HIV (Human Immunodeficiency Virus) is the virus that causes AIDS. HIV can only infect human beings. It attacks and weakens the immune system by destroying the T-helper white blood cells, the cells in your body that fight off other diseases and infections.
There is no vaccine to prevent HIV or a cure for those who are already infected. But there are medications that help many people with HIV to live long, healthy lives. For someone who is HIV positive, it is important to know as soon as possible so you can work with your doctor to determine the best treatment for you.
AIDS (Acquired Immune Deficiency Syndrome) is the condition caused by HIV. AIDS is only acquired or contracted through infection. It results from the destruction of the infected person’s immune system. It is the most advanced stage of HIV infection and may include a wide range of specific illnesses, called opportunistic infections.
The average time between HIV infection and signs that could lead to an AIDS diagnosis is 8-11 years. This time varies greatly among individuals and can depend on many factors including a person’s health status and behaviors.
The key to slowing the progression of HIV to AIDS is early testing, care and treatment. Certain medical treatments can slow down the rate at which HIV weakens the immune system or prevent or cure some of the illnesses associated with AIDS. As with other diseases, early detection offers more options for treatment and preventative health care.
Primary HIV infection is the first stage of HIV disease, when the virus first establishes itself in the body. Acute HIV infection is the period of time between when a person is first infected with HIV and when antibodies against the virus are produced by the body (usually 6-12 weeks).
Some people newly infected with HIV will experience some “flu-like” symptoms. These symptoms, which usually last no more than a few days, might include fevers, chills, night sweats and rashes. Other people do not experience acute infection or have symptoms so mild that they may not notice them.
There are no common symptoms for people diagnosed with AIDS. When immune system damage is more severe, some people may experience opportunistic infections. Most of these more severe infections, diseases and symptoms fall under the CDC definition of full-blown AIDS.
The only way to determine whether you are infected with HIV is to be tested. You cannot rely on symptoms to know whether or not you have HIV infection. Many people who are infected with HIV may not show symptoms for five to ten years. People who look completely healthy can still have HIV.
You cannot rely on symptoms to establish you have AIDS. The symptoms associated with AIDS are similar to the symptoms of many other diseases. AIDS is a diagnosis made by a doctor based on specific criteria established by the CDC.
The two ways that doctors decide when a person infected with HIV is considered to have advanced to AIDS are:
From other infections: When a person’s immune system is so weakened by HIV that one or more opportunistic infections take hold. These illnesses do not generally affect a person with a healthy immune system.
From certain blood tests (CD4 counts): When the number of healthy immune system cells in an HIV-positive person’s body drops to a certain low point or when the amount of HIV in his/her blood reaches a certain high point (called the “viral load”).
People with other STDs (such as chlamydia, gonorrhea, genital herpes or syphilis) are at greater risk of getting HIV if they have unprotected sex with someone who is HIV positive. In addition, if someone with HIV is also infected with another STD, he or she is more likely to transmit the virus through sexual contact.
Having an STD can increase a person’s risk of becoming infected with HIV, whether or not that STD causes lesions or breaks in the skin. If the STD infection causes irritation of the skin, breaks or sores, it may make it easier for HIV to enter the body during sexual contact. Even an STD that causes no breaks or sores can stimulate an immune response in the genital area that can make HIV transmission more likely.
The only way to know if you have an STD, including HIV, is to get tested. Many STDs are curable and all are treatable. Getting treated for an STD can help prevent more serious health effects and reduce your risk of contracting HIV if you are exposed.
Unprotected sex is the most common way people get infected with HIV in the U.S., followed by sharing needles.
Unprotected sexual contact:
HIV is primarily spread through unprotected sexual contact – vaginal, anal or oral sex. The chances of getting or passing HIV from oral sex are lower than vaginal or anal sex, but there is still a risk. Certain bodily fluids that can be shared during unprotected sex, such as pre-semen, semen, vaginal fluids or blood (including menstrual blood), can contain the virus.
In the genitals and the rectum, HIV may infect the mucous membranes directly or enter through cuts and sores caused during sexual intercourse. Vaginal and anal intercourse is a high-risk practice.
The mouth is an inhospitable environment for HIV (in semen, vaginal fluid or blood), meaning the risk of HIV transmission through the throat, gums and oral membranes is lower than through vaginal or anal membranes. HIV can be transmitted from pre-semen or semen coming into contact with oral problems, such as open sores or bleeding gums. Oral sex (mouth-penis or mouth-vagina) is considered a low-risk practice.
