Human immunodeficiency virus (HIV) is a sexually transmitted disease (STD) that attacks your immune system, making it harder for your body to fight off infections and disease. Although HIV is most commonly spread through contact with bodily fluids during unprotected sex, it can also be passed by sharing needles while injecting drugs. Left untreated, HIV can lead to acquired immunodeficiency syndrome (AIDS). Currently, there isn't an effective cure for HIV, but it can be controlled with appropriate medical care.
- 1 About one in seven people with HIV, or 14%, are unaware they’re infected.
- 2 Male-to-male sexual contact makes up 66% of all HIV diagnoses.
- 3 The CDC recommends that people at higher risk get tested annually.
- 4 The most common way HIV is spread is by having vaginal or anal sex with an HIV-positive partner without protection.
Written by Moira K. McGhee
HIV remains an unrelenting problem in the United States and around the globe. Approximately 1.1 million people in the United States were living with HIV at the end of 2015, with 38,700 new cases reported in 2016 and 38,739 new cases in 2017. About one in seven people with HIV, or 14%, are unaware they’re infected.
In 2017, male-to-male sexual contact made up 66% of all HIV diagnoses. African Americans were most affected, making up 43% of all new HIV diagnosis that year. Young people aged 13 to 24 accounted for 21% of new diagnoses, and gay and bisexual men in this age bracket accounted for 83% of this number. Young African American gay or bisexual men in this age bracket were the most severely impacted.
This guide provides basic information on the STD known as HIV. Readers will learn about common symptoms of HIV and how it can progress to AIDS if left untreated. Other information discussed includes testing options and where to get tested. Treatment options for HIV and how to prevent HIV exposure are also covered.
|Formal Name||Human immunodeficiency virus|
|Other Commonly Used Names||HIV, Pre-AIDS, The Virus, Hi-Five, The Deadliest Catch|
|Testing Collection Method||Blood, oral fluid, urine|
|Transmission||Primarily unprotected anal or vaginal sex; sharing needles or other drug-injection equipment; from mother to child during pregnancy, birth, or breastfeeding|
Overview of HIV Testing
The purpose of HIV testing is to screen for the presence of the virus in your body. The only sure way to know whether you’re HIV-positive is to get tested. As part of your routine health care, the Centers for Disease Control and Prevention (CDC) recommends everyone between 13 and 64 years of age get tested at least one time. If it’s been more than a year since you tested HIV-negative, the CDC recommends you get tested right away if you’ve:
- had male-to-male sexual intercourse
- had anal or vaginal sex with an HIV-positive partner
- injected drugs or shared needles or any other intravenous drug equipment
- had more than one sexual partner since your previous test
- been diagnosed with another STD
- been diagnosed with tuberculosis or hepatitis
- had sex with someone whose sexual history is unknown to you
- had sex with someone with a high-risk sexual or drug-use history
The CDC recommends that people at higher risk get tested annually, but sexually active gay and bisexual men should get tested even more frequently. There are three types of HIV tests available, including the nucleic acid, antigen/antibody, and antibody tests. HIV tests are typically performed on blood or oral fluid, but they may also be performed on urine. No preparation is needed for HIV testing, other than you may have to schedule an appointment with your doctor.
How an HIV Infection Works
HIV can only be transmitted through certain body fluids from an HIV-positive person, which includes pre-seminal fluid, semen, vaginal fluid, rectal fluid, blood, and breast milk. The most common way HIV is spread is by having vaginal or anal sex with an HIV-positive partner without the protection of a condom and/or when they’re not taking medicines that treat or prevent HIV. Sharing needles or other equipment used to prepare drugs for intravenous injection is also a common way to contract the virus.
Less common ways of transmission are from a mother to her child during pregnancy, birth, or breastfeeding and from being stuck with an HIV-contaminated needle. While extremely rare, HIV may also be spread by having oral sex, getting a blood transfusion, being bitten by an HIV-positive person, or direct contact between HIV-infected blood and broken skin, an open wound, or mucous membranes. There are three stages of HIV with distinct symptoms that vary from one person to the next.
