HIV OVERVIEW

What is HIV?

HIV, or Human Immunodeficiency Virus, is a virus that targets the body’s immune system. Left untreated, HIV can progress to AIDS (Acquired Immunodeficiency Syndrome). While there’s no cure, with proper medical care, HIV can be managed effectively. People with HIV who receive appropriate treatment can lead long, healthy lives and reduce the risk of transmitting the virus to others.

Where did HIV come from?

HIV originated from a type of chimpanzee in Central Africa, likely transmitted to humans through the hunting and consumption of infected meat in the late 1800s. Over time, the virus spread within African populations and eventually reached other parts of the world. In the United States, HIV has been documented since at least the mid to late 1970s, primarily affecting marginalized groups.

Are there symptoms?

Following HIV infection, many experience flu-like symptoms within 2 to 4 weeks, including fever, fatigue, sore throat, swollen glands, and rash. However, not everyone shows symptoms. Testing is the only way to confirm HIV status, as symptoms can be similar to other illnesses.

FAQ's

Getting tested is the only definitive way to know if you have HIV. Testing is straightforward and can be done by asking your healthcare provider or visiting clinics, community health centers, or hospitals that offer HIV testing. If you test positive, you can start HIV care and treatment promptly. A negative result empowers you to take preventive measures to avoid HIV transmission in the future.

HIV can only be transmitted through direct contact with certain body fluids from an HIV-positive person with a detectable viral load. These fluids include blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, and breast milk. Transmission occurs when HIV enters the bloodstream of an HIV-negative person through mucous membranes, open cuts or sores, or direct injection with a needle.

However, individuals with HIV who adhere to HIV treatment and maintain an undetectable viral load can lead long and healthy lives. Importantly, they do not transmit HIV to their HIV-negative partners through sexual contact.

HIV transmission primarily occurs through specific activities, with the most common being:

1. Unprotected vaginal or anal sex with an HIV-positive person.
2. Sharing needles or injection equipment contaminated with HIV-infected blood during drug use.
3. Perinatal transmission from an HIV-positive mother to her baby during pregnancy, childbirth, or breastfeeding.

Less common modes of transmission include:

1. Occupational exposure to HIV through needlestick injuries among healthcare workers.
2. Theoretical risk of HIV transmission through oral sex, blood transfusions, or organ/tissue transplants (although the risk is extremely low due to rigorous testing protocols).
3. Bite-related transmission, though this is extremely rare and requires severe trauma with extensive tissue damage and exposure to blood.

Notably, HIV is not transmitted through casual contact like kissing, sharing food, or through saliva. Understanding these modes of transmission helps in preventing HIV infection and promoting safer practices.

Viral load refers to the amount of HIV present in an HIV-positive person’s blood. When HIV medication (antiretroviral therapy or ART) is taken consistently as prescribed, it can reduce the viral load to a very low level, a state known as viral suppression. Viral suppression, defined as having less than 200 copies of HIV per milliliter of blood, helps keep the immune system strong and prevents HIV-related illnesses.

In some cases, HIV medication can lower the viral load to such an extent that it becomes undetectable by standard lab tests. Achieving an undetectable viral load is a goal for most individuals on HIV treatment, typically achieved within six months of starting therapy.

It’s crucial to note that individuals with HIV who maintain an undetectable viral load through consistent medication adherence and regular healthcare visits can lead long and healthy lives. Importantly, they cannot transmit HIV to their HIV-negative partners through sexual contact.

HIV medication plays a vital role in preventing sexual transmission of HIV, but it’s effective only when the HIV-positive individual achieves and maintains an undetectable viral load. Regular viral load tests and adherence to medication are essential to ensure viral suppression and prevent transmission.

HIV is not transmitted through:

1. Air or water.
2. Mosquitoes, ticks, or other insects.
3. Saliva, tears, sweat, feces, or urine that is not mixed with HIV-infected blood.
4. Casual contact like shaking hands, hugging, sharing toilets, dishes, silverware, or drinking glasses, or engaging in closed-mouth or social kissing with an HIV-positive person.
5. Drinking fountains.
6. Other sexual activities that don’t involve the exchange of body fluids (e.g., touching).
7. Donating blood.
8. Healthy, unbroken skin.

Understanding these modes of transmission helps dispel misconceptions and promotes accurate knowledge about HIV prevention.

HIV can affect anyone regardless of sexual orientation, race, ethnicity, gender, age, or location. However, certain factors increase the likelihood of HIV transmission among specific groups in the United States.

