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Virus

HIV is a retrovirus belonging to the group of lentiviruses and causes AIDS (acquired immunodeficiency syndrome).

There are several strains and subtypes of HI virus, but HIV-1 and particularly its subtype M have caused the current global epidemic (pandemic). Other HI virus types have mainly caused some regional cases such as HIV-2 in West Africa. The virus remains in the cells of the body and cannot be removed with current treatments.

Situation in Finland

The first cases of AIDS in Finland were detected at the beginning of the 1980s. These cases were shown to result from HIV when a diagnostic test became available in 1985 and stored blood samples were examined. By the end of 2018, HIV had been diagnosed in 4,000 people in Finland. In 2018, there were 153 new cases. This is about the average number of cases during the past 10 years. The majority of those infected have been between 20 and 59 years of age (peak: 30 to 39 years of age).

In 2018, more than half (59%) of those infected were of foreign origin. Over two-thirds of all infected Finns were males. In 8 out of 10 cases where the mode of transmission was known, it was sex. In recent years, those who had sex with the opposite sex showed twice the rate of infection as those who had sex with the same sex. Two-thirds of the infections had been caught outside Finland. As in previous years, the main sources of infection were Thailand, Russia and Estonia. Over half of the cases in Finland were diagnosed in the Helsinki region.

During the past eight years, no HIV infections in Finland have been transmitted from blood products or from mother to child. During this time, there have been only four infections due to injecting drugs.

Modes of transmission

The HI virus is unable to penetrate through healthy skin, and is unlikely to pass through the body’s mucous membranes. HIV is not transmitted through daily activities such as sharing meals, touching hands, hugging, kissing, or sharing the living environment with someone with HIV. There have been no infections at schools or daycare centres or through physical exercise contacts. HIV can only be transmitted if HIV-positive blood or semen finds its way into the tissue or open wound of another person. No infections have been reported after bite wounds, scratches or exercise injuries.

Sexual contact is by far the most common mode of HIV transmission, both in Finland and elsewhere. The second most common mode is through blood-contaminated paraphernalia used for injecting drugs. Sharing needles, etc. can cause epidemics among drug users.

HIV prevention

Sex and blood-contaminated drug paraphernalia

Safe sex is key in HIV prevention. This means using a condom, which also protects against other sexually transmitted diseases. HIV cannot be transmitted by kissing.

Intravenous drug users should ensure that they always obtain and use clean drug paraphernalia and that they do not share needles with others.

Acupuncture, tattooing or piercing performed by a professional has not been found to pose a risk of HIV transmission through blood. However, there have been HIV infections when tattoos and piercings have been performed at home, between friends, and particularly in prison. Companies doing tattoos and piercings must possess a safety document required by the Consumer Safety Act and verified by the authorities. The customer has the right to require information about this.

When should you be tested?

While the most typical HIV-positive person in Finland is a 25 to 45-year-old male from the Helsinki region who’s had unprotected casual sex, the HIV risk applies to everyone who’s had sex and depends on the person’s sexual behaviour. In Finland, everyone has the right to have an HIV test in public healthcare without revealing their identity or the reason for attending for the test.

Laboratory examinations: excluding and diagnosing the infection

An HIV infection is diagnosed by means of a blood test (EIA test) that detects virus particles (antigens) and antibodies to the virus. After transmission, it takes several weeks for the virus, and particularly the antibodies to the virus, to appear in the blood.

The test can detect the infection within 2 to 3 weeks after transmission, and most cases of infection can be detected within six weeks. If the result is negative, the infection can be firmly excluded after three months following the exposure. Although the test is virtually 100% accurate, a confirmation test (immunoblot test) will be performed if the sample is positive. If you want to have an HIV test, contact a healthcare professional to get a referral to the laboratory.

Information sources: The Finnish Medical Society Duodecim: Terveysportti, Lääkärin tietokanta database

FSHS General Practitioner / 09 January 2020

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