Introduction
The HI-virus was discovered in the mid 1980s. Initially it was clouded in mystery, simply because people did not know much about the causes and effects of HIV infection. During that time many myths came into being and misinformation was fed to the general public. Some of these myths exist even today.

Myths about HIV/AIDS can be dangerous. Incorrect information can lead to people being afraid or even stigmatising other people. Myths can, on the other hand, motivate people to exhibit very dangerous behaviour where caution is needed.

Since accurate information is the key to understanding, let us look at some myths:

Myths on HIV transmission
Myth: We both have HIV, so we do not need a condom.
The reality: This is incorrect, because a person can become re-infected, making HIV treatment very difficult, because of another strain of HIV being present in the body. A new infection can also cause an increase in the viral load of the blood. This may, in turn, lead to a further decrease in CD4 cells and a further weakening of the immune system¹.

Myth: People over 50 cannot get infected with HIV.
The reality: Although the age group with the highest HIV prevalence is between 14 and 24, HIV infection does not discriminate according to age. Everybody can become infected through unprotected sex.

Myth: People do not need a condom when engaging in oral sex.
The reality: This has the potential to become a very dangerous myth. There are people who think that oral sex is a much safer option, but, like any other sexual activity, oral sex also carries a risk of transmitting HIV and even other sexually transmitted diseases. The risk becomes even greater if one partner is HIV-positive and the other is HIV-negative². Transmission normally happens when an HIV-positive person performing oral sex, passes blood from their mouth to another person through the lining of the urethra (the opening at the tip of the penis), the lining of the vagina, the lining of the anus or directly into the blood through small cuts or open sores³.

The risk of HIV transmission increases when a person performing oral sex has cuts or sores around or in their mouth or throat.

Myth: There is no relation between sexually transmitted diseases (STD) and HIV transmission.
The reality: There is indeed a direct relation between STDs and HIV transmission. It is estimated that an HIV-infected person who has an STD, is three to four times more likely than other HIV-infected persons, to transmit HIV through sexual contact⁴. In addition, a STD can increase a person’s risk of becoming infected with HIV, whether the STD causes open sores or breaks in the skin or not. The STD infection causes irritation of the skin, breaks or sores and makes it easier for HIV to enter the body during sexual contact⁵.

Myth: ‘Straight’ people do not get HIV.
The reality: The majority of HIV-positive people worldwide are heterosexual⁶. Men can infect women and women can infect men. Risk is based upon certain behaviour. Such risky behaviour can include, amongst other things, having unprotected sexual intercourse, and sharing needles and syringes that are not clean.

Myth: I have just found out that I am HIV-positive. I will not be able to have children anymore.
The reality: Years ago it was widely accepted that HIV-positive mothers can transmit the virus to their unborn child during pregnancy, during birth or through breastfeeding. Unfortunately it is still happening today. However, the situation of mother-to-child-transmission has changed these days.

• If an HIV-positive woman takes a regimen of certain antiretroviral medication (ART) during the last six months of her pregnancy and during the delivery, and if the baby is given ART after being born, the risk of the baby becoming infected can be significantly decreased.
• Since there is a good chance of the baby becoming infected when it moves through the birth canal, there is one way to avoid this - by using a Caesarean section. Under certain conditions doctors will recommend a normal vaginal delivery.
• The absence of clean water and a steady supply of formula in some poor countries will impact negatively on the baby. It is therefore suggested that HIV-infected women living in the developing world should, as the safer option, breastfeed up to six months. Women living in the developed world should use commercial baby formula.

It seems that the risk of HIV transmission from mother to child can be greatly reduced to as little as 2% if a woman takes HIV medication at appropriate times during her pregnancy, delivers her baby by C-section and does not breastfeed⁷.

Myth: I am safe, because I am in a monogamous relationship.
The reality: In order to be safe in a monogamous relationship it would be wise for both partners to get tested first. Only if both tests are HIV-negative, are you relatively safe. Both partners should also be faithful to one another in the relationship.

Myths on HIV/AIDS treatment
Myth: My family doctor can treat my HIV.
The reality: Experts believe that given the complexities of antiretroviral treatment and care, one should be very careful with the person who manages one’s HIV care. The easy option is to choose a doctor who cares for HIV patients regularly. According to Cichocki⁸, it is all about asking your physician the right questions. Find out if he/she is an HIV specialist, what services is offered (are there, apart from doctors, also social workers, nutritionists, psychologists and so forth) and what is their philosophy regarding patient participation in treatment decisions?

Myth: Why don’t we have a vaccine? Shouldn’t it be easy to develop one?
The reality: An AIDS vaccine could be effective in two ways. A “protective” vaccine would stop HIV infection occurring and a “therapeutic” vaccine would prevent or, at least, delay the illness and it might even prevent the further transmission of the virus. Research on the development of an effective vaccine has come a long way and there are reasons to be optimistic about finding an AIDS vaccine. One must remember that the HI-virus was only discovered in the mid 1980s, which is fairly recently. However, it is predicted that we will only have an effective HIV vaccine available in 10 years’ time⁹.

