The human immunodeficiency virus, or HIV, weakens your immune system so it can't fight off common germs, viruses, fungi, and other invaders. It's the virus that causes AIDS, acquired immune deficiency syndrome. Someone with HIV can get sick from things that don't usually affect people, and people with AIDS tend to get certain uncommon diseases and illnesses.
Anyone can get HIV. Both men and women can spread HIV. A person with HIV can feel OK and still give the virus to others.
According to the CDC, about 1.1 million people in the U.S. are living with the HIV infection, and there are about 37,600 new HIV infections each year.
Having HIV does not always mean that you have AIDS. It can take many years for people with the virus to develop AIDS.
HIV and AIDS can't be cured, but the medications available today help people stay healthy, live longer, and even obtain a normal life expectancy.
HIV and CD4 T-Cells
HIV attacks and destroys a type of white blood cell: the CD4 cell, also called the T-cell. Its job is to fight disease. But HIV uses proteins in the cell to make a copy of itself and then kills the cell. This can go on for 10 years or more without you having any symptoms.
AIDS is the later stage of HIV infection. When your immune system has a very low level of CD4 cells, you can't fight off things that most people wouldn't get sick from. People with HIV are said to have AIDS when they get certain infections or cancers, called AIDS-defining illnesses, or when their CD4 count in a blood test is less than 200.
How You Can Get It
You can get HIV when an infected person's body fluids -- including blood, semen, fluids from the vagina, or breast milk -- get into your blood. That can happen through broken skin or the linings in your mouth, anus, penis, or vagina.
People commonly get HIV from:
- Having unprotected sex with an infected person
- Sharing a needle to take drugs
- Dirty needles used for a tattoo or in body piercing
Mothers with HIV also can give the virus to their babies, before or when they're born or through breastfeeding.
It's possible to get HIV from a blood transfusion from an infected person, although it's very unlikely in the U.S. and Western Europe, where all medical blood is tested for HIV.
Health care workers have to take special precautions. They could get HIV after being poked with needles that have HIV-infected blood or after infected blood gets on an open cut or splashes into their eyes or inside their nose.
The best way to protect yourself from HIV is to avoid activities that put you at risk. Use latex condoms or a latex barrier whenever you have sex -- vaginal, anal, or oral. Don't inject drugs, and don't use someone else's needle if you do.
Some people who are at very high risk for an HIV infection use pre-exposure prophylaxis (PrEP). They don't have HIV yet, but they take medicines every day to help lower their chance of getting infected.
The only way to know if you have HIV is to take an HIV test. Most look for antibodies that fight the virus or traces of the virus itself in your blood, but you can also check urine or fluid from your mouth (not saliva). A positive test means that there were traces of HIV; a negative test means that no signs of HIV were found. Some kinds of tests can give a result in 20-30 minutes.
Most tests can't detect HIV right after infection, because it takes usually takes 2-8 weeks for your body to make antibodies or for enough virus to grow inside you. It may take up to 6 months before you'll see a positive result, which means an early test could be negative even though you're infected.
Clinics that do HIV tests keep your results secret. Some may even do tests anonymously, without ever taking your name. You can also buy test kits at the drugstore and take the test at home.
Everyone between 15 and 65 should get tested, as well as all pregnant women. If you're at high risk, because you use needles for drugs or have multiple sex partners, for example, you should get tested at least once a year.
If you've been stuck by a needle or been in contact with a lot of blood from a person you aren't sure is negative for HIV, you should get tested, too.
Symptoms of HIV and AIDS
Some people get flu-like symptoms within a month after they've been infected, but these symptoms often go away within a month. You could have HIV for many years before feeling ill at all.
Before you're diagnosed with HIV, you may get shingles.
Signs that HIV is turning into AIDS include:
Related Infections and Illnesses
People with AIDS can get other infections very easily. These "opportunistic infections" aren't a problem for someone with a healthy immune system, but someone with a low CD4 count can't fight them off. They can lead to a diagnosis of AIDS because doctors know that HIV probably played a role.
Some health problems that people with AIDS often have are:
- Kaposi's sarcoma, a skin tumor that looks like dark or purple blotches on their skin or in their mouth
- Mental changes and headaches caused by fungal infections or tumors in their brain and spinal cord
- Shortness of breath and difficulty breathing because of infections in their lungs
- Severe malnutrition
- Chronic diarrhea
We've come a long way from the days when a diagnosis of HIV equaled a death sentence. Today, a variety of treatments can significantly slow down, and sometimes stop altogether, the progress of HIV infection.
After you're diagnosed, your doctor will start you on a treatment plan with different types of anti-HIV drugs. This is called ART, for antiretroviral therapy, and each medicine is an ARV, or antiretroviral.
You must take the right drugs at the right time, every single day. If you don't, the virus can change into a strain that is harder to treat. Although the great majority of persons tolerate ARVs very well, these medicines can cause side effects, including:
If you develop these or other symptoms while taking ARVs, you should contact your doctor before stopping the drugs. There may be ways to treat the symptoms rather than having to stop the life-saving ARV drugs.
Newer HIV medications only need to be taken once a day. But these may not work on treatment-resistant strains.
If you have AIDS, you'll probably also take drugs to combat and prevent opportunistic infections.
Your doctor can check how well your treatment is working by measuring the amount of HIV in your blood, which is called your viral load. The goal is to get it so low that most labs tests can't detect it, less than 20 copies in a milliliter. This doesn't mean the virus is gone or cured; it does means the medication is working and you should keep taking it.
Most people who get the right treatment will do well and live healthy lives for years. Starting ART soon after diagnosis of HIV infection, especially before the CD4 count drops to low levels, is key. Even with treatment, though, some people may get sicker faster than others.
Take good care of yourself. Build a good relationship with an experienced doctor specializing in HIV and AIDS. Stick to your HIV medication schedule, and get regular lab work to catch any problems early.