HIV attacks and destroys cells of the body's immune system. This damage progressively weakens the body's ability to fight infections and certain cancers.

The most advanced stage of HIV infection is known as AIDS.

People with AIDS are at great risk of getting very sick from conditions that are more common and more severe in people with weakened immune systems. These conditions include viral infections that cause skin tumors and pneumonia; fungal infections of the mouth, lungs, and genitals; and certain cancers.

AIDS was first reported in the United States in 1981; it is now recognized that HIV is a major worldwide epidemic.

Today, most people with HIV do not develop AIDS thanks to highly effective treatments that stop progression of HIV and allow people with HIV to live long, healthy lives.

Key Points

• The human immunodeficiency virus (HIV) is the virus that causes HIV infection. If untreated, HIV may cause acquired immunodeficiency syndrome (AIDS), the most advanced stage of HIV infection.
• People with HIV who are not on medication and do not have consistent control of their HIV can transmit HIV through vaginal or anal sex, sharing of needles, pregnancy, and/or breastfeeding. If HIV is controlled, the risk of transmission is close to zero.
• Antiretroviral therapy (ART) is the use of HIV medicines that reduce the level of HIV in the blood (called viral load). ART is recommended for everyone who has HIV. ART cannot cure HIV infection, but HIV medicines help people with HIV have about the same life expectancy as people without HIV.
• HIV medicines (ART) can eliminate the risk of HIV transmission. For parents with HIV that want to breastfeed, the risk of transmitting HIV through breast milk is less than 1% with the consistent use of HIV medicine (ART) and an undetectable viral load.
• People on ART take a combination of HIV medicines (called an HIV treatment regimen) every day (pills) or by schedule (injections). In many cases oral medicines may be combined into a single pill or capsule. There are newer long-acting medicines given by an injection every 2 months that may be used in some people.

What is HIV and AIDS?

HIV stands for human immunodeficiency virus, which is the virus that causes HIV infection. The abbreviation “HIV” can refer to the virus or to HIV infection.

AIDS stands for acquired immunodeficiency syndrome. AIDS is the most advanced stage of HIV infection.

HIV attacks and destroys the infection-fighting CD4 cells (CD4 T lymphocyte) of the immune system. The loss of CD4 cells makes it difficult for the body to fight off infections, illnesses, and certain cancers. Without treatment, HIV can gradually destroy the immune system, causing health decline and the onset of AIDS. With treatment, the immune system can recover.

How is HIV transmitted?

HIV can be transmitted from one person to another when certain bodily fluids are shared between people. Bodily fluids that can transmit HIV include blood, semen (“cum”), pre-seminal fluid (“pre-cum”), vaginal fluids, rectal fluids, and breastmilk. HIV can be transmitted during vaginal or anal sex, through sharing needles for injecting drugs or tattooing, by getting stuck with a needle that has the blood of someone with HIV on it, through pregnancy, and through breastfeeding.

The transmission of HIV from a birthing parent with HIV to their child during pregnancy, childbirth, or breastfeeding is called perinatal transmission of HIV.

You cannot get HIV by shaking hands or hugging a person who has HIV. You also cannot get HIV from contact with objects, such as dishes, toilet seats, or doorknobs, used by a person with HIV. HIV is not spread through the air or water or by mosquitoes, ticks, or other insects.

What is the treatment for HIV?

Antiretroviral therapy (ART) is the use of HIV medicines to treat HIV infection. People on ART take a combination of HIV medicines (called an HIV treatment regimen) every day (pills) or by schedule (injections). In many cases oral medicines may be combined into a single pill or capsule. There are newer long-acting medicines given by an injection every 2 months that may be used in some people.

ART is recommended for everyone who has HIV. ART prevents HIV from multiplying, which reduces the amount of HIV in the body (called the viral load). Having less HIV in the body protects the immune system and prevents HIV infection from advancing to AIDS. ART cannot cure HIV, but HIV medicines can help people with HIV live long, healthy lives.

How can a person reduce the risk of transmitting HIV?

ART reduces the risk of HIV transmission. ART can reduce a person’s viral load to an undetectable level. An undetectable viral load means that the level of HIV in the blood is too low to be detected by a viral load test. People with HIV who maintain an undetectable viral load have no risk of transmitting HIV to their HIV-negative partner through sex.

HIV medicines taken during pregnancy, childbirth, and breastfeeding can also reduce the risk of perinatal (parent to infant) transmission of HIV. Previously, replacement feeding (properly prepared formula or pasteurized donor human milk from a milk bank) was recommended instead of breastfeeding since the risk of HIV transmission was considered high. Now, there is evidence that the risk of transmission through the breastmilk of someone consistently using ART and maintaining an undetectable viral load is low (less than 1%). Pregnant people with HIV can speak with their health care provider to determine what method of feeding their baby is right for them.

How can a person reduce the risk of getting HIV?

For people without HIV, there are several ways to reduce the risk of acquiring (getting) HIV infection. Using condoms correctly with every sexual encounter, particularly with partners that are HIV positive with a detectable viral load or with partners whose HIV status is unknown, can reduce the risk of acquiring HIV. Reducing HIV risk also involves limiting and reducing sexual partners, and avoiding sharing needles.

Persons who do not have HIV should talk to their health care provider about pre-exposure prophylaxis (PrEP). PrEP is an HIV prevention option for people who do not have HIV but who are at risk of becoming infected with HIV. PrEP involves taking a specific HIV medicine every day or a long-acting injection. For more information, read the HIVinfo fact sheet on Pre-exposure Prophylaxis (PrEP).

What are the symptoms of HIV and AIDS?

Within 2 to 4 weeks after infection with HIV, some people may have flu-like symptoms, such as fever, chills, or rash. The symptoms may last for a few days to several weeks. Other possible symptoms of HIV include night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and mouth ulcers. Having these symptoms does not mean you have HIV. Other illnesses can cause the same symptoms. Some people may not feel sick during early HIV infection (called acute HIV). During this earliest stage of HIV infection, the virus multiplies rapidly. After the initial stage of infection, HIV continues to multiply but at lower levels.

