HIV

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What is HIV?

HIV stands for Human Immunodeficiency Syndrome, and we hope this resource will be a source of information about all aspects of the syndrome for educational purposes.

What is Human Immunodeficiency Syndrome?

HIV (human immunodeficiency virus) is the virus that causes AIDS. It attacks the cells of your immune system, making you more vulnerable to get sick or even die from illnesses your body would normally be able to fight off. HIV is spread through sex, so condoms help protect you.

Approximately 1.1 million people in the United States are living with HIV. About 14% (1 in 7) are unaware that they are infected.1 Because many people with HIV don’t show symptoms for years after infection, getting tested is important for early detection, and it can even be lifesaving.

Although there is no cure, medication can help people with HIV have a near-normal life span and a healthy quality of life. HIV treatment can also manage the condition to help the virus become non-transmittable.

HIV Meaning

HIV means “Human Immunodeficiency Virus.” This virus attacks the immune system, specifically the CD4 cells (T cells), crucial in our body’s defense against infections and diseases. Over time, HIV can destroy so many of these cells that the body cannot effectively fight off infections and diseases.

When a person becomes infected with HIV, their body will try to fight off the infection by producing antibodies. However, these antibodies are not enough to eliminate the virus, leading to a chronic condition where the virus continues to multiply and weaken the immune system.

There are 2 types of HIV: HIV-1 and HIV-2. HIV-1 is the most common type responsible for most HIV infections globally. HIV-2 is less common and is mainly found in certain parts of West Africa.

It’s important to note that having HIV meaning does not automatically link a person to having AIDS. AIDS is the most advanced stage of HIV infection, characterized by a severely damaged immune system and the occurrence of certain defining illnesses. With modern antiretroviral treatment, many people with HIV do not progress to this stage. We discuss that more later in this article.

Is HIV Curable?

Is HIV curable is a question we get all the time. As of now, in 2023, HIV remains a significant global health issue. While there isn’t a universal cure yet, there have been significant advancements in treatment and some rare instances of individual cures.

The standard treatment for HIV is antiretroviral therapy (ART). This therapy involves a combination of medicines to slow down the virus’s progression in a person’s body. Although ART does not eliminate HIV, it can control it and help people with HIV live longer healthier lives. It also reduces the risk of transmission.

Moreover, scientific research continues to progress toward finding a cure. There have been cases where individuals have been effectively ‘cured’ of HIV. For instance, as of the recent report, five people have been confirmed to have been cured of the virus. These cases often involve complex and risky procedures such as stem cell transplants, which are not feasible or safe for all people with HIV.

In these instances, a ‘functional cure’ is achieved, meaning that while the virus may still be present in the body, its levels are so low that it doesn’t cause illness and cannot be detected by standard tests. However, these cases remain the exception rather than the rule. Nonetheless, they provide valuable insights for researchers working on developing a more widely applicable cure. So, is HIV curable… not yet, but the ultimate goal of ongoing research is to find a remedy that is safe, effective, and accessible for everyone living with HIV. However, the nature of the virus presents significant challenges. HIV has a unique ability to integrate its genetic material into the cells of the host, making it challenging to eradicate.

Furthermore, the virus continually mutates and evolves, making it a moving target for treatments and potential cures. The virus can also remain dormant in what are known as ‘viral reservoirs,’ hiding in specific cells and tissues, making it even harder to eliminate completely.

While HIV is currently not curable in the conventional sense, advancements in medical science and research bring us closer to a potential cure. In the meantime, effective treatments allow those living with HIV to manage the disease and lead healthy lives.

HIV Vaccine

In early 2022, the first of its kind appeared in medical history, three mRNA-based vaccines against HIV. This was a trial on volunteers conducted by virologists and epidemiologists. These vaccines are meant to be for prevention, as in they are taken to prevent an individual from being infected with HIV. Currently, there is no HIV cure, but this could be the first step in at least preventing further infection rates from rising.

What is the Difference Between HIV and AIDS?

HIV and AIDS are not the same thing. HIV is a virus that makes copies of itself and can eventually lead to the condition AIDS. Not all people with HIV have AIDS. However, anyone diagnosed with AIDS has previously contracted HIV.

AIDS stands for acquired immunodeficiency syndrome. It is the third and final stage of HIV infection when the virus has caused serious damage to the immune system. HIV destroys immune cells called CD4 cells, or T cells. You have AIDS when your CD4 cells reach a dangerously low amount (below 200 cells/mm) or if you develop opportunistic illnesses.2

When the body’s defense has deteriorated, it is no longer able to properly protect against infection or detect faulty cells. Therefore, people living with AIDS can develop opportunistic infections that the body would otherwise be able to fight off, or types of cancer.3  Learn more about AIDS symptoms on our dedicated page.

