Frequently Asked Questions

Signs and symptoms vary among people infected with HIV and may not appear for many years. Symptoms can be similar to those caused by other illnesses. Getting tested is the only way to know if you have been infected with HIV.

After initial infection of HIV (stage 1), the bloodstream contains high levels of the virus. At this stage, it can easily be passed to other people. Within 2 to 4 weeks of exposure, many people develop flu-like symptoms. Not everyone has these symptoms and it is possible for HIV to progress without any indication that the virus is present in the body. At this stage, symptoms may include:

• Muscle and joint aches and pains
• Tiredness
• Fever
• Ulcers in the mouth
• Night sweats
• Body rash
• Sore throat
• Swollen glands

It is important to consult a doctor if these symptoms occur, especially if you believe you may have been exposed to HIV. Detecting HIV early and getting on treatment can be lifesaving.

During stage 2, the virus is active but reproduces at very low levels. Those who follow a treatment program may remain in this stage for many decades, possibly for the rest of their life. Without treatment, this stage lasts around 10 years but treatment can reduce the virus in the blood.

If left untreated, HIV can lead to AIDS (stage 3). Some of the more common symptoms of AIDS include:

• Blotches under the skin or in the mouth and nose
• Blurred vision
• Diarrhea lasting longer than 1 week
• Swollen glands
• Constant tiredness
• Recurring fever
• Memory loss
• Depression
• Pneumonia
• Weight loss
• Mouth, anus, or genital sores

Conditions that commonly develop at this stage include tuberculosis (TB), fungal infections of the respiratory system, lymphoma, and hepatitis. A person is diagnosed with AIDS when their CD4 cell count reduces to less than 200 cells/mm3 or if they have opportunistic infections (infections that occur in people with weakened immune systems).

HIV can spread from one person to another by:

• Having anal or vaginal sex without using a condom with someone who has HIV
• Sharing needles (while injecting drugs) with someone who has HIV
• A mother with HIV may give it to her baby during pregnancy, childbirth or breastfeeding
• Receive blood / organ / tissue of a person with HIV

You cannot get HIV through:

• Air
• Water
• Saliva
• Sweat
• Common toilet sites
• Insect bites (mosquitoes etc.)
• Casual contact – hugging, kissing, sharing food / utensils, shaking hands

It is important to test for HIV regularly if you think you may be at risk of HIV. If you acquire HIV, detecting it early and starting treatment as soon as possible can lead to a longer, healthier life. It also helps to keep your spouses, children, partners and family safe.

Through Safe Zindagi, you can order a HIV self-testing kit for your spouse or partner, with their consent.

HIV self-testing is easy to perform and allows you to screen for HIV whenever and wherever you want. With HIV self-testing, you do not have to travel or wait in lines at a facility to screen for HIV. Test results are available quickly, within 20-40 minutes. A positive HIV-self-testing result should always be confirmed with an HIV test at a health facility.

HIV self-testing is recommended for anyone who may have been exposed to HIV, who is 18 years or older, and has never tested positive for HIV. Please do not complete HIV self-testing if you are taking antiretroviral therapy (ART).

• Sex (vaginal, oral or anal) with multiple sex partners
• Sex with someone who is living with HIV or whose HIV status you don’t know
• Sex without using a condom
• Sharing needles while injecting drugs

Globally:

There are two types of HIV self-testing kits

1. Finger-prick test: A blood sample is taken from the finger by a lancet and the results are available in 20-40 minutes.
Examples: INSTI HIV Self-Testing

2. Mouth-swab test: Oral fluid sample is taken using a swab by brushing the oral cavity and the results are available in 20-40 minutes.

Both types of HIV self-testing kits have a sensitivity and specificity of more than 99%.

India:

There is only one type of HIV self-testing kit which is DCGI approved and is available on Safe Zindagi:

1. Mouth-Swab test: This kit is manufactured by Invex Health and is called MORCHECK. This is an Oral Mucosal Transudate which uses Lateral flow Immunochromatographic Assay to detect antibodies against HIV 1 and 2 infection that are produced by the body in response to HIV infection.

Through Safe Zindagi, you can order the MORCHECK HIV self-testing kit, which uses oral fluid to detect HIV antibodies. MORCHECK is a 3^rd generation, single-use, visually read, in-vitro immunoassay rapid antibody test.

Benefits of using an oral HIV self-testing kit include:

• It is safe to use
• No blood, needles, lancets or syringes
• Convenient to use anywhere
• Quick availability of results within 20-40 minutes

The MORCHECK rapid antibody self-testing kit detects antibodies to HIV Type 1 (HIV-1) and Type 2 (HIV-2) present in oral fluid specimens.