Myth: I have just been diagnosed … I am going to die.
The reality: New antiretroviral drugs have made it possible to realise that being infected with HIV is not a death penalty. There is a far better understanding of HIV today and many HIV-infected people can live normal, healthy, productive lives after becoming infected. It is estimated that the average is 10 years between infection and the onset of AIDS¹⁰. AIDS is actually the onset of the last phase of the HIV-infection, commonly known as the severe symptomatic phase; it is associated with a high HIV viral load and severe immune-deficiency¹¹.

Myth: Sexual intercourse with a virgin will cure AIDS.
The reality: This myth is common in some parts of Africa and has, unfortunately, resulted in many rapes of young girls and even children¹². Sex with a virgin does not cure an HIV-infected person, and such contact will expose the uninfected person to HIV, potentially spreading the disease even further. This myth of virgin cleansing probably originated during the sixteenth century when Europeans believed that they could rid themselves of a sexually transmitted disease by transferring it to a virgin through sexual intercourse¹³.

Myths on testing
Myth: The test for HIV cannot be trusted.
The reality: These tests are indeed reliable. They measure the body’s response to HIV. The tests are HIV antibody tests - they detect the presence of HIV antibodies in the blood. It is believed that the most common test, called ELISA, is about 99% accurate¹⁴. This is the most popular test; it is widely available and is relatively cheap. This test reacts to the number of HIV antibodies that are formed by the immune system in an unsuccessful attempt to protect the body against the virus in the blood¹⁵.

Rapid HIV antibody test: This test can be performed outside the laboratory, for instance next to a patient’s bed. The results are usually available within 10 to 30 minutes. These tests are relatively cheap, easy to perform and reliable. It is particularly useful in rural areas. This test also reacts to the number of HIV antibodies in the blood¹⁶.

What’s more, all positive results should be confirmed with another test to ensure that no mistakes were made.

Myths on prevention
Myth: The contraceptive pill can prevent HIV transmission
The reality: This is absolutely not true. The contraceptive pill will only prevent pregnancy, but not HIVinfection. There is still an exchange of semen and vaginal fluids and in these conditions it is very likely that HIV transmission will take place if either one of the partners is HIV-positive¹⁷.

Myth: Cleaning (washing) the vagina or penis after sex, reduce the risk of HIV infection.
The reality: There is no evidence to support the belief that cleansing of the vagina or penis after sex, can prevent HIV infection¹⁸. Cleaning of the vagina is positively not advised, because it may actually facilitate HIV infection by washing infected semen deeper into the vagina.

Conclusion
It seems that there is still a lot of ignorance with regard to HIV/AIDS. It is indeed vitally important to know the facts, because it can eventually liberate people, assisting them to live full lives free of fear of the unknown.

References

1. Van Dyk, A. HIV/AIDS Care and Counselling – A multidisciplinary approach. Pearson Education South Africa 2001
2. Cichocki, M. HIV and oral sex http://www.aids.about.com/cs/
   safesex/a/oralsex.htm Viewed on 24 July 2007
3. Frequently asked questions: HIV Prevention and Transmission 19 December 2003 http://www.thebody.com/cdc/
   faq/transmissionFAQ.html Viewed on 1 March 2007
4. Frequently asked questions: HIV Prevention and Transmission 19 December 2003 http://www.thebody.com/cdc/
   faq/transmissionFAQ.html Viewed on 1 March 2007
5. Ibid
6. Trisdale, S.K., Myths and misperceptions about HIV. July 2003 http://www.thewellproject.org/en_US/
   HIV_The_Basics/Myths_and_Misperceptions.jsp Viewed on 25 March 2007
7. Cichocki, M. HIV and oral sex http://www.aids.about.com/cs/safesex/a/oralsex.htm Viewed on 24 July 2007
8. Ibid
9. Jewkes, R. et al A cluster randomized-controlled trial to determine the effectiveness of Stepping Stones in preventing HIV infections and promoting safer sexual behaviour amongst youth in the rural Eastern Cape, South Africa: trial design, methods and baseline findings. 16 January 2006 Page 2
10. Evian, C. Primary HIV/AIDS care. Jacana: Malaysia 2006 Page 27
11. Ibid, page 31
12. What is AIDS? 26 June 2007 http://www.avert.org/aids.htm Viewed on 24 July 2007
13. Wikipedia, HIV and AIDS misconceptions http://en.wikipedia.org/wiki/
    HIV_and_AIDS_misconceptions 15 July 2007 Viewed on 24 July 2007
14. Van Dyk, A. HIV/AIDS Care and Counselling – A multidisciplinary approach. Pearson Education South Africa 2001, page 144
15. Evian, C. Primary HIV/AIDS care Jacana: Malaysia 2006, page 41
16. Ibid, page 41
17. Van Dyk, A. HIV/AIDS Care and Counselling – A multidisciplinary approach. Pearson Education South Africa 2001, page 144
18. Ibid, page 145

Author: Mr P J Visser
Source: AfroAIDSinfo at www.afroaidsinfo.org
E-mail: afroaidsinfo@mrc.ac.za

Last updated: 19 May 2008