HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. HIV hurts the immune system by destroying cells called CD4 cells, better known as T cells. These cells help the body fight infections. Eventually, the body doesn’t have enough T cells to fight infections and cancers a healthy immune system can easily fight. These are called opportunistic infections. In this final stage of HIV infection, a person is considered to have AIDS (acquired immunodeficiency syndrome).
HIV is spread through certain body fluids, such as blood and semen. The most common way to get HIV is through unprotected sex with someone who is infected. Another way HIV spreads is through sharing drug needles, or when someone’s blood comes into contact with the blood of an infected person. A woman can pass HIV to her child during pregnancy or childbirth.
A person with HIV has the virus for life because it stays in the body. There is no cure. But there are medicines that can control the infection and prevent HIV from becoming AIDS. With treatment, a person with HIV has the ability to live a normal and healthy life.
It’s important to know if you’ve been exposed and get tested so you can take the medicine in time to fight the virus and keep your immune system healthy.
Symptoms of HIV infection depend on the stage of infection.
- Early stage of HIV. Some people have no symptoms during this stage. This is the most important time to get treatment, so be sure to get tested if there is any chance you’ve been exposed to the virus. Some people have flu-like symptoms within the first 2 to 4 weeks after being infected. Symptoms at this stage include:
- Muscle aches
- Night sweats
- Mouth sores
- Swollen glands
- Clinical latency stage. The virus is slowly establishing itself in the body during this stage, so most people either have no symptoms or have mild symptoms of feeling unwell. This phase can last as long as 10 years or more even without treatment. With treatment, this phase can last for much of the person’s life. A person who is in the clinical latency stage can still spread the virus. But those who are receiving treatment are much less likely to spread it than those with no treatment.
- AIDS development stage. At this stage, the virus has weakened the immune system and the person begins to have serious symptoms. These symptoms may include:
- Weight loss
- Regular fever
- Night sweats
- Extreme tiredness
- Swollen glands in the armpits, groin, or neck that stay swollen
- Diarrhea that lasts for more than a week
- Sores in the mouth, anus, or genitals
- Red, brown, pink, or purplish blotches on the skin or inside the mouth, nose, or eyelids
- Cognitive and mental health problems, like depression and memory loss
See a doctor immediately if you have been exposed to HIV. HIV may be prevented if a certain medicine is taken within 72 hours of exposure.
You can’t rely on symptoms to tell you that you have HIV. Only HIV testing will tell you if you have the infection. About 1 in 7 Americans with HIV is not aware they have it. The Centers for Disease Control and Prevention recommends that everyone between the ages of 13 and 64 gets tested for HIV at least once. People who believe they may have been exposed to HIV or who are at higher risk for HIV should consider getting tested more frequently.
You are at a higher risk for HIV infection and should be tested if you:
- Are a man who has had sex with another man
- Have had anal or vaginal sex with an HIV-infected partner
- Have had more than one sex partner since their last HIV test
- Inject drugs and share needles with others
- Have or had another sexually transmitted disease (STD)
- Have or had hepatitis or tuberculosis (TB)
- Had sex with someone who could fall into any of these categories or whose sexual history you don’t know
HIV infections are caused by the HIV virus that can spread:
- Through anal or vaginal sex with someone who is infected, or by sharing needles or other equipment for injecting drugs.
- From a mother to a child during pregnancy, birth, or breastfeeding. All pregnant women should be tested for HIV.
- When people get stuck with a needle contaminated by HIV. This is a risk mainly for health care professionals and is not very common.
- Through other means that put their blood in contact with infected blood or semen. For example, a person could become infected during oral sex, especially if the person has an open sore in the mouth.
- Rarely, from a blood transfusion because of how carefully donated blood is tested now.