It takes one to three months after exposure before HIV antibodies can be detected. If negative, it is recommended to repeat HIV self-testing after 3 months if you believe you may have been exposed to HIV.

The HIV self-testing kit has an 18-month shelf life (best before 18 months after manufacturing date). The kit can be stored anywhere with a temperature from 2 to 30 degrees Celsius. Do not freeze the kit.

The MORCHECK HIV self-testing kit has 99.3% sensitivity and 99.3% specificity. This was tested through 21 clinical evaluations involving 10,775 people.

Inside the HIV self-testing kit, you will find:

• 1 foil pouch containing oral fluid test strip
• 1 capped test tube containing oral fluid sample buffer (1 ml)
• 1 oral fluid sample collection swab
• Detailed instructions for use

Through Safe Zindagi, the kit is available free of cost!

Yes, you can view detailed instructions here. When conducting HIV self-testing, you can receive real-time help and support from a Safe Zindagi virtual counsellor.

You can complete HIV self-testing at home or any other comfortable location.

It takes about 5 minutes to carry out the kit instructions, and takes 20-40 minutes to see the results. You should wait to view the result after 20 minutes, but no more than 45 minutes. After 45 minutes, the test will be invalid.

Assisted self-testing involves having real-time support, either in-person or virtually, from a healthcare worker or counsellor trained to walk you through the steps to complete HIV self-testing and answer any questions you may have. This can be over a telephonic call or a video call using a convenient application like WhatsApp or Zoom.

When ordering your HIV self-testing kit, there will be an opportunity to select assisted self-testing. A personal virtual counsellor from Safe Zindagi will then get in touch with you to set up a date and time to complete the self-testing kit with remote support through video or audio communication. If you select a pick up location to collect the HIV self-testing kit, you can also seek in-person support from the doctor or healthcare staff at the selected facility.

Unassisted self-testing involves completing HIV self-testing independently without support from a healthcare provider. After selecting the unassisted option when ordering a kit, you will still receive information and instructions for HIV self-testing. If you select unassisted testing, it is important to review the instructions on how to complete the test. You can view instructions here.

After selecting unassisted, you can reach out to Safe Zindagi staff if you would like additional support from a virtual counsellor at any point. You can message your personal virtual counsellor assigned to you over text message or WhatsApp, or get in touch here.

• Brush your upper gum up and down from left to right and then from right to left. Repeat on the lower gum.
• Put the brush in the test tube and move it up and donwn for 8 minutes. Gently dip the test strip in the test tube. Wait for 20 minutes (but not more than 40 minutes)
• One line on the swab means you are HIV negative. Two lines on the swab means that you have screened positive and will need to take a confirmatory test at a clinic.

View the instructions at How to use the self-testing kit.

After completing the steps of HIV self-testing, lines will appear on the test strip.

One line on the test strip means that HIV antibodies were not detected and your screening test is negative. It is recommend to test again after 3 months. You should practice risk-reducing behaviors, like using condoms, and consider taking PrEP (learn about PrEP here: https://www.safezindagi.in/prep or talk to your virtual counsellor).

Two lines on the test strip means HIV antibodies were detected and your screening test is positive. This does not mean you are HIV positive – the kit is only a screening test. Please go to an integrated counseling and testing centre (ICTC) or a clinic for a confirmatory test. Find a clinic here.

After completing HIV self-testing, you can take a picture of the test kit after 20 minutes and before 45 minutes. Share the picture on WhatsApp with your virtual counsellor or directly upload the result on your profile. Access your profile here.

The virtual counsellor will contact you to support the next steps based on your HIV self-testing result.

A negative result means that HIV antibodies were not detected and your screening test is negative. However, if you have continued risk of acquiring HIV or believe you were exposed to HIV in last 3 months, it is recommended that you repeat HIV self-testing in 3 months.

A positive result means HIV antibodies were detected and your screening test is positive. A positive HIV self-testing result should be immediately followed up with a confirmatory test at a government or private clinic. Please go to an integrated counseling and testing centre (ICTC) or a clinic for a confirmatory test. Find a clinic here.

• When ordering your kit, provide an address of your choice for the kit to be delivered to
• Provide a mobile number for delivery contact
• The courier agent will deliver the kit to the provided address
• After placing your order, you will receive an Order ID
• Provide the Order ID that you receive from Safe Zindagi to the courier service when receiving the kit

• Yes4Mme is an online platform funded by USAID and PEPFAR and implemented through Program ACCELERATE, in partnership with the National AIDS Control Organization of India. Program ACCELERATE is led by the Johns Hopkins University School of Medicine. Safe Zindagi aims to offer online information and services for HIV testing, prevention, treatment, and retention in care through the public and private sectors of India.
• If you have further questions, please get in touch here.

