There can be a lot of misinformation and misconceptions about the human immunodeficiency virus, otherwise known as HIV.
Below, we answer some of the most frequently asked questions to help you understand more about the virus, including how it is transmitted, who may be at risk, and treatment options.
What exactly is HIV?
HIV is a virus that attacks and weakens the immune system, making it more difficult for the body to fight disease. Blood and semen are among the bodily fluids that spread it.
HIV is currently incurable. But there is treatment to help people with HIV live healthy lives.
How is HIV different from AIDS?
HIV can lead to acquired immunodeficiency syndrome (AIDS) if left untreated. This progression can take an average of 5 to 10 years.
AIDS is the final and most serious stage of HIV infection, in which the body struggles to fight infection and disease because the virus has destroyed too many white blood cells. White blood cells play a crucial role in the immune system and help fight infections.
Symptoms may include:
- persistent fevers, diarrhea and headaches
- severe fatigue
- significant weight loss
- opportunistic infections such as pneumonia and tuberculosis
- AIDS is ultimately fatal.
Who is at risk for HIV?
Some people are more at risk of contracting HIV than others. They include:
- people who have penises who have sex without a condom with other people who have penises
- people who have had penetrative vaginal or anal sex without a condom with someone who is HIV positive
- people who share syringes or needles or come into contact with infected blood in other ways
- children whose natural parent is HIV positive
How is HIV transmitted?
HIV can be transmitted through a variety of body fluids, including:
- pre-ejaculated
- semen
- blood
- vaginal secretions
- rectal secretions
- breast milk
The fluid must come into contact with another person’s bloodstream through cuts, sores, or mucous membranes to transmit the virus.
Many cases of transmission involve vaginal or anal sexual intercourse with penetration without a condom or other barrier methods. HIV can spread through oral sex, but the risk is regarded as being significantly lower.
Sexual transmission is only possible if an HIV-positive person has a detectable viral load. The viral load can become undetectable with effective treatment.
Sharing needles and syringes while injecting drugs is another high-risk activity if a person is HIV positive.
It is also possible for a pregnant person with HIV to pass the virus to the baby before, during, or after birth (after birth, the virus can be passed through breast milk).
According to the Office on Women’s Health, the risk of transmitting HIV to a baby is less than 1 percent if the pregnant person receives treatment and has an undetectable viral load.
How is HIV not transmitted?
It is impossible to contract HIV from close, nonsexual contact with others.
This means you don’t have to worry if someone coughs or sneezes near you, if you shake or hold someone’s hand, or if you visit public places like bathrooms or swimming pools.
Additionally, HIV cannot be transmitted through saliva, so you can safely kiss and share food, drinks or cutlery with others.
What does U=U mean?
U=U is short for an information campaign. It means undetectable = untransmittable.
Explain why regular and effective treatment is so important.
If a person with HIV receives treatment and consistently maintains an undetectable viral load, there is essentially no risk of him or her transmitting the virus to a sexual partner.
How can you reduce your risk of HIV?
The best way to prevent HIV transmission is to abstain from partnered sexual activity and never share syringes and needles with others. It is the only 100% effective method.
However, you don’t have to (unless you want to) take your sex life too seriously. You can lower your risk overall by:
- be honest and open about STD status, including HIV, with each sexual partner
- use barrier methods such as condoms consistently and correctly every time you have sex
- taking pre-exposure prophylaxis (PrEP)
- Get tested regularly for sexually transmitted diseases
- treat any sexually transmitted diseases found
What is pre-exposure prophylaxis (PrEP)?
PrEP is a drug you can take regularly to further reduce your risk of contracting HIV. It is available in pill or injection form and stops the virus from multiplying inside your body.
When taken correctly, PrEP can reduce the risk of sexual transmission of HIV by about 99%, according to the Centers for Disease Control and Prevention (CDC).
PrEP tablets can lower the risk of HIV infection in injecting drug users by at least 74%. The PrEP injection is not recommended for people who use injected medications.
