Learn more about this potentially life-threatening infection that spreads through blood, sex and childbirth. Know how to prevent and treat it.
Acquired immunodeficiency syndrome (AIDS), is an ongoing, also called chronic, condition. It's caused by the human immunodeficiency virus, also called HIV. HIV damages the immune system so that the body is less able to fight infection and disease. If HIV isn't treated, it can take years before it weakens the immune system enough to become AIDS. Thanks to treatment, most people in the U.S. don't get AIDS.
HIV is spread through contact with genitals, such as during sex without a condom. This type of infection is called a sexually transmitted infection, also called an STI. HIV also is spread through contact with blood, such as when people share needles or syringes. It is also possible for a person with untreated HIV to spread the virus to a child during pregnancy, childbirth or breastfeeding.
There's no cure for HIV/AIDS. But medicines can control the infection and keep the disease from getting worse. Antiviral treatments for HIV have reduced AIDS deaths around the world. There's an ongoing effort to make ways to prevent and treat HIV/AIDS more available in resource-poor countries.
The symptoms of HIV and AIDS vary depending on the person and the phase of infection.
Some people infected by HIV get a flu-like illness within 2 to 4 weeks after the virus enters the body. This stage may last a few days to several weeks. Some people have no symptoms during this stage.
Possible symptoms include:
These symptoms can be so mild that you might not notice them. However, the amount of virus in your bloodstream, called viral load, is high at this time. As a result, the infection spreads to others more easily during primary infection than during the next stage.
In this stage of infection, HIV is still in the body and cells of the immune system, called white blood cells. But during this time, many people don't have symptoms or the infections that HIV can cause.
This stage can last for many years for people who aren't getting antiretroviral therapy, also called ART. Some people get more-severe disease much sooner.
As the virus continues to multiply and destroy immune cells, you may get mild infections or long-term symptoms such as:
Better antiviral treatments have greatly decreased deaths from AIDS worldwide. Thanks to these lifesaving treatments, most people with HIV in the U.S. today don't get AIDS. Untreated, HIV most often turns into AIDS in about 8 to 10 years.
Having AIDS means your immune system is very damaged. People with AIDS are more likely to develop diseases they wouldn't get if they had healthy immune systems. These are called opportunistic infections or opportunistic cancers. Some people get opportunistic infections during the acute stage of the disease.
The symptoms of some of these infections may include:
If you think you may have been infected with HIV or are at risk of contracting the virus, see a healthcare professional as soon as you can.
HIV is caused by a virus. It can spread through sexual contact, shooting of illicit drugs or use of shared needles, and contact with infected blood. It also can spread from parent to child during pregnancy, childbirth or breastfeeding.
HIV destroys white blood cells called CD4 T cells. These cells play a large role in helping the body fight disease. The fewer CD4 T cells you have, the weaker your immune system becomes.
You can have an HIV infection with few or no symptoms for years before it turns into AIDS. AIDS is diagnosed when the CD4 T cell count falls below 200 or you have a complication you get only if you have AIDS, such as a serious infection or cancer.
You can get infected with HIV if infected blood, semen or fluids from a vagina enter your body. This can happen when you:
You can't become infected with HIV through casual contact. That means you can't catch HIV or get AIDS by hugging, kissing, dancing or shaking hands with someone who has the infection.
HIV isn't spread through air, water or insect bites. You can't get HIV by donating blood.
Anyone of any age, race, sex or sexual orientation can have HIV/AIDS. However, you're at greatest risk of HIV/AIDS if you:
HIV infection weakens your immune system. The infection makes you much more likely to get many infections and certain types of cancers.
Toxoplasmosis. This infection is caused by Toxoplasma gondii, a parasite spread primarily by cats. Infected cats pass the parasites in their stools. The parasites then can spread to other animals and humans.
Toxoplasmosis can cause heart disease. Seizures happen when it spreads to the brain. And it can be fatal.
There's no vaccine to prevent HIV infection and no cure for HIV/AIDS. But you can protect yourself and others from infection.
