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HIVWhat is human immunodeficiency virus (HIV)?

HIV is a virus that attacks the bodyā€™s immune system. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome)ā€‹. There is currently no effective cure ā€“ once people get HIV they have it for life. But with proper medical care, HIV can be effectively treated and controlled. People with HIV who get effective HIV treatment can live long, healthy lives and protect their partners. Some groups of people in the United States are more likely to get HIV than others because of many factors, including social determinants of health (PDF), who their sex partners are and whether they have access to HIV prevention methods. The only way to know if you have HIV is to get tested. ā€‹

How It Spreads

HIV is mainly spread through unprotected anal or vaginal sex, or sharing syringes, needles, or other drug injection equipment with someone who is infected with HIV. If someone with HIV has a detectable viral load (the amount of HIV in their blood), they can pass on HIV through the following body fluids: 

  • Blood 

  • Semen (including pre-cum) 

  • Vaginal fluid 

  • Rectal fluid 

  • Breast milk/Chest milk 

Fortunately HIV medications can also prevent HIV transmission. Based on multiple large clinical studies, people with HIV who take medication as prescribed and keep undetectable viral load will not transmit HIV to their sex partners. This is commonly referred to as ā€œUndetectable equals Untransmittableā€ or ā€œU = Uā€.  Achieving and maintaining an undetectable viral load with HIV medication during pregnancy and postpartum decreases breastfeeding/chestfeeding transmission risk to less than one percent, but not zero. Parents with HIV who wish to breastfeed/chestfeed should talk with their health care provider to determine the safest way to do so.  ā€‹

People can get HIV through:

  • ā€‹Anal sex without a condom 

  • Vaginal/frontal sex without a condom 

  • Sharing drug injection equipment 

  • Transmission to baby during pregnancy or breastfeeding/chestfeeding 

  • Other injection or mucosal exposure to blood (like getting stuck with a needle or other sharp object used by someone with HIV) ā€‹

  • Learn more about ways people can get HIV

Most activities pose no risk of getting or passing on HIV. HIV cannot be passed on by: 

  • ā€‹Kissing 

  • Hugging  

  • Shaking hands 

  • Sharing space with someone 

  • Sharing a toilet  

  • Sharing household items such as cups, plates, cutlery, or bed linen 

  • Any other general social contact ā€‹

Signs and Symptoms

When people with HIV donā€™t get treatment, they typically progress through three stages. HIV treatment can slow or prevent progression of the disease. With advances in HIV treatment, progression to Stage 3 (AIDS) is far less common today than in the early years of HIV. 

Stage 1: Acute (Very Early) HIV Infection ā€‹ 

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

  • Many people with acute HIV have flu-like symptoms like: 

    • Fever 

    • Sore throat 

    • Swollen lymph nodes 

    • Rash 

    • Muscle aches 

    • Night sweats 

    • Mouth ulcers 

    • Chills 

    • Fatigue (feeling very tired) 

  • Some people with acute HIV have a rash on their body often involving their chest and back 

  • If you have flu-like symptoms with or without a rash and think you may have been exposed to HIV, get tested 

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

Stage 2: Chronic HIV Infection ā€‹

This stage is also called asymptomatic HIV infection 

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

  • People may not have any symptoms or get sick during this phase, and can still transmit HIV 

  • 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) 

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

  • 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 infections not common with a healthy immune system (these are called opportunistic infections) or other serious illnesses 

  • Without HIV treatment, people with AIDS typically survive about three years ā€‹


Order a free HIV home testā€‹

Testing

HIV tests are quick, free, and painless. There are three types of tests: antibody, antigen/antibody, and nucleic acid test (NAT). Depending on the type of test you take there is a 10ā€“42-day window period (the time between an exposure and when a test can detect HIV in your body. All HIV tests in the U.S. have been approved for use by the Food and Drug Administration (FDA). ā€‹

HIV Antibody Test

An antibody test looks for antibodies to HIV in your blood or oral fluid produced by your immune system when you're exposed to viruses like HIV.

  • An antibody test looks for antibodies against HIV in your blood or oral fluid produced by your immune system in response to HIV infection. Many rapid tests and the in-home HIV self-test (available over the counter and by mail) are antibody tests  

  • These tests have a 3 to 12 week (18-90 day) window period meaning they become positive after a person has had HIV infection for 3 to 12 weeks. ā€‹

HIV Antigen/Antibody Test

  • An antigen/antibody test looks for both HIV antigens (or proteins that the virus makes) and antibodies. 

  • Antigen/antibody tests are common and are recommended for testing done in labs. This lab test involves drawing a tube of blood  

  • There is also a rapid antigen/antibody test available that is done with blood from a finger stick 18 to 45 day window period 

ā€‹HIV Nucleic Acid Test (NAT) and HIV RNA Viral Load Tests

HIV NAT or RNA Viral Load detects and measures HIV virus in the blood. 

  • These tests can tell if a person has HIV and how much virus is present in the blood   

  • HIV NAT and HIV RNA Viral Loads are common tests for people with HIV in care.  These tests are done in labs and involve drawing a tube of blood  

  • These tests can detect HIV sooner than other types of HIV tests 

  • This test should be considered for people who have had a recent exposure or a possible exposure and have symptoms of acute HIV.  

  • 10 to 33 day window period ā€‹

CDPH recommends everyone between the ages of 13 and 64 years get tested for HIV at least once. People with certain risk factors should get tested at least annually. It is important to talk to your health care provider about what type of HIV test is right for you and how frequently you should be testing. 

Prevention

There are now more options than ever before to reduce the risk of getting or transmitting HIV. 

If you are sexually active, you can do the following things to lower your chances of getting HIV: 

To learn more about the risk reduction methods that are right for you, talk to a health care provider or use this HIV Risk Reduction Tool. ā€‹

Antiretroviral Therapy (ART) treats HIV!

By taking antiretroviral therapy (ART) daily as prescribed, people with HIV can lower the amount of HIV in their blood (viral load) to an undetectable level. Reaching and maintaining undetectable levels stops HIV infection from progressing, helps people living with HIV stay healthy and live longer, and prevents sexual transmission of the virus. People who achieve and maintain an undetectable viral load by continuing to take ART cannot sexually transmit HIV to others. For most people with HIV, it takes three to six months of daily medication to achieve an undetectable viral load. Once undetectable an individual is no longer at risk for transmitting HIV to their partners so long as they remain on medication and maintain an undetectable viral load.    

When HIV medication is stopped, HIV comes back, and the risk of transmitting HIV to a sexual partner in the absence of other prevention methods returns. Stopping and re-starting treatment can make treatment less effective. If you are having any trouble taking your HIV medications, talk with your health care provider. 

If you have HIV, itā€™s important to get on HIV medication as soon as possible. HIV medication should be accessible and affordable to everyone and there are a lot of organizations that specialize helping patients access this life-saving treatment.  ā€‹

HIV Stigma ā€‹

HIV stigma is negative attitudes and beliefs about people with HIV. Here are a few examples: 

  • Believing that only certain groups of people can get HIV 

  • Making moral judgements about people who take steps to prevent getting or giving HIV 

  • Feeling that people deserve to get HIV because of their choices 

HIV stigma causes discrimination, impacts the well-being of people living with HIV, and can prevent people from getting tested and treated for HIV. Learn more about HIV stigma and how to prevent it. ā€‹



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