If you think you have been exposed to HIV, you should be tested. You're at greatest risk for acquiring HIV if you:

• Share drug needles or syringes
• Have anal sex without a condom, especially receptive anal intercourse
• Have sex with an infected person without using a condom
• Have vaginal or anal sexual contact without using a condom with someone whose HIV status is unknown, especially those who are at high risk for acquiring HIV
• Have a sexually transmitted disease such as syphilis, genital herpes, chlamydial infection, gonorrhoea and bacterial vaginosis, which appear to increase susceptibility to HIV infection during sex with infected partners

Most tests look for antibodies produced by your body to fight HIV infection. These antibodies don't develop immediately but emerge within a few weeks to six months of being infected. The average time for antibodies to develop is three to four weeks.

It is not effective to get tested immediately after you think you may have been infected. If you do so, you should be re-tested in three months and then again at six months if your test results are negative. During this period of testing, avoid all behaviour that could spread HIV to others, such as unprotected sex and sharing needles or syringes. Consult with your doctor or nurse or the health care providers who perform your HIV test for more information.

Missed Call - +91 9700710071 and Helpline - +91 9700710071

HIV testing is available at SafeZindagi.in throughout the year. All our Sexual health managers will assist you and can support you to get tested in private labs, ICTC labs, YRGcare own labs (ICC), HIV test through self-testing kit and other hospitals and clinics. Some sites offer free of cost and some are in discounted price.

This testing is usually confidential, but not anonymous. it means no one has access to your test results since your name is never recorded at the test site. Confidential testing means that you and the health care provider know your results, which may be recorded in your medical record and may be available to those who have legal access to your medical record. This may include lab/clinic (Private or public) in certain circumstances.

Most testing sites provide HIV and AIDS counselling, where our counsellors privately discuss the test, HIV, risky behaviour and ways to protect yourself from HIV and AIDS. Counsellors also discuss test results and offer support and recommendations, if necessary.

If you test positive, this does not mean you have AIDS or that you will develop AIDS. It means you are carrying the virus that can cause AIDS and you can infect others. You should begin an HIV management plan and take precautions to avoid spreading the virus.

If you are HIV positive, our health manager will arrange appointments with a doctor as soon as possible about an HIV care plan. Early diagnosis and consistent care are essential for your health. Counsellors or doctors are available and will work with you to develop a care plan or refer you to a health care professional who can provide care. Your counsellor or doctor also can refer you to support networks and resources in your community. You're not alone. Seeking the support of others can help you deal with your diagnosis.

A new client needs to follow any of one step for booking a test, mentioned below: -

• Clients need to visit SafeZindagi.in website Browse and clicking the Book a Test/Get Tested option
• Need to click on advertisements, encouraging them to book a HIV Test.
• Use a link provided by a vCounsellor (our health managers) who has engaged and shared with a client.
• By engaging him/herself with our official social media platform
• Client can call our vCounsellor/ Health manager they will book a test behalf of client.
• If the user has done a test outside the platform and wants to re-confirm by doing another test on this platform

An existing client needs to follow any of one step for booking a test, mentioned below:

• Clients need to visit SafeZindagi.in website Browse and clicking the Book a Test/Get Tested option.
• Use his mobile number followed by OTP and login in the system
• Have taken the Risk Assessment and now want to book a test
• Want to get tested again, having been tested in the past
• Have missed an appointment and need to take a new appointment
• Want to Reschedule a booking
• Based on above, proceed for book a test

Once you click on ‘Book a Test’ option the client will be prompted with the following:

• The client will be prompted to provide a Mobile number. This will trigger an OTP to the provided number.
• The Client will be prompted to enter the OTP received.
• On successful verification of the OTP, the system will identify if it is an existing or new Client. The Client will be prompted to indicate - What would you like to do?

Once you ‘Book a Test’ clients take HIV and STI related tests i.e. HIV Screening, VDRL and in some cases Hepatitis B. There are 2 types of tests for HIV: Screening test and Confirmatory Test.

The Screening test can be done in any of the partner Labs/Testing Centres and the Confirmatory test need to be done in the ICTCs (Integrated Counselling and Testing Centres) which are Govt. units.

Under our ACCELERATE project, client can request for home collection. But we have these facilities in seven cities only i.e. Bangalore, Pune, Thane, Delhi, Kanpur, Chennai, Hyderabad with very nominal charges.

Yes, our project and work encourage partners testing in all our testing centres.

Yes, any new/ existing client bookings can be ‘Rescheduled’. In case of active booking an reschedule appointment, need to be change for new time and date.

While booking appointment, the Client will be prompted for permission to use the Current location. If the Client allows Location to be used, the City and Locality of the Client will be determined using the Google map services.

