DEFINITION

Human immunodeficiency virus (HIV) is an infection that attacks the body’s immune
system, specifically the white blood cells called CD4 cells. HIV destroys these CD4
cells, weakening a person’s immunity against opportunistic infections, such as
tuberculosis and fungal infections, severe bacterial infections and some cancers.
SIGNS AND SYMPTOMS
The three stages of HIV and some of the symptoms people may experience.

Stage 1: Acute HIV Infection

Within 2 to 4 weeks after infection with HIV, about two-thirds of people will have a
flu-like illness. This is the body’s natural response to HIV infection. 

Flu-like symptoms can include:

 Fever
 Chills
 Rash
 Night sweats
 Muscle aches
 Sore throat
 Fatigue
 Swollen lymph nodes
 Mouth ulcers

These symptoms can last anywhere from a few days to several weeks. But some
people do not have any symptoms at all during this early stage of HIV.

Don’t assume you have HIV just because you have any of these symptoms—they can
be similar to those caused by other illnesses. But if you think you may have been
exposed to HIV, get an HIV test.

Here’s what to do:

  Find an HIV testing site near you—You can get an HIV test at your primary
care provider’s office, your local health department, a health clinic, or many
other places. Use the HIV Services Locator to find an HIV testing site near
you.
 Request an HIV test for recent infection—Most HIV tests detect antibodies
(proteins your body makes as a reaction to HIV), not HIV itself. But it can
take a few weeks after you’re infected for your body to produce them. There
are other types of tests that can detect HIV infection sooner. Tell your doctor
or clinic if you think you were recently exposed to HIV, and ask if their tests
can detect early infection.
 Know your status—After you get tested, be sure to learn your test results. If
you’re HIV-positive, see a doctor as soon as possible so you can start
treatment with HIV medicine. And be aware: when you are in the early
stage of infection, you are at very high risk of transmitting HIV to
others. It is important to take steps to reduce your risk of transmission. If you
are HIV-negative, there are prevention tools like pre-exposure
prophylaxis (PrEP) that can help you stay negative.

Stage 2: Clinical Latency

In this stage, the virus still multiplies, but at very low levels. People in this stage may
not feel sick or have any symptoms. This stage is also called chronic HIV infection.

Without HIV treatment, people can stay in this stage for 10 or 15 years, but some
move through this stage faster.

If you take HIV medicine every day, exactly as prescribed and get and keep an
undetectable viral load, you can protect your health and have effectively no risk of
transmitting HIV to your sexual partner(s).

But if your viral load is detectable, you can transmit HIV during this stage, even when
you have no symptoms. It’s important to see your health care provider regularly to get
your viral load checked.

Stage 3: AIDS
If you have HIV and you are not on HIV treatment, eventually the virus will weaken
your body’s immune system and you will progress to AIDS (acquired
immunodeficiency syndrome). This is the late stage of HIV infection.

Symptoms of AIDS can include:

 Rapid weight loss

 Recurring fever or profuse night sweats
 Extreme and unexplained tiredness
 Prolonged swelling of the lymph glands in the armpits, groin, or neck
 Diarrhea that lasts for more than a week
 Sores of the mouth, anus, or genitals
 Pneumonia
 Red, brown, pink, or purplish blotches on or under the skin or inside the
mouth, nose, or eyelids
 Memory loss, depression, and other neurologic disorders

Each of these symptoms can also be related to other illnesses. The only way to know
for sure if you have HIV is to get tested. If you are HIV-positive, a health care
provider will diagnose if your HIV has progressed to stage 3 (AIDS) based on certain
medical criteria.

Many of the severe symptoms and illnesses of HIV disease come from
the opportunistic infections that occur because your body’s immune system has been
damaged. See your health care provider if you are experiencing any of these
symptoms.

CAUSES

HIV is caused by a virus. It can spread through sexual contact or blood, or from
mother to child during pregnancy, childbirth or breast-feeding.

 How does HIV become AIDS?

 HIV destroys CD4 T cells — white blood cells that play a large role in
helping your body fight disease. The fewer CD4 T cells you have, the weaker
your immune system becomes.
You can have an HIV infection, with few or no symptoms, for years before
it turns into AIDS. AIDS is diagnosed when the CD4 T cell count falls below
200 or you have an AIDS-defining complication, such as a serious infection or
cancer.

 How HIV spreads

To become infected with HIV, infected blood, semen or vaginal secretions
must enter your body. This can happen in several ways:

 By having sex. You may become infected if you have vaginal, anal or oral sex
with an infected partner whose blood, semen or vaginal secretions enter your
body. The virus can enter your body through mouth sores or small tears that
sometimes develop in the rectum or vagina during sexual activity.

