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 a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body's ability to fight infection and disease.
HIV is a sexually transmitted infection (STI). It can also be spread by contact with infected blood and from illicit injection drug use or sharing needles. It can also be spread from mother to child during pregnancy, childbirth or breastfeeding. Without medication, it may take years before HIV weakens your immune system to the point that you have AIDS.
There's no cure for HIV/AIDS, but medications can control the infection and prevent progression of the disease. Antiviral treatments for HIV have reduced AIDS deaths around the world, and international organizations are working to increase the availability of prevention measures and treatment in resource-poor countries.
The symptoms of HIV and AIDS vary, depending on the phase of infection.
Some people infected by HIV develop a flu-like illness within 2 to 4 weeks after the virus enters the body. This illness, known as primary (acute) HIV infection, may last for a few weeks.
Possible signs and symptoms include:
These symptoms can be so mild that you might not even notice them. However, the amount of virus in your bloodstream (viral load) is quite high at this time. As a result, the infection spreads more easily during primary infection than during the next stage.
In this stage of infection, HIV is still present in the body and in white blood cells. However, many people may not have any symptoms or infections during this time.
This stage can last for many years if you're receiving antiretroviral therapy (ART). Some people develop more severe disease much sooner.
As the virus continues to multiply and destroy your immune cells — the cells in your body that help fight off germs — you may develop mild infections or chronic signs and symptoms such as:
Access to better antiviral treatments has dramatically decreased deaths from AIDS worldwide, even in resource-poor countries. Thanks to these life-saving treatments, most people with HIV in the U.S. today don't develop AIDS. Untreated, HIV typically turns into AIDS in about 8 to 10 years.
When AIDS occurs, your immune system has been severely damaged. You'll be more likely to develop diseases that wouldn't usually cause illness in a person with a healthy immune system. These are called opportunistic infections or opportunistic cancers.
The signs and 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 health care provider as soon as possible.
HIV is caused by a virus. It can spread through sexual contact, illicit injection drug use or sharing needles, contact with infected blood, or from mother to child during pregnancy, childbirth or breastfeeding.
HIV destroys CD4 T cells — white blood cells that play a large role in helping your 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 an AIDS-defining complication, such as a serious infection or cancer.
To become infected with HIV, infected blood, semen or vaginal secretions must enter your body. This can happen in several ways:
You can't become infected with HIV through ordinary contact. That means you can't catch HIV or AIDS by hugging, kissing, dancing or shaking hands with someone who has the infection.
HIV isn't spread through the air, water or insect bites.
Anyone of any age, race, sex or sexual orientation can be infected with HIV/AIDS. However, you're at greatest risk of HIV/AIDS if you:
HIV infection weakens your immune system, making you much more likely to develop many infections and certain types of cancers.
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 (PrEP). The combination oral drugs emtricitabine plus tenofovir disoproxil fumarate (Truvada) and emtricitabine plus tenofovir alafenamide fumarate (Descovy) can reduce the risk of sexually transmitted HIV infection in people at very high risk. PrEP can reduce your risk of getting HIV from sex by about 99% and from injection drug use by at least 74%, according to the Centers for Disease Control and Prevention. Descovy hasn't been studied in people who have receptive vaginal sex.
The FDA recently approved cabotegravir (Apretude), the first injectable PrEP to reduce the risk of sexually transmitted HIV infection in people at very high risk. The injection is given by a health care provider. After the first two monthly injections, cabotegravir is given every two months. The injection is an option in place of a daily PrEP pill.
Your health care provider will prescribe these drugs for HIV prevention only if you don't already have HIV infection. You will need an HIV test before you start taking any PrEP. The test should then be done every three months for pills or before each injection for as long as you're taking PrEP. Your health care provider will also test your kidney function before prescribing Truvada and continue to test it every 6 to 12 months. Other regular testing may also be needed.
You need to take the pill form every day or closely follow the injection schedule for cabotegravir. They don't prevent other STIs, so you'll still need to practice safe sex. If you have hepatitis B, you should be evaluated by an infectious disease or liver specialist before beginning therapy.
HIV can be diagnosed through blood or saliva testing. Available tests include:
Antigen/antibody tests. These tests usually involve drawing blood from a vein. Antigens are substances on the HIV virus itself and are usually detectable — a positive test — in the blood within a few weeks after exposure to HIV.
Antibodies are produced by your immune system when it's exposed to HIV. It can take weeks to months for antibodies to become detectable. The combination antigen/antibody tests can take 2 to 6 weeks after exposure to become positive.
Talk to your health care provider about which HIV test is right for you. If any of these tests are negative, you may still need a follow-up test weeks to months later to confirm the results.