The Symptoms of HIV
There are several potential symptoms of HIV, which vary based on the individual and what stage they’re in. Not every HIV-positive person will have the same symptoms. Some common symptoms you may experience in each stage include:
Stage 1: Acute HIV Infection
While some people won’t have any symptoms during stage one, about two-thirds of people experience flu-like symptoms within two to four weeks of becoming infected. However, symptoms may take longer to appear in some people. If symptoms do occur, they may last anywhere from a few days to several weeks and include:
- Night sweats
- Sore throat
- Swollen lymph nodes
- Mouth ulcers
- Muscle aches
- Joint pain
During this stage, the viral load in your bloodstream is quite high, and your body’s immune system is attempting to fight off the virus. It’s extremely easy to transmit HIV to others during this time, but you can still spread HIV even if you don’t feel sick and have mild or no symptoms.
Stage 2: Clinical Latency
This stage is also called chronic HIV infection, and some people don’t have any symptoms or feel sick at all during this time. However, some people may have persistent swelling of lymph nodes during this stage. The virus continues to multiply throughout this stage, slowly destroying the cells in your immune system.
Without treatment, you may move through this stage quickly or stay in this stage for 10 years or more before entering stage three. Getting HIV treatment may delay or even keep you from entering stage three while preventing transmission of the virus to others. It’s vital to follow your treatment exactly as prescribed by your doctor.
Stage 3: AIDS
Without treatment, and potentially even with treatment, your immune system eventually becomes weakened by the disease. If your immune system becomes severely damaged, you may progress to the final stage, or AIDS. Symptoms are often a side effect of an opportunistic infection and may include:
- Chronic fatigue
- Long-lasting, recurring fever
- Rapid weight loss
- Profuse night sweats
- Chronic, severe diarrhea
- Thrush or unusual lesions in your mouth
- Prolonged swelling of the lymph glands
- Skin rash or purple spots on or under your skin
- Memory loss
The amount of time it takes for HIV to become AIDS is different for everyone. Taking your HIV medication every day as prescribed by your doctor may stop the progression of the virus and prevent you from ever entering stage three.
Testing for HIV
HIV tests are usually performed on blood or oral fluid, but they may also be done on urine. There are three types of HIV tests available, including:
- Nucleic acid tests (NAT) are blood tests that look for the actual virus, not the antibodies, so these tests can detect HIV the soonest. A NAT test can usually provide a positive or negative result 10 to 33 days after exposure, but taking pre-exposure or post-exposure medications can reduce the accuracy of the test. NAT tests can also be used to determine the amount of virus present in the blood of HIV-positive patients, which is called an HIV viral load test.
- Antigen/antibody tests are what most laboratories now use to look for HIV antibodies and antigens. These tests are performed on blood taken from a vein and can usually detect HIV 18 to 45 days after exposure. If the test is done from a finger-stick, instead of a venous blood sample, it can take 18 to 90 days to detect infection. Rapid antigen/antibody tests are also available.
- Antibody tests look for HIV antibodies in blood or oral fluid. Usually, antibody tests can reliably detect HIV in 23 to 90 days. Antibody tests using blood taken from a vein detects HIV sooner than those using oral fluid or blood from a finger-stick. Most rapid screening tests and home tests are antibody tests.
- Rapid tests performed in clinical and nonclinical facilities are usually done through a finger-stick or oral fluid with results in 30 minutes or less.
- At-home testing is available for HIV. Oral fluid antibody self-test kits require you to swab your mouth and test the sample yourself — results are available in 20 minutes. For blood collection kits, a small amount of blood is collected and sent into a lab to analyze the results. If you test positive for any at-home test, you must schedule follow-up testing with a health care provider.
You can purchase a home testing kit online or at various pharmacies, or you can ask your doctor to give you an HIV test. Many hospitals, medical clinics, community health centers, and substance abuse treatment programs also offer HIV testing. You can also find a testing site near you by visiting gettested.cdc.gov, texting your ZIP code to KNOW IT (566948), or contacting the CDC at 800-CDC-INFO (232-4636).
Treatment for HIV
Because HIV is a retrovirus, it’s treated with a combination of drugs called antiretroviral therapy (ART). This treatment is recommended for everyone with HIV, no matter how long they’ve had the virus. However, the U.S. Department of Health and Human Services recommends you begin ART as soon after diagnosis as possible. ART is recommended even if you’re healthy to reduce the chance of passing the virus onto others. ART is usually a combination of three or more drugs, but your doctor may change your prescription if the medicines you’re taking aren’t working as well as they should.
