Question 1

How is HIV transmitted?

Accepted Answer

HIV is transmitted through specific bodily fluids from a person who has HIV and is not virally suppressed: blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids and breast milk. Transmission requires these fluids to contact a mucous membrane, damaged tissue or be injected directly. HIV is not transmitted through air, water, saliva, sweat, tears, casual contact, mosquitoes or shared toilets.

Question 2

What is the difference between HIV and AIDS?

Accepted Answer

HIV is the virus that causes infection. AIDS is the advanced stage of untreated HIV infection, defined by a severely weakened immune system or the presence of an AIDS-defining illness. With modern ART, people with HIV can maintain healthy immune function indefinitely and may never develop AIDS.

Question 3

What is U=U (Undetectable = Untransmittable)?

Accepted Answer

U=U is a scientific consensus statement supported by three large studies (PARTNER, Opposites Attract, HPTN 052): a person with HIV who is on effective ART and has an undetectable viral load cannot sexually transmit the virus — zero transmissions were documented across 75,000+ unprotected sex acts. U=U is endorsed by WHO, UNAIDS and the US CDC and is transformative for both transmission prevention and reducing stigma.

Question 4

What are the UNAIDS 95-95-95 targets?

Accepted Answer

UNAIDS's 95-95-95 targets (2020) are the pathway to ending AIDS as a public health threat by 2030: 95% of people with HIV know their status; 95% of those diagnosed are on ART; 95% of those on ART have suppressed viral load. Global progress in 2022 was 86-76-71. The biggest gap is in treatment initiation, reflecting health system access barriers.

Question 5

What is PrEP and who should take it?

Accepted Answer

PrEP (pre-exposure prophylaxis) involves HIV-negative people taking antiretroviral medicines before potential exposure to prevent infection. Oral PrEP (tenofovir/emtricitabine) reduces HIV risk through sex by >99% when taken as directed. Long-acting injectable cabotegravir is an alternative. Lenacapavir (twice-yearly injection, PURPOSE trials 2024) achieved 99.9% protection. PrEP is recommended for people at substantial risk including MSM, transgender women, sex workers and serodifferent couples.

Question 6

Is there a cure or vaccine for HIV?

Accepted Answer

There is no widely available cure for HIV. A small number of people have been functionally cured through stem cell transplants from CCR5-delta32 donors — not feasible broadly. Research into gene therapy, broadly neutralising antibodies and therapeutic vaccines is active. No licensed HIV vaccine exists; RV144 showed modest 31% protection and HVTN 702 was discontinued. This remains a major scientific and public health priority.

Question 7

What causes AIDS-defining illnesses?

Accepted Answer

As HIV destroys CD4+ T cells, the immune system progressively loses ability to fight infections and cancers. When CD4 falls below 200, opportunistic infections — Pneumocystis pneumonia, cryptococcal meningitis, CMV retinitis, toxoplasmosis — become life-threatening. Kaposi sarcoma and other AIDS-defining cancers also emerge. Effective ART essentially eliminates these risks by restoring immune function.

Question 8

How does HIV affect women differently?

Accepted Answer

Women account for 54% of people living with HIV globally. Young women aged 15-24 in sub-Saharan Africa face the fastest-growing burden. Gender-based violence and power imbalances increase HIV risk and undermine women's ability to access prevention and treatment. Vertical transmission can be reduced to below 2% with appropriate ART — yet 130,000 children still acquired HIV at birth in 2022.

Question 9

What is the Global Fund and what does it do for HIV?

Accepted Answer

The Global Fund to Fight AIDS, Tuberculosis and Malaria has saved an estimated 50 million lives and is the single largest multilateral financer of HIV, TB and malaria programmes in LMICs. PEPFAR (US President's Emergency Plan for AIDS Relief) has spent over $100 billion on HIV since 2003. Together, these two mechanisms fund the majority of HIV treatment and prevention in high-burden countries.

Question 10

How is HIV transmitted from mother to child?

Accepted Answer

Without intervention, the risk of mother-to-child transmission is 15-45%. With a full course of ART for the mother during pregnancy and breastfeeding, and prophylaxis for the infant, risk falls below 2%. Elimination of mother-to-child transmission (EMTCT) has been achieved in several countries. In 2022, 130,000 children still acquired HIV at birth, reflecting testing and treatment access gaps.

Question 11

What is the role of UNAIDS?

Accepted Answer

UNAIDS is the Joint UN Programme on HIV/AIDS, co-sponsored by 11 UN organisations. It leads global advocacy, monitors the epidemic through global reporting (annual Global AIDS Update), coordinates the political response, and supports country programmes. UNAIDS tracks the 95-95-95 targets and is the primary source for global HIV epidemiological data.

Question 12

How does GMJ News cover HIV/AIDS?

Accepted Answer

GMJ News follows UNAIDS, WHO and major conference (IAS, CROI) updates on HIV treatment, prevention and policy. Georgia has a concentrated HIV epidemic, particularly among people who inject drugs and MSM, making local policy coverage directly relevant to the Georgian Medical Journal and PHIG's public health mission.

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