If the location is not allowed by the Client, the system will prompt the client to select the City. There will also be an option for the Client to allow the system to use their Current location.

The city can be changed at any point in the process. During the booking process, the Client has the option to add locality if not identified using the Use Current location option. The Client will be required to provide Name, Date of Birth, Age and Gender. In case the appointment is being booked for Partner/Spouse/Others, the system will prompt for Partner’s Name, Date of Birth, Age and Gender in addition to the Client’s details.

Note: For Name, a note will indicate that any name can be provided, which will be used only for communication. As while filling this information all the fields will be mandatory.

Client will have to provide their Consent to take this HIV screening test. The legalese for the Consent will be provided by the ACCELERATE project team. The option available will be "I agree to the terms and conditions". The Consent page will also include an option - I would like to provide feedback on the services rendered - Yes/No. The selection/non-selection will be saved with the Client’s profile and used to determine if the survey is to be sent to the Client. Consent for notifications will be taken for a new client on the system (if already taken on HIVST - will not be taken again)

PrEP has been shown to reduce the risk of getting HIV from sex by up to 99% if taken correctly. For injecting drug use, studies show PrEP reduces HIV risk by at least 74%.

When taken regularly, PrEP can provide a high level of protection against HIV, but it is important to still use condoms to protect against other STIs like syphilis and gonorrhoea. PrEP does not prevent pregnancy.

It takes about 7 days of taking PrEP daily before it provides maximum protection for anal sex (bottoming), and 21 days for receptive vaginal sex and injection drug use.

No data are available for insertive anal sex (topping) or insertive vaginal sex.

When HIV enters the body, it attacks healthy immune cells (https://www.avert.org/about-hiv-aids/what-hiv-aids).

The HIV virus breaks up the immune cells and infects the body. PrEP stops the HIV virus from replicating within immune cells and taking hold within the body, thus preventing an infection.

PrEP has been shown to be highly effective in reducing the risk of getting HIV when taken daily. If PrEP is taken correctly/daily, studies have shown that PrEP reduces the risk of HIV infection from sex by up to 99%. PrEP has been shown to reduce the risk of HIV infection from injecting drugs by at least 74%. Its efficacy reduces when taken inconsistently.

PrEP should be taken by those who are HIV negative and are at risk of getting HIV. Consider taking PrEP if:

• You have had vaginal or anal sex in the past 6 months and:
  • You have multiple sexual partners and don’t always use condoms
  • You have a sexual partner living with HIV (with an unknown or detectable viral load)
  • You have been diagnosed with a sexually transmitted infection in the past 6 months
  • You have taken post exposure prophylaxis (PEP) in the past year
  • You are considering getting pregnant with an HIV positive partner

• You are a person who injects drugs and:
  • You have an injection partner living with HIV
  • You share needles, syringes, or other equipment to inject drugs

PrEP, like other drugs, may have side effects which are usually mild and temporary. Side effects can include:

• Diarrhea, nausea or headache - These symptoms usually go away in a few days to weeks. Sometimes, they can be avoided by taking the pill with food or at bedtime.

Less common side effects, which are reversible, include:

• Reduced kidney function - It is important that kidney function is monitored at follow-up visits with your medical provider.
• Reduced bone density - In very rare cases, PrEP may reduce bone mineral density (bone strength).

These symptoms return to normal when PrEP is stopped.

If you are feeling any side effects from taking PrEP, please consult your medical provider immediately.

The usage mantra for PrEP is ‘One pill. Once a day.’ Remember, PrEP should be taken under supervision of a medical practitioner. Don’t try to buy it over the counter or share the medicine with your friend or your partner.

There are various combinations of drugs available for PrEP. Please consult your medical provider. A qualified medical provider will recommend an appropriate dosage for you.

Talk to your medical provider before stopping or restarting PrEP. You should continue taking PrEP as long as you are still at risk of HIV. Also, you shouldn’t stop taking PrEP immediately if you think you are not at risk of HIV anymore. PrEP should be continued for 28 days after an exposure to HIV.

PrEP is only effective for HIV prevention. PrEP can’t provide protection against STI/STDs such as Syphilis, Gonorrhoea, Hepatitis B, Hepatitis C, or Chlamydia. The best way to protect against STIs is to use condoms regularly.

Yes. It is strongly advised that you use condoms along with PrEP as additional protection against STIs, unless you are trying to get pregnant.

Yes! PrEP provides protection from HIV only when the tablet is taken every day. This leaves some risk of contracting HIV, so it is important to get an HIV test every 3 months when on PrEP. If you become HIV positive while on PrEP, you should start taking treatment for HIV as soon as possible with help from your medical provider.

