In the 1980s and ’90s, HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) entered the public consciousness in a big way: Think about the musical Rent or the moment when basketball player Magic Johnson publicly revealed his diagnosis.
After those two decades, HIV quickly seemed to disappear from popular culture and fade from people’s memories. But HIV is not a thing of the past.
HIV is a continuing endemic infection with 31,000 to 38,000 new adult cases in the U.S. every year. And though it’s often wrongly thought of as an issue that only affects gay men, in 2018, the CDC estimated that 19% of new HIV diagnoses were in women.
Read on for answers to some common questions about HIV and AIDS.
Q: What exactly is HIV?
A: HIV is a virus that lives inside human immune cells, which allows it to hide from your immune system. Over time, the virus becomes part of the genetic code and is able to multiply using the cells it lives in. This weakens the body’s immune system to the point where it can’t fight off some infections — and even some cancers — like our bodies typically do. This makes HIV dangerous, and if it’s not controlled through treatment, leads to AIDS. AIDSis a more severe form of HIV, which indicates that your immune system is even weaker and puts you at higher risk for infections, chronic diseases like diabetes, heart disease, kidney disease, strokes and some cancers.
Q: Do you feel sick if you get infected by HIV?
A: When initially infected with HIV, you may have symptoms of a nonspecific flu-like illness including joint and muscle aches, a fever, a sore throat, and swollen lymph nodes. This usually goes away after a few days or weeks. After that, you can feel normal for months, or even years, without being treated. However, HIV is still damaging and invading your immune system silently, which is why it is important to get tested regularly if you are at risk of acquiring HIV.
Q: How do you get HIV?
A: You get HIV from direct contact between infected body fluid and your blood. The body fluids that can pass HIV to another person are blood, semen, pre-seminal fluid (just prior to ejaculation), rectal fluids, vaginal fluids and breast milk.
For women, the most common way to acquire HIV is through vaginal or anal sex with an HIV-infected male partner. Sharing needles with HIV-infected people also can lead to infection. A pregnant woman infected with HIV and not on medications to control the virus can pass HIV to her developing fetus while carrying the baby, during delivery or by breastfeeding.
If you share needles or syringes, have unprotected sex, or have an STI, you’re at higher risk for HIV.
Q: What happens if you get HIV?
A: HIV is a noncurable infection, which leads to a lifetime of complications and medications. However, research has led to very effective treatments for HIV to keep the HIV viral load undetectable, which helps people living with HIV to lead relatively healthy lives. Most HIV treatment regimens can now be taken as one pill a day.
However, HIV does change your health risks. Being infected with HIV leads to an increased risk of:
- Repeated vaginal yeast infections
- Severe pelvic inflammatory disease
- Increased risk and worse outcomes for many cancers including cervical cancer, head and neck cancer, and anal cancer
- High risk of low bone density (osteoporosis)
- Increased risk of heart disease, stroke and kidney dysfunction
If your HIV is not controlled, you can pass HIV to someone else.
Q: How can I prevent HIV?
A: There are many ways to protect yourself from acquiring HIV:
- Don’t share needles. If you are using intravenous drugs, do not share needles with anyone. Take advantage of sterile needle exchanges in your area.
- Talk to your sexual partners. Don’t hesitate to ask sexual partners of any gender whether they have HIV or any other sexually transmitted infections. However, know that if a sexual partner has HIV but is treated so that their viral load is undetectable, they should not be able to pass the virus to you.
- Avoid unprotected sex. Use a condom with all sex — vaginal, anal or oral — to prevent HIV. Condoms also help prevent gonorrhea, syphilis and chlamydia infections.
A newer method of preventing HIV is called PrEP (pre-exposure prophylaxis). PrEP is about 99% effective in preventing HIV infection if it is taken every day. PrEP is a single pill — the pill includes two medications that are also used in HIV treatment regimens — taken once per day. PrEP is not a treatment for HIV infection, so people taking it need to test regularly for HIV.
Talk to your primary care physician about starting PrEP if you are interested and at high risk. PrEP does not prevent infection from other STIs like gonorrhea, chlamydia and syphilis.
Q: Where can I get tested for HIV?
A: Most health centers can test you, including primary care and obstetricians/gynecologists (OB/GYN). If you have a relationship with one of these health care providers, ask to get tested. If you do not have access to a provider, contact your local health department. The department should be able to connect you to screening and treatment at little to no cost.
For those at risk of HIV, it’s recommended that you are tested routinely and with any new symptoms such as discharge, pain or flu-like illness.
Q: What if I don’t have insurance and I get infected with HIV?
A: Learning you have HIV is stressful, but there are resources to help you. Federal legislation in the U.S. known as the Ryan White HIV/AIDS Program funds state programs to provide HIV medical care, treatment and support services to people living with HIV who do not have insurance or are underinsured. So don’t be frightened by quoted costs of HIV medication; there are assistance programs to help.