Direct blood contact:
Sharing injection drug needles, blood transfusions, accidents in health care settings or certain blood products may transmit the HIV virus. An injection needle can pass blood directly from one person’s bloodstream to another. It is a very efficient way to transmit a blood-borne virus. Sharing needles is considered a high-risk practice.
Women who are HIV positive can pass HIV to their babies before or during delivery or through breastfeeding after birth. While small amounts of breast milk do not pose significant threat of infection to adults, it is a viable means of transmission to infants. There are medications that can greatly reduce the chance of an HIV-positive mother passing HIV to her baby.
Saliva, tears or sweat have never been shown to cause an HIV infection. Feces and urine also are not infectious.
Closed-mouth or “social” kissing is not a risk for transmission of HIV. Deep, open-mouth kissing if both partners have sores or bleeding gums and blood from the HIV-positive partner gets into the bloodstream of the HIV-negative partner. HIV is not spread through saliva.
No. HIV is not transmitted by day-to-day contact in the home, the workplace, schools or social settings. HIV is not transmitted through shaking or holding hands, sitting on toilet seats, hugs, casual kisses, drinking fountains, doorknobs, dishes, drinking glasses, food or pets. HIV is a fragile virus that does not live long outside the body. HIV is not an airborne or food-borne virus.
Often, people do not think of themselves or their partners as being at risk, so they do not worry about using protection or getting tested. But anyone who has had unprotected sex, used injected drugs or has a partner who has done either of these things may be at risk. The CDC estimates that one in five people who are HIV positive do not know it. For more information on HIV infections in Florida, visit the Florida Department of Health at http://www.floridahealth.gov/.
When you donate blood, it is tested for HIV and other infections to make sure it is safe for others to receive. This kind of testing is why the blood supply of the U.S. and other developed countries is so safe. Any blood found to be unhealthy in some way is not used. Also, you cannot get infected with HIV from donating blood. If you want to be sure of your HIV status, the best way to find out is not by donating blood but by getting an HIV test. The results from HIV testing are timelier and a provider can link you to the right kind of care and resources if you do test positive.
The time it takes for a person who has been infected with HIV to seroconvert (test reactive) for HIV antibodies is commonly called the “window period”. The three-month window period is normal for approximately 95% of the population. The CDC has said that in some rare cases, it may take up to six months for one to seroconvert. If you feel any anxiety about relying on the three-month result, by all means you should have another test at six months.
The HIV virus is very fragile outside the body, but it can live for a short time depending on the situation and environmental factors. The potency of the virus outside the body diminishes over time. Most household cleaners such as soap, bleach or peroxide will kill it. When cleaning any blood spills, use universal precautions, including wearing latex gloves. To be completely safe, toothbrushes and shaving equipment, which may contain small particles of blood, should not be shared.
The tests commonly used to determine HIV infection look for antibodies produced by the body to fight HIV. According to the CDC, most people will develop detectable antibodies within three months after infection. In rare cases, it can take up to six months. The CDC recommends testing at 6 months after the last possible exposure (unprotected vaginal, anal or oral sex or sharing injecting drug needles). It would be extremely rare to take longer than six months to develop detectable antibodies. It is important, during the six months between exposure and the six-month test, to protect yourself and others from further exposures to HIV.
There are no known cases in the United States of anyone getting HIV this way. However, it is possible to get HIV from a reused or not properly sterilized tattoo or piercing needle or other equipment, or from contaminated ink. It’s possible to get HIV from tattooing or body piercing if the equipment used for these procedures has someone else’s blood in it or if the ink is shared. The risk of getting HIV this way is very low, but the risk increases when the person doing the procedure is unlicensed, because of the potential for unsanitary practices such as sharing needles or ink. If you get a tattoo or a body piercing, be sure that the person doing the procedure is properly licensed and that they use only new or sterilized needles, ink and other supplies.
Yes, as an HIV-positive person’s viral load goes down, the chance of transmitting HIV goes down. Viral load is the amount of HIV in the blood of someone who is HIV-positive. When the viral load is very low, it is called viral suppression. Undetectable viral load is when the amount of HIV in the blood is so low that it cannot be measured.
In general, the higher someone’s viral load, the more likely that person is to transmit HIV. People who have HIV but are in care, taking HIV medicines and have a very low or undetectable viral load are much less likely to transmit HIV than people who have HIV and do not have a low viral load.