PrEP (pre-exposure prophylaxis) is taken daily by HIV negative people to prevent acquiring HIV. PEP (post-exposure prophylaxis) is for people who may have been exposed to HIV to stop getting infected. PEP is for emergency situations and must be taken within 3 days of a possible HIV exposure.

Once you have a valid prescription for PrEP from a qualified medical practitioner, you are eligible to buy PrEP from a pharmacy. You can also buy PrEP online. Register for PrEP here (link ).

The best way to know your eligibility for PrEP is to consult a medical provider. You can also read the FAQ “How do I know if I am at risk for HIV” above. Your medical provider will help you complete the required tests to see if you can start PrEP. If you are HIV positive, you are not eligible for PrEP.

If you think you’re at risk of HIV, consult a qualified medical provider.

To get started on PrEP, you need a medical provider’s prescription. Safe Zindagi can help you find a medical provider to consult about getting a PrEP prescription.

Call us on 9700720072: to get a call back from our v-Counsellor and book a provider consultation for free.

Before getting a PrEP prescription, your virtual counsellor will inform you about the process. They will help you complete your tests as per the medical provider’s advice before starting PrEP. The mandatory tests that will be done are HIV, Hepatitis, Syphilis and Creatinine. Once these are done, the virtual counsellor will help you get an online appointment with your medical provider to start PrEP. You will receive the prescription after giving consent. The virtual counsellor will help you pick up or receive the PrEP medication after you make the payment. All tests and the medication is offered at a subsidised cost (>50%) through our platform.

You should continue to take PrEP if you continue to be at risk of HIV. If your risk of HIV changes, you should consult your medical provider to talk about stopping PrEP.

It takes about 7 days of taking PrEP daily before there is enough medication in your body to provide protection for anal sex (bottoming). It takes 21 days of taking PrEP daily to provide protection for vaginal sex and injection drug use. Also, PrEP should be continued for 28 days after an exposure to HIV. Consult your medical provider before stopping PrEP.

Yes. You should take one pill every day even if you do not have sex every day to keep a consistent level of medication in your blood and tissues to provide protectio

If a dose is missed, PrEP should be taken whenever you remember. If two doses are taken by mistake, that is okay, only take one pill the next time. Otherwise, try to consistently take PrEP around the same time daily.

Alcohol and drug use should not directly affect how well PrEP works; however, substance use may affect how consistently you take the medication. Missing doses can lower PrEP’s effectiveness.

PrEP is safe to take during pregnancy as well as for women who are breastfeeding. PrEP can be started or continued during pregnancy or breastfeeding.

No adverse effects have been found among infants exposed to Truvada, one of the approved forms of PrEP.

Yes, it is safe to combine contraceptives and PrEP.

Yes. It is safe to be on PrEP if you are taking gender affirming hormones.

Available data on PrEP use among transgender women suggest that it is very effective in protecting against HIV when taken as prescribed.

Yes, you can safely combine PrEP and anti-depressant medications.

You should let your medical provider know all medications, supplements, and vitamins you are taking to avoid potential drug interactions.

STIs are infections that can be passed on from an infected person to you when you have unprotected sex, or close sexual contact with that person. The STIs could manifest as Sexually Transmitted Diseases (STD).

STI stands for sexually transmitted infection while STD stands for sexually transmitted disease. These terms are often used interchangeably, though technically they are different.

Sexually transmitted infections are infections caused by sexual contact that may manifest with symptoms or may also be asymptomatic (silent). Sexually transmitted diseases are caused by sexually transmitted infections and manifesting with signs and symptoms (symptomatic). However, irrespective of manifesting with symptoms or signs, the STIs needs to be treated/managed. Not all sexually transmitted infections manifest in symptoms or turn into a disease.

Sexually transmitted infections (STIs) can be passed on when you have unprotected sex, or other close sexual contact with another person.

The common STIs include:

• Syphilis,
• Gonorrhea
• Chlamydia
• Non Specific Urethritis (NSU)
• Gonorrhoea
• Genital herpes
• HIV

Infections such as Hepatitis A, B and C may also be transmitted through sexual route. And, infections such as Candida (thrush) and Bacterial vaginosis can be transmitted by sexual contact.

The only way to know for sure is to get tested. Sometimes, the STIs may be asymptomatic i.e. the infection does not manifest any symptom or sign. Thus, if you have had a high risk sexual encounter, be it vaginal or anal or oral sex, it is better to consult health care provider.

It is important to get consulted (and tested) with a health care provider, if you think you along with the partner(s) which whom you had sexual contact are at-risk. Many people with STIs don’t have symptoms (but carry infection), so it is worth getting tested even if you feel healthy. If you think you have an STI, you should consider having protected sex until you have had a check-up and treatment (if you are diagnosed with a STI).

