HIV Overview

On This Page: Symptoms | Stages | Causes | Risk Factors | Prevention

What is Human Immunodeficiency Syndrome (HIV)?

HIV (human immunodeficiency virus) is the virus that causes AIDS. It attacks the cells of your immune system, making you more vulnerable to get sick or even die from illnesses your body would normally be able to fight off. HIV is spread through sex, so condoms help protect you.

Approximately 1.1 million people in the United States are living with HIV. About 14% (1 in 7) are unaware that they are infected.¹ Because many people with HIV don’t show symptoms for years after infection, getting tested is important for early detection, and it can even be lifesaving.

Although there is no cure, medication can help people with HIV have a near-normal life span and a healthy quality of life. HIV treatment can also manage the condition to help the virus become non-transmittable.

What’s the Difference Between HIV and AIDS?

HIV and AIDS are not the same thing. HIV is a virus that makes copies of itself and can eventually lead to the condition AIDS. Not all people with HIV have AIDS. However, anyone diagnosed with AIDS has previously contracted HIV.

AIDS stands for acquired immunodeficiency syndrome. It is the third and final stage of HIV infection when the virus has caused serious damage to the immune system. HIV destroys immune cells called CD4 cells, or T cells. You have AIDS when your CD4 cells reach a dangerously low amount (below 200 cells/mm) or if you develop opportunistic illnesses.²

When the body’s defense has deteriorated, it is no longer able to properly protect against infection or detect faulty cells. Therefore, people living with AIDS can develop opportunistic infections that the body would otherwise be able to fight off, or types of cancer.³

Signs and Symptoms

Many people with HIV don’t show symptoms right away. Because they feel fine, they don’t know they have it and might unknowingly spread the virus. Some people with HIV experience a flu-like illness within 2-4 weeks of infection, but this passes after a short time and can be easy to overlook. It can take years for someone with HIV to start feeling really sick.

If someone with HIV does not get tested and treated, they will progress through the three stages of HIV, which are marked by different signs.

Stages of HIV

Early HIV – Acute Infection Symptoms

Acute HIV is the earliest stage of HIV infection, and it generally develops within 2 to 4 weeks after infection. Some (but not all) people may experience flu-like symptoms.⁴ These first signs can be mild and easily mistaken or dismissed as something else.

Early HIV symptoms include:

• Fever
• Swollen lymph glands
• Body rash
• Fatigue
• Joint pain
• Muscle ache
• Sore throat
• Headache
• Upset stomach

During this stage, the virus multiplies at a rapid rate, spreading throughout the body. The concentration of HIV is very high, so there is a great risk of transmission. In response, your body begins to produce antibodies in a process called seroconversion to try to fight the virus.

Chronic HIV Infection Symptoms (Clinical Latency)

This stage is typically asymptomatic, meaning that it shows no symptoms. This doesn’t mean the virus is gone. It is still transmittable and active, duplicating at low levels and continuing to infect new cells. At the end of this phase, the viral load increases, and the CD4 cell count decreases, so the person may begin to have third-stage symptoms.

AIDS Symptoms

When someone has AIDS, their immune system is severely damaged, and they are more likely to suffer from serious or even life-threatening diseases and rare bacterial or fungal infections.

AIDS symptoms include:⁵

• Weight loss
• Chronic diarrhea
• Weakness
• Fever
• Night sweats
• Swollen lymph glands
• Mouth and skin problems
• Oral thrush, a yeast infection in the mouth
• Persistent cough
• Genital/anal sores
• Memory loss
• Pneumonia

How Is HIV Spread?

HIV can be transmitted only through certain body fluids: blood, semen, vaginal fluids, anal fluids/mucus, and breast milk. You can contract HIV if the virus enters your body through mucous membranes like the vagina, the rectum, the opening of the penis. It can also enter the body through cuts or sores on your skin.

Most commonly, HIV is spread through:

• Unprotected anal and vaginal sex
• Shared needles or syringes, such as contaminated drug equipment

The risk of acquiring HIV depends on the type of sexual activity.⁶ Unprotected receptive anal sex (bottoming) is the highest-risk sexual behavior. This is because rectal tissue is thin and fragile and tearing occurs easily.⁷ An insertive partner (or top) can also get HIV through the urethra at the tip of the penis or through cuts or sores on the penis.

Pregnant women with HIV can pass HIV to their baby during pregnancy, labor, childbirth, or breastfeeding. Taking HIV medicine helps lower the risk of mother-child transmission and keep both the mother and baby healthy.

