HIV and AIDS
HIV and AIDS are rare but serious STIs. If you don’t know you’re infected with HIV or don’t stay in treatment, HIV can turn into AIDS, which can be extremely dangerous. HIV is treatable, so it’s important to get tested and take care of your health.
What is HIV?
HIV (or human immunodefiency virus) is a rare but serious virus. The virus attacks CD4 cells (sometimes called T cells), which fight off infections and diseases. This weakens the body’s immune system, which defends your body against viruses, bacteria, and other foreign tissue. If left untreated, HIV can lead to AIDS (acquired immunodeficiency syndrome).
HIV is not curable, so once you get it you have it for life. However, it is treatable. People who follow their treatment plan live long, healthy, normal lives. The sooner HIV is diagnosed and treated, the less damage it can do to your health.
If you’re having sex or doing other activities that can spread HIV, it’s very important to get tested regularly.
What is AIDS?
If you don’t know you have HIV or don’t stay in treatment, HIV can turn into AIDS. AIDS is the most advanced stage of HIV infection. People with AIDS have severely damaged immune systems and get sick very easily. They often have opportunistic infections. These are infections that happen more often or are more severe in persons with weakened immune systems.
Opportunistic infections are very dangerous and can even lead to death. This is part of the reason that getting regularly tested for HIV and staying in treatment if you have HIV is so important.
In the United States, having AIDS is not very common. This is because HIV is usually identified and treated before it turns into AIDS. Without treatment, it usually takes 10-15 years for HIV to become AIDS.
How common is HIV?
HIV is relatively rare, but the chance of infection varies depending on your race, gender, behavior and where you live. Over 1.1 million people in the United States currently have HIV, but 1 in 7 doesn’t know it.
How can I get or spread HIV?
You can get or spread HIV from specific bodily fluids: semen (come or ejaculate), vaginal fluids, blood, breast milk and anal fluids. You can contract HIV by:
- Having unprotected anal, vaginal or oral sex with someone who has HIV.
- Sharing needles, such as those used for drug injection, tattoos, or ear piercings.
- From a mother to the baby through breastfeeding or during childbirth (though there are ways to prevent this).
Unprotected anal and penis-in-vagina (PIV) sex are the most high-risk sexual activities for spreading HIV.
Oral sex (going down on, eating out, blow job, any contact between a mouth and a penis or a vulva) is a low-risk activity for getting or spreading HIV, but it is still possible to get the virus this way. The risk is higher if there are cuts or sores in or around the giver’s mouth, and if the receiver ejaculates (or comes) in their partner’s mouth.
Manual sex (hand job, fingering) is also very low risk. However, it is possible to spread the virus if there is enough friction (usually during fingering) to draw blood. It is also possible to get infected if someone else’s semen, pre-come, or vaginal fluids come into contact with any cuts or sores on your hands.
You can NOT get HIV from…
You can NOT get HIV from skin-to-skin contact (so long as there are not fluids present). Here are some other ways you can NOT get HIV:
- Kissing—no matter how “deep.” There is not enough HIV in saliva to infect someone.
- Sharing straws
- Sharing towels
- Holding hands
- Public toilet seats
How can I prevent it?
Using condoms (the right way, every time, for every sex act) can help keep you away from any fluids that could contain HIV.
Getting regularly tested for HIV will help you recognize HIV quickly if you do get it—and the sooner you know you have HIV, the better. Testing also stops you from accidentally passing the virus to someone else. You should also get regularly tested for other STIs—when you have one infection, it is easier for you to catch another. Talk to your healthcare provider about how often you should be tested. They’ll make a recommendation based on your sexual activity.
PrEP (pre-exposure prophylaxis) is a pill that, when taken once a day every day, protects your body against HIV and makes it extremely unlikely that you’ll get the virus. Of course, this is only if you take it every day, as recommended by your health care provider. If you forget to take it sometimes, PrEP will become less effective at preventing HIV. Remember, though, that it doesn’t protect you against other STIs. If you think you may be at risk for HIV (for example, if your partner has HIV), consider talking to your health care provider about whether PrEP is right for you. We talk more about PrEP here.
If you think you may have been exposed to HIV in the last 72 hours, you can take PEP (post-exposure prophylaxis) to greatly decrease the chances of getting HIV. It’s sort of like Plan B for HIV—it’s not perfect, but it is a good HIV prevention tool to keep in mind. A course of PEP lasts several months. You can get it at walk-in and urgent care clinics, or at your health care provider’s office.
If you have HIV, getting treatment is one of the best things you can do to prevent spreading the virus. If you follow the treatment plan you and your health care provider agree on, it is likely that you will eventually have an undetectable viral load. This means that there is only a very small amount of HIV in your body. You cannot pass on the virus if you have an undetectable viral load. Remember: Undetectable = untransmittable. Being undetectable does not mean that you are cured—it’s still important to stick with your medication regimen and see your health care provider as often as they recommend. This is to make sure the amount of HIV in your body doesn’t increase without your knowledge.
What are the symptoms?