To help prevent the spread of HIV:
Consider preexposure prophylaxis, also called PrEP. There are two PrEP medicines taken by mouth, also called oral, and one PrEP medicine given in the form of a shot, called injectable. The oral medicines are emtricitabine-tenofovir disoproxil fumarate (Truvada) and emtricitabine-tenofovir alafenamide fumarate (Descovy). The injectable medicine is called cabotegravir (Apretude). PrEP can reduce the risk of sexually transmitted HIV infection in people at very high risk.
PrEP can reduce the risk of getting HIV from sex by about 99% and from injecting drugs by at least 74%, according to the Centers for Disease Control and Prevention. Descovy hasn't been studied in people who have sex by having a penis put into their vaginas, called receptive vaginal sex.
Cabotegravir (Apretude) is the first U.S. Food and Drug Administration-approved PrEP that can be given as a shot to reduce the risk of sexually transmitted HIV infection in people at very high risk. A healthcare professional gives the shot. After two once-monthly shots, Apretude is given every two months. The shot is an option in place of a daily PrEP pill.
Your healthcare professional prescribes these medicines to prevent HIV only to people who don't already have HIV infection. You need an HIV test before you start taking any PrEP. You need to take the test every three months for the pills or before each shot for as long as you take PrEP.
You need to take the pills every day or closely follow the shot schedule. You still need to practice safe sex to protect against other STIs. If you have hepatitis B, you should see an infectious disease or liver specialist before beginning PrEP therapy.
Use treatment as prevention, also called TasP. If you have HIV, taking HIV medicines can keep your partner from getting infected with the virus. If your blood tests show no virus, that means your viral load can't be detected. Then you won't transmit the virus to anyone else through sex.
If you use TasP, you must take your medicines exactly as prescribed and get regular checkups.
Use a new condom every time you have anal or vaginal sex. Both male and female condoms are available. If you use a lubricant, make sure it's water based. Oil-based lubricants can weaken condoms and cause them to break.
During oral sex, use a cut-open condom or a piece of medical-grade latex called a dental dam without a lubricant.
HIV can be diagnosed through blood or saliva testing. Tests include:
Antigen-antibody tests. These tests most often use blood from a vein. Antigens are substances on the HIV virus itself. They most often show up in the blood within a few weeks after being exposed to HIV.
The immune system makes antibodies when it's exposed to HIV. It can take weeks to months for antibodies to show up in blood. You may not show a positive result on an antigen-antibody test until 2 to 6 weeks after exposure to HIV.
Nucleic acid tests (NATs). These tests look for the virus in your blood, called viral load. They use blood from a vein.
If you might have been exposed to HIV within the past few weeks, your healthcare professional may suggest NAT. NAT is the first test to become positive after exposure to HIV.
Talk with your healthcare professional about which HIV test is right for you. If any of these tests are negative, you may need a follow-up test weeks to months later to confirm the results.
If you've been diagnosed with HIV, find a specialist trained in diagnosing and treating HIV to help you:
If you get a diagnosis of HIV/AIDS, tests can help your healthcare professional learn the stage of your disease and the best treatment, including:
Your healthcare professional also might order lab tests to check for other infections or complications, including:
There's no cure for HIV/AIDS. Once you have the infection, your body can't get rid of it. But there are medicines that can control HIV and prevent complications.
Everyone diagnosed with HIV should take antiretroviral therapy medicines, also called ART. This is true no matter what stage the disease is in or what the complications are.
ART is usually a mix of two or more medicines from several classes. This approach has the best chance of lowering the amount of HIV in the blood. There are many ART options that mix more than one HIV medicine into a single pill, taken once daily.
Each class of medicines blocks the virus in different ways. Treatment involves mixing medicines from different classes to:
Two medicines from one class, plus a third medicine from another class, are most often used.
The classes of anti-HIV medicines include the following:
Non-nucleoside reverse transcriptase inhibitors (NNRTIs) turn off a protein needed by HIV to make copies of itself.
Examples include efavirenz, rilpivirine (Edurant) and doravirine (Pifeltro).
Nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs) are faulty versions of the building blocks that HIV needs to make copies of itself.
