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Human immunodeficiency virus (HIV) can make it harder for your body to fight infections. If untreated, HIV can progress to acquired immune deficiency syndrome (AIDS) which increases the risk of certain types of cancer. Learn more about these infections, how to protect yourself, and how they are treated.

Human immunodeficiency virus (HIV) attacks and destroys the body’s immune system by killing a specific type of white blood cell known as the CD4 cell or helper T cell.

Acquired immune deficiency syndrome (AIDS) is the most advanced stage of HIV. AIDS happens when HIV has badly damaged the immune system, which can take years. The loss of CD4 cells allows infections and cancers to occur that usually don’t affect healthy people. These are called opportunistic infections and opportunistic cancers.

Anti-retroviral therapy (ART) is medicine used to treat HIV infection. Because of ART, fewer people living with HIV (PLWH) are developing AIDS. In fact, PLWH can live long and healthy lives by taking ART.

How are people infected with HIV?

HIV can spread when an uninfected person is exposed to blood, semen, vaginal fluids, rectal fluids, or breast milk from someone living with HIV. There are several possible routes of HIV transmission (spread):

• Unprotected vaginal, anal, or oral sex with a person with HIV
• Sharing needles or syringes with a person with HIV, possibly by injecting drugs or tattooing
• Infants born to mothers living with HIV
• Breastfeeding by mothers living with HIV
• Injuries or accidents that break the skin while handling the blood of or caring for PLWH (usually needle sticks in health care workers)

HIV is NOT spread through:

• Casual contact like talking, shaking hands, hugging, coughing, or sneezing
• Saliva (spit), tears, or sweat
• Sharing dishes, bathrooms, telephones, or computers
• Insect or tick bites or through water

Blood transfusions and organ donations

With new precautions and careful testing at blood banks, the risk of HIV spread through transfusions of blood and blood products has been almost eliminated. There is a 1 in 2 million chance of being infected with HIV through a blood transfusion in the United States.

Infection through organ transplants is very rare because donor organs and tissues are thoroughly tested for HIV before transplant.

Should I be tested for HIV?

The US Centers for Disease Control and Prevention (CDC) recommends everyone between the ages of 13 and 64 to get HIV tested at least once.

However, HIV testing might not be done unless you have certain medical problems, are pregnant, or ask to be tested.

Why to get tested

HIV infection might not cause symptoms for years, and a person can have HIV for a long time and not know it. HIV is often diagnosed after the development of opportunistic infections or cancer. But with testing, HIV can be diagnosed, and treatment can be started before someone gets seriously ill.

Finding an HIV test

If you have any doubt about your HIV status, talk with your health care provider or visit a health department clinic where testing is offered.

To have the HIV test done without giving your name and address (anonymous testing), you can buy a home collection kit at the drugstore or online or go to an anonymous testing site. Some state health departments also offer anonymous HIV tests.

HIV testing is covered by insurance without a co-pay. If you don’t have insurance, look for a testing site that provides free tests.

How is HIV treated?

HIV is a type of virus called a retrovirus. Treatment for HIV is known as anti-retroviral therapy or ART.

Once someone is diagnosed with HIV, ART should start as soon as possible. HIV infections cannot be cured, but they can be managed long-term with ART. By taking ART regularly, PLWH can have a normal life span, and if they develop AIDS, they can live longer.

Choosing the ART medicines

Treatment for HIV often uses 3 or more ART medicines. These medicines are taken daily to help keep the virus from making more copies of itself (replicating).

The combination of ART medicines varies with each person depending on:

• How severe their HIV infection is
• Whether the infection is resistant to any of the ART medicines
• Side effects
• Other factors, such as other diseases that they might have

Different combinations might be tried. Over time, the ART medicines might need to be changed.

Goal of treatment

The main goal of ART is to lower the amount of HIV in your blood, hopefully to make it undetectable. This can reduce damage to your immune system and decrease the risk of opportunistic infections, cancers, AIDS, and other long-term effects of HIV. Reducing the amount of HIV also greatly lowers the risk of spread.

It is important that you take your ART as prescribed to keep your HIV blood levels as low as possible.

Other considerations

Self-care methods can also support your immune system. Try:

• Eating well and getting regular exercise
• Managing stress
• Avoiding infections by staying away from people who are sick, practicing food safety, getting certain vaccines, taking antibiotics, and using safer sex practices
• Stopping tobacco, alcohol, and other drug use?

How can the risk of HIV spread be reduced?

Using condoms during vaginal or anal sex: Avoid unprotected sex with someone living with HIV. If one partner is known to be infected or their HIV status is uncertain, using condoms every time, from start to finish, can lower the risk.

Using clean, sterile needles and supplies if injecting drugs: Never share needles. The second most common cause of HIV infection is sharing used needles or drug equipment with injection drug users living with HIV.

Using pre-exposure prophylaxis (PrEP): For people who are at high risk of HIV infection, taking a prescription pill every day is another way to help lower the risk of infection.

Taking post-exposure prophylaxis (PEP): If you have been exposed to HIV, such as from a broken condom or needle stick injury, PEP treatment might reduce the risk of HIV infection. This treatment involves taking anti-HIV drugs every day for 28 days. PEP works best if started as soon as possible after exposure, within 72 hours.

Treatment as prevention?: In PLWH, ART lowers the amount of HIV in the body, often to levels that cannot be detected on a blood test. When HIV is undetectable, it cannot be passed on to others. For PLWH, taking ART prevents the spread of the virus to others.   

Reducing mother-to-infant transmission: All pregnant women should be tested for HIV. If HIV is diagnosed, treatment with ART should be started right away. Treating the mothers and infants with ART and avoiding breastfeeding reduces the risk of HIV infection in infants. Also, the baby might need to be delivered by C-section if the mother’s HIV levels are high.