Like all STIs, the only way to know whether you have HIV is to get tested. Many people do not get any symptoms of HIV for 10 years or more. However, around 40-90% of people who have HIV get symptoms similar to the flu 2-4 weeks after getting infected. This includes a fever, rash, fatigue, muscle aches, chills, night sweats, a sore throat, swollen lymph nodes, and mouth sores. They can last from a few days to a week.
How do I get tested and what can I expect?
Your normal doctor’s office, a community, family planning or walk-in clinic, or special HIV testing sites provide testing. Many places have free or low-cost tests available.
All HIV testing is confidential. If you are under 18 years old, have HIV, and your health care provider does not think that you can manage your own care, they may notify your parents or legal guardians. However, they will only notify if this does not put you in any danger. These laws vary by state. Ask your health care provider about confidentiality if you’re worried about being safe.
Many HIV testing sites and clinics have counselors who talk to you about what to expect from the test. If your results come back positive for HIV, they will talk to you about next steps and connect you to other services.
Tests range from cheek swabs to finger pricks to blood draws. Ask the clinic or provider what you can expect. They can also tell you how long it will take to get results. If they’re doing a rapid blood test, results may take 15-20 minutes. But if they’re having the test sent to a lab, it may take a few days to a few weeks.
Keep in mind that HIV tests do not come back positive if you have only just been infected. It can take anywhere from 3 to 12 weeks for most tests to pick up on the virus. If you think you’ve been recently exposed, talk to your health care provider about when you should get tested. You can also ask about rapid HIV testing. These tests can detect HIV as soon as 7 days after infection.
How is it treated?
HIV is treated with a mix of medications called antiretroviral therapy (ART). When taken as directed, these pills can reduce the amount of HIV in the body (or the viral load) to undetectable levels. When HIV is undetectable, it is untransmittable. This means that it cannot be passed on to others. This doesn’t mean that the HIV is cured. If you have an undetectable viral load but stop taking your meds, the amount of HIV in your body will increase. It’s important to listen to your doctor’s recommendations and take your medication as directed.
I just found out I have HIV. What’s next?
For many people, learning that they have HIV is deeply upsetting. Make sure you’re taking care of yourself. Remember, you can still live a long, healthy, normal life. HIV is NOT a death sentence. You are still the same person you were before you found out you had HIV.
Hopefully, your health care provider or a counselor talked to you about next steps when they discussed your test results with you. If not, HIV.gov can help you find a provider and prepare for your first HIV care visit.
If you still feel a little lost, here are your next steps:
- Do some research. There are a lot of myths out there about HIV, so it’s important to learn the facts. It can be hard to face an HIV diagnosis at first, so you should feel proud of yourself for taking this important step by being here!
- Get treatment. The faster you start treating your HIV, the better. Your primary care provider should be able to provide HIV treatment. Community health clinics (including Planned Parenthoods) often also provide free or affordable HIV treatment. You can find more details about what to expect at your first appointment here.
- Notify partners. Your health care provider should have talked to you about who you should notify and how you can do it. Telling partner(s) can be really hard, but it’s important so they can get tested and treated and don’t spread HIV to others. We talk more about how to tell partners about HIV You can also have your health care provider or your local health department contact your partners for you. They will not tell your partners your name, only that they may have been exposed to the virus. If you fear that someone may become violent or threatening, this is a good option. Many states have laws about who you have to tell about your HIV status. Know your state’s laws, which you can find here.
- Set up a support network. Telling others that you have HIV may feel impossible, but loved ones can be a great source of support as you begin your HIV treatment. When you are ready (and if you feel safe), consider telling a family member or loved one. In addition, consider talking to a therapist. Therapy is a great tool for processing and learning how to cope with your emotions. You also may want to join an HIV support group so you can meet other young people who have HIV.
- Get help paying for treatment. Health insurance will cover your HIV treatment. If you don’t have insurance or still can’t afford treatment, there are resources to help you. The Ryan White HIV/AIDS Program was created for just this purpose. You can also try hiv.gov for more information and resources.
- Continue practicing self-care. It’s important to take care of yourself mentally and physically. Eating well, exercising, getting enough sleep and practicing mindfulness and self-love are all crucial parts of self-care, for people with and without HIV. For a lot of people, therapy is an important self-care tool, too. We talk more about general self-care practices here, and about self-care when you’re dealing with STI stigma here.
Overcoming HIV Stigma
Having HIV says nothing about who you are as a person or how lovable you are. You still deserve respect. If you’re struggling with your emotions after diagnosis with HIV, try some of the self-care practices we link to above, and consider talking to a therapist or counselor or joining an HIV support group.
Mount Sinai Adolescent Health Center’s Project IMPACT (Improving Access to Care and Treatment) service provides treatment, support and care for HIV + young people ages 13-24 in the New York City area, including comprehensive medical services, case management and mental health counseling for any young people and their families impacted by HIV/AIDS. Call Project IMPACT at 212-731-7688, or the Mount Sinai Adolescent Health Center’s front desk at 212-423-3000, to get treatment, care and support.
This information is not intended to provide medical advice, professional diagnosis, opinion, treatment or services, only general information for education purposes only.