More severe symptoms of HIV infection for persons not on ART may not appear for many years until HIV has developed into AIDS. People with AIDS have weakened immune systems that make them prone to opportunistic infections. Opportunistic infections are infections and infection-related cancers that occur more frequently or are more severe in people with weakened immune systems than in people with healthy immune systems.

Without treatment, HIV transmission is possible at any stage of HIV infection—even if a person with HIV has no symptoms of HIV.

How is AIDS diagnosed?

Symptoms such as fever, weakness, and weight loss may be a sign that a person’s HIV has advanced to AIDS. However, a diagnosis of AIDS is based on the following criteria:

• A drop in CD4 count to less than 200 cells/mm³. A CD4 count measures the number of CD4 cells (CD4 T lymphocyte) in a sample of blood.
  OR
• The presence of certain opportunistic infections.

Although an AIDS diagnosis indicates severe damage to the immune system, HIV medicines can still help people at this stage of HIV infection.

About 1.2 million people in the United States have HIV. In 2018, nearly 38,000 people received an HIV diagnosis in the United States and dependent areas. Though the number of new HIV diagnoses has declined over the last few years, the number of people who have HIV has been increasing because people with HIV are now living longer.

In 2018, 81% of new diagnoses in the United States and dependent areas were among adult and adolescent men and 19% were among adult and adolescent women. Most new HIV diagnoses among women were from heterosexual contact (85%), and another 15% were from injection drug use. By age, 21% of new HIV diagnoses in 2018 were among young people aged 13 to 24, 36% were among people aged 25 to 34, 19% were among people aged 35 to 44, 14% were among people aged 45 to 54, and 10% were among people aged 55 and older.

When you live in a community where many people have HIV infection, the chances of having sex with someone who has HIV are higher. Within any community, the prevalence of HIV can vary among different populations.

HIV is transmitted when engaging in risky behaviors, like (1) having anal or vaginal sex without a condom or without taking medicine to prevent or treat HIV and (2) sharing needles, syringes or other injection equipment (for example, cookers). Certain cultural and societal factors can also play a part in HIV risk. These factors include poverty, lack of educational opportunities, lack of access to health care, homophobia , stigma, and racial/ethnic or gender discrimination.

Overall, data show

• Gay, bisexual, and other men who have sex with men (MSM) have the largest number of new HIV diagnoses in the United States and dependent areas.

  About 4% of the US male population is gay or bisexual, but gay and bisexual men accounted for 86% of all new HIV diagnoses among men and 69% of all diagnoses in 2018. The number of new HIV diagnoses among gay and bisexual men was highest in men aged 25 to 34. Young black/African American gay and bisexual men (aged 13 to 24) accounted for 51% of new diagnoses among all young gay and bisexual men and 34% of new diagnoses among all black/African American gay and bisexual men.

  Many factors may increase HIV risk for some gay, bisexual, or other men who have sex with men (MSM). For example,

  • Homophobia, stigma, and discrimination may place gay and bisexual men at risk for multiple physical and mental health problems and may affect whether they seek and are able to obtain high-quality health services.
  • Most gay and bisexual men get HIV from having anal sex without using condoms or taking medicines to prevent or treat HIV. Anal sex is the riskiest type of sex for getting or transmitting HIV. Receptive anal sex is 13 times as risky for getting HIV as insertive anal sex.
  • Socioeconomic factors, such as having limited access to quality health care, lower income and educational levels, and higher rates of unemployment and incarceration, may place some gay and bisexual men at higher risk for HIV.

• Blacks/African Americans and Hispanics/Latinos are disproportionally affected by HIV than other racial and ethnic groups.

  About 13% of the US population is black/African American, but they accounted for 42% of new HIV diagnoses in 2018. Similarly, although about 18% of the total US population is Hispanic/Latino, they accounted for 27% of new HIV diagnoses in 2018.

  Many cultural, socioeconomic, and health-related factors may increase HIV risk for some African Americans and Hispanics/Latinos. For example,

  • Stigma, fear, discrimination, and homophobia may place many African Americans and Hispanics/Latinos at higher risk for HIV.
  • The poverty rate is high among African Americans. The socioeconomic issues associated with poverty—including limited access to high-quality health care, housing, and HIV prevention education—directly and indirectly increase the risk for getting HIV and affect the health of people with and at risk for HIV.
  • Similarly, poverty, migration patterns, lower educational level, and language barriers may make it harder for some Hispanics/Latinos to get HIV testing and care. Undocumented Hispanics/Latinos may be less likely to use HIV prevention services, get an HIV test, or get treatment for HIV because of concerns about being arrested and deported.

• Transgender women who have sex with men are among the groups at highest risk for HIV infection.

  Because we don’t have complete data for this population, we don’t know how many transgender women in the United States have HIV. However, data collected by local health departments and scientists studying these communities show high levels of HIV infection, with a recent study reporting that an estimated 14% of transgender women have HIV.

  Many cultural, socioeconomic, and health-related factors may increase HIV risk for some transgender people. For example,

  • Discrimination and social stigma can reduce access to education, jobs, health care, and housing.
  • Commercial sex work, mental health issues, incarceration, homelessness, unemployment, and high levels of substance misuse compared to the general population, as well as violence and lack of family support, may put transgender people at risk for HIV.
  • Health care providers may be insensitive to transgender identity or sexuality, which can make it harder for transgender people who have HIV to seek health care. Research shows that even if transgender women seek care, they are less likely to take antiretroviral therapy (ART) than nontransgender (cis-gender) people with HIV, though transgender women are just as likely to have health insurance coverage. The lower rates of taking ART could be because of provider decisions or because transgender people are concerned about potential interactions between ART and hormones.

• People who inject drugs remain at significant risk for getting HIV.

  In 2018, 7% of new HIV diagnoses in the United States and dependent areas were attributed to injection drug use and another 3% to male-to-male sexual contact and injection drug use (men who reported both risk factors). Of the HIV diagnoses attributed to injection drug use, 58% were among men and 42% were among women.

