Human immunodeficiency virus (HIV) is a virus that attacks the immune system. If left untreated, HIV can lead to acquired immune deficiency syndrome (AIDS). AIDS weakens the immune system so much that common infections can become dangerous or even life-threatening.
UPMC experts provide comprehensive care for people with HIV and AIDS, helping them manage their condition and live healthy, full lives. UPMC also offers preventive care to reduce the risk of HIV infection.
On this page:
What Is HIV Infection and AIDS?
Human immunodeficiency virus (HIV) is a virus that attacks the immune system. Left untreated, HIV leads to acquired immune deficiency syndrome (AIDS). AIDS causes the immune system to become so weak that common infections can be dangerous and even fatal.
What are the stages of HIV infection and AIDS?
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.
A low white blood cell count dramatically reduces your body's ability to fight infections, which causes acquired immunodeficiency syndrome (AIDS).
Medications suppress the level of HIV so that the virus can't cause damage. Today, people with HIV lead long, active, and full lives. It can take years for HIV to lead to AIDS.
Without treatment, AIDS is fatal because the body can no longer fight off infections.
How common is HIV infection and AIDS?
According to the U.S. Centers of Disease Control and Prevention, approximately 1.2 million people in the U.S. are living with HIV. Far fewer people are living with AIDS, as advanced medical therapies can now prevent progression of the disease.
What causes HIV infection?
People pass HIV mostly through sex. It is transmitted through blood, semen, vaginal fluid, and rectal fluid. It does not spread through saliva or touch.
People can also spread HIV:
- By sharing needles.
- From mother to baby.
- Through an accidental workplace needlestick injury.
HIV transmission through 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 vaginal fluid, rectal fluid, or blood can enter the penis through the urethra or small sores or cuts.
HIV transmission through needle sharing
People can contract HIV by using a needle or other equipment that someone with HIV has used before them. It's crucial to never share needles or syringes when injecting 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 who may be exposed to HIV during pregnancy or are at higher risk of contracting it should retake testing later in their pregnancy.
Taking HIV medicine during pregnancy and breastfeeding helps women lower the risk of transmitting the infection to their baby. With these precautions, the chance the child will contract HIV is less than 1 percent.
Other causes of HIV transmission
Health workers could contract HIV from a needle stick injury if the needle is contaminated with the virus. Hospitals have protocols to prevent HIV transmission by administering medicines after a needlestick injury.
Very rarely, HIV can spread through a physical fight if blood from one person enters the other person's bloodstream.
You cannot get HIV just by living with someone, sharing food or utensils, or social kissing or hugging. Although blood transfusions caused HIV in the past, this is not a risk now. All blood banks in the U.S. test donated blood to ensure it doesn't contain HIV.
HIV infection risk factors
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, people who inject drugs and share needles or other equipment are at higher risk of getting HIV.
Complications of HIV infection
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 the chance it can progress to AIDS and lead to fatal infections.
How can I prevent HIV infection?
You can reduce your risk of getting HIV by:
Using 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 70-80 percent.
Getting tested for STIs and 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 get tested 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.
Taking preventive HIV 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 percent effective at preventing HIV from both anal and vaginal sex. It does not protect against other STIs.
What Are the Signs and Symptoms of HIV Infection and AIDS?
Some people have symptoms 2-4 weeks after HIV enters their body. This is an acute HIV infection. Not everyone has symptoms as the body initially fights HIV.
Acute HIV infection symptoms
Symptoms of an acute HIV infection are much like a “flu-like illness” and include:
- Chills.
- Cough and sore throat.
- Fever.
- Mouth sores.
- Muscle aches.
- Night sweats.
- Rash.
- Swollen lymph glands, mainly on the neck.
Chronic HIV and AIDS symptoms
After the acute period, HIV “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 diarrhea.
- Chronic or recurring fever.
- Oral yeast infection (thrush).
- Pneumonia.
- Shingles.
- Skin rashes.
- Tiredness.
- Weight loss.
When should I see a doctor about my HIV infection symptoms?
If you have symptoms of HIV, you should schedule an appointment with your doctor right away. If you don’t have a primary care provider or health insurance, visit your local community health center and ask about free testing for HIV and other STIs. Early diagnosis and treatment for HIV can reduce the chances of spreading it to others and prevent serious complications.
How Do You Diagnose HIV Infection and AIDS?
To diagnose HIV infection, your doctor will perform a physical exam, order blood tests, ask about your symptoms, and review your medical history.
What to expect during your visit
If your doctor suspects HIV infection, they will:
- Ask you about your symptoms.
- Order blood tests.
- Perform a physical exam.
- Review your medical history.
Tests to diagnose HIV infection
Tests to diagnose HIV infection include:
- Blood test — Doctors mainly diagnose HIV through a blood test. A small blood sample is sent for testing and the results usually come back from the lab within a few days.
- Rapid blood or saliva tests — 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.
How soon does HIV show up on a blood test?
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 levels are 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 and AIDS prognosis
With treatment, many people with HIV lead long, active, and full lives. Medications suppress the level of HIV so that the virus can't cause damage and can’t be transmitted to others.
Left undiagnosed and untreated, HIV infection can progress to AIDS and will eventually result in death. Without treatment, you are also more likely to spread the disease to others.
How Do You Treat HIV Infection and AIDS?
The goals of HIV treatment are to suppress the virus so it doesn’t cause symptoms, progress, or spread to others.
If you're HIV-positive, you should start treatment right away, even if you don't have symptoms. Treatment does not cure HIV but turns it into a chronic manageable condition as long as you take your medicine every day.
Medications to treat HIV infection
Doctors prescribe drugs that treat HIV. In most cases, this is a single pill that you take once a day. Many kinds of HIV drugs 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.
Ongoing follow-up care
Thanks to advanced medications, if you are diagnosed with HIV today, you can live a healthy and full life into old age. But you must take your medications and continue to get routine medical 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.
Reducing the risk of HIV transmission
It's crucial to tell all sexual partners about your HIV status. In addition to managing your HIV infection with medication to reduce the chances that you could spread it to your partner, your partner should also talk to their doctor about medications they can take to reduce their risk of contracting HIV.
Resources and support groups
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.
Why Choose UPMC for HIV Infection and AIDS Care?
When you choose UPMC for HIV infection and AIDS care, you will receive:
- Access to board-certified specialists — Our infectious disease experts provide comprehensive HIV and AIDS care, offering the latest, leading-edge medical therapies.
- Personalized, compassionate care — Our team will partner with you to manage your condition and tailor your treatment to your unique needs.
- A full range of supportive services — We offer resources and supportive services to help you navigate the physical, financial, social, and emotional challenges associated with your HIV diagnosis.
