El VIH infecta y destruye las células del sistema inmunitario, produciendo un deterioro progresivo de las defensas del organismo. Sin tratamiento la infección por VIH puede durar asintomática de 5 a 10 años. El Sida ocurre cuando el sistema inmunitario ya no puede combatir las infecciones y otras enfermedades, y se presentan las infecciones oportunistas y ciertos tipos de cáncer. La infección oportunista que más gente afecta y más mortalidad ocasiona es la tuberculosis, por lo que hay programas especiales para trabajar esta coinfección.
Este virus se puede transmitir por el contacto con la sangre, la leche materna, el semen o las secreciones vaginales de personas infectadas. No es posible contagiarse a través de besos, abrazos o apretones de manos o por el hecho de compartir objetos personales, baños, gimnasios, alimentos o bebidas, tampoco por la picadura de mosquitos.
El VIH, a pesar de ser una infección prevenible, sigue siendo un problema de salud pública mundial que aún cobra millones de vidas. Según la OMS hay cerca de 37 millones de personas infectadas por VIH en el mundo y anualmente ocurren más de un millón de muertes por esta causa. Las medidas tomadas para combatir la epidemia han dado resultados positivos; se calcula que entre los años 2000 y 2015 las nuevas infecciones por el VIH han disminuido en un 35% y las muertes relacionadas con el Sida en un 24%. El país ha estructurado su respuesta al VIH y a las ITS incorporando estos aprendizajes en un Plan Nacional que orienta la gestión en salud pública y ha incluido todas las intervenciones recomendadas en los planes de beneficios a los cuales tienen derecho todas las personas residentes en Colombia.
Para prevenir el VIH unas de las acciones más importantes son: la educación sexual integral, asesoría antes y después de las pruebas de VIH, asesoría sobre prácticas sexuales más seguras, reducción de riesgos y promoción del uso del condón. También son esenciales las intervenciones dirigidas a grupos de población claves, incluidos los hombres que tienen que tienen relaciones sexuales con otros hombres, mujeres transgénero, trabajadores sexuales, personas habitantes de calle, personas usuarias de sustancias psicoactivas por vía inyectada, población privada de la liberta, y mujeres en contexto de vulnerabilidad, y otras poblaciones priorizadas. El uso correcto y consistente del condón masculino o femenino es uno de los métodos de protección más eficaces contra el VIH y otras ITS.
Para la prevención a escala poblacional es muy importante que las personas que viven con VIH tomen tratamiento antirretroviral. En la medida que el tratamiento sea efectivo y la carga de virus en la sangre alcance niveles muy bajos en la sangre, la posibilidad de transmitir la infección se reduce hasta en 96%. También existen regímenes de profilaxis preexposición —útil en parejas serodiscordantes (solo uno de los miembros de la pareja vive con el VIH)—, y profilaxis post exposición al VIH —para casos de exposición de riesgo laboral o no laboral como ruptura del condón, relaciones únicas desprotegidas o violencia sexual— queincluye varias intervenciones, entre ellas, la administración de antirretrovirales durante 28 días, así como de antibióticos para prevenir otras ITS y la anticoncepción de emergencia.
Las personas con VIH deben aprender a manejar su condición y recibir la atención integral que ofrece la ruta de atención específica en ITS y VIH, que facilitan el acceso a los cuidados incluidos en las guías de práctica clínica para niñas, niños, adolescentes y adultos. El tratamiento antirretroviral iniciado oportunamente y tomado correctamente permite que las personas con VIH vivan bien y por muchos años. El tratamiento es de por vida, pues hasta el momento no se ha descubierto un tratamiento curativo
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