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Understanding HIV: Basics and Facts
Understanding HIV: Basics and Facts
Written by Hannah May
Updated over a week ago

What is HIV?

  • HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome).

  • There is currently no effective cure. Once people get HIV, they have it for life.

  • But with proper medical care, HIV can be controlled. People with HIV who get effective HIV treatment can live long, healthy lives and protect their partners.

How is HIV spread?

The spread of HIV from person to person is called HIV transmission. HIV is spread only through certain body fluids from a person who has HIV. These body fluids include:

  • Blood

  • Semen

  • Pre-seminal fluid

  • Vaginal fluids

  • Rectal fluids

  • Breast milk

HIV transmission is only possible through contact with HIV-infected body fluids. In the United States, HIV is spread mainly by:

  • Having anal or vaginal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV

  • Sharing injection drug equipment (works), such as needles or syringes, with someone who has HIV

The spread of HIV from a woman with HIV to her child during pregnancy, childbirth, or breastfeeding is called perinatal transmission of HIV.

You cannot get HIV by shaking hands or hugging a person who has HIV. You also cannot get HIV from contact with objects, such as dishes, toilet seats, or doorknobs, used by a person with HIV. HIV is not spread through the air or water or by mosquitoes, ticks, or other blood-sucking insects. Use the HIVinfo You Can Safely Share…With Someone With HIV infographic to spread this message.

Are there symptoms?

  • For many, yes. Most people have flu-like symptoms within 2 to 4 weeks after infection. Symptoms may last for a few days or several weeks.

  • Having these symptoms alone doesn’t mean you have HIV. Other illnesses can cause similar symptoms.

  • Some people have no symptoms at all. The only way to know if you have HIV is to get tested.

HIV symptoms

Graphic courtesy of the CDC

What are the stages of HIV?

When people with HIV don’t get treatment, they typically progress through three stages. But HIV treatment can slow or prevent the progression of the disease. With advances in HIV treatment, progression to Stage 3 (AIDS) is less common today than in the early years of HIV.

Stage 1: Acute HIV Infection

  • People have a large amount of HIV in their blood and are very contagious.

  • Many people have flu-like symptoms.

  • If you have flu-like symptoms and think you may have been exposed to HIV, get tested.

Stage 2: Chronic HIV Infection

  • This stage is also called asymptomatic HIV infection or clinical latency.

  • HIV is still active and continues to reproduce in the body.

  • People may not have any symptoms or get sick during this phase but can transmit HIV.

  • People who take HIV treatment as prescribed may never move into Stage 3 (AIDS).

  • Without HIV treatment, this stage may last a decade or longer, or may progress faster. At the end of this stage, the amount of HIV in the blood (viral load) goes up and the person may move into Stage 3 (AIDS).

Stage 3: Acquired Immunodeficiency Syndrome (AIDS)

  • The most severe stage of HIV infection.

  • People with AIDS can have a high viral load and may easily transmit HIV to others.

  • People with AIDS have badly damaged immune systems. They can get an increasing number of opportunistic infections or other serious illnesses.

  • Without HIV treatment, people with AIDS typically survive about three years.

How can a person reduce the risk of getting HIV?

  • To reduce your risk of HIV infection, use condoms correctly every time you have sex, limit your number of sexual partners, and never share injection drug equipment.

  • Also talk to your health care provider about pre-exposure prophylaxis (PrEP). PrEP is an HIV prevention option for people who do not have HIV but who are at high risk of becoming infected with HIV. PrEP involves taking a specific HIV medicine every day.

  • HIV medicines, given to people with HIV during pregnancy and childbirth and to their babies after birth, reduce the risk of perinatal transmission of HIV. Pregnant people with HIV are encouraged to talk to their medical team about options for feeding their baby after birth. With consistent use of HIV medication and an undetectable viral load during pregnancy and throughout breastfeeding, the risk of transmission to a breastfed baby is low: less than 1%, but not zero. Alternatively, properly prepared formula and pasteurized donor human milk from a milk bank are options that eliminate the risk of transmission to a baby after birth. Pregnant people with HIV can speak with their health care provider to determine what method of feeding their baby is right for them.

What is the treatment for HIV?

  • Antiretroviral therapy (ART) is the use of HIV medicines to treat HIV infection. People on ART take a combination of HIV medicines (called an HIV treatment regimen) every day.

  • ART is recommended for everyone who has HIV. ART prevents HIV from multiplying, which reduces the amount of HIV in the body (called the viral load). Having less HIV in the body protects the immune system and prevents HIV infection from advancing to AIDS. ART cannot cure HIV, but HIV medicines help people with HIV live longer healthier lives.

  • ART also reduces the risk of HIV transmission. A main goal of ART 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 partner through sex.

What is the connection between HIV and HBV?

Both HIV and HBV spread from person to person in semen, blood, or other body fluids. For this reason, the main risk factors for HIV and HBV are the same: having sex without a condom and injection drug use.

According to the Centers for Disease Control and Prevention (CDC), approximately 10% of people with HIV in the United States also have HBV. Infection with both HIV and HBV is called HIV/HBV coinfection.

Chronic HBV advances faster to cirrhosis, end-stage liver disease, and liver cancer in people with HIV/HBV coinfection than in people with only HBV infection. But chronic HBV does not appear to cause HIV to advance faster in people with HIV/HBV coinfection.

Should people with HIV get tested for HBV?

CDC recommends that all people with HIV get tested for HBV. Testing can detect HBV even when a person has no symptoms of the infection.

There are several HBV blood tests. Results of different tests show different things. For example, a positive hepatitis B surface antigen (HBsAg) test result shows that a person has acute or chronic HBV and can spread the virus to others.

To learn more about HBV tests, visit the CDC webpage Hepatitis B Questions and Answers for the Public.

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