If you've been diagnosed with HIV, it's important to find a specialist trained in diagnosing and treating HIV to help you:
If you receive a diagnosis of HIV/AIDS, several tests can help your health care provider determine the stage of your disease and the best treatment, including:
Your health care provider might also order lab tests to check for other infections or complications, including:
Currently, there's no cure for HIV/AIDS. Once you have the infection, your body can't get rid of it. However, there are many medications that can control HIV and prevent complications. These medications are called antiretroviral therapy (ART). Everyone diagnosed with HIV should be started on ART, regardless of their stage of infection or complications.
ART is usually a combination of two or more medications from several different drug classes. This approach has the best chance of lowering the amount of HIV in the blood. There are many ART options that combine multiple HIV medications into one pill, taken once daily.
Each class of drugs blocks the virus in different ways. Treatment involves combinations of drugs from different classes to:
Two drugs from one class, plus a third drug from a second class, are typically used.
The classes of anti-HIV drugs include:
Non-nucleoside reverse transcriptase inhibitors (NNRTIs) turn off a protein needed by HIV to make copies of itself.
Examples include efavirenz (Sustiva), 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).
Combination drugs also are available, such as emtricitabine/tenofovir disoproxil fumarate (Truvada) and emtricitabine/tenofovir alafenamide fumarate (Descovy).
Protease inhibitors (PIs) inactivate HIV protease, another protein that HIV needs to make copies of itself.
Examples include atazanavir (Reyataz), darunavir (Prezista) and lopinavir/ritonavir (Kaletra).
Integrase inhibitors work by disabling a protein called integrase, which HIV uses to insert 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).
Everyone with HIV infection, regardless of the CD4 T cell count or symptoms, should be offered antiviral medication.
Remaining on effective ART with an undetectable HIV viral load in the blood is the best way for you to stay healthy.
For ART to be effective, it's important that you take the medications as prescribed, without missing or skipping any doses. Staying on ART with an undetectable viral load helps:
Staying on HIV therapy can be challenging. It's important to talk to your health care provider about possible side effects, difficulty taking medications, and any mental health or substance use issues that may make it difficult for you to maintain ART.
Having regular follow-up appointments with your health care provider to monitor your health and response to treatment is also important. Let your provider know right away if you're having problems with HIV therapy so that you can work together to find ways to address those challenges.
Treatment side effects can include:
Some health issues that are a natural part of aging may be more difficult to manage if you have HIV. Some medications that are common for age-related heart, bone or metabolic conditions, for example, may not interact well with anti-HIV medications. It's important to talk to your health care provider about your other health conditions and the medications you're taking.
If you are started on medications by another health care provider, it's important to let the provider know about your HIV therapy. This will allow the provider to make sure there are no interactions between the medications.
Your health care provider will monitor your viral load and CD4 T cell counts to determine your response to HIV treatment. These will be initially checked at 4 to 6 weeks, and then every 3 to 6 months.
Treatment should lower your viral load so that it's undetectable in the blood. That doesn't mean your HIV is gone. Even if it can't be found in the blood, HIV is still present in other places in your body, such as in lymph nodes and internal organs.
Along with receiving medical treatment, it's essential to take an active role in your own care. The following suggestions may help you stay healthy longer:
People who are infected with HIV sometimes try dietary supplements that claim to boost the immune system or counteract side effects of anti-HIV drugs. However, there is no scientific evidence that any nutritional supplement improves immunity, and many may interfere with other medications you're taking. Always check with your health care provider before taking any supplements or alternative therapies to ensure there are no medication interactions.
There's little evidence on the effectiveness and benefits of supplements for HIV. 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.
Receiving a diagnosis of any life-threatening illness is devastating. The emotional, social and financial consequences of HIV/AIDS can make coping with this illness especially difficult — not only for you but also for those closest to you.
But today, there are many services and resources available to people with HIV. Most HIV/AIDS clinics have social workers, counselors or nurses who can help you directly or put you in touch with people who can.
Services they may provide:
It's important to have a support system. Many people with HIV/AIDS find that talking to someone who understands their disease provides comfort.
If you think you might have HIV infection, you're likely to start by seeing your family health care provider. You may be referred to an infectious disease specialist — who additionally specializes in treating HIV/AIDS.
Before your appointment, consider answering these questions and take them to your appointment:
Your health care provider will ask you questions about your health and lifestyle and perform a complete physical exam, checking you for:
If you think you might have HIV infection, take steps to protect yourself and others before your appointment. Don't have unprotected sex. If you use illicit injection drugs, always use a fresh, clean needle. Don't share needles with others.