STDs usually manifest with the following symptoms. However, sometimes, STIs may not have any symptoms and signs to be noticed by the client or have only minor symptoms that are ignored by the clients. Thus you need to consult with a healthcare provider (and get tested for STI) if you think that you (or your partner) have put yourselves at risk of STI. Some of the common symptoms of STI include:

• Discharge or unusual (may be foul smelling) fluid that may be white or yellow that comes out of the vagina or penis (not semen) or anus.
• A change in discharge from the vagina.
• Itching or redness over genitals /genital area.
• A burning sensation or pain while urinating or passing stools.
• Bumps, sores, blisters, or warts on the genital area, lips or mouth.
• Bleeding between periods or after sex, in women.
• Pain during sex.
• Sore throat or unusual rashes over the body including palms.

Yes. STIs can affect mucosal surfaces such as lip, mouth, throat, anus and skin around your genitals, breast etc, meaning whichever vulnerable part of your body that came in contact with infectious material during the sex/close contact may potentially get infected. Common examples are oral herpes, peri-anal wart (wart around anus), gonorrhoea of throat. However, the extra-genital STI manifestations are also curable or manageable as like genital STIs. That is the reason why you need to be open and respond to the questions asked by the healthcare provider to facilitate proper clinical examination, STI tests and treatment.

Many of the STDs are curable while some others don’t have cure but are manageable. You need to follow preventive measures as advised by the doctor and counsellor to avoid its complications and to prevent its transmission to your partners and children (especially, in case of pregnant women).

For the STDs/STIs, you (and your partner) need to take all the prescribed medicines in time and adhere to the other advises if any, such as repeat testing to make sure that the infection is cleared from your (and your partner’s) body. It is essential that you and your partner(s) need to be treated at the same time to avoid the chance of reinfection from your partner. Proper treatment will also decrease the chances of passing on the infection to your partners.

In general, the treatment of most STDs is simple. It is important that the course of treatment is completed. You and your partner(s) get treated at SAME time, to prevent chance of re-infection. Follow up with the provider, at recommended intervals. Also, follow any advice given by the doctor about safer sexual practices.

Some of the STIs can cause permanent damage to your health and body system, if not treated properly. In addition, you may continue to transmit the infection to others. The damage caused may include:

• infertility
• pain or swelling in the testicles
• complications of pregnancy
• spreading infection to your new born baby
• pelvic inflammatory disease in women
• weakened immune system
• eye, brain or nervous system, heart or brain damage
• cervical cancer
• liver damage or liver cancer

The national guidelines recommend screening for STI every three months if you are sexually active (due to that fact that often the STIs may not manifest any signs or symptoms). However, it is essential to consult with a health care provider at the earliest whenever you or your partner get signs and symptoms of STI.

No. There are many sexually transmitted infections. Each STI requires specific modality of testing and sampling for example urine or blood or swab test. The tests may also vary from simple microscopy tests to sophisticated molecular laboratory tests. Based on sexual and clinical history and clinical examination, the provider will advise relevant STI tests, as required. Again, providers will recommend for STI testing only when required, to decide or guide the treatment. Sometimes, you may also be treated by the provider without STI tests solely on the basis of your symptoms (syndromic management).

No. STIs, like any other infection, have an incubation period i.e. time between your first contact with the infection and when your body develops symptoms of the disease. During this period, the body recognizes the infection and produces antibodies in the blood; and sometimes the infectious agent or particle starts appearing in blood or urine or discharges. These antibodies or infectious particles are detected by the STI tests, prescribed by the doctors. Thus it takes around 1-2 week or more time (depending on individual STI) to detect the STI by a lab test. Hence, getting lab test or clinical examination immediately after having exposure to STI (such as high-risk sex) will not reveal any finding though such consultation with provider will help in deciding the treatment and follow up plan. In addition, immediate consultation will also help to assess the need for post exposure prophylaxis (PEP) to prevent HIV infection.

If you are sexually active, there are many things you can do to minimize the chances of getting an STD.