However, a person with HIV can still potentially transmit HIV to a partner even if they have an undetectable viral load, because
- HIV may still be found in genital fluids (semen, vaginal fluids). The viral load test only measures virus in blood.
- A person’s viral load may go up between tests. When this happens, they may be more likely to transmit HIV to partners.
- Sexually transmitted diseases increase viral load in genital fluids.
If you are HIV-positive, getting into care and taking HIV medicines (called antiretroviral therapy or ART) the right way, every day will give you the greatest chance to get and stay virally suppressed, live a longer, healthier life and reduce the chance of transmitting HIV to your partners.
If you are HIV-negative and have an HIV-positive partner, encourage your partner to get into care and take HIV treatment medicines.
Taking other actions, like using a condom the right way every time you have sex or taking daily medicine to prevent HIV (called pre-exposure prophylaxis(http://www.cdc.gov/hiv/risk/prep/index.html) or PrEP) if you’re HIV-negative, can lower your chances of transmitting or getting HIV even more.
The CDC recommends HIV testing for everyone between the ages of 13 and 64. This does not mean that testing is done automatically when you see a healthcare provider, even if you have blood drawn. The only way to know for sure you are being tested is to ask to be tested.
HIV testing also is recommended for all pregnant women as a routine part of prenatal care. A woman who has HIV and is pregnant can take certain medications during pregnancy that, combined with medical care, can significantly lower the chances of passing HIV to her baby.
Most HIV tests check for antibodies that the body produces once infected with HIV. Antibodies are proteins that the immune system produces to fight off different kinds of infections, including HIV. If an HIV test detects HIV antibodies, a person is infected with HIV.
If antibodies are not present, a person is considered non-reactive for HIV. It can take as long as 90 days for the body to develop enough antibodies to be measurable on this type of test. The time period between HIV exposure and a positive test is called the “window period,” during which you could test non-reactive for HIV but still be infected with HIV and able to transmit the virus to others. It is important to get tested (or re-tested) after a sufficient period of time has passed to know for sure.
There are several types of HIV tests, but the two most common types are blood tests and oral swab tests. Both forms have the same accuracy with their results. HIV blood tests use a sample of blood, either from a finger prick or a larger sample often taken from the inner arm, to test for HIV antibodies. Oral tests use a swab to collect cells from inside the mouth to test for HIV antibodies. Traditional HIV test results can take one to two weeks to come back from a lab, but rapid tests that can provide a result in about 20 minutes are widely available.
There are some home tests, but only the Home Access Test has been approved by the FDA. That test kit can be found at most local pharmacies or online. The testing procedure involves pricking your finger with a special device, placing a drop of blood on a specially-treated card and mailing in the card for testing. You are given an identification number to use when you phone in for the test results – three days or two weeks later, depending on the one purchased.
Viral load tests are used by physicians to monitor their patients who have already tested positive for HIV antibodies. These are very costly and should not be used to determine if one is HIV positive.
Even though HIV testing is recommended as part of routine medical care, many doctors do not offer testing for HIV or other STDs unless you specifically ask to be tested. If you are not comfortable talking with your regular healthcare provider or do not have a provider, there are many clinics that specialize in testing.
Anonymous testing means that absolutely no one has access to your test results since your name is never recorded at the test site. Anonymous testing sites are not available in all states and at all locations. Home tests also are anonymous.
Confidential testing means that you and the healthcare provider know your results, which will be recorded in your medical file, just like the results of any other tests. If you test positive for HIV, your result will also be shared with your state’s health department for purposes of monitoring trends in the HIV epidemic. Remember, if you do test positive, it is very important for you to work closely with your doctor to get the care and treatment you need.
The cost of HIV testing varies. Clinics that offer tests for free or on a sliding scale are available in most areas. We offer confidential, rapid testing at no charge at our four locations and mobile unit. Health insurance may cover the cost of HIV testing. Call ahead to your doctor or local clinic to find out how they charge for HIV tests or to your health insurance provider to find out if the tests are covered.
The most important thing to do if you test negative is to stay negative. Your HIV test result reveals only your HIV status. It does not indicate whether or not your partner(s) has HIV. HIV is not necessarily transmitted every time you have sex. Ask your partner if he or she has been tested for HIV and what risk behaviors he or she has engaged in, both currently and in the past. Think about getting tested together.
