from the World Wide Web, the media, and even our peers, which could cause us to feel more confused instead of feeling better informed. Let’s keep it simple: The thing to remember is to always evaluate our exposure to the virus by using the ESSE mnemonic. There is nothing wrong in seeking information by researching on our own, but we just have to make sure that the information comes from reliable sources. When in doubt, seek help from an HIV-specialized clinic or trained medical staff for proper guidance.

LoveYourself Uni and LoveYourself Anglo are open from Wednesdays to Sundays. Feel free to drop by any of our clinics. We provide safe and private spaces should you wish to get tested or need information on HIV.