1. Communities: Living in communities with high HIV prevalence increases the risk of exposure to the virus through sexual contact or sharing needles.

2. Subpopulations: Gay, bisexual, and other men who have sex with men (MSM) are most affected by HIV, followed by Blacks/African Americans, Hispanics/Latinos, and transgender women who have sex with men. People who inject drugs also face significant risk.

3. Risk Behaviors: HIV transmission occurs mainly through anal or vaginal sex without protection and sharing needles or syringes with an HIV-positive partner. Anal sex poses the highest risk.

Prevention tools such as condom use, pre-exposure prophylaxis (PrEP), and treatment as prevention (maintaining an undetectable viral load) are crucial in reducing HIV transmission and improving the health outcomes of people living with HIV.

If you suspect you’re at risk of HIV or already have HIV, it’s crucial to get tested and learn about the effective prevention and treatment options available today.

Testing is the only way to confirm your HIV status. Many tests are now quick, free, and painless. You can ask your healthcare provider for an HIV test or use the HIV Services Locator to find a testing site nearby. FDA-approved home testing kits are also available for purchase at pharmacies or online.

Knowing your HIV status empowers you to take steps to maintain your health and protect your partners:

1. If you test positive, you can start HIV treatment to manage the virus and prevent transmission.
2. If you test negative, you can use HIV prevention tools like condoms and PrEP to reduce your risk of contracting HIV in the future.

The National HIV/AIDS Strategy (2022-2025) outlines goals, objectives, and strategies to prevent new HIV infections, improve health outcomes for those living with HIV, reduce disparities, and coordinate efforts to end the epidemic in the United States. It identifies priority populations disproportionately affected by HIV:

1. Gay, bisexual, and other men who have sex with men, especially Black, Latino, and American Indian/Alaska Native men.
2. Black women.
3. Transgender women.
4. Youth aged 13-24.
5. People who inject drugs.

Focusing on these groups is crucial for addressing HIV-related disparities and achieving the goal of ending the HIV epidemic by 2030. Additionally, the Strategy recognizes other populations with or at risk for HIV who require tailored services, such as immigrants, individuals with disabilities, justice-involved individuals, older adults, people experiencing housing instability or homelessness, and sex workers. It also emphasizes addressing social determinants of health that influence HIV risk and outcomes.

Getting tested is the only reliable way to determine if you have HIV, as symptoms alone cannot confirm HIV infection.

Knowing your HIV status is crucial for taking proactive steps to maintain your health and protect your partners:

1. If you test positive, starting HIV treatment (antiretroviral therapy or ART) can effectively manage the virus. Maintaining an undetectable viral load through consistent medication adherence ensures you can live a long and healthy life, and you won’t transmit HIV to your HIV-negative partners through sex.

2. If you test negative, several HIV prevention tools are available, such as pre-exposure prophylaxis (PrEP) for those at risk of HIV and post-exposure prophylaxis (PEP) taken after potential exposure to prevent HIV infection.

3. Pregnant individuals should undergo HIV testing to begin treatment if positive. With proper medication adherence during pregnancy and childbirth, and providing HIV medicine to the baby, the risk of mother-to-child transmission can be reduced to less than 1%, ensuring the health of both mother and child.

HIV symptoms can vary depending on the stage of the disease:

Stage 1: Acute HIV Infection
– Occurs within 2 to 4 weeks after HIV infection.
– Symptoms include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and mouth ulcers.
– Not everyone experiences symptoms during this stage.

Stage 2: Clinical Latency (Chronic HIV Infection)
– Virus continues to multiply at low levels.
– People may not feel sick or have noticeable symptoms.
– Without treatment, this stage can last 10 to 15 years or more.

Stage 3: AIDS (Acquired Immunodeficiency Syndrome)
– Occurs if HIV is not treated and weakens the immune system.
– Symptoms include rapid weight loss, recurring fever or night sweats, extreme fatigue, swollen lymph glands, prolonged diarrhea, mouth/anal/genital sores, pneumonia, skin blotches, memory loss, and depression.
– Opportunistic infections are common in this stage due to weakened immunity.

Testing is crucial for an accurate HIV diagnosis, as symptoms can mimic other illnesses. Early diagnosis and treatment are key to managing HIV and preventing progression to AIDS. Effective treatment helps maintain a healthy life and prevents HIV transmission to others. Regular healthcare visits and adherence to medication are essential for HIV management.