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HIV Infection and AIDS

HIV is a virus that attacks the immune system. Left untreated, HIV leads to AIDS. With AIDS, the immune system is so weak that common infections can be dangerous and even fatal.

People pass the virus mostly through sex, but they can also spread HIV:

  • By sharing needles.
  • From mother to baby.
  • Through an accidental workplace needlestick injury.

Medications suppress the level of HIV so that the virus can't cause damage. Today, people with HIV lead long, active and full lives.

Call the UPMC Center for Care of Infectious Diseases to learn more or make an appointment at 412-647-7228 or 1-877-788-7228.

What Are HIV and AIDS?

HIV is a virus that attacks the immune cells. It enters your bloodstream through contact with someone else's blood or sexual fluid.

At first, HIV stays at low levels and doesn't cause problems. But over time, the virus level becomes high enough to deplete white blood cells.

This, in turn, dramatically reduces the body's ability to fight infections. causing acquired immunodeficiency syndrome (AIDS).

It can take years for HIV to lead to AIDS.

Without treatment, AIDS is fatal because the body can no longer fight off infections.

HIV causes

HIV transmits through blood and semen, vaginal fluid, and rectal fluid. It does not transmit through saliva or touch.

Sex

The most common way that HIV spreads is through anal or vaginal sex.

The virus can enter the bloodstream through small tears in the vagina or rectum. Since the rectum is especially prone to tears, anal sex poses the highest risk for HIV.

The virus can also enter the body by weakening the cells lining the vagina and rectum.

The receptive partner is at higher risk for HIV, but the inserting partner is also at risk.

The virus in the vaginal fluid, rectal fluid, or blood can enter the penis through the urethra or small sores or cuts.

Needle sharing

People can contract HIV by using a needle or other equipment that a person with HIV used before them.

It's vital to never share needles or syringes to inject drugs.

Mother-to-baby HIV transmission

Babies can contract HIV through pregnancy, birth, or breastfeeding. This is why it's crucial for women to test for HIV early in pregnancy.

Women possibly exposed to HIV during pregnancy or at higher risk for contracting it should test again later in the pregnancy.

By taking HIV medicine while pregnant and when breastfeeding, women can reduce the risk of passing the infection to their baby. With these precautions, the chances the child will contract HIV is less than 1%.

Other causes of HIV and AIDS

While blood transfusions caused HIV in the past, this is not a risk today. All blood centers in the U.S. test donated blood to make sure it doesn't contain HIV.

Health workers could contract HIV through a needle stick injury if it's contaminated with HIV. Hospitals have protocols to prevent HIV by giving medicines after a needle stick injury.

Very rarely, HIV could spread through a physical fight, if blood from one person gets into the other person's bloodstream.

You have no risk of getting HIV simply by living with someone, sharing food or utensils, or social kissing or hugging.

HIV risk factors and complications

People who have sex with multiple partners without using condoms are at a higher risk of contracting HIV. Men who have sex with men are at an especially high risk.

Other sexually transmitted infections (STIs) increase the risk of getting HIV. That is because STIs can cause sores that make it easier for HIV to enter the blood.

Finally, those who use injectable drugs and share needles or other injecting equipment have an increased risk of getting HIV.

HIV usually replicates slowly in the first few years and may not cause any serious infections. But the longer you go without treatment, the higher chance it can progress to AIDS and lead to fatal infections.

How to Prevent HIV and AIDS

Use condoms

Only condoms can prevent HIV transmission during sex. Studies show that consistent condom use during sex reduces the risk of HIV transmission by around 70% to 80%.

Test for HIV

Another way to protect yourself against HIV is to test for STIs, including HIV, along with your partner.

The U.S. Department of Health suggests that every person get tested at least once for HIV in their lifetime.

People who should test more often include:

  • Men who have sex with men.
  • People who have vaginal or anal sex with many partners.
  • Those who have had prior bacterial STIs.
  • People who share injection needles.
  • Take medicine

If one person in a sexual relationship is HIV positive, they can avoid passing the virus on by taking medicine as prescribed.

After six months of properly taking HIV medications, people can reduce the virus to the point where it can't spread. But missing or delaying doses can give the virus a chance to replicate in the blood and then spread to another person.

Another way to prevent the spread in those who don't have HIV is to take a daily drug called pre-exposure prophylaxis (PrEP). You must have a prescription for it from your family doctor or an HIV provider.

If you take PrEP daily as prescribed, it's about 99% effective at preventing HIV from both anal and vaginal sex. It does not protect against other STIs.

HIV Symptoms and Diagnosis

Some people have symptoms two to four weeks after HIV enters the body. This is an acute HIV infection.

Not everyone has symptoms as the body initially fights HIV, however.

Symptoms of an acute HIV infection are much like a “flu-like illness" and include:

  • Fever.
  • Cough and sore throat.
  • Night sweats.
  • Muscle aches.
  • Rash.
  • Mouth sores.
  • Swollen lymph glands, mainly on the neck.
  • Chills.

After this acute period, the virus 'hides' in immune system cells. The virus may stop replicating or may replicate at a very low level, for many years.

Eventually, the level of the virus becomes high enough to damage the immune system's ability to fight infections.

Symptoms of chronic HIV and AIDS include:

  • Chronic or recurring fever.
  • Tiredness.
  • Pneumonia.
  • Chronic diarrhea.
  • Weight loss.
  • Oral yeast infection (thrush).
  • Shingles.
  • Skin rashes.

Diagnosing HIV

Doctors mostly diagnose HIV through a blood test. A nurse or technician takes a small sample of blood and sends it for testing. Results usually come back from the lab within a few days.

Some clinics offer rapid blood or saliva swab tests. These tests show the result within 30 minutes. Some offer at-home testing. If these rapid tests are positive, it's vital to see your doctor for a blood test to confirm infection.

It takes time for HIV to move through the body. So even if someone does contract HIV, they do not get a positive test result right away.

By three months post-exposure, the virus is high enough that a test will detect it. This is why it's important to re-test if you're at risk of contracting HIV.

HIV Treatment

If you're HIV positive, you should start treatment right away, even if you don't have symptoms.

Doctors prescribe drugs that treat HIV. In most cases, this is a single pill that you take once a day.

There are many kinds of HIV drugs that all suppress the virus but do so in slightly different ways.

Your doctor will choose the best HIV medicine for you, based on factors such as:

  • Your age.
  • Other health problems you have and medications you take.
  • Cost in some cases.

It's vital to take medications as prescribed. If you skip doses, the HIV virus can mutate slightly in ways that make the drugs less effective.

Treatment does not cure HIV but turns it into a chronic manageable condition as long you take your medicine every day.

Living with HIV and AIDS

Thanks to advanced medications, people diagnosed with HIV today can live healthy and full lives into old age. But you must take your medications and continue routine care.

Your doctor will check the status of HIV in your body through bloodwork and routine checks of your health. This way, they can see that your medicine continues to work as it should.

At times, your doctor may need to switch you from one drug to another that may work better for you.

It's crucial to tell all sexual partners of your HIV status.

Various resources and support groups can help you:

  • Learn more about HIV.
  • Meet other people with HIV.
  • Find ways to talk with your loved ones about your diagnosis.

Contact the UPMC Center for Care of Infectious Diseases

To learn more about the UPMC Center for Care of Infectious Diseases or to make an appointment, call 412-647-7228 or 1-877-788-7228.