To test for HIV infection, these tests are available:
- Rapid antibody test. These tests use blood from a finger prick or saliva to test for HIV antibodies (blood proteins produced in response to the infection). These tests can be done in a clinic or in other places, and results are ready in 30 minutes or less. There is also a self-test kit you can do by swabbing your mouth for saliva. Some home kits also use a finger prick to collect a blood sample. You send these tests to a lab when you are done. This test is not as good at finding HIV in the very early stages. Most people develop antibodies between 3 and 12 weeks after being infected, so this test won’t detect HIV until at least 3 weeks after infection.
- Antigen/antibody test. This test uses a blood draw from your vein to look for HIV antibodies and antigens. Antibodies are made by your immune system and are a sign that your body is trying to fight HIV. Antigens are things that cause your immune system to become active and ready to fight. An antigen called p24 is produced with HIV infection. This test can find infection 2 to 6 weeks after being infected.
- Nucleic [noo-KLAY-ick] Acid Testing, or NAT. This test looks for the HIV virus in your blood. In addition to telling you whether HIV is present in your blood, this test can tell the viral load— how much of the virus is there. This test is expensive and is used mostly for people who are at high risk and believe they were exposed to the virus. This test can detect HIV from 1 to 4 weeks after infection. It’s not as good as an antibody test for detecting HIV in people who are taking medicine to prevent getting HIV. See the “Treatment” section for more information about this medicine. If you were exposed and this test shows that you don’t have the virus, your doctor may recommend doing an antibody test to follow up.
Talk to your doctor about which test is best for you. Follow up with your doctor if you have an HIV test that comes back positive (shows you have the virus).
See a doctor immediately if you have been exposed to HIV. HIV may be prevented if a certain medicine is taken within 72 hours of exposure to the virus.
Treatment begun later can’t cure you. However, certain medicines can slow down the spread of the virus. Medicines that treat HIV are called antiretrovirals (ARVs) because the HIV virus is one type of retrovirus.
Doctors use a combination of ARV medicines to treat HIV infection. This is called antiretroviral therapy (ART). This therapy can keep you healthy for many years and reduce your chances of giving HIV to someone else.
Everyone infected with HIV should have ART, no matter how long they’ve been infected, how healthy they are, or whether they have symptoms. The sooner you start treatment, the better it will work to keep you healthier longer.
Some forms of HIV are resistant to antiretroviral medicines. You can reduce the risk of drug-resistant HIV by taking your medicine exactly as prescribed.
Not having oral, vaginal, or anal sex is the only sure way to prevent HIV infections. However, the risk of getting an HIV infection is much lower if you:
- Use a condom for anal or vaginal sex. Use a male condom or female condom every time you have sex. Receptive anal sex (receiving anal sex) is the riskiest type of sex for HIV. Be especially careful to take preventive steps if the person inserting the penis has HIV infection and the receptive partner doesn’t.
- Limit the number of sexual partners you have. Having fewer partners lowers your chances of having sex with someone infected with HIV.
- Don’t share needles or other equipment used to inject drugs.
- Talk to your doctor about pre-exposure prophylaxis (PrEP). If you are at very high risk for HIV infection, your doctor may recommend PrEP, a medicine you take every day to prevent HIV infection.
- Take post-exposure prophylaxis (PEP) if you think you were exposed to HIV. If you think you were exposed to HIV, you can take PEP before being diagnosed with HIV. You should call your doctor right away or go to the emergency room so you can start PEP within 3 days of an exposure
- Get tested, and encourage your sexual partners to do the same. You can take steps to prevent the spread of HIV when you know who is infected.
- Take your medicine to prevent spreading the infection to your baby. Be sure to get tested for HIV when you’re pregnant. If you have HIV, take your medicine to keep the virus in check so you don’t spread it to your baby. You can also reduce the chances of spreading the infection to the baby by not breastfeeding your baby.
If you are infected with HIV, prevent spread of HIV by taking your medicine. The best thing you can do to prevent spreading HIV is to get ART and take your medicine exactly as the doctor tells you. When you suppress the virus, you reduce the chance that you will spread it to someone else.