Signs and Symptoms

Many people with HIV or AIDS don’t show HIV symptoms right away. Because they feel fine, they don’t know they have it and might unknowingly spread the virus. Some people with HIV experience a flu-like illness within 2-4 weeks of infection, but this passes after a short time and can be easy to overlook. It can take years for someone with HIV to start feeling really sick.

How Is HIV Transmitted?

You probably have a million questions about how you might catch HIV. Can HIV be transmitted through saliva or through saliva to an open wound? How much saliva is needed to transmit HIV? Is HIV transmitted through kissing? Can HIV be transmitted through oral sex? How quickly can HIV be transmitted? Can HIV be transmitted through breast milk? Can mosquitoes transmit HIV?  Is HIV transmitted through mucous membranes? How is HIV trasmitted through sex or birth? 

HIV can be transmitted only through certain body fluids: blood, semen, vaginal fluids, anal fluids/mucus, and breast milk. You can contract HIV if the virus enters your body through mucous membranes like the vagina, the rectum, the opening of the penis. It can also enter the body through cuts or sores on your skin.

Most commonly, HIV is spread through:

• Unprotected anal and vaginal sex
• Shared needles or syringes, such as contaminated drug equipment

The risk of acquiring HIV depends on the type of sexual activity.6 Unprotected receptive anal sex (bottoming) is the highest-risk sexual behavior. This is because rectal tissue is thin and fragile and tearing occurs easily.7 An insertive partner (or top) can also get HIV through the urethra at the tip of the penis or through cuts or sores on the penis.

Pregnant women with HIV can pass HIV to their baby during pregnancy, labor, childbirth, or breastfeeding. Taking HIV medicine helps lower the risk of mother-child transmission and keep both the mother and baby healthy.

You can’t get HIV from:

• Saliva, tears, or sweat
• Closed-mouth kissing
• Using a toilet
• Close contact like hugging or holding hands
• Coughing or sneezing
• Mosquitoes

HIV is primarily transmitted through direct contact with certain body fluids from a person with HIV. These fluids must come into contact with a mucous membrane or damaged tissue. Another way is for it to be directly injected into the bloodstream for transmission. Here are the primary ways in which HIV can be transmitted:

1. Sexual Transmission: This is the most common way HIV is transmitted. The virus can be present in semen, vaginal and rectal fluids, and breast milk. During vaginal or anal sex, the virus can enter the body through the mucous membranes of the vagina, penis, rectum, or mouth. The risk increases significantly if there are sores or inflammation due to sexually transmitted infections or other factors.
2. Sharing Injection Equipment: Sharing needles or syringes, rinse water, or other equipment to prepare drugs for injection can carry HIV and other viruses. The blood in the used needle can have the virus; if another person uses the same needle, they can get infected.
3. Mother-to-child Transmission: A mother can pass HIV to her child during pregnancy, childbirth, or breastfeeding. However, suppose a woman living with HIV takes HIV medication as prescribed throughout pregnancy, labor, and delivery and gives HIV medicine to her baby for 4-6 weeks after delivery. In that case, the risk of transmitting HIV can be lowered to 1% or less.
4. Blood Transfusion and Organ Transplants: In some cases, it’s possible to contract HIV through blood transfusions, organ transplants, or receiving donated tissue. However, this is extremely rare nowadays because all donated blood, organs, and tissues in many countries, including the U.S., are tested for HIV.
5. Occupational Exposure: Healthcare workers can potentially be exposed to HIV in the workplace, usually through accidental injuries from needles and other sharp objects. However, this type of infection is scarce, especially given the safety measures in healthcare settings.

It’s crucial to note that HIV is not transmitted through casual contact. It cannot be spread through air or water, saliva, sweat, tears, closed-mouth kissing, insects or pets, or sharing toilets, food, or drinks.

Understanding these modes of transmission is essential for preventive measures. Using condoms correctly and consistently, not sharing injection equipment, and taking pre-exposure prophylaxis (PrEP) if you’re at high risk are effective strategies to prevent HIV transmission. If you’re living with HIV, taking your medication as intended and maintaining an undetectable viral load can prevent transmission to others.

Who Is At Risk?

