Human Immunodeficiency Virus, commonly known as HIV, is a virus that affects the immune system by destroying white blood cells known as CD4 cells. These cells are responsible for fighting disease. The reduction of CD4 cells prevents a person’s body from fighting infections.
HIV is a lifelong disease for which there is currently no cure. However, the virus can be controlled with proper medical treatment.
How are HIV and AIDS different?
If someone is HIV positive, it does not mean that he/she has developed AIDS. The virus and the disease are often referred to collectively as HIV/AIDS. HIV is the virus that causes AIDS. AIDS is the condition diagnosed in an individual when one tests positive for HIV and develops an “opportunistic” infections or when their immune system is severely affected.
The spread and transmission of HIV
HIV is spread when infected bodily fluid enters the bloodstream of someone who is not HIV positive. After exposure to the virus, the risk of infection depends on the type of exposure and the amount of virus in the infected bodily fluids. Both men and women can spread the HIV virus.
The primary routes of transmitting HIV include:
- Sexual intercourse (anal, oral or vaginal) without protection (male or female condoms) with someone who has HIV. The virus can be transmitted through any of the following bodily fluids: blood, preseminal fluid (“pre-cum”), semen, and vaginal fluid.
- Sharing needles or syringes with someone who has HIV. This may result from the injection of drugs or through use of a dirty needle for tattooing or body piercing.
- Pregnancy, birth or breastfeeding: women who have HIV can transmit the virus to their babies before, during or after the child’s birth.
While these are not the only ways one can be infected, it is important to remember that the virus is not spread through kissing, sharing food, beverages or utensils, public swimming pools, or casual contact like hugging.
The stages of HIV
There are multiple stages of HIV. Infection occurs when the virus enters the bloodstream and begins to dwell inside those cells. HIV is commonly referred to as a progressive disease, which means the health of a person infected with HIV worsens over time. Without proper treatment, people who are infected are likely to reach an advanced stage of HIV, often leading to Acquired Immune Deficiency Syndrome, or AIDS.
The stages of HIV are:
- Acute Infection – This is the first stage of HIV, which usually happens 2-4 weeks after initial exposure to the virus. During this time, infected individuals may experience flu-like symptoms such as fevers, sore throat, mouth ulcers, aches, rashes and night sweats. However, some individuals experience no symptoms at all. During this stage, the virus travels to lymph nodes and makes copies of itself, releasing more of the virus into the bloodstream. During this time, the amount of the virus in the blood is very high, and HIV-positive individuals are very infectious.
- Clinical inactivity (latency) – Following the acute stage, the virus will become less active. People will continue to appear healthy, often for many years following infection. Although someone may have a clinically “undetectable viral load” and may seem healthy, the HIV is still active and infected people can still pass along the infection to others.
- AIDS – This is the last stage of infection. AIDS is characterized by severe damage to the immune system. Infected individuals who experience one or more life-threatening infections (also known as opportunistic infections) are characterized as having AIDS.
Acquired Immune Deficiency Syndrome – AIDS Defined
The last stage of HIV virus is Acquired Immune Deficiency Syndrome, or AIDS. People with AIDS have extremely damaged and weak immune systems. Healthy individuals have anywhere between 500 and 1,500 CD4 cells in each milliliter of blood. A person with a CD4 count below 200 is considered to have AIDS. As a result, HIV-positive people with AIDS are especially susceptible to other infections, even certain cancers. Bacteria, parasites, and fungi that may not have affected individuals when they were healthy can make HIV-positive individuals very sick. These infections are called opportunistic infections (OIs) because the compromised immune system creates an “opportunity” for the infection to take place. By definition, if you have HIV and develop an OI, you have AIDS. Additionally, people with AIDS are much more susceptible to certain cancers that are often prevented by a functioning immune system. These include Kaposi sarcoma, some types of cervical cancer, and lymphoma.
Who is at risk for HIV infection?
Anyone can be infected with HIV. However, there are certain groups that experience HIV more frequently than others. In the United States, sexuality and ethnicity are risk factors for being infected with the virus. Gay and bisexual men (also known as men who have sex with men, or MSM) are at particularly higher risk for infection. Additionally, African Americans, Blacks, Latinos and Hispanics of any gender have higher rates of HIV. Individuals who use abuse drugs intravenously, as well as babies of HIV-positive mothers, are also at risk.
The importance of knowing your HIV status
While there is currently no known cure for HIV, with medication, HIV-positive individuals can manage their illness and prolong their lives. In order to do so, it’s important to get tested for HIV as soon as possible in order to receive effective treatment. Recent studies suggest that HIV-positive individuals whose condition is well controlled can expect to live well into their 60s and longer. How can you know for sure if you have HIV? The only way to truly know is by taking an HIV test. This test is performed by taking a small sample of blood from a vein in the arm. The blood is then tested for signs of HIV. Alternatives to blood testing include testing the urine and oral fluid for HIV. However, urine testing is not considered sensitive enough to provide an early diagnosis.
Important steps you can take to prevent HIV
It is very important that you avoid activities that can put you at risk of getting HIV. Key steps in preventing HIV include:
- Staying educated about HIV and AIDS
- Using latex or polyurethane condoms (male or female) when engaging in any type of sex (anal, oral, vaginal).
- Avoiding condoms made from animal products (e.g., lambskin), which do not offer the same level of protection as latex condoms
- Limiting the number of sexual partners you have
- Knowing the sexual history of all new partners before engaging in sexual activity
- Avoiding sharing needles with others and using only clean, sterile needles
- Not sharing any personal instruments with blood residue (e.g, razors)