  Many factors may increase HIV risk for some people who inject drugs (PWID). For example,

  • The high-risk practices of sharing needles, syringes, and other injection equipment (for example, cookers) are common among PWID.
  • PWID may also engage in risky sexual behaviors, such as having sex without a condom or without medicines to prevent or treat HIV, having sex with multiple partners, or trading sex for money or drugs.
  • The prescription opioid and heroin epidemic has led to increased numbers of PWID, placing new populations at increased risk for HIV. The epidemic has disproportionately affected nonurban areas, where HIV prevalence rates have historically been low. These areas have limited services for HIV prevention and treatment and substance use disorder treatment.
  • Social and economic factors limit access to HIV prevention and treatment services among PWID.
  • PWID may face stigma and discrimination. Often, injection drug use is viewed as a criminal activity rather than a medical issue that requires counseling and rehabilitation. Stigma and mistrust of the health care system may prevent PWID from seeking HIV testing, care, and treatment.

Key Points

• HIV attacks and destroys the CD4 cells (CD4 T lymphocyte) of the immune system. CD4 cells play a major role in protecting the body from infection.
• HIV uses the machinery of the CD4 cells to multiply and spread throughout the body. This process, which is carried out in seven steps or stages, is called the HIV life cycle. HIV medicines protect the immune system by blocking HIV at different stages of the HIV life cycle.
• Antiretroviral therapy (ART) is the use of a combination of HIV medicines to treat HIV infection. People on ART take a combination of HIV medicines from at least two different HIV drug classes every day. Because each class of drugs is designed to target a specific step in the HIV life cycle, ART is very effective at preventing HIV from multiplying.

What is the HIV life cycle?

HIV attacks and destroys the CD4 cells (CD4 T lymphocyte) of the immune system. CD4 cells are a type of white blood cell that play a major role in protecting the body from infection. HIV uses the machinery of the CD4 cells to multiply and spread throughout the body. This process, which is carried out in seven steps or stages, is called the HIV life cycle.

What is the connection between the HIV life cycle and HIV medicines?

Antiretroviral therapy (ART) is the use of a combination of HIV medicines to treat HIV infection. People on ART take a combination of HIV medicines (called an HIV treatment regimen) every day. HIV medicines protect the immune system by blocking HIV at different stages of the HIV life cycle. HIV medicines are grouped into different drug classes according to how they fight HIV. Each class of drugs is designed to target a specific step in the HIV life cycle.

Because an HIV treatment regimen includes HIV medicines from at least two different HIV drug classes, ART is very effective at preventing HIV from multiplying. Having less HIV in the body protects the immune system and prevents HIV from advancing to acquired immunodeficiency syndrome (AIDS).

ART cannot cure HIV, but HIV medicines help people with HIV live longer, healthier lives. HIV medicines also reduce the risk of HIV transmission (the spread of HIV to others).

What are the seven stages of the HIV life cycle?

The seven stages of the HIV life cycle are: 1) binding, 2) fusion, 3) reverse transcription, 4) integration, 5) replication, 6) assembly, and 7) budding.

To understand each stage in the HIV life cycle, it helps to first imagine what HIV looks like.

Now, follow each stage in the HIV life cycle as HIV attacks a CD4 cell and uses the machinery of the cell to multiply.

Key Points

• Without treatment with HIV medicines, HIV infection advances in stages, getting worse over time.
• The three stages of HIV infection are (1) acute HIV infection, (2) chronic HIV infection, and (3) acquired immunodeficiency syndrome (AIDS).
• There is no cure for HIV, but treatment with HIV medicines (called antiretroviral therapy or ART) can slow or prevent HIV from advancing from one stage to the next. HIV medicines help people with HIV live longer, healthier lives.

HIV Infection

Without treatment, HIV infection advances in stages, getting worse over time. HIV gradually destroys the immune system and eventually causes acquired immunodeficiency syndrome (AIDS).

There is no cure for HIV, but treatment with HIV medicines (called antiretroviral therapy or ART) can slow or prevent HIV from advancing from one stage to the next. HIV medicines help people with HIV live longer, healthier lives. One of the main goals of ART is to reduce a person's viral load to an undetectable level. An undetectable viral load means that the level of HIV in the blood is too low to be detected by a viral load test. People with HIV who maintain an undetectable viral load have effectively no risk of transmitting HIV to their HIV-negative partner through sex.

There are three stages of HIV infection:

1. Acute HIV Infection

   Acute HIV infection is the earliest stage of HIV infection, and it generally develops within 2 to 4 weeks after infection with HIV. During this time, some people have flu-like symptoms, such as fever, headache, and rash. In the acute stage of infection, HIV multiplies rapidly and spreads throughout the body. The virus attacks and destroys the infection-fighting CD4 cells (CD4 T lymphocyte) of the immune system. During the acute HIV infection stage, the level of HIV in the blood is very high, which greatly increases the risk of HIV transmission. A person may experience significant health benefits if they start ART during this stage.

2. Chronic HIV Infection

   The second stage of HIV infection is chronic HIV infection (also called asymptomatic HIV infection or clinical latency). During this stage, HIV continues to multiply in the body but at very low levels. People with chronic HIV infection may not have any HIV-related symptoms. Without ART, chronic HIV infection usually advances to AIDS in 10 years or longer, though in some people it may advance faster. People who are taking ART may be in this stage for several decades. While it is still possible to transmit HIV to others during this stage, people who take ART exactly as prescribed and maintain an undetectable viral load have effectively no risk of transmitting HIV to an HIV-negative partner through sex.

3. AIDS

   AIDS is the final, most severe stage of HIV infection. Because HIV has severely damaged the immune system, the body cannot fight off opportunistic infections. (Opportunistic infections are infections and infection-related cancers that occur more frequently or are more severe in people with weakened immune systems than in people with healthy immune systems.) People with HIV are diagnosed with AIDS if they have a CD4 count of less than 200 cells/mm3 or if they have certain opportunistic infections. Once a person is diagnosed with AIDS, they can have a high viral load and are able to transmit HIV to others very easily. Without treatment, people with AIDS typically survive about 3 years.

Key Points

• A latent HIV reservoir is a group of immune system cells in the body that are infected with HIV but are not actively producing new HIV.

• Finding ways to target and destroy latent reservoirs is a major challenge facing HIV researchers who are exploring different strategies for clearing out reservoirs.

What is a latent HIV reservoir?