The most common locations for HIV testing are local health departments, private physicians, hospitals and test sites specifically set up for HIV testing. EPIC provides free confidential, rapid testing at our four locations and mobile unit. The OraSure test currently only is available through healthcare providers or clinics and urine tests at some clinics. Home tests may be performed anonymously in your own home.
The CDC National AIDS Hotline can answer questions about testing and refer you to testing sites in your area. The hotline numbers are 1-800-342-2437 (English), 1-800-344-7432, (Spanish), or 1-800-243-7889 (TTY). Go to the Testing page on our website for our locations and testing hours or call us at 727-328-3260.
If you test positive, the sooner you take steps to protect your health, the better. With treatments today, you can lead a long, healthy life as an HIV-positive person. Get connected with services and support as soon as possible. Early medical treatment, a healthy lifestyle and a positive attitude can help you stay well.
It is important to know that a positive HIV test should always be confirmed, to be sure that it is a true positive. If your test result is positive, you immediately should:
- See a doctor or other licensed healthcare provider, even if you don’t feel sick. Try to find one who has experience treating HIV infection. There are tests, immunizations and medications to treat HIV infection and help you maintain good health.
- Have a tuberculosis (TB) test done. You may be infected with TB and not know it. Undetected TB can cause serious illness, but it can be treated successfully if detected early.
- Stop or reduce the use of recreational drugs, alcoholic beverages and cigarettes, which can weaken your immune system. There are programs to help you quit these substances.
- Get screened for other STDs. Undetected STDs can cause serious health problems.
- Consider joining a support group for people with HIV or speaking with a counselor.
- Connect with other local and/or national resources that might help you.
- Talk with your sexual partner(s) about your HIV status and make sure you reduce your risk of transmitting the virus by practicing safer sex, including using latex condoms.
For information on our services and other available local resources, call us at 727-328-3260.
For additional information and referrals, call the CDC National AIDS Hotline at 1-800-342-2437 (English), 1-800-344-7432 (Spanish) or 1-800-243-7889 (TTY).
Not having (abstinence) sex is the most effective way to avoid transmitting HIV. Having sex with one person who only has sex with you (mutual monogamy) and who is uninfected also is effective. If you choose to be sexually active, use condoms each and every time you have sex. When used consistently and correctly latex condoms are considered highly effective, though not 100%, in preventing the spread of HIV and protecting against other STDs. If you or your partner(s) are allergic to latex, plastic (polyurethane) condoms (male or female) can be used.
It is important to know your own – and your partner’s – HIV status. By knowing if you have HIV or another STD, you can take precautions to protect your own health and your partner’s. Get tested regularly, especially before starting a new relationship.
When performing oral sex on a man (fellatio), the use of latex condoms, withdrawal before ejaculation without a condom (avoiding semen in the mouth) and/or refraining from this activity when cuts or sores are present in the mouth can reduce the risk of transmission.
When performing oral sex on a woman (cunnilingus), moisture barriers such as a dental dam (sheet of latex), a cut-open and flattened condom or household plastic wrap can reduce the risk of exposure to vaginal secretions and/or blood.
Avoid using needles or drug works (commonly called paraphernalia). If you do use them, make sure they are new and sterile (along with sterile water, new containers and new filters), do not share them with other people and safely dispose of them after one use. Only use syringes obtained from reliable sources, such as pharmacies or needle exchange programs and clean the injection site with a new alcohol swab before injection. If new, sterile syringes and equipment are not available, then previously-used equipment should be boiled in water or disinfected with bleach before reuse.
Safe sex refers to sexual activities that do not involve any sexual fluid from one person getting into another person’s body. If two people are having safe sex, even if one person is infected there is no possibility of the other person becoming infected. Safe sex activities include hugging, touching, caressing and mutual masturbation.
Safer sex refers to a range of sexual activities that hold little risk of HIV infection or other STDs. If you are not in a mutually-monogamous relationship (sex with only you and your partner) and you and your partner are negative, safer sex can include properly using a barrier (latex condom or dental dam) each time you have sex, from start to finish. Condoms are the only method that provides protection against HIV, other STDs and unintended pregnancy. The best way to prevent HIV and other STDs is to abstain from sex.
We provide condoms free-of-charge at all of our offices, in our mobile unit and at some community events. Testing centers and health clinics also may have free condom supplies. You can buy condoms in pharmacies, grocery stores, convenience stores, dispensers in restrooms, online and other places.
