The following people are most at risk of HIV infection:
• People who have unprotected vaginal or anal sex
• People who have sex with many partners, thereby increasing the chance that they will encounter a partner who is HIV infected
• People who share needles (for example for intravenous drug use, tattooing or body piercing)
• Babies of mothers who are HIV infected
• People who have another STI, especially STIs that cause open sores or ulcers such as herpes, chancroid or syphilis
• Haemophiliacs and other people who frequently receive blood products (this risk is now very much diminished, but there are still countries where blood is not adequately screened)
• Health care workers, where precautions are neglected or fail (for example through not wearing gloves or accidental needle injuries)
When to call a health professional
A health care professional should be seen if:
• You have been at risk of HIV infection (for example through unprotected sex, rape or sharing of needles). Anti-HIV drugs taken within hours of exposure to HIV can decrease the risk of contracting the virus.
• Your sexual partners engage in high-risk behaviour or are known to be HIV positive.
• You are pregnant or plan to have a child.
• Any of the symptoms listed above are present.
• An HIV-positive person develops shortness of breath, convulsions, weakness in a limb or one side of the body, or loses consciousness (they should receive emergency care).
Before being tested for HIV, it is best to seek counselling. All clinics and doctors should insist on pre- and post-test counselling to help patients deal with the psychological stress and anxiety they are likely to experience while waiting for results or when they have to deal with the consequences of a positive result. Pre- and post-test counselling for HIV testing is a requirement by law in South Africa. Avoid sexual contact with others while waiting for test results.
(Reviewed by Dr Diana Hardie, clinical virologist, National Health Laboratory Service and University of Cape Town, July 2010, Additional review by Dr Avron Urison, Medical Director of AllLife, 2013)