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What is HIV?

HIV is an infection caused by a virus called the Human Immunodeficiency Virus (HIV). Without appropriate treatment, an HIV infection can cause AIDS (Acquired Immune Deficiency Syndrome). Unlike some other viruses, the human body cannot get rid of HIV. That means that once you have HIV, you have it for life. HIV affects specific cells of the immune system, called CD4 cells, or T cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. When this happens, HIV infection leads to AIDS.

How common is HIV?

About 1.1 million people in the United States have HIV. People have it in some places and among some populations more than others. For example, it is estimated that 2.7% of people in Washington D.C. have HIV.

How is HIV spread?

  • During vaginal sex (both partners)
  • During anal sex (both partners)
  • From mother to child through birth or breastfeeding
  • Through shared syringes
  • During oral sex (though this is rare)
  • HIV is more likely to spread if one or both partners has another STD.
  • Even when people with HIV are on medication, they can still give other people HIV.

How can I prevent getting HIV?

  • If you have vaginal or anal sex, use a latex male condom or female condom (used correctly, condoms prevent the spread of HIV 98-100% of the time)
  • If you have oral sex, use condoms or a latex or plastic barrier
  • Avoid direct contact with bodily fluids (blood or any fluid containing blood)
  • Don't share needles if there's a chance they might be infected

If I have HIV, how can I prevent giving it to someone else?

  • Get treated. Make sure that you are taking your HIV medication when and how your doctor tells you. HIV medication will lower your viral load (which is the amount of the virus in your blood) and reduce the chances that you spread the virus.
  • Have lower risk sex. You are more likely to spread or get HIV during anal sex and vaginal sex than during oral sex or mutual masturbation. This means that you should be more careful when having anal and vaginal sex - wear a condom and call a doctor if it breaks.
  • Wear a condom. Wear a condom whenever you have oral, vaginal, or anal sex to avoid giving your partner HIV
  • Vaginal or anal sex: use a latex male condom or female condom
  • Oral sex: use condoms or a latex or plastic barrier
  • Have your partners wear a condom. Your partner should also wear a condom when they are having sex with you.
  • Avoid direct contact with bodily fluids (blood or any fluid containing blood)
  • Have your partners use pre-exposure prophylaxis (PrEP).
  • PrEP is a new form of HIV protection. It is a medication that can be taken by people who are negative, but want to avoid getting HIV. You should talk to your doctor about PrEP if you have HIV and your partner if negative.
  • Don't share needles; join a needle exchange program to get clean needles.

Can I still infect others with HIV if I don't have symptoms?

Yes. You are most likely to spread HIV in the first three months after infection. This is usually before you have symptoms and before the infection is detectable by tests.

Am I more infectious with HIV at certain times?

Yes, you are more likely to spread HIV when you have a high viral load in your blood. This occurs in the first three months after infection, before your body has had a chance to fight back, and later in the disease if you develop AIDS. Medication for HIV can lower your viral load and decrease the chance you will infect others.

If I have HIV, will I know it?

Many people with HIV don’t know they have it. Some people have symptoms right after they are infected with HIV, but many do not. Most people who do not take medication for HIV will have symptoms by the time HIV has progressed to AIDS. A small minority of people living with HIV (often referred to as "long term nonprogressors") never develop symptoms.

What are the stages of HIV?

There are three stages of an HIV infection - the acute infection, chronic HIV infection, and AIDS. HIV treatment can slow or prevent progression to AIDS, but without medication, HIV may quickly lead to AIDS. It is important to get tested regularly so that if you have HIV, you could get medication before HIV turns into AIDS.

A person can give HIV to others during any of these stages:

Acute infection: Within 2 to 4 weeks after being infected with HIV, you may feel sick with flu-like symptoms. This is called an acute HIV infection. During this time, large amounts of HIV are being produced in your body. The immune system refers to cells that try to heal the body from sickness or injury The virus uses important immune system cells called CD4 cells to make copies of itself (the virus) and destroys the CD4 cells in the process. Because of this, the CD4 count (the amount of CD4) can fall quickly.

Your ability to spread HIV is highest during this stage because the amount of virus in the blood is very high.

Eventually, your immune response will begin to bring the amount of virus in your body back down to a stable level. At this point, your CD4 count will then begin to increase, but it may not return to pre-infection levels.

Chronic HIV infection: This period is sometimes called asymptomatic HIV infection. During this phase, HIV is still active, but you may not have any symptoms or get sick during this time. People who are on medication may live with clinical latency for several decades. It is important to remember that you are still able to transmit HIV to others during this phase even if you are on medication.

Towards the middle and end of this period, your viral load begins to rise and your CD4 cell count begins to drop. As this happens, you may begin to have symptoms of HIV infection as your immune system becomes too weak to protect you.

AIDS (acquired immunodeficiency syndrome): This is the stage of infection that occurs when your immune system is badly damaged. You will become vulnerable to infections and infection-related cancers called opportunistic illnesses. Without treatment, people who are diagnosed with AIDS typically survive about 3 years. Once someone has a dangerous opportunistic illness, life expectancy without treatment falls to about 1 year. People with AIDS need medical treatment to prevent death.

What are the symptoms of HIV?

There are different symptoms at each stage of an HIV infection.

The symptoms of acute infection (2-4 weeks after infection) are:

  • Fever
  • Night sweats
  • Malaise (general feeling of discomfort)
  • Swollen glands (swollen and tender in the neck, armpits, and groin)
  • Skin rash
  • Headache
  • Diarrhea
  • Sore throat
  • Joint and muscle pain

The symptoms of AIDS (years after infection) are:

  • Rapid (quick) weight loss
  • Dry cough (nothing comes up with the cough)
  • Fever or night sweats
  • Intense and unexplained fatigue (feeling very tired)
  • Swollen glands (swollen and tender in the neck, armpits, and groin)
  • Diarrhea that lasts for more than a week
  • White spots or unusual marks on the tongue, in the mouth, or in the throat
  • Pneumonia (infection of the lungs)
  • Red, brown, pink, or purplish spots on or under the skin or inside the mouth, nose, or eyelids
  • Memory loss, depression, and other neurological disorders
  • Severe or recurring vaginal yeast infections
  • ­­Bruising more easily than normal

What is the treatment for HIV?

There is no cure for HIV, but treatment may be able to lower your viral load. This will lower your chance of spreading the virus to others and developing AIDS or opportunistic infections (meaning bad infections with other diseases).

You need to talk about treatment options with a doctor. If you have HIV, you will get medication called "Highly Active Antiretroviral Therapy" (HAART). HAART will not cure the infection, but will slow your progression to AIDS.

What will happen if I have HIV, but I don't get treated?

You can develop AIDS. You are also more likely to spread the virus to other people if you don't get treated.

How can I get tested for HIV?

You can get tested for HIV at a doctor's office, the Druid or Eastern STD clinics, or a mobile HIV-testing van.

There are two different types of HIV tests: the antibody test and the RNA test. Most HIV tests are antibody tests that use blood (from a vein or a finger stick) or oral fluid. These tests look for material (called antibodies) that your body produces to help fight an HIV infection. If you have a positive (sometimes called "reactive") test, you will need to have more tests. It can take your body 3-6 months after infection to produce enough antibodies to show up on a test, so it is possible to not test positive in this period even if you have the virus.

The RNA test looks for the actual virus in your blood. These tests are more expensive and less commonly used than antibody tests, but they can detect HIV 9-11 days after infection. They might be used if you have symptoms of "acute retroviral syndrome" or if you think you may have been infected in the past 3 months.