HIV

Overview

HIV attacks the body's immune system. Without treatment, it can lead to AIDS, when the immune system is badly damaged.

With treatment, HIV medicine can lower the virus so much that a test can't find it. People with an undetectable viral load stay healthy and do not pass HIV to partners through sex. There are also medicines that prevent HIV: PrEP before exposure and PEP after.

Symptoms

Some people have no symptoms at all.

• Fever
• Chills or night sweats
• Rash
• Sore throat
• Swollen glands
• Fatigue and muscle aches

Less common

• Mouth sores
• Headache
• Weight loss and frequent infections (later, without treatment)

How it usually goes

• 2 to 4 weeks: Flu-like symptoms may start. HIV spreads very easily at this stage.
• Years: Without treatment, the virus slowly damages the immune system, often with no symptoms.
• With treatment: Most reach an undetectable viral load within 6 months.

When to get medical care

Causes

HIV spreads through certain body fluids: blood, semen, vaginal and rectal fluids, and breast milk. It's most often spread through sex without a condom or by sharing needles. It can also pass from mother to baby during pregnancy, birth, or breastfeeding.

Does it spread or run in families?

• Yes, it can spread from person to person.
• How it spreads: sex, contact with infected blood, or mother to baby around birth.
• Condoms lower the risk. Sex partners should be tested and treated too.

Who is more likely to get it

• Sex without a condom with a partner who has or might have HIV
• Having another STI
• Sharing needles
• Not taking PrEP when at risk

Possible complications

• Syphilis: Often occurs along with HIV
• Genital herpes: Raises the risk of getting HIV

Diagnosis

The only way to know if you have HIV is to get tested. Testing is quick and often free.

Questions you may be asked

• Recent sex without a condom or a partner with HIV
• Sharing needles
• When the possible exposure happened
• Fever, rash, sore throat, or swollen glands

The exam

They may check for swollen glands, rash, and mouth sores.

Tests

Tests include:

• HIV test: A blood test or rapid test. Some can't detect very recent infection, so a repeat test may be needed.
• Viral load test: Measures the amount of virus, to guide treatment.
• Tests for other STIs: Including syphilis, gonorrhea, and chlamydia.

Treatment

HIV is treated with daily medicine called antiretroviral therapy (ART). Start it as soon as possible after diagnosis.

Self-care

• Take your HIV medicine every day as prescribed
• Keep regular checkups and viral load tests
• Tell your partners so they can get tested and consider PrEP
• Use condoms for extra protection and to prevent other STIs
• Never share needles

Medicines

HIV medicines need a prescription.

Most people reach an undetectable viral load within 6 months of starting treatment. If your viral load goes up, your treatment may need to change.

How it compares

Prevention

There are many ways to prevent HIV:

• Use condoms correctly every time
• Ask about PrEP if you're at risk
• Get PEP within 72 hours after a possible exposure
• Never share needles
• Get tested, and ask partners to get tested

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a sexual health clinic, an OB-GYN, or a urologist; your local health department can test for free or low cost.

Living with it

• Keep a simple diary of symptoms, triggers, and medicines to bring to visits.
• Bring a list of your medicines and questions to each visit.
• Stay active in ways that feel good to you.
• Get enough sleep and manage stress.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Support groups and helplines

• HIV.gov: U.S. government help finding testing, care, and services.

Back to school, work, or sports

• You can go to school and work as usual.
• Don't have sex until you and your partners finish treatment and your doctor says it's OK.

Children, pregnancy, and older adults

• Pregnancy: Treatment that keeps the viral load undetectable lowers the chance of passing HIV to the baby. Ask to be tested.
• After sexual assault: Go to an emergency room right away; PEP and other care can be given.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Some infections can pass to the baby during pregnancy or birth. Tell your provider if you've been exposed.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Take breaks and ask for help. Caregivers need care too.

Outlook

There's no cure, but with treatment, people with HIV can live long, healthy lives and won't pass HIV to partners through sex when their viral load is undetectable.

Getting ready for your visit

HIV testing and care are private.

What to bring

• When the possible exposure happened
• Your medicines and supplements
• Questions about PrEP or PEP

Questions to ask

• Which HIV test is right for me now?
• When should I test again?
• Should I take PrEP?
• If positive, how soon can I start treatment?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on HIV