 By sharing needles. Sharing contaminated IV drug paraphernalia (needles and

syringes) puts you at high risk of HIV and other infectious diseases, such as
hepatitis.

 From blood transfusions. In some cases, the virus may be transmitted through
blood transfusions. American hospitals and blood banks now screen the blood
supply for HIV antibodies, so this risk is very small.

 During pregnancy or delivery or through breast-feeding. Infected mothers can

pass the virus on to their babies. Mothers who are HIV-positive and get
treatment for the infection during pregnancy can significantly lower the risk to
their babies.

 How HIV doesn't spread

You can't become infected with HIV through ordinary contact. That means
you can't catch HIV or AIDS by hugging, kissing, dancing or shaking hands
with someone who has the infection. HIV isn't spread through the air, water or
insect bites.
 TREATMENT
How do HIV/AIDS medicines work?
HIV/AIDS medicines reduce the amount of HIV (viral load) in your body, which
helps by
 Giving your immune system a chance to recover. Even though there is still
some HIV in your body, your immune system should be strong enough to fight
off infections and certain HIV-related cancers.
 Reducing the risk that you will spread HIV to others

What are the types of HIV/AIDS medicines?

There are several different types of HIV/AIDS medicines. Some work by blocking or
changing enzymes that HIV needs to make copies of itself. This prevents HIV from
copying itself, which reduces the amount of HIV in the body. Several medicines do
this:
 Nucleoside reverse transcriptase inhibitors (NRTIs) block an enzyme
called reverse transcriptase
 Non-nucleoside reverse transcriptase inhibitors (NNRTIs) bind to and later
change reverse transcriptase
 Integrase inhibitors block an enzyme called integrase
 Protease inhibitors (PIs) block an enzyme called protease

Some HIV/AIDS medicines interfere with HIV's ability to infect CD4 immune system
cells:
 Fusion inhibitors block HIV from entering the cells
 CCR5 antagonists and post-attachment inhibitors block different
molecules on the CD4 cells. To infect a cell, HIV has to bind to two types of
molecules on the cell's surface. Blocking either of these molecules prevents
HIV from entering the cells.
 Attachment inhibitors bind to a specific protein on the outer surface of HIV.
This prevents HIV from entering the cell.

In some cases, people take more than one medicine:

 Pharmacokinetic enhancers boost the effectiveness of certain HIV/AIDS
medicines. A pharmacokinetic enhancer slows the breakdown of the other
 medicine. This allows that medicine to stay in the body longer at a higher
concentration.
 Multidrug combinations include a combination of two or more different
HIV/AIDS medicines

When do I need to start taking HIV/AIDS medicines?

It's important to start taking HIV/AIDS medicines as soon as possible after your
diagnosis, especially if you
 Are pregnant
 Have AIDS
 Have certain HIV-related illnesses and infections
 Have an early HIV infection (the first 6 months after infection with HIV)

Treatment options for HIV

Treatment should begin as soon as possible after a diagnosis of HIV, regardless of
viral load.
The main treatment for HIV is antiretroviral therapy, a combination of daily
medications that stop the virus from reproducing. This helps protect CD4 cells,
keeping the immune system strong enough to take measures against disease.
Antiretroviral therapy helps keep HIV from progressing to AIDS. It also helps reduce
the risk of transmitting HIV to others.
When treatment is effective, the viral load will be “undetectable.” The person still has
HIV, but the virus is not visible in test results.
However, the virus is still in the body. And if that person stops taking antiretroviral
therapy, the viral load will increase again, and the HIV can again start attacking CD4
cells.
PREVENTIONS

1. PROTECT YOURSELF DURING SEX

How can I prevent getting HIV from sex?

1) Choose Sexual Activities With Little to No Risk
  Choose sex that is less risky than anal or vaginal sex. There is little to
no risk of getting HIV through oral sex.
 You can’t get HIV from sexual activities that don’t involve contact
with body fluids (semen, vaginal fluid, or blood).
 Learn more about how HIV is and is not transmitted.
2) Use Condoms the Right Way Every Time You Have Sex

 Condoms are highly effective in preventing HIV and other sexually

transmitted diseases (STDs), like gonorrhea and chlamydia.
 Use water-based or silicone-based lubricants to help prevent condoms
from breaking or slipping during sex.
 Learn the right way to use an external condom (sometimes called a
male condom) and an internal condom (sometimes called a female
condom).
3) Take PrEP