Examples include abacavir (Ziagen), tenofovir disoproxil fumarate (Viread), emtricitabine (Emtriva), lamivudine (Epivir) and zidovudine (Retrovir). Retrovir is no longer suggested for routine use in the U.S. because of high rates of toxic effects.
Mixes of medicines also are available, such as emtricitabine-tenofovir disoproxil fumarate (Truvada) and emtricitabine-tenofovir alafenamide fumarate (Descovy).
Protease inhibitors (PIs) make HIV protease inactive. HIV protease is another protein that HIV needs to make copies of itself.
Examples include atazanavir (Reyataz), darunavir (Prezista) and lopinavir-ritonavir (Kaletra).
Integrase inhibitors stop the action of a protein called integrase. HIV uses integrase to put its genetic material into CD4 T cells.
Examples include bictegravir sodium-emtricitabine-tenofovir alafenamide fumarate (Biktarvy), raltegravir (Isentress), dolutegravir (Tivicay) and cabotegravir (Vocabria).
Entry or fusion inhibitors block HIV's entry into CD4 T cells.
Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry). Newer medicines include ibalizumab-uiyk (Trogarzo) and fostemsavir (Rukobia).
Everyone with HIV infection, no matter what the CD4 T cell count or symptoms are, should be offered antiviral medicine.
Staying on ART that keeps your HIV viral load in the blood from being detected is the best way for you to stay healthy.
For ART to work, you must take the medicines as prescribed. Don't miss or skip doses. Staying on ART with an undetectable viral load helps:
Staying on HIV therapy can be hard. Talk to your healthcare professional about possible side effects, trouble you have taking medicines, and any mental health or substance use issues that may make it hard for you to stay on ART.
Have regular follow-up appointments with your health professional to check your health and response to treatment. Let your health professional know right away if you have problems with HIV therapy. Then you can work together to find ways to deal with those issues.
Treatment side effects can include:
Some health issues that are a part of aging may be harder to manage if you have HIV. Some medicines that are common for age-related heart, bone or metabolic conditions, for example, may not mix well with anti-HIV medicines. Talk with your healthcare professional about your other health conditions and the medicines you take for them.
If another health professional prescribes a medicine for another condition, let that health professional know about your HIV therapy. Then the health professional can make sure there are no problems with taking the medicines together.
Your healthcare professional will watch your viral load and CD4 T cell counts to see your response to HIV treatment. The first check is at 4 to 6 weeks. After that, you see your health professional every 3 to 6 months.
Treatment should lower your viral load so that can't be found in the blood. That doesn't mean your HIV is gone. Even if it can't be found in the blood, HIV is still in your body.
Besides getting medical treatment, you need to take an active role in your own care. The following may help you stay healthy longer:
People who are infected with HIV sometimes try dietary supplements that claim to boost the immune system or help with side effects of anti-HIV medicines. But there are no studies that show these claims are true. And many supplements can get in the way of other medicines you take.
Always check with your healthcare professional before taking any supplements or alternative therapies to make sure they won't affect the way your medicines work.
There's little evidence to show that any supplements for HIV work. Some examples with limited research include:
Practices such as yoga, meditation and massage have been shown to reduce stress as well as provide relaxation and improve quality of life. While they need more study, these practices may be helpful if you're living with HIV/AIDS.
Getting a diagnosis of any life-threatening illness can cause distress. The emotional, social and financial effects of HIV/AIDS can make coping with this illness very hard for you and for those close to you.
But there are many services and resources for people with HIV. Most HIV/AIDS clinics have social workers, counselors or nurses who can help you or put you in touch with people who can help you.
They may be able to:
It's important to have a support system. Many people with HIV/AIDS find that talking with someone who knows about their disease gives them comfort.
If you think you might have an HIV infection, you're likely to start by seeing your family healthcare professional. You may be sent to an infectious disease specialist who focuses on treating HIV/AIDS.
Before your appointment, think about the answers to these questions and take them to your appointment:
Your healthcare professional asks you questions about your health and lifestyle and does a physical exam, checking you for:
If you think you might have an HIV infection, protect yourself and others before your appointment. Don't have sex without using protection. If you shoot illicit drugs, always use a fresh, clean needle. Don't share needles with others.