About HIV and AIDS
What is HIV?
The human immunodeficiency virus (HIV) targets cells of the immune system, called CD4 cells, which help the body respond to infection. Within the CD4 cell, the HIV replicates and in turn damages and destroys the cell. Without effective treatment, using a combination of antiretroviral drugs, the immune system will become weakened to the point that it can no longer fight infection and disease.
At the end of 2018, nearly 38 million people worldwide were living with HIV, according to the World Health Organization (WHO).
What is AIDS?
Acquired immunodeficiency syndrome (AIDS) is a term that applies to the most advanced stages of HIV infection. It is defined by the occurrence of any of the more than 20 life-threatening cancers or “opportunistic infections”, so named because they take advantage of a weakened immune system.
There currently isn’t a cure for HIV. However, with the continued use of antiretroviral therapy (ART), HIV infection can be contained and managed as a chronic health condition, without progressing to AIDS. In most cases, people living with HIV who are on ART can live a long and healthy life.
About the Michigan Medicine HIV-AIDS Treatment Program
In 1995, in response to the AIDS epidemic, Michigan Medicine established the HIV-AIDS Treatment Program (HATP). The HIV-AIDS Treatment Program offers both primary and specialized care to HIV-positive individuals. Investigational treatments are also available for interested and qualifying patients.
We provide complete care for the whole person through a multi-focused team approach that incorporates physical health care, mental health care, and psychosocial support. Our HATP team is made up of specialists who are solely dedicated to providing care for people living with HIV and AIDS including infectious diseases physicians, a psychiatrist, social workers, medical case managers, a nurse, medical assistants, and a dietician.
See “What to Expect” below to learn more about our approach.
Risk Factors
HIV is transmitted through blood, semen, vaginal secretions, and breast milk. Risk factors for contracting HIV include sex without condoms or other barriers, IV drug use while sharing needles, and mother-to child transmission in-utero, during labor, or from breast-feeding. There are many ways to reduce the risk of transmitting and contracting HIV.
In the United States, most people living with HIV are men who have sex with men, however, contracting HIV through heterosexual sex is also possible.
Symptoms
Some people may experience a flu-like illness within 2 to 4 weeks after infection (Stage 1 HIV infection). But some people may not feel sick during this stage. Flu-like symptoms include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, or mouth ulcers. These symptoms can last anywhere from a few days to several weeks.
During this time, HIV infection may not show up on a HIV test, but people who have it are highly infectious and can spread the infection to others.
After acute symptoms, many people may go years with no symptoms at all. If AIDS develops, someone may get very sick with an opportunistic infection. They could end up in the hospital with many serious medical complications. To avoid this, it is best that people living with HIV see a physician regularly and get on ART to treat their HIV and prevent them from transmitting it to others.
Diagnosis and Testing
A doctor may suspect HIV if symptoms last and no other cause can be found, or if you are engaging in behaviors that may put you at risk for contracting HIV. It is important to be honest with your providers about your sexual behaviors and IV drug use so they know whether they should be testing you for HIV.
If you have been exposed to HIV, your immune system will make antibodies to try to destroy the virus. Doctors use tests to find these HIV antibodies or antigens in saliva or blood.
Most doctors use a blood test to diagnose HIV infection. If the test is positive, meaning that HIV antibodies or antigens are found, a test to detect HIV DNA or RNA will be done to confirm.
HIV antibodies or antigens usually show up in the blood within 3 months. If you think you have been exposed to HIV, but you test negative for it:
- Get tested again. A repeat test may be done after a few weeks to be sure you are not infected.
- Meanwhile, take steps to prevent the spread of the virus, in case you do have it – such as using condoms for sex, avoiding breast-feeding, and not sharing needles with others while using drugs.
You can get HIV testing in most doctors' offices, public health clinics, hospitals, and Planned Parenthood clinics. You can also buy a home HIV test kit in a drugstore or by mail order. You will want to make sure it's one that is approved by the Food and Drug Administration (FDA). If a home test is positive, see a doctor to have the result confirmed and to find out what to do next.
What to Expect
New Patients
New patients are scheduled to see one of the Michigan Medicine HATP physicians to establish care. At the appointment, patients will meet with a medical assistant, their physician, and potentially an attending physician.