 PrEP (pre-exposure prophylaxis) is medicine people at risk for HIV

take to prevent HIV.
 If taken as prescribed, PrEP is highly effective for preventing HIV
from sex.
 PrEP is much less effective when it is not taken as prescribed.
 Find out if PrEP is right for you.
4) Decide Not to Have Sex
  Not having sex (also known as being abstinent) is a 100% effective
way to make sure you won’t get HIV through sex.
 You can be abstinent at different times in your life for different reasons
that may change over time.
 Not having sex also prevents other STDs and pregnancy.
5) Get Tested and Treated for Other STDs
 If you have another STD, you are more likely to get HIV. Getting
tested and treated for other STDs can lower your chances of getting
HIV.
 Many people with an STD may not know they have one because they
don’t have symptoms.
 Find a testing site near you.
6) If Your Partner Has HIV, Encourage Your Partner to Get and Stay in
Treatment
 This is the most important thing your partner can do to stay healthy.
 If your partner takes HIV medicine and gets and keeps an undetectable
viral load, there is effectively no risk of you getting HIV from sex with
your partner.
 Learn more about the benefits of HIV treatment as prevention.

2. PROTECT YOURSELF IF YOU INJECT DRUGS

How can I prevent getting HIV from injection drug use?

1) Never Share Needles, Syringes, or Other Drug Injection Equipment
 Use new, clean syringes and injection equipment every time you
inject.
 Many communities have syringe services programs (SSPs) where
you can get new needles and syringes and safely dispose of used
ones.
 Some pharmacies sell needles without a prescription.
  Find an SSP near youexternal icon.

2) Take PrEP
 PrEP (pre-exposure prophylaxis) is medicine people at risk for HIV
take to prevent HIV.
 If taken as prescribed, PrEP is highly effective for preventing HIV
from injection drug use.
 PrEP is much less effective when it is not taken as prescribed.
 Find out if PrEP is right for you.

3) Don’t Have Sex When You’re High on Drugs

 You’re more likely to engage in risky sexual behaviors.
 If you do have sex, use condoms the right way every time.
 Learn the right way to use an external condom (sometimes called
a male condom) and an internal condom (sometimes called a female
condom).

4) If You Do Share Needles, Syringes, or Other Drug Injection Equipment,

Use Bleach to Clean Them
  A disinfected syringe is not as good as a new, sterile syringe, but it can
greatly reduce your risk for HIV and viral hepatitis.
 Learn how to clean your syringes [PDF – 268 KB].

3. Decide Not to Inject Drugs

 This is the best way to prevent getting HIV through injection drug use.
 Talk with a counselor, doctor, or other health care provider about
treatment for substance use disorder, including medication-assisted
treatment.
4. PROTECT OTHER IF YOU HAVE HIV

If I have HIV, what is the best way to protect others?

 Get in care and take medicine to treat HIV.
 HIV medicine (called antiretroviral therapy or ART) can reduce the
amount of HIV in the blood (called viral load). HIV medicine can
make the viral load very low—so low that a test can’t detect it (called
an undetectable viral load).
 People with HIV who keep an undetectable viral load (or stay virally
suppressed) can live long, healthy lives. Viral suppression is defined as
having less than 200 copies of HIV per milliliter of blood.
 If a person has an undetectable viral load, they have effectively no risk
of transmitting HIV to an HIV-negative partner through sex.
 Having an undetectable viral load also helps prevent transmission to
others through sharing needles, syringes, or other injection equipment,
and from mother-to-child during pregnancy, birth, and breastfeeding.
 Most people can get the virus under control within six months.
  Taking ART does not prevent transmission of other sexually
transmitted diseases (STDs).

5. PREVENT MOTHER TO CHILD TRANSMISSION

How can I prevent transmitting HIV to my baby?

1) Get Tested for HIV As Soon As Possible to Know Your Status
 The earlier HIV is diagnosed and treated, the more effectively HIV
medicine will prevent transmission to your baby.
 If you or your partner engage in behaviors that put you at risk for HIV,
get tested again in your third trimester.
 You should also encourage your partner to get tested for HIV.

2) Take Medicine to Prevent HIV if You Do Not Have HIV But Are at Risk
 If you have a partner with HIV and are considering getting pregnant,
talk to your health care provider about PrEP (pre-exposure
prophylaxis).
 PrEP may be an option to help protect you and your baby from getting
HIV while you try to get pregnant, during pregnancy, or while
breastfeeding.
 Find out if PrEP is right for you.
 3) Take Medicine to Treat HIV
 If you have HIV and take HIV medicine as prescribed throughout
pregnancy and childbirth, and give HIV medicine to your baby for 4 to
6 weeks after giving birth, your risk of transmitting HIV to your baby
can be 1% or less.
 After delivery, you can prevent transmitting HIV to your baby by
avoiding breastfeeding, since breast milk contains HIV.
 If your partner has HIV, encourage your partner to get and stay on
treatment. This will help prevent your partner from transmitting HIV to
you. People with HIV who take HIV medicine as prescribed and get
and keep an undetectable viral load have effectively no risk of
transmitting HIV to an HIV-negative partner through sex.