Although people at higher risk for HIV are more likely to use PrEP, anyone who is sexually active can use it.
It may be right for you if:
- you have an HIV-infected sexual partner who has an unknown or detectable viral load
- you have multiple sexual partners
- you inject drugs and share the equipment with others
- you have been prescribed post-exposure prophylaxis (PEP) on multiple occasions
- Talk to a doctor or other healthcare provider if PrEP is something you would like to explore.
What is post-exposure prophylaxis (PEP)?
Unlike PrEP which acts as prevention, PEP is taken after a potential exposure to HIV to help prevent the virus from replicating.
You may get PEP if you have had sex without a condom with someone who has or may have HIV, if you have shared drug-injecting equipment with others who may have the virus, or if you have been sexually assaulted.
Think of PEP as an emergency treatment. PEP pills are taken for 28 days, but treatment must be started within 72 hours of possible exposure to HIV. The earlier you start, the more effective PEP is.
How often should you get tested for HIV?
According to the CDC, everyone between the ages of 13 and 64 should be tested for HIV at least once.
Some people may need to get tested more frequently. If you are at increased risk of contracting HIV, the CDC recommends getting tested at least once a year.
It may be a good idea for those who have a penis and engage in penis-to-penis sexual activity to get tested every three to six months.
Pregnant people should also get tested in the early stages of pregnancy.
How is HIV diagnosed?
There is no single test that can diagnose HIV: there are a few.
But everyone has a different window for when they can accurately detect the virus after potential exposure.
Nucleic acid tests, which detect the virus in the blood, are often effective as soon as possible after exposure, between 10 and 33 days. Antibody tests are typically used 23 to 90 days after exposure.
Rapid antigen/antibody tests using blood from a finger prick can be used 18 to 90 days after exposure. Rapid antigen/antibody tests that use blood drawn from a vein are designed to be used 18 to 45 days after potential exposure.
If you receive a negative result, you should take a second test after the window to make sure you don’t have HIV.
Positive results are also checked with a second test before the diagnosis is made.
What are the early symptoms of HIV?
HIV symptoms come in three stages.
The first stage often causes flu-like symptoms, including:
- fever
- sore throat
- heachache
- fatigue
- muscle and joint pain
People may also notice swollen lymph nodes, mouth sores, or an itchy, bumpy rash. However, some initial symptoms are so mild as to be almost unnoticeable.
Does sex assigned at birth influence the onset of symptoms?
HIV symptoms are similar in everyone. But there may be some differences.
For example, people classified as male at birth may be more likely to experience spots, sores, or other visible changes to their genitals.
People assigned female at birth have a higher risk of vaginal infections and pelvic inflammatory disease, as well as changes in their menstrual cycle.
How long does it take for symptoms to appear?
The HIV flu-like symptoms mentioned above may begin to appear approximately 2-4 weeks after exposure and may last days or weeks.
In cases where only mild symptoms occur, it can take a decade or more for people to experience noticeable symptoms.
How is HIV treated?
Antiretroviral therapy (ART) can treat HIV to the point where it is no longer detectable in the blood. This means that the virus will not progress to later stages, such as AIDS, and is unlikely to be transmitted to others through sexual activity.
But it is important to remember that there is currently no cure for HIV, so lifelong treatment is required.
Antiretroviral drugs work by blocking the virus from replicating within the body and preventing further damage to the immune system. Sometimes a combination of medications is needed, but these can be combined into a single daily pill.
Most people taking antiretroviral drugs for HIV have an undetectable viral load within 6 months.
Where can you learn more about HIV?
To find out more about HIV, including where to get tested, treated and find support, visit these sites:
- HIV Basics from the CDC
- HIV.gov
- National information network on prevention
The bottom line:
Getting tested regularly for sexually transmitted diseases and practicing safe sex and drug use are the best ways to prevent HIV.
The virus is incurable. But if you test positive, treatment can help you live a healthy life, manage any symptoms, and reduce your risk of transmitting the virus to others.