One of our social workers will meet with the patient to conduct a complete assessment and create an individualized treatment plan. A new patient may also meet with a nutritionist, registered nurse, or a psychiatrist, however this may not occur at every new patient visit.
Once a patient meets all appropriate team members, the patient will be scheduled for the next visit and most likely will go to the lab to have blood work and other labs completed.
Individuals are seen more frequently when they are new patients, usually every 6-12 weeks for the first year. If a new patient comes to our program already on HIV medication, our provider will assess the regimen and its effectiveness, using diagnostic lab work, and the patient’s ability to take the medication every day without missing doses.
If a new medication regimen is indicated, our providers and staff will make certain patients are fully educated on the new regimen and have insurance coverage in place prior to any medication change.
Established Patients
After this step is completed, and if the patient is stable, they are seen twice a year for lab work and a physician visit. They may see or talk with a social worker, dietician, psychiatrist, or nurse more often, depending on need. A social worker will meet with most patients at least once each year to check in and do a brief re-assessment to identify new or ongoing needs.
Patients are screened for sexually transmitted infections, mental health, housing, substance abuse, smoking and income information yearly as part of the Ryan White HIV/AIDS Program federal grant, which funds the HATP.
Our Services
We offer a wide-range of comprehensive services:
Medical Care and Case Management
- Expert management of HIV Infection and complications related to AIDS
- Primary medical care
- Coordination with your physician and medical case management
- Specialty referrals
Counseling and Support
- Mental health counseling
- Harm reduction/Safer sex education
- Risk-reduction counseling and education: Includes assistance with substance use, disclosure, interpersonal concerns, and other risk behaviors
- Tobacco cessation counseling
- Nutritional assessments, counseling, and assistance
- Support group for gay and bisexual men living with HIV
General Assistance and Education
- General assistance: Includes assistance with transportation, financial concerns, housing referrals, and medical marijuana applications
- Insurance assistance: Includes assistance with patient’s insurance, Michigan HIV/AIDS Drug Assistance Program (MIDAP) and other insurance assistance programs, dental assistance, cost of medications or medical care, Medicaid or DHS issues, financial barriers, Social Security, SSI, and FMLA papers
- Educational programs and events about living with HIV: Includes Annual HIV Update and Long-term survivors of HIV
Research
Prior research efforts have been focused on the development of many of the antiretroviral medications that are presently in common use today. Researchers are now working on finding more long-term curative therapies by studying the HIV reservoir, which include investigating bone marrow stem cells as a reservoir site, as well as immune cells associated with the GI tract. Studies are collaborative in nature and involve large teams leveraging their individual areas of expertise to solve complex problems. Learn more about HIV-AIDS Treatment Program research.
Prevention Access Campaign U=U Partner
Michigan Medicine (and the HIV-AIDS Treatment Program) is a community partner with the Prevention Access Campaign to support Undetectable = Untransmittable (U=U). U=U means that people living with HIV can feel confident that if they have an undetectable viral load and take their medications as prescribed, they cannot pass on HIV to sexual partners.
In endorsing the U=U message, Michigan Medicine and HATP believe the following:
- We can comfortably say that a person living with HIV, who is on ART and has an undetectable viral load, cannot transmit HIV to sexual partners (endorsed by leading HIV experts and researchers from around the world).
- We agree that the health and prevention benefits of viral suppression are platforms to underscore the importance of universal access to treatment and care for all people living with HIV worldwide.
- We agree that treatment is a personal choice, that treatment is first and foremost for personal health, that there are unjust barriers to accessing treatment, that not all people living with HIV will achieve an undetectable viral load, and there is no place for stigmatizing anyone living with HIV at any viral load.
U=U offers freedom and hope. For many people living with HIV and their partners, U=U opens up social, sexual, and reproductive choices they never thought would be possible. Michigan Medicine and HATP are proud to share the message of U=U with our patients and the wider community.
Consumer Advisory Council
Our Consumer Advisory Council (CAC) is a group of HIV-positive individuals who want to use their experience to help others, ensure that we provide the best care possible, and talk about how their experience as a patient could be improved. If you are a patient of the HATP and would like to be involved with the CAC, please contact Charletta Hill, LMSW at [email protected] or 734-936-5212.
Make an Appointment
Please call the HIV-AIDS Treatment Program at 734-647-5899 or 888-229-7409.