You can’t get HIV from:

• Saliva, tears, or sweat
• Closed-mouth kissing
• Using a toilet
• Close contact like hugging or holding hands
• Coughing or sneezing
• Mosquitoes

Who Is At Risk?

Anyone can get HIV, regardless of sexual orientation, gender, race, or age. That being said, gay and bisexual men are the population most affected by HIV, making up more than half of the people living with HIV. The CDC recommends that sexually active men who have sex with men get tested at least once a year for HIV.⁸

You may be at increased risk of getting HIV if you have:

• Risky, unprotected vaginal or anal sex without a condom, especially with a partner that has a high viral load
• Shared needles, syringes, or other equipment for drug injection
• Sex with multiple partners
• Sex while high from drugs or intoxicated
• Other STDS

How Long Does It Take for HIV to Develop into AIDS?

Without treatment, it usually takes about 8–10 years to develop AIDS after initial HIV infection.⁹ It can advance slower or quicker depending on factors like age and general health. HIV treatment makes it possible to slow down the progression, and some people can live with HIV without ever developing AIDS. This is why getting tested for HIV and knowing your status is so crucial.

Is HIV/AIDS Fatal?

Untreated HIV develops into AIDS, which eventually leads to death. HIV itself does not kill most people, but it compromises the immune system so that people with HIV/AIDS are more likely to die from pneumonia, diarrhoeal illnesses, brain infections, or certain tumors such as cervical lymphoma.

Without treatment, people with AIDS generally survive for about 3 years. But having HIV is not a death sentence, thanks to modern medicine. It is very important you seek treatment if you know you have HIV/AIDS so that you can manage the virus. Proper medication lowers the amount of HIV in the body and slows the virus’ progression.

Types of HIV

There are two main types of HIV: HIV-1 and HIV-2. As with other viruses, HIV has different strains and variants. While HIV-1 and HIV-2 are different, both can lead to AIDS. HIV-1 is the most common type and accounts for around 95% of infections worldwide. HIV-2 is not commonly seen outside of West Africa, but it has been seen in other places. HIV-2 is generally less infectious and takes longer to progress to AIDS compared to HIV-1.¹⁰

Is There a Cure for HIV?

No, once you have HIV, it is a lifelong infection. That being said, people living with HIV can take medicine to reduce the amount of virus in the blood and other bodily fluids. This medicine is called antiretroviral therapy (ART), and it helps you suppress the virus and stay healthy for many years. In fact, by following treatment, it is possible to achieve an undetectable viral load, meaning that viral levels are so low that tests can’t detect it. People with an undetectable viral load have effectively no risk of spreading HIV to partners during sex.

How Do You Prevent HIV?

Condoms and Lubricants

You can lower your risk of getting or spreading HIV by using latex or polyurethane condoms correctly every time you have sex. Water- or silicone-based lubes can help prevent condom breakage and torn tissue during sex. Since condoms are not 100% effective, other prevention methods can further lower your risk.

PrEP

PrEP stands for pre-exposure prophylaxis. It is a pill taken daily by mouth that can stop HIV from taking hold and spreading. The CDC reports that PrEP is highly effective, reducing the risk of getting HIV from sex by about 99% and reducing the risk for people who inject drugs by at least 74%.¹¹

PEP

PEP stands for post-exposure prophylaxis. It is an antiretroviral medicine (used to treat HIV), and it is taken only in emergencies after being potentially exposed to the virus (for example, if the condom broke, you shared needles or drug equipment, or were sexually assaulted).

PEP must be started as soon as possible, within 72 hours (3 days) of a possible HIV exposure. Every hour counts, so the sooner you start PEP, the better.

Lower Risk Sexual Activities

Certain behaviors like oral sex have little to no risk of HIV transmission.¹² However, oral sex can spread other STDs like herpes, syphilis, chlamydia, and gonorrhea, so it’s recommended to use protection like condoms and dental dams.

Being in a mutually monogamous relationship with someone who has tested negative or limiting your amount of sexual partners can also lower your chances of getting or spreading HIV.

By talking openly with partners and getting tested for HIV, you can protect your health. Getting tested for HIV is the only way to know for sure if you have it. If you do, knowing your status can help you get the support and treatment. The proper care and medicine can keep an HIV-positive person healthier and prolong their life.

Medically Reviewed by J. Frank Martin JR., MD on February 5, 2020

Written by Taysha on January 29, 2020

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