Condoms come in lots of colors, textures, lengths, widths and thicknesses. Make sure they are latex or polyurethane (plastic), which both are effective in preventing HIV, other STDs and pregnancy. Avoid using animal skin (or “natural”) condoms, which prevent pregnancy but are not as effective in preventing all STDs, including HIV. While male condoms are more popular, female condoms, which are inserted into the vagina, also are an option when male condoms cannot be used. There are latex-free condoms available for those who might have allergies to latex.
Condoms can break, slip or leak if they are not put on and taken off properly. If you feel the condom break at any point during sexual activity, you should stop immediately, withdraw, remove the broken condom and put on a new condom. Emergency contraception, which prevents pregnancy but not STDs, can be started five days after unprotected sex, but the sooner it is started the better it works.
For many people, it may be uncomfortable bringing up the topic of condoms with their partners. It is likely your partner will be relieved that you are taking the lead to use condoms to protect each other from HIV and other STDs.
Here are some tips for starting the conversation:
Know Yourself: Think through what feels right for you so you are clear about how you feel and can talk about it with someone else.
Get the Facts: Read up on STDs, pregnancy prevention and using condoms correctly and consistently so you are prepared if any questions come up.
Talk Before it is Too Late: Talk about condoms before you are in a situation when you might need one (before you take your clothes off). Find a time and place where you are comfortable and can talk without other things going on.
Be Confident: Be up front and direct about wanting to use condoms each and every time you have sex. There is no shame in wanting to protect yourself and others from STDs or pregnancy.
Explain the Risks: Using condoms does not mean you have trust issues. STDs often show no symptoms and many of those who are infected do not know it, so condoms are good common sense.
Be Respectful: Respect yourself, your partner and your relationship. If part of why you want to talk about condoms is to tell your partner about an STD you have, just say so. Talking about it will it help you take the right precautions to protect you and your partner’s health.
Love Yourself: If your partner refuses to use condoms, be firm. No condom, no sex. If your partner does not want to protect you and his/herself and does not respect your wishes, you might want to ask yourself if you really want to have sex with this person.
If you are HIV positive, we can help you coordinate and receive the care and treatment you will need to stay healthy. We offer pharmacy, counseling, support groups and other services as well as medical case management that can help you access all your medical and social support needs. Services are available at our Clearwater and St. Petersburg locations, including our one-stop Home 3050 medical home in St. Petersburg.
The CDC National AIDS Hotline can offer practical information on maintaining health, general information on a variety of treatments (such as antiretroviral therapy and prophylaxis for opportunistic infections) and referrals to national treatment hotlines, local AIDS service organizations and HIV/AIDS-knowledgeable physicians. The hotline numbers are 1-800-342-2437 (English), 1-800-344-7432 (Spanish) or 1-888)-480-3739 (TTY).
For information on treatments and clinical trials, visit the Department of Health and Human Services (DHHS) AIDSinfo website or call at 1-800-448-0440 (English and Spanish) or 1-888-480-3739 (TTY). For information on enrolling in clinical trials, call 1-800-874-2572 (English and Spanish) and 1-888-480-3739 (TTY).
Ongoing medical care is one of the most important things you can do to stay healthy. Once you find a doctor or clinic, you should get an evaluation of your general health and immune function. Many doctors will:
- Administer lab tests to evaluate your immune system.
- Determine if you have other diseases that might become problematic in the future, including syphilis, TB, hepatitis-B, and toxoplasmosis.
If you are already infected with one or more of these other illnesses, there may be treatments or prophylaxis available to prevent it from becoming more serious or recurring. If you are not already infected, doctors may be able to prevent future infection by:
- Administering vaccines. Many HIV-positive people get a hepatitis-B vaccine and bacterial pneumonia vaccines, since contracting these diseases could be dangerous for immune-suppressed people.
- Prescribing antiretroviral treatments and protease inhibitors when tests show immune system impairment.
Scheduling regular check-ups, every three to six months, is essential. Some people need more frequent check-ups, particularly when they are starting new antiviral drugs.
It is also important to take care of your emotional well-being by going to counseling or support groups. Many HIV-positive people struggle emotionally because of isolation, depression, anxiety or other challenges and this support can provide a safe way of sharing feelings and practical information.
HIV can be treated and controlled with antiretroviral therapy (ART), a combination of medicines (called an HIV regimen) that must be taken every day as prescribed. Other treatment may include over-the-counter supplements, integrative therapies and medications to manage pain and other symptoms. Exercise, healthy eating, counseling and support groups also can help maintain your health and wellness. A qualified physician can help manage your care.