Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) represent significant global health challenges, affecting millions of people worldwide. Despite advancements in treatment and prevention, misinformation persists. Understanding what HIV/AIDS is, its symptoms, and how it spreads is crucial for prevention, early diagnosis, and effective management.
In this comprehensive guide, we’ll explore:
- What HIV and AIDS are
- The symptoms of HIV and AIDS
- How HIV is transmitted
- Prevention and treatment options
What Is HIV/AIDS?
HIV is a virus that attacks the body’s immune system, specifically targeting CD4 cells (T-cells), which are essential for fighting infections. If untreated, HIV can progressively weaken the immune system, making the body vulnerable to opportunistic infections and certain cancers. According to the World Health Organization (WHO), “Human immunodeficiency virus (HIV) is an infection that attacks the body’s immune system, specifically the white blood cells called CD4 cells”.
AIDS is the most advanced stage of HIV infection, characterized by severe immune system damage. The Centers for Disease Control and Prevention (CDC) defines AIDS as occurring when “the number of their CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3)” or when certain opportunistic infections or cancers develop. Not everyone with HIV progresses to AIDS, especially with early and consistent treatment.
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Key Facts About HIV/AIDS
- Global Impact: As of 2024, approximately 40.8 million people are living with HIV globally, with 1.3 million new infections and 630,000 AIDS-related deaths reported.
- No Cure, But Manageable: There is no cure for HIV, but antiretroviral therapy (ART) allows people to live long, healthy lives and prevents transmission when viral loads are undetectable.
- Prevention Advances: Tools like pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) have significantly reduced HIV transmission rates.
Symptoms of HIV/AIDS
HIV infection progresses through stages, each with distinct symptoms or, in some cases, none at all. Recognizing these stages is critical for timely testing and treatment.
1. Acute HIV Infection
Within 2 to 4 weeks of contracting HIV, many individuals experience flu-like symptoms, known as acute retroviral syndrome. These symptoms include:
- Fever
- Fatigue
- Sore throat
- Swollen lymph nodes
- Rash
- Muscle and joint aches
- Night sweats
However, some people may not experience symptoms, making testing essential. You can have HIV without any symptoms. Getting tested and starting treatment early gives you the best chance of living a long life.
2. Chronic HIV Infection (Asymptomatic Stage)
After the acute phase, HIV enters a chronic or asymptomatic stage, where the virus continues to replicate but often without noticeable symptoms. This stage can last for 10–15 years without treatment, though it may progress faster in some individuals. Often, there are no symptoms during this stage. If it is not treated, eventually the virus will weaken the body’s immune system.
3. Advanced HIV Disease (AIDS)
When HIV significantly damages the immune system, it progresses to AIDS. Symptoms at this stage include:
- Rapid weight loss
- Recurring fever or night sweats
- Extreme fatigue
- Prolonged swelling of lymph nodes
- Diarrhea lasting more than a week
- Sores in the mouth, anus, or genitals
- Opportunistic infections like tuberculosis, Pneumocystis jirovecii pneumonia, or cryptococcal meningitis
- Certain cancers, such as Kaposi’s sarcoma or lymphomas
The WHO highlights that “someone with a CD4 count below 200 is described as having an advanced HIV disease (AHD).” Without treatment, individuals with AIDS typically survive about three years, but ART can still be effective even at this stage.
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How Is HIV Transmitted?
HIV is transmitted through specific bodily fluids from a person with a detectable viral load. These fluids include blood, semen, vaginal fluids, anal mucus, and breast milk. Transmission occurs when these fluids enter the bloodstream of an HIV-negative person through mucous membranes, open cuts, sores, or direct injection. Below are the primary modes of transmission, as outlined by authoritative sources.
1. Sexual Transmission
The most common mode of HIV transmission is through unprotected vaginal or anal sex. Having vaginal or anal sex with someone who has HIV without using a condom the right way every time or taking medicines to prevent or treat HIV is a primary transmission route. Anal sex carries a higher risk than vaginal sex, with receptive anal sex having an estimated 1.4% transmission risk per act.
Other factors increasing sexual transmission risk include:
- Presence of other sexually transmitted infections (STIs), which can increase HIV transmission risk by up to 8 times
- High viral load in the HIV-positive partner
- Lack of condom use or improper use
Importantly, individuals with an undetectable viral load due to consistent ART cannot transmit HIV sexually. People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load can live long and healthy lives and will not transmit HIV to their HIV-negative partners through sex.
2. Sharing Needles or Drug Equipment
Sharing needles, syringes, or other drug injection equipment is a significant transmission route, particularly among people who inject drugs. Harm reduction strategies, such as needle exchange programs, are effective in reducing this risk.
3. Perinatal Transmission
HIV can be transmitted from a mother to her child during pregnancy, childbirth, or breastfeeding, known as perinatal transmission. However, ART significantly reduces this risk. The NIH reports, “Evidence suggests that the odds of perinatal transmission are less than one percent when someone breastfeeds with an undetectable viral load.” Programs to prevent vertical transmission have reduced rates by 92–99% in some settings.
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4. Blood Transfusions and Medical Procedures
Though rare in countries with robust screening, HIV can be transmitted through contaminated blood transfusions, tissue transplantation, or unsterile medical procedures.
Non-Transmission Routes
HIV is not spread through casual contact, such as hugging, shaking hands, sharing food, or using public facilities like toilets. It is also not transmitted through air, water, or insects like mosquitoes. UNAIDS clarifies, “You cannot get HIV from kissing, hugging or shaking hands, or from sharing toilet seats, food, drinks, or normal everyday household items.”
Prevention Strategies
Preventing HIV transmission involves a combination of behavioral, medical, and social strategies:
- Condom Use: Consistent and correct condom use significantly reduces HIV transmission risk during sex.
- PrEP and PEP: PrEP is a daily medication for HIV-negative individuals at high risk, while PEP is taken within 72 hours of potential exposure. PrEP is daily medicine that can reduce your chance of getting HIV.
- ART for Prevention: Maintaining an undetectable viral load through ART prevents sexual transmission, a strategy known as Treatment as Prevention (TASP).
- Testing and Early Treatment: Regular HIV testing allows for early diagnosis and treatment, reducing transmission risk. The CDC recommends that everyone ages 13–64 get tested at least once.
- Harm Reduction: Needle exchange programs and opioid substitution therapy reduce transmission among people who inject drugs.
Diagnosis and Treatment
HIV is diagnosed through rapid diagnostic tests, blood tests, or self-tests, which detect HIV antibodies or the virus itself.
ART is the cornerstone of HIV treatment, involving a combination of medications taken daily or via injections. ART prevents HIV from multiplying, which reduces the amount of HIV in the body (called the viral load. ART enables people with HIV to maintain a suppressed viral load, preventing progression to AIDS and transmission to others.
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Living with HIV/AIDS
With effective treatment, people with HIV can lead long, healthy lives. In fact, you have the best chance of living a long life if you’re diagnosed early and are able to get on and stick with ART medications. Support systems, including counseling and community organizations, play a vital role in managing the emotional and social challenges of an HIV diagnosis.
Conclusion
HIV/AIDS remains a significant public health issue, but advances in prevention, testing, and treatment have transformed it into a manageable chronic condition. By understanding the symptoms and transmission routes, individuals can take proactive steps to protect themselves and others. Regular testing, consistent ART, and preventive measures like PrEP and condom use are key to reducing new infections and improving quality of life for those living with HIV.
Get tested for HIV today to know your status. If you’re at risk, talk to a healthcare provider about PrEP or other prevention options.