6. CONDOMS

What are condoms?

Most condoms are highly effective in preventing HIV and certain other
sexually transmitted diseases (STDs), like gonorrhea and chlamydia.

Condoms provide less protection against STDs that can be transmitted through
sores or cuts on the skin, like human papillomavirus, genital herpes, and
syphilis.

Condoms help prevent HIV for higher risk sexual activities like anal or
vaginal sex, and for lower risk activities, like oral sex and sharing sex toys.

You can buy condoms at many stores or online, and you can sometimes get
them for free from clinics or health departments.

What are the main types of condoms?

There are two main types of condoms: condoms used
externally and condoms used internally.

An external condom (sometimes called a male condom or just a condom) is

worn over the penis during sex. It is a thin layer of latex, plastic, synthetic
rubber, or natural membrane.

 Latex condoms provide the best protection against HIV.

 Plastic (polyurethane) or synthetic rubber condoms are good for people
with latex allergies. Note: Plastic condoms break more often than latex
condoms.
 Natural membrane (such as lambskin) condoms have small holes in
them and don’t block HIV and other STDs. These should not be used
for HIV or STD prevention.

An internal condom (sometimes called a female condom) is used in

the vagina or anus during sex. It is a thin pouch made of a synthetic latex
product called nitrile. HIV can’t travel through the nitrile barrier.

How do I use an external condom?

To use an external condom

 Carefully open and remove the condom from the wrapper.

 Place the condom on the tip of the hard penis. If uncircumcised, pull
back the foreskin first.
 Pinch the air out of the tip of the condom. While holding the tip, unroll
the condom all the way down the penis.
  After sex but before pulling out, hold the bottom of the condom and
carefully pull out the penis.
 Carefully remove the condom and throw it in the trash.

If you feel the condom break any time during sex, stop immediately, pull out
the penis, take off the broken condom, and put on a new condom.

Use water-based or silicone-based lubricants during sex to help keep the

condom from tearing. Don’t use oil-based lubricants because they can weaken
the condom and cause it to break.

How do I use an internal condom?

To use an internal condom

 Carefully open and remove the condom from the package.

 While holding the condom at the closed end, squeeze the sides of the
inner ring together and insert it into the vagina or anus.
 Use your finger to push the inner ring up until it rests against the cervix
in the vagina or as far into the anus as it can go.
 Be sure the condom is not twisted. The thin, outer ring should remain
outside the vagina or anus.
 Guide your partner’s penis into the opening of the condom.
 After sex, gently twist the outer ring and pull the condom out.
 Carefully throw the condom in the trash after using it one time.

7. PEP
 PEP (post-exposure prophylaxis) means taking medicine to prevent HIV after
a possible exposure. PEP should be used only in emergency situations and
must be started within 72 hours after a recent possible exposure to HIV.

This section answers some of the most common questions about PEP. You can
also download PEP materials to share.
8. PrEP

PrEP (pre-exposure prophylaxis) is medicine people at risk for HIV take to

prevent getting HIV from sex or injection drug use. When taken as prescribed,
PrEP is highly effective for preventing HIV.

This section answers some of the most common questions about PrEP. You
can also download materials to share or watch videos on the benefits of PrEP.

9. OTHER HIV PREVENTION METHOD

1) How can I prevent getting HIV after a recent possible exposure, like if a
condom breaks or I’m sexually assaulted?
There is medicine you can take to prevent getting HIV after a recent exposure.
Talk to your health care provider, an emergency room doctor, or an urgent
care provider right away about PEP (post-exposure prophylaxis).

 PEP must be started within 72 hours after a possible exposure.

 The sooner you start PEP, the better. Every hour counts.
 If you’re prescribed PEP, you’ll need to take it daily for 28 days.
2) Can male circumcision prevent HIV?
Talk to your health care provider about the risks and benefits of male
circumcision.
  Male circumcision does decrease the risk of getting HIV in some
situations, but it doesn’t decrease the risk of HIV as much as other HIV
prevention options.
 Circumcised men are less likely than uncircumcised men to get HIV
from vaginal sex with a partner with HIV.
 Male circumcision does not decrease a woman’s risk of getting HIV.
 The benefits of circumcision for gay and bisexual men are unknown.
 Circumcised men should take other actions to prevent getting HIV or
to protect their partners.
3) Can I get vaccinated to prevent HIV?
 No vaccine is currently available to prevent HIV.
10. Download HIV prevention materials

Sexual Transmission
https://www.cdc.gov/hiv/pdf/library/consumer-info-sheets/cdc-hiv-consumer-
info-sheet-safer-sex-101.pdf