A latent HIV reservoir is a group of immune system cells in the body that are infected with HIV but are not actively producing new virus.

HIV attacks immune system cells in the body and uses the cells’ own machinery to make copies of itself. However, some HIV-infected immune cells go into a resting or latent state. While in this resting state, the infected cells do not produce new virus. HIV can hide inside these cells for years, forming a latent HIV reservoir but, at any time, cells in the latent reservoir can become active again and start making more virus.

To find out more about how HIV attacks cells, read the HIV Life Cycle fact sheet from HIVinfo.

Do HIV medicines work against latent HIV reservoirs?

HIV medicines prevent HIV from multiplying, which reduces the amount of the virus in the body (called the viral load). Because the HIV-infected cells in a latent reservoir are not producing new copies of the virus, HIV medicines have no effect on them.

People with HIV must take a daily combination of HIV medicines (called an HIV treatment regimen) to keep their viral loads low. If a person stops taking their HIV medicines, the infected cells of the latent reservoir can begin making HIV again and the person's viral load will increase. That is why it is important to continue taking HIV medicines every day as prescribed, even when viral load levels are low.

Are researchers studying ways to target latent HIV reservoirs?

Finding ways to target and destroy latent reservoirs is a major challenge facing HIV researchers. Researchers are exploring different strategies for clearing out reservoirs, including:

• Using gene therapy (manipulating genes to treat or prevent disease) to cut out certain HIV genes and inactivate the virus in HIV-infected immune cells.
• Developing drugs or other methods to reactivate latent HIV so that the HIV can be destroyed by the immune system or new HIV therapies. This means of eliminating latent HIV reservoirs is sometimes known as the “shock and kill” or “kick and kill” strategy.

What is HIV superinfection? HIV superinfection is when a person with HIV also gets another type, or strain, of the HIV virus. The new strain of HIV can replace the original strain or remain along with the original strain. This usually happens when a person first gets HIV, or soon after they get a new strain.

What we know about super-infection

Superinfection may cause some people to get sicker faster because the medicine (antiretroviral therapy or ART) they’re taking to treat the original strain of HIV doesn’t work on the new strain.

It’s hard to know how often superinfections occur. Research suggests that a hard-to-treat superinfection is rare, less than 1% to 4%. Taking ART can help protect someone from getting a superinfection. In fact, if two people have HIV and both keep an undetectable viral load , neither partner will transmit HIV to the other through sex.

What you can do

If you have HIV, take HIV medicine and use condoms or other barrier methods the right way, every time you have sex to protect yourself and your partners from superinfection.

HIV passes between people through blood and certain other body fluids, including semen, pre-seminal fluid, rectal fluids, vaginal fluids, and breast milk.

For transmission to occur, HIV present in these fluids must get into the bloodstream through a mucous membrane (found in the rectum, vagina, penis, and mouth), open cuts or sores, or by direct injection.

The most common ways that HIV can be passed from person to person include:

• Having anal or vaginal sex with someone who has HIV without using condoms or medicines to prevent or treat HIV. Worldwide, most new HIV acquisitions occur through sex. Women are particularly at risk of acquiring HIV through heterosexual sex. Having another sexually transmitted disease (STD) may increase a person’s risk of getting or transmitting HIV. For more information, see the Centers for Disease Control and Prevention's STDs and HIV Fact Sheet.
• Sharing needles, syringes, or other injection drug equipment with someone who has HIV.
• Perinatal transmission, which refers to HIV transmission from mother to child during pregnancy, labor and delivery, or breastfeeding. Pregnant women with HIV can prevent perinatal transmission by taking anti-HIV drugs. Additionally, in areas of the world where infant formula and safe water are available, women with HIV are recommended to avoid breastfeeding their children. Read more about preventing perinatal transmission of HIV.

In very rare cases, HIV also can be transmitted through other means, including oral sex, biting, deep open-mouth kissing, and pre-chewed food. The only known cases of transmission through pre-chewed food are among infants and involved blood from a caregiver’s mouth mixing with the food before feeding it to the infant. HIV also can be acquired through donated blood products or organ or tissue transplants, but this is rare today because of testing of the blood supply and organ and tissue donations.

How is HIV not transmitted?

HIV cannot be transmitted by:

• Contact with saliva, tears, or sweat
• Shaking hands
• Hugging
• Sharing food utensils
• Swimming in the same pool
• Using the same toilet seats
• Bites from insects or other animals

Anyone can get HIV, regardless of sexual orientation, race, ethnicity, gender, age, or geographic location.

Certain groups of people are at higher risk for getting HIV because of certain factors, such as engaging in risk behaviors. For example:

• HIV is mainly spread by having anal or vaginal sex without a condom or without medications to prevent or treat HIV. Risk behaviors such as having condomless sex and having multiple sexual partners are common among teens and young adults, who have very high rates of HIV compared to other Americans.
• Babies born to mothers living with HIV can get HIV before or during birth or through breastfeeding, although effective prevention strategies can nearly eliminate the risk of this form of transmission.
• People with other sexually transmitted infections, such as chlamydia, gonorrhea, syphilis, bacterial vaginosis, and herpes, increase their risk of getting HIV if they are exposed to the virus through sex or blood exposure.
• Using drugs can increase risk. Sharing needles, syringes, or other drug injection equipment can spread HIV. Drug and alcohol use also can impair judgement and lead to risk behaviors like having sex without a condom or having multiple sexual partners.

Risk Factors Specific to Adolescents

Many factors can increase or decrease HIV risk among youth. The Centers for Disease Control and Prevention's (CDC) National Youth Risk Behavior Survey and other CDC data have identified the following leading risk factors that can increase adolescents' and young adults' risk of HIV:

• Use of alcohol or drugs before sex. This can affect decision making about whether to engage in sex or to use condoms during sex.
• Not using an HIV prevention method during sex. Using condoms or taking medicine to prevent or treat HIV are highly effective HIV prevention options.
• Sex with multiple partners. The more sexual partners a person has, the more likely they are to be exposed to HIV or other sexually transmitted infections.
• Male–male sex. Young men who have sex with men, especially those who are Black/African American and Hispanic/Latino, have high rates of new HIV diagnoses. Anal sex is the riskiest type of sex for getting or transmitting HIV.
• Sharing needles, syringes, or other drug injection equipment.

