Learn about
HIV
HIV (Human Immunodeficiency Virus) attacks CD4 T-cells — the immune system's coordinators — progressively weakening the body's ability to fight infection. Without treatment, HIV advances to AIDS (Acquired Immunodeficiency Syndrome), a stage defined by severe immune suppression and life-threatening opportunistic infections. With effective antiretroviral therapy (ART), people with HIV can live near-normal lifespans, maintain undetectable viral loads, and cannot sexually transmit the virus to partners. HIV is not a death sentence; untreated HIV is.
HIV Symptoms
Acute HIV infection (2–4 weeks after exposure) causes acute retroviral syndrome in 40–90% of people: fever, sore throat, swollen lymph nodes, rash, muscle aches, and sometimes mouth sores. This typically resolves within a few weeks and is often mistaken for flu or mononucleosis. After acute infection, HIV enters a chronic asymptomatic phase that can last years or decades while silently damaging the immune system. Symptoms of advanced HIV reflect immune compromise rather than the virus itself — opportunistic infections, unexplained weight loss, persistent fevers, and night sweats. Most people diagnosed with HIV today are identified through routine testing, not symptoms.
HIV Transmission
HIV is transmitted through blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, and breast milk from a person with HIV. The most common routes in the US are receptive anal sex (highest per-act risk), vaginal sex, and sharing injection equipment. HIV cannot be transmitted through saliva, tears, sweat, casual contact, hugging, sharing food, or insect bites. People on effective ART with a documented undetectable viral load cannot sexually transmit HIV — this is the U=U principle (Undetectable = Untransmittable), confirmed by multiple large clinical studies.
HIV Treatment
ART — antiretroviral therapy — suppresses HIV replication to undetectable levels in the blood. Modern ART typically involves a single daily pill combining two or three antiretroviral drugs. When taken consistently, ART reduces viral load to undetectable within 3–6 months, preserves immune function, prevents progression to AIDS, and eliminates sexual transmission risk (U=U). ART does not cure HIV, but with consistent treatment people with HIV have near-normal life expectancy. Long-acting injectable ART (given every 1–2 months) is now available for people who prefer not to take daily pills.
HIV Health Risks
Untreated HIV progressively destroys CD4 T-cells, leading to AIDS when the count falls below 200 cells/mm3. At this stage, the body cannot defend against opportunistic infections including Pneumocystis pneumonia (PCP), Toxoplasma encephalitis, cytomegalovirus (CMV) retinitis, cryptococcal meningitis, and certain cancers including Kaposi sarcoma and non-Hodgkin lymphoma. These conditions are the proximate cause of death in AIDS, not HIV itself. Early diagnosis and treatment prevents this progression in virtually all cases.
HIV Diagnosis
HIV is diagnosed through blood or oral fluid testing. The preferred test is a 4th-generation antigen/antibody combination immunoassay, which can detect HIV as early as 18–45 days after exposure. If reactive, a confirmatory HIV-1/HIV-2 differentiation immunoassay is performed. Nucleic acid testing (NAT) can detect HIV within 10–33 days of exposure and is used when very recent infection is suspected. Rapid tests (results in 20 minutes) are available at many clinics. The CDC recommends at least one HIV test for all adults aged 13–64, and annual testing for MSM and others at ongoing risk.
HIV Complications
Without treatment, HIV progresses to AIDS, characterised by a CD4 count below 200 cells/mm3 and susceptibility to a range of opportunistic infections and AIDS-defining cancers. Neurological complications including HIV-associated neurocognitive disorders (HAND) can occur even in people on ART. Long-term HIV infection and ART use are associated with increased cardiovascular, kidney, and liver disease risk — managed through regular monitoring. People with HIV are also at higher risk for certain cancers including anal, cervical, and non-AIDS-defining malignancies.
HIV Post-Diagnosis Advice
Start ART immediately after diagnosis — current evidence supports treatment as soon as HIV is confirmed, regardless of CD4 count. Early treatment consistently leads to better long-term outcomes. Take ART every day as prescribed — consistent adherence is the most important factor in achieving and maintaining an undetectable viral load. Attend regular monitoring appointments: viral load and CD4 count are checked every 3–6 months initially, then annually once stable. Inform recent sexual partners and encourage testing — many clinics offer partner notification assistance. If you're newly diagnosed and feeling overwhelmed, this is normal and expected: support services, peer networks, and mental health resources are available through your HIV clinic.
HIV Myths & Facts
HIV FAQ
Is there a vaccine for HIV?
There is currently no licensed HIV vaccine. However, pre-exposure prophylaxis (PrEP) — a daily pill containing tenofovir and emtricitabine, or a twice-yearly injectable cabotegravir — reduces HIV transmission risk by over 99% when used consistently. PrEP is recommended for all HIV-negative people at substantial ongoing risk of HIV exposure.
Can HIV-positive people have children safely?
Yes. With effective ART and an undetectable viral load, the risk of transmitting HIV to a partner is effectively zero (U=U). Babies born to HIV-positive parents on ART have less than 1% risk of acquiring HIV during pregnancy, delivery, or breastfeeding with appropriate management. Specialist guidance from an HIV and maternal-fetal medicine team is recommended for pregnancy planning.
Further Reading on HIV:
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