Frequently Asked Questions
How is a home HIV test used?
There are two available at-home testing kits for HIV — oral fluid antibody kits and blood collection kits. The tests require either a swab of saliva (oral antibody test) or a small amount of blood. If you test positive, always schedule a follow-up test with a health care provider.
How can you order an HIV test?
Home HIV testing kits are available online and at many pharmacies. You can also get tested at numerous places, including doctor’s offices, community health centers, health clinics, STD clinics, family planning clinics, pharmacies, and local health departments, or through substance abuse treatment programs and various community-based programs.
What does a positive result for HIV mean?
If your HIV test result is positive, a follow-up test is conducted. A positive result on a follow-up test means you have HIV. You must begin taking HIV medicine daily as prescribed to prevent passing it to others and to live a longer, healthier life. You should also contact previous sexual partners to let them know they should be tested and practice safe sex with current and future partners. You may also want to seek counseling to help you emotionally handle your diagnosis.
What does a negative result for HIV mean?
If you test negative for HIV, it doesn’t necessarily mean you don’t have HIV. The time between exposure to HIV and testing positive for the virus varies. If you took a blood test, take another one in 45 days, but for all others, get tested again in 90 days. If you test negative and haven’t done anything that would expose you to HIV in three months, it’s unlikely you have HIV, and you should take steps to prevent getting the virus.
HIV prevention medications called pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) help protect you from getting HIV. Other prevention methods you should use include always using a condom during sexual intercourse, limiting your sexual partners, choosing less risky sexual behaviors, practicing abstinence, and entering a mutually monogamous relationship with a partner who is also HIV-negative. If you’re HIV-negative, but your partner is HIV-positive, encourage them to get HIV treatment to protect you from transmission by obtaining an undetectable viral load.
What does an undetectable viral load mean?
Having an undetectable viral load doesn’t mean you’re cured. You will always have HIV, but by taking medications that lower your viral load to a point it’s undetectable in monitoring tests you have less HIV in your body. With fewer copies of the virus in your body, it’s unable to attach your immune system and cause damage. This lets you live a longer, healthier life and prevents you from transmitting the virus to others during sexual encounters.
What’s important to know about HIV?
One of the most important things to know is that being HIV-positive doesn’t mean you have AIDS. However, if you don’t take care of your health and follow your doctor’s prescribed treatment plan, HIV can lead to AIDS, which is the most advanced, life-threatening stage of the virus.
Another important aspect is the type of testing available. You can take an anonymous test, and only you will know the results. You get your results using a unique identifier, but nothing ties you to your test results. You can also get confidential testing, which does attach your name to the results and becomes part of your medical record. However, this information is protected by state and federal privacy laws and can only be released with your permission. Confidential testing with HIV-positive results are shared with local health departments who share this information with the CDC, but your name and other identifying information are removed from the report.
It’s also important to share your HIV status with your sexual partners. If you’re afraid to disclose your test results for fear of retribution, you can request partner notification services from your doctor or local health department. During notification, your name is never revealed, your previous sexual partners are simply told they’ve been exposed to HIV and they should get tested. Some states can charge you with a crime, regardless of transmission, if you don’t inform your partner that you’re HIV-positive.
How long does it take to get results from an HIV test?
The time it takes to get your results back depends on the type of test you took. Laboratory-based antibody tests can take several days to get back, depending on the lab. With rapid antibody screening tests, results are typically available in 30 minutes or less. Results from an oral fluid antibody test performed with a swab from your mouth are ready in 20 minutes.
- CDC.gov is a great source of information on the spread of HIV, its symptoms, and treatment solutions. The website also has a search tool to help you find convenient testing near you.
- The federal government manages a site, HIV.gov, that discusses ways to end the HIV epidemic and includes a listing of HIV awareness days.
- The U.S. Department of Health and Human Services has a website with a focus on AIDS treatment solutions, including clinical trials and FDA approved drugs.
- Pregnant women who test positive for HIV can find reliable information on managing the virus during pregnancy and delivery at the American College of Obstetricians and Gynecologists website.
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