Additional factors that can increase a young person’s chance of getting or transmitting HIV include inadequate education about safe sex, having older sexual partners, and having another sexually transmitted disease. Youth also have low rates of use of pre-exposure prophylaxis (PrEP), a medication taken to prevent getting HIV.

People with HIV experience different symptoms in the early and late stages of infection.

Acute HIV Infection

A few weeks after getting HIV, many people have flu-like symptoms, which may last days or weeks. These symptoms can include fever, headache, tiredness, and enlarged lymph glands in the neck and groin area. Some people may have no symptoms.

HIV symptoms can be similar to those caused by other illnesses.

An HIV test is the only way to tell for sure whether you have HIV.

However, even if people with HIV feel healthy, the virus is still affecting their bodies. Once HIV enters the body, it infects large numbers of CD4+ cells and rapidly spreads throughout the body and into many organ systems.

During this early period, HIV is present in large amounts in genital fluids and in blood and can be passed to others.

Chronic HIV Infection

In the next stage of HIV infection, the virus still multiplies, but at very low levels. People may not feel sick or have any symptoms.

If they are not getting treatment for HIV during this stage, they can still pass the virus to other people. Getting and staying on treatment prevents passing HIV to others.

Without HIV treatment, people can stay in this stage for a decade or more, although some move through this stage faster.

With treatment, HIV is only present in very small amounts in genital fluids and blood, or it may not be detectable at all. People with low or undetectable levels of HIV may never develop AIDS.

AIDS

AIDS is the most advanced stage of HIV infection, when a person's immune system is severely weakened and has difficulty fighting infections and certain cancers. At this stage, serious symptoms develop, such as:

• Rapid weight loss
• Serious infections
• Pneumonia
• Recurrent fevers
• Prolonged swelling of the lymph glands
• Skin blotches
• Prolonged diarrhea
• Sores of the mouth, anus, or genitals
• Memory loss
• Depression
• Other neurologic disorders

In the United States, most people with HIV do not develop AIDS thanks to highly effective treatments that stop progression of the virus.

The most common tests examine a blood sample for evidence that a person's body is fighting HIV. These tests detect HIV antibodies, which are substances the body creates in response to infection. Some tests look for both antibodies and an antigen, a substance the virus makes before antibodies develop.

However, no HIV test can detect HIV immediately after infection. This is because it takes some time for the immune system to produce enough antibodies for the antibody test to detect. The time between when a person gets HIV and when a test can accurately detect it is called the window period. The window period varies from person to person and also depends on the type of HIV test. Ask your healthcare provider about the window period for the test you had and whether you will need a follow-up test to confirm the results.

Diagnosis in Children and Youth

There are special challenges in diagnosing HIV in infants and youth.

Because HIV antibodies pass from mothers with HIV to their infants, finding HIV antibodies in an infant does not indicate that the infant has HIV. Maternal HIV antibody in an HIV-negative infant can persist as long as 12 to 18 months before it disappears. Therefore, an HIV antibody test cannot be used to diagnose HIV in infants younger than age 18 months.

Scientists have developed highly accurate blood tests for diagnosing HIV in infants. One laboratory test, called polymerase chain reaction, can detect extremely small quantities of HIV's genetic material in an infant's blood and allow a diagnosis to be made in the first few months of life.

The challenge in youth is different: Many young people think they're not at risk for HIV. This makes them less likely to seek testing. As a result, the Centers for Disease Control and Prevention recommends routine HIV screening in healthcare settings starting at age 13 years. The U.S. Preventive Services Task Force recommends routine screening for HIV beginning at age 15 years or earlier for adolescents at increased risk.

If you answer "yes" to any of the following questions, you are at risk for HIV and should talk to your provider about testing.

• Have you ever had sex (including oral, vaginal, or anal sex) without a condom or other latex barrier?
• Have you ever had sex (including oral, vaginal, or anal sex) with someone who is living with HIV?
• Have you ever had sex with someone who used injection drugs?
• Have you ever had sex with a man who has sex with other men?
• Have you ever had a sexually transmitted disease (STD) such as herpes, chlamydia, gonorrhea, trichomoniasis, or hepatitis?
• Have you ever been sexually assaulted (raped, or forced or talked into having sex when you didn't want to)?
• Have you ever passed out or forgotten what happened after you were drinking or getting high?
• Have you ever shared needles or other equipment to inject drugs or pierce the skin, such as tattoo needles?

To understand what your test results mean, you first have to understand what kind of test is being used and what a "window period" is.

Most HIV screening tests look for HIV antigen (part of the HIV virus) or for HIV antibodies (produced by the person's body), or may look for both. Newer testing strategies use a combination antigen/antibody test. Some testing sites also use a test that looks for genetic material of the HIV virus.

The window period is the period between the time someone is first infected with the HIV virus and the time an HIV test can detect HIV infection. After someone has been infected with the virus it can take about 2 weeks for HIV antigen to be detectable with current antigen tests, and more than 3 weeks to produce enough HIV antibodies to be detected by antibody tests. In a very small number of people, the process takes up to several months.

During the window period, someone might be infected with HIV yet still have a negative result on an HIV test. Here's how that can happen. Let's say you have condomless sex on Saturday night and become infected with HIV. On Monday, you get an HIV test. The test almost certainly will come back negative, because there is not yet enough HIV antigen or HIV antibody for the tests to detect.

Even if you go for an HIV test 2 or 3 weeks later, an antibody test result might be negative because your body still has not produced antibodies (an antigen test may be positive at an earlier time point). If you think you have been exposed to HIV, and your test results are negative, be sure to discuss this with your medical providers--they may want to test you directly for HIV virus (an HIV viral load) or repeat a sensitive HIV antigen/antibody test.

Newer methods of HIV testing are narrowing the time of the "window period" and reducing the chance of a falsely negative result.

When testing is completed, your provider will tell you the result. Possible results are:

Positive: means that you have HIV infection. Your provider will discuss treatment and refer you to a specialist for HIV care.