Anyone can get HIV, regardless of sexual orientation, gender, race, or age. That being said, gay and bisexual men are the population most affected by HIV, making up more than half of the people living with HIV. The CDC recommends that sexually active men who have sex with men get tested at least once a year for HIV. Read on to see how HIV is transmitted through sex.

You may be at increased risk of getting HIV if you have:

• Risky, unprotected vaginal or anal sex without a condom, especially with a partner that has a high viral load
• Shared needles, syringes, or other equipment for drug injection
• Sex with multiple partners
• Sex while high from drugs or intoxicated
• Other STDS

HIV Vs. AIDS

HIV can cause infections, AIDS is a condition. Contracting HIV can develop into AIDS. Otherwise known as stage 3 HIV, AIDS happens when HIV is done heavy damage to the immune system. You can have HIV without it developing into AIDS. It all depends on how well you manage your HIV and how compromised your immune system is. AIDS is life-threatening and is meant to describe an accumulation of infections that the body is susceptible to since the immune system is no longer able to produce enough white blood cells to fight off the infections.

How Long Does It Take for HIV to Develop into AIDS?

Without treatment, it usually takes about 8–10 years to develop AIDS after initial HIV infection.9 It can advance slower or quicker depending on factors like age and general health. HIV treatment makes it possible to slow down the progression, and some people can live with HIV without ever developing AIDS. This is why getting tested for HIV and knowing your status is so crucial.

Is HIV Fatal?

Untreated HIV develops into AIDS, which eventually leads to death. HIV itself does not kill most people, but it compromises the immune system so that people with HIV/AIDS are more likely to die from pneumonia, diarrhoeal illnesses, brain infections, or certain tumors such as cervical lymphoma.

Without treatment, people with AIDS generally survive for about 3 years. But having HIV is not a death sentence, thanks to modern medicine. It is very important you seek treatment if you know you have HIV/AIDS so that you can manage the virus. Proper medication lowers the amount of HIV in the body and slows the virus’ progression.

Types of HIV

There are two main types of HIV: HIV-1 and HIV-2. As with other viruses, HIV has different strains and variants. While HIV-1 and HIV-2 are different, both can lead to AIDS. HIV-1 is the most common type and accounts for around 95% of infections worldwide. HIV-2 is not commonly seen outside of West Africa, but it has been seen in other places. HIV-2 is generally less infectious and takes longer to progress to AIDS compared to HIV-1.10

Is There a Cure for HIV?

As mentioned earlier, no. Once you have HIV, it is a lifelong infection. That being said, people living with HIV can take medicine to reduce the amount of virus in the blood and other bodily fluids. This medicine is called antiretroviral therapy (ART), and it helps you suppress the virus and stay healthy for many years. In fact, by following treatment, it is possible to achieve an undetectable viral load, meaning that viral levels are so low that tests can’t detect it. People with an undetectable viral load have effectively no risk of spreading HIV to partners during sex.

How Do You Prevent HIV?

Condoms and Lubricants

You can lower your risk of getting or spreading HIV by using latex or polyurethane condoms correctly every time you have sex. Water- or silicone-based lubes can help prevent condom breakage and torn tissue during sex. Since condoms are not 100% effective, other prevention methods can further lower your risk.

PrEP

PrEP stands for pre-exposure prophylaxis. It is a pill taken daily by mouth that can stop HIV from taking hold and spreading. The CDC reports that PrEP is highly effective, reducing the risk of getting HIV from sex by about 99% and reducing the risk for people who inject drugs by at least 74%.11

PEP

PEP stands for post-exposure prophylaxis. It is an antiretroviral medicine (used to treat HIV), and it is taken only in emergencies after being potentially exposed to the virus (for example, if the condom broke, you shared needles or drug equipment, or were sexually assaulted).

PEP must be started as soon as possible, within 72 hours (3 days) of a possible HIV exposure. Every hour counts, so the sooner you start PEP, the better.

Lower Risk Sexual Activities

Certain behaviors like oral sex have little to no risk of HIV transmission.12 However, oral sex can spread other STDs like herpes, syphilis, chlamydia, and gonorrhea, so it’s recommended to use protection like condoms and dental dams.

Being in a mutually monogamous relationship with someone who has tested negative or limiting your amount of sexual partners can also lower your chances of getting or spreading HIV.

By talking openly with partners and getting tested for HIV, you can protect your health. Getting tested for HIV is the only way to know for sure if you have it. If you do, knowing your status can help you get support and treatment. The proper care and medicine can keep an HIV-positive person healthier and prolong their life.

Medically Reviewed by Julie Hutchinson, MD on July 2, 2023