• Use condoms. Use it correctly every time you have sex (vaginal, anal or oral), can be very good protection against many STDs.
• Have fewer partners. The more people you have sex with, the greater your chances of getting an STD. Go with new partners to get tested.
• If it is relevant to you, prefer to be in active sexually active relationship with only one person, who has mutually agreed to be active sexually only with you.
• Don’t mix drugs and alcohol with sex. Getting drunk or high can affect your ability to make smart decisions about safer sex.
• Don’t use IV street drugs and never share needles. Many STDs are transmitted through blood.
• Avoid rough forceful sexual activities including group sex. Use lubricants in case of anal sex
• Consult with a health care provider in case you or your partner have symptoms and signs of STI. Be open and honest to the questions asked by the provider, which will help to provide best possible care to you.
• Vaccination against Hepatitis A, Hepatitis B and HPV are recommended to prevent hepatitis A, hepatitis B, and HPV.
• In case of sex between two vulva owners (or—genital or vulvo-vulval contact), barriers such as dental dam or repurposed condoms will be of help in preventing STIs.
• Use of dental dams can also be considered during oro-vaginal (cunnilingus) and oro-anal (annilingus).
• Use of pre-exposure prophylaxis (medicines to reduce the risk of getting HIV in at-risk individuals) under medical supervision can also be considered.

Yes. A common misconception is that one cannot get an STD from giving or receiving oral sex. This is not true. STIs such as gonorrhea, chlamydia, syphilis and herpes are also transmitted through oral sex.

Yes, many people who are infected with STIs have no symptoms but are still very contagious.

Yes. It is possible to get STIs such as Herpes through kissing.

If you think that you have put yourselves at risk of HIV (for example, had vaginal, anal or oral sex with a new partner) should be tested. If you or your partner have signs and symptoms of STD, you should consult a healthcare provider. Pregnant women should also be tested for STDs.

If you or your partner is sexually active with multiple partners, regular testing for STDs including HIV should be considered once in 3 – 6 months.

Yes. You can get infections such as chlamydia, gonorrhoea and syphilis more than once, even if you’ve been treated before. That’s why it’s so important to make sure your partners are also tested and treated.

It’s very unlikely. There is no evidence STDs can be transmitted by contact with public toilets.

Once started, ART should be continued for life.

Antiretroviral therapy, or ART, is safe but it can sometimes cause side effects. Most side effects from HIV medicines are mild and manageable; however, this may vary from person to person. Side effects from ART usually go away over time.

Different HIV medicines can cause various side effects. In addition, people taking the same HIV medicine can have different side effects.

People starting HIV medicines can talk to their health care provider about possible side effects and ways to manage them.

ART is available free of cost at government ART centers. These centers are established in most medical colleges and district-level hospitals.

ART is also available in the pharmacies for purchase, with a prescription by a registered medical practitioner.

In government centers, ART is available free of cost.

Elsewhere, the cost of the medicines varies depending on regimen, formulations, and brand in the market. On average, the medicine may cost around Rs 1500 per month (not including consultation fees or lab tests).

If you want to avail ART from government ART centers, you will need:

• ICTC report
• Valid address proof
• Photograph

HIV attacks and destroys the immune system's infection-fighting CD4 cells (also known as CD4+ T cells). Loss of CD4 cells makes it hard for the body to fight off infections.

ART prevents HIV from multiplying (making copies of itself), which reduces the amount of HIV in the body (called the viral load). Having less HIV in the body gives the immune system a chance to recover and produce more CD4 cells. Even though there is still some HIV in the body, the immune system is strong enough to fight off infections and certain HIV-related cancers.

By reducing the amount of HIV in the body, ART also reduces the risk of HIV transmission.

The goal of HIV treatment is to reduce a person’s viral load to an undetectable level. An undetectable viral load means that the level of HIV in the blood is too low to be detected by a viral load test. People with HIV who maintain an undetectable viral load have effectively no risk of transmitting HIV to their HIV-negative partners through sex.

To know whether HIV treatment is working, your health care provider regularly monitors clinical and laboratory tests. These include:

• Viral load testing: With treatment, the amount of HIV virus in blood (or viral load) is expected to decrease over time and eventually reach an undetectable level.
• CD4 testing: with effective treatment and a decrease in viral load, the body will replenish immunity with infection-fighting CD4 cells.

Your health care provider will also monitor your wellbeing through clinical check-ups and monitoring of any symptoms.

Viral load is the term used to describe the amount of HIV in your blood. Viral load tests measure the amount of HIV’s genetic material in a blood sample. The viral load test results are described as the number of copies of HIV RNA in a millilitre of blood.

CD4 cells (also known as CD4+ T cells) are white blood cells that fight infection in the body. It serves as an indicator of immune function in patients living with HIV. It is measured at the time of diagnosis of HIV infection, which serves as a baseline, and then every six months.

Good nutrition supports overall health and helps maintain the immune system. A nutritious diet also helps people living with HIV better absorb HIV medicines.

In general, the basics of a healthy diet are the same for everyone, including people living with HIV.

• Eat a variety of foods across food groups: fruits, vegetables, grains, protein, and dairy.
• Eat the right amount of food to maintain a healthy weight.
• Choose foods low in saturated fat, sodium (salt), and added sugars.
• Maintain hydration by drinking a sufficient amount of water daily.