Negative: means either you do not have HIV or you got it so recently that your body has not had time to make enough antibodies to be detected by the test. If your result is negative but other things seem to point to HIV as a possibility, you should have the test repeated later.

Indeterminate: means that the test did not show whether or not you have HIV. This could happen if you have another medical condition that interfered with the test or you have been infected recently. If you have an indeterminate HIV test result, you need to have an HIV test repeated at a later date.

HIV drugs keep the virus from multiplying in the body, which benefits the person with HIV and prevents transmission of the virus to others.

Research has firmly established that people with HIV who achieve and maintain an undetectable viral load—the amount of HIV in the blood—by taking HIV treatment as prescribed cannot transmit the virus during sex. An undetectable viral load also reduces the risk of HIV transmission during pregnancy, labor, and delivery to 1% or less, according to the Centers for Disease Control and Prevention. It also substantially decreases, but does not eliminate, the risk of HIV transmission through breastfeeding.

People with HIV sometimes get other illnesses and complications related to HIV, even when the virus is well-controlled with treatment. These include co-infections like hepatitis C and tuberculosis, as well as non-infectious complications such as heart disease. People with advanced-stage HIV may develop serious opportunistic infections, like pneumocystis pneumonia or cryptococcal disease. There are treatments available for many of these other illnesses.

Treatment Considerations for Women

For the most part, HIV treatments for women are the same as for men. However, there are some special considerations related to treatment of HIV for women, including:

• Birth control. Some anti-HIV drugs interact with hormonal birth control. This may mean that a woman taking certain HIV medications is more likely to become pregnant even if she's using contraception. Women with HIV who want to avoid pregnancy should talk to their healthcare providers about the safest and most effective birth control method for them.
• HIV medication during pregnancy. All pregnant people with HIV should receive HIV medications to benefit their health and prevent transmission of the virus during pregnancy and childbirth.
• Perinatal transmission. During pregnancy, birth, and nursing, HIV can pass from a mother to her child. Pregnant people with HIV can prevent this if they take their anti-HIV drugs as prescribed and give HIV medicine to their babies in the weeks after birth. Avoiding breastfeeding when formula feeding is available also is recommended. Read more about preventing perinatal transmission of HIV.

Treatment Considerations for Children and Adolescents

Because of their developing bodies, children and teens have to take different amounts, formulations, and combinations of anti-HIV drugs than adults.

Children and youth might also require special treatments for side effects of HIV or anti-HIV drugs. For example, the widely used anti-HIV drug tenofovir can make youths' bones weaker and could endanger their long-term bone health. NICHD-sponsored research found that vitamin D pills may prevent this problem.

The best treatment strategy may be different for each child or teen. These are some factors that affect treatment decisions:

• Availability of pediatric anti-HIV drug formulations. Young infants cannot swallow pills or capsules and, therefore, require special drug formulations, such as liquids. Not all anti-HIV drugs available for adults have formulations that infants and young children can take.
• Availability of pediatric dosing information. The doses of anti-HIV drugs that need to be given are different in children than adults, and also vary in children of different ages. Not all anti-HIV drugs approved for adults have been studied in children to determine the right dose for children. Additionally, dosing information for some anti-HIV drugs may be available for older but not younger children.
• Treatment adherence. Many children and teens are concerned about fitting in with their friends and may not think about future consequences. For these and other reasons, some have trouble taking their medication as directed. Taking HIV medicine consistently is the best way to protect health and prevent onward transmission of the virus. Many strategies can help improve treatment adherence among youth, including simpler treatment plans, text message reminders for taking pills, and support from peers with HIV.
• Prior anti-HIV treatment. Some anti-HIV treatments stop working after a period of time because the virus may become resistant to those drugs. For example, teens who got the virus at birth might harbor HIV that has become resistant to some drugs during periods when they had trouble with treatment adherence.

Several challenges make it difficult for youth to access the tools they need to get treatment and care if they have HIV.

• Youth ages 13 to 24 years are the least likely of any age group to know their HIV status. Not knowing you have HIV means you cannot take advantage of HIV care and treatment and may transmit HIV to others.
• Young people also are more likely than older people to be living in low-income households or to have been recently homeless, recently incarcerated, or uninsured. These social and economic challenges pose additional obstacles to accessing HIV treatment and prevention services.

Today, numerous HIV prevention methods are available for use in combination or on their own. These range from pre-exposure prophylaxis (PrEP)—in which healthy people routinely take anti-HIV drugs to reduce their risk of getting HIV—to condom use. Scientists continue to develop new tools and techniques to prevent HIV, including work toward an HIV vaccine.

Preventing Perinatal Transmission

Advances in HIV treatment and prevention have greatly decreased transmission of HIV from mother to child during pregnancy, childbirth, and breastfeeding. Prevention strategies and interventions can reduce this risk to 1% or less.

If you are pregnant or planning to become pregnant, experts recommend that you:

• Get an HIV test. If you know you have HIV, you can take steps to lower your risk of perinatal transmission.
• If you have HIV, take anti-HIV drugs for yourself and your child. You should take anti-HIV drugs during pregnancy, labor, and birth, and your child should take them for the first weeks of life.
• If you have HIV, avoid breastfeeding. HIV can pass to your child through breast milk. If you live in the United States or another country with safe water, formula feeding is best for prevention of HIV.

HIV is spread mostly through four body fluids:

• semen
• vaginal fluid
• blood
• breast milk

There is no vaccine to prevent HIV, and no cure for HIV, but there ARE ways you can reduce your risk of HIV. We can reduce risk by:

• HIV testing: A step toward prevention. If you've never had one before, ask your provider for an HIV test. Everyone should be tested at least once in their lifetime. If you think you might be at risk for HIV, talk to your provider about how often you should be tested and about the prevention methods listed below. In addition to HIV testing, ask about testing for other sexually transmitted infections (STIs). If you do have an STI, it is important to be tested for HIV as well and to talk about prevention methods.
• Treating people who have HIV. If a person with HIV is on HIV meds (antiretroviral therapy, or ART) with a consistently undetectable HIV viral load, the HIV virus cannot be transmitted to a sex partner. A good way to remember this is U=U or "Undetectable = Untransmittable." As a prevention strategy, this is often referred to as Treatment as Prevention, or TasP.
• Using PrEP for people at high risk for HIV. PrEP is a medication that is highly effective at preventing HIV. PrEP is available at VA! Make sure you get an HIV test before you start and stay up to date on STI testing while on PrEP. Ask your provider about self-testing options.
• Practicing safer sex. Condoms are available via prescription. Ask your provider for a condom prescription at your next appointment.
• Practicing safer injection drug use. If you need help to stop using drugs, please talk to your healthcare provider. If you do inject drugs, make sure you use clean equipment and practice safer injecting.

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.

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).

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.

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.

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.

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, you will not get HIV from sex with your partner.
• Learn more about the benefits of HIV treatment as prevention.

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.

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.

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).

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.

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.

• 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 will not transmit HIV to their partner through sex.
• Having an undetectable viral load substantially reduces but does not eliminate the chance of HIV transmission to others through sharing needles, syringes, or other injection equipment, and to infants during pregnancy, birth, and breast/chestfeeding.
• Most people can get the virus under control (undetectable) within six months of starting HIV medicine.
• Taking ART does not prevent transmission of other sexually transmitted diseases (STDs).

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.

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.

Take Medicine to Treat HIV

• If you have HIV and take HIV medicine as prescribed throughout pregnancy and childbirth, have a suppressed viral load , and give HIV preventive medicine to your baby after giving birth, the chances of transmitting HIV to your baby are less than 1%.
• After delivery, you can prevent transmitting HIV to your baby by feeding your infant with properly prepared formula or pasteurized donor human milk from a milk bank. These are recommended if you have a detectable viral load.
• If you have undetectable viral load during pregnancy and you wish to breast/chestfeed, you can discuss this with your provider and make a plan together on the best way to breast/chestfeed safely. Taking HIV medicine and maintaining an undetectable viral load during pregnancy, labor and delivery and while breast/chestfeeding reduces the chances of transmission through breastfeeding to less than 1% .
• If your partner has HIV, encourage your partner to get and stay on treatment. This will 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 will not transmit HIV to their sex partner.

What is HIV?

HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. It is spread through certain body fluids, including blood, sexual fluids (like semen and vaginal or rectal fluids) and breast milk. Most people get HIV from having unprotected sex (including vaginal or anal sex) with someone who has HIV, or from sharing needles or other drug injection equipment with someone who has HIV.

Early symptoms of HIV infection may include cough, body aches, headaches, nasal congestion, and sore throat. These symptoms usually go away on their own and can be mistaken for flu-like illness. Some people may have no early symptoms at all and may feel healthy. The only way to know for sure whether you have HIV is to get tested.

Over time, HIV infection damages the immune system, making it harder for the body to fight off infections and other diseases, including heart disease, kidney disease, liver disease, and cancer. Left untreated, HIV infection can lead to AIDS (acquired immune deficiency syndrome). AIDS is the most severe phase of HIV infection. People with AIDS have such badly damaged immune systems that they get severe infections that don’t normally infect healthy people, called opportunistic infections, and eventually the infection leads to death. No effective cure exists, but with early diagnosis and proper medical care, HIV can be managed and controlled.

Who is at risk?

Travelers are generally at low risk for getting HIV unless they engage in activities that could put them at risk, such as having unprotected sex or sharing needles.

A person can get HIV by being stuck with a contaminated needle or another sharp object, though this is more of a risk for healthcare workers. Some low-income countries may not adequately screen their blood supplies or properly sterilize medical equipment used in medical clinics, dental clinics, and hospitals. There is a small chance that travelers to these countries who receive medical care could get infected.

HIV infection affects people globally. Sub-Saharan Africa remains the most affected part of the world. Still, other regions significantly affected by HIV include Asia and the Pacific, Latin America, the Caribbean, Eastern Europe, and Central Asia.

What can travelers do to prevent HIV?

• Talk with your health care provider about PrEP or pre-exposure prophylaxis. It is usually a pill or a shot. PrEP is most effective when it is prescribed by your healthcare provider
• Before having sex for the first time with a new partner, you and your partner should talk about your sexual and drug-use history, disclose your HIV status, and get tested for HIV and other sexually transmitted infections.
• If you have sex, use condoms the right way every time you have vaginal, oral, or anal sex, from start to finish.
• Do not inject drugs or share needles or other devices that can break the skin. If you do inject drugs, use only new, sterile syringes and needles.
• If you get tattoos, piercings, or acupuncture abroad, make sure a new, sterile needle is used each time.
• If you get medical or dental care abroad, make sure the equipment is unused or properly sterilized.

If you have HIV and are traveling, your destination may increase your risk of getting opportunistic infections or more severe illnesses from infections like travelers’ diarrhea. Bring enough of your medications to last your entire trip since not all countries have all HIV medication.

Consult your doctor or travel medicine specialist at least 4 weeks before leaving as you may not be eligible for certain travel vaccines required at your destination, or you may need to take additional precautions.

Check the Department of State website for any restrictions on travel for people with HIV at your destination.

After Travel

If you traveled and feel sick, particularly if you have a fever, talk to a healthcare provider and tell them about your travel.

Like most people, you probably have heard a lot about HIV and AIDS. You may have thought that these diseases aren't your problem and that only younger people have to worry about them. But, anyone at any age can be infected with HIV.

What is HIV? What is AIDS?

HIV is a virus that damages and weakens the body's immune system — the system your body uses to fight off infection and disease. Having HIV puts a person in danger of experiencing other life-threatening infections and certain cancers.

When the body cannot fight off infections and some other diseases anymore, HIV can lead to a serious illness called AIDS. When someone has AIDS, they are more likely to get infections, and more vulnerable to unusual forms of cancers and other serious diseases. But, with early and uninterrupted treatment, it is possible that a person with HIV will never develop AIDS.

If you think you may have HIV, you should get tested. Everyone age 13 to 64 should be tested at least once for HIV. If you are over 64 and are at risk for HIV, talk with your doctor. Your doctor can help determine how often you should be tested and help find ways to reduce your risk.