A healthy lifestyle promotes wellbeing for anyone, including people living with HIV. A healthy lifestyle includes:

• Being physically active
• Getting plenty of sleep and rest
• Eating a balanced diet

Yes!

If your partner is HIV negative, remember that HIV does not spread through the air, by sharing food, or by casual contact.

To prevent transmitting HIV to your partner,

• Use condoms during sex
• Take ART regularly and maintain an undetectable viral load
• Consider whether pre-exposure prophylaxis (PrEP) may be a good option for your partner

If your partner is also living with HIV,

• Use condoms during sex to avoid re-infection
• Support your partner to take ART regularly as well
• Do not share HIV medicine with your partner
• Support each other to maintain adherence to treatment and a healthy lifestyle

You should take your HIV medicine regularly—adherence is necessary to reduce HIV infection in your body.

If you miss one dose of your medicine, you should take it immediately whenever you remember it. Continue taking medication from the next day at a regular time.

If you take medicines irregularly, HIV has a higher chance of replicating and developing mutations which will make ART less effective. Eventually, the regimen could become ineffective.

• If you and your partner are both living with HIV: It is unlikely you will pass HIV on to children if you and your partner are both on HIV and your viral load is undetectable. The risk of transmission to children is minimal (<1%) in this case.
• If only you or your partner is living with HIV, the partner who is HIV negative can consider starting PrEP, which reduces the chance of infection, prior to trying to get pregnant

Your health care provider will advise you on how to protect your child. Children born to someone living with HIV will take prophylaxis medication for at least six weeks after delivery.

Please get in touch with your health care provider for further advice on PrEP, or to talk about having children safely.

U=U stands for undetectable=untransmissible. This infers that people living with HIV who are adherent to ART with a consistently undetectable viral load have almost no chance of transmitting HIV through sex.

If your viral load is detectable, ensure that you take HIV medicines regularly as advised by your healthcare provider. Continue taking ART regularly for three months and repeat the viral load test.

If your viral load is detectable even after maintaining proper adherence, talk to your health care provider who may advise changing the ART regimen.

No, undetectable means that ART is suppressing the HIV virus to such an extent that tests cannot detect it. However, the HIV virus still remains in the body.

Yes, condoms should be used as a safe sex practice even if your viral load is undetectable. ART does not protect against other STIs, like syphilis or gonorrhoea, so condoms are important to protect against other STIs.

For people living with HIV, ART needs to be taken lifelong. If you stopped ART, you should consult a health care provider immediately and restart ART under medical supervision as soon as possible.

Your health care provider will advise on the best possible regimen for you.

Alternative medicines cannot cure or stop the progression of HIV; generally, these are not disease-specific.

It is important to consult a health care provider to make sure you are under the supervision of a medical professional before taking any other medicine.

There is no available cure for HIV as of now. ART is the only proven treatment for HIV.

Only the consulting doctor will be able to join your tele-consulting call. Once you are ready and in a private space, you can click on “Start Video Consultation” to start the call.

The System gives you the option to Mute/Unmute your mic as well as Show/Hide your Video.

Yes, your Virtual Counsellor can book your online consultation after you share your consent via the link sent to your phone.

The Doctor will be able to see your Name, Registration Number, Age and Location in addition to any of your previous records available with Safe Zindagi.

The Doctor’s Name & Registration number will be displayed as per the State Medical Council. Further, this information will be available on all Prescriptions, Electronic Communication and Receipts. The Doctor shall issue prescription as per the specified format, which will have their digital signature and the Registration number. The Registration of the RMP can always be counter checked, if desired on the websites of relevant Medical Councils.

You, Your Doctor or your Virtual Counsellor can reschedule the teleconsultation after discussion with you as per the availability of open slots.

As per the Tele-Medicine Guidelines from the Ministry of Health, your teleconsultation will be recorded and stored on a secure server.

We understand that internet connectivity can be unreliable at times; Both you and your doctor can drop/disconnect/leave and re-join the meeting on the same link till the Consultation is marked as Complete and within the 30 minutes window of the slot.

The Safe Zindagi Platform follows the Tele-Medicine Guidelines which have laid down strict norms for the RMPs not to breach the privacy of the patients in any form. However, the RMP cannot be held responsible if there is reasonable evidence to believe that patient’s privacy and confidentiality has been compromised by a technology breach or by a person other than RMP.

All of the Program Data, including your recordings will be stored at a MeITY empanelled Data Center in India.

All of the data will be encrypted during transmission and at rest during storage. Further, access to the data will be restricted to authorized users only and the log of access will be tracked and audited on a periodical basis.