There are drugs that, when taken consistently, can help suppress the amount of HIV in your blood to undetectable levels, improving your health overall and making it harder to pass HIV on to your sexual partners. To get the best results, it is important to start treatment as soon as possible. If you are unsure about your HIV status, get tested. Always protect yourself and your partners when having sex or using needles.

How do I get tested for HIV?

A small blood sample, mouth swab, or urine sample is used to test people for HIV. It can take as long as three to six months after initial exposure for the signs of the virus to show up in your blood, and years before you show any symptoms.

You can be tested at a doctor's office, hospital, community health center, or other health clinic. Some places have mobile testing vans. AIDS services organizations also may provide testing. At-home testing kits are also available.

Depending on where you go, testing may be free. You may be able to choose to take the test without giving your name. Many providers or groups that offer HIV testing also provide counseling.

If you choose to take a test at home, make sure to use a test that has been approved by the U.S. Food and Drug Administration (FDA). If the test has not been approved by the FDA, it may not give accurate results. Home tests are sold at drugstores and online. Follow up with your doctor to confirm the results of at-home tests and, if necessary, begin treatment.

How is HIV transmitted?

Anyone, at any age, can get HIV. People usually acquire HIV from unprotected sex with someone living with HIV, through contact with HIV-infected blood, or by sharing needles with a person living with HIV. You may be at risk if:

• You had sex without a latex or polyurethane condom. The virus passes from the person living with HIV to his or her partner via blood, semen, or vaginal fluid. During sex, HIV can get into your body through body fluids and any opening, such as a tear or cut in the lining of the vagina, vulva, penis, rectum, or — rarely — the mouth. Latex condoms can help prevent HIV transmission between sexual partners. (Natural condoms, like condoms made from lambskin, are not as effective as latex and polyurethane condoms at protecting against HIV/AIDS.)
• You or your sexual partners have shared needles with a person living with HIV. People who inject illegal drugs are not the only people who might share needles. For example, people with diabetes who inject insulin or draw blood to test glucose levels could also share needles. Talk to your partner(s) about their drug and sexual history, and always use a new, sterile needle for injections.
• You had a blood transfusion or operation in a developing country at any time.
• You had a blood transfusion in the United States between 1978 and 1985.
• You were diagnosed with or treated for hepatitis or tuberculosis (TB) at any time.

What are the symptoms of HIV?

Many people do not notice symptoms when they first acquire HIV. It can take as little as a few weeks for minor, flu-like symptoms to show up, or more than 10 years for more serious symptoms to appear, or any time in between. Signs of early HIV infection include flu-like symptoms such as headache, muscle aches, swollen glands, sore throat, fevers, chills, and sweating, and can also include a rash or mouth ulcers. Symptoms of later-stage HIV or AIDS include swollen glands, lack of energy, loss of appetite, weight loss, chronic or recurrent diarrhea, repeated yeast infections, short-term memory loss, and blotchy lesions on the skin, inside the mouth, eyelids, nose, or genital area.

Is HIV/AIDS different in older adults?

A growing number of older people are living with HIV/AIDS. One reason is because improved treatments are helping people with the disease live longer. Nearly half of people living with HIV in the United States are age 50 and older. Many of them were diagnosed with HIV in their younger years. However, thousands of older people get HIV every year.

Older people are less likely than younger people to get tested, so they may not know they have HIV. Signs of HIV/AIDS can be mistaken for the aches and pains of normal aging. Older adults might be coping with other diseases and the aches and pains of normal aging, which can mask the signs of HIV/AIDS.

Some older people may feel ashamed or afraid of being tested. Plus, doctors do not always think to test older people for HIV. Some people may not have access to high-quality health facilities and services, which can limit their treatment options. By the time the older person is diagnosed, the virus may be in the late stages and more likely to progress to AIDS.

Remember, if you are at risk, get tested regularly for HIV.

For people who have HIV, it is important to start treatment as soon as possible after diagnosis. Treatment can help reduce the level of HIV in the blood to undetectable levels. When treatment makes HIV undetectable, the possibility of spreading the virus to a sexual partner becomes very low. This is known as treatment as prevention (TasP).

Even when the disease is well controlled, people with HIV may develop aging-related conditions at a younger age. HIV and its treatment can also affect other parts of the body, such as the brain and the heart. For example, people living with HIV are significantly more likely to develop cardiovascular disease than people without HIV. Older people living with HIV also have an increased risk of dementia, diabetes, osteoporosis, frailty, and some cancers. They also may be more likely to fall. It’s common for older adults with HIV to experience mental illness, especially depression and addiction, and they tend to be more isolated. Talk with your doctor if you are concerned about how living with HIV could affect you as you grow older.

Is there a cure for HIV?

There is no cure for HIV. But if you acquire the virus, there are drugs that help suppress the level of HIV in the body and prevent its spread to other people. Doctors use a combination of drugs called HAART (highly active antiretroviral therapy) to treat HIV/AIDS. Although it is not a cure, HAART has greatly reduced the number of deaths from HIV-related complications in the United States. HIV has become like a chronic disease, and people living with HIV receiving successful treatment can live a long and healthy life.

Preventing HIV

Remember, there are things you can do to keep from getting or transmitting HIV. Take the following steps to lower your risk:

• If you are having sex, consider limiting your number of sexual partners. If you or your partner is having sex with other people, or if you don't know his or her sexual or drug history, always use protection. The more partners you have, the more likely you are to be exposed to a sexually transmitted infection.
• Before having sex with someone, talk with them about HIV. Ask about their sexual and drug history. Get tested for sexually transmitted infections every year.
• Learn about the risks of different sexual activities and reduce your risk.
• Use male or female condoms (latex or polyurethane) during sexual intercourse.
• Do not share needles or any other equipment used to inject drugs. Always use new, sterile needles for injection.
• Get tested if you or your partner has had an operation or blood transfusion in a developing country at any time.
• Get tested if you or your partner had a blood transfusion between 1978 and 1985 in the United States.

If you are at very high risk for HIV infection through sex or injection drug use, you may prevent it by taking an anti-HIV medication daily, called pre-exposure prophylaxis, or PrEP. PrEP is effective at reducing the risk of acquiring HIV, but it must be taken every day. Talk with your doctor to find out whether PreP is right for you.