Essential facts about human immunodeficiency virus (HIV)

In June 1981, a group of researchers and scientists published a report in the Centers for Disease Control and Prevention's (CDC’s) Morbidity and Mortality Weekly Report (MMWR) about cases of an uncommon type of pneumonia in gay men. Whether the authors of that MMWR study realized it or not, the AIDS crisis had begun.

Since the epidemic started, more than 700,000 people have died from HIV-related illnesses in the United States. As many as 40.4 million have died around the world. Roughly 39 million people globally were living with HIV in 2022, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS).

The good news is that HIV/AIDS is no longer a fatal disease for people who have access to treatments. In fact, treatments can help people live long, healthy lives.

Major strides have been made in the decades since the HIV/AIDS epidemic began, but stigma and misinformation remain. Here are essential facts about HIV/AIDS that everyone should know.

HIV explained

HIV (human immunodeficiency virus) is a virus that destroys the body’s CD4 cells (or T cells), which ordinarily help fight off infections and diseases. If HIV goes undiagnosed, the number of T cells in a person’s body will decrease.

The body can’t get rid of this virus completely, so once you have HIV, you have it for life. HIV develops in stages from the time of infection, but if treated with the proper medications, a person can live healthily for many years with HIV.

HIV affects roughly 1.2 million people in the U.S. aged 13 and over, though roughly 13 percent of them doesn’t know they have it. Meanwhile, rates have been gradually declining in the U.S. In 2010, an estimated 48,298 people were newly diagnosed, according to data from the CDC. By 2021, that number dropped to 36,136 new HIV cases.

Where did HIV come from?

HIV originated from a certain type of chimpanzee in Central Africa. The initial spread to humans is believed to have begun in the late 1800s. The chimpanzees had a version of the virus called simian immunodeficiency virus that probably began spreading to humans when humans hunted them for meat and came into contact with their blood in the process. Once humans became infected, the virus spread through Africa and other parts of the world, then to the U.S. by the 1970s.

AIDS and HIV: How are they related?

AIDS is the most advanced stage of HIV. It typically develops when a person isn’t diagnosed or adequately treated for HIV. It takes, on average, 10 or more years for AIDS symptoms to appear after an initial HIV infection.

Once AIDS develops, the immune system is already severely damaged and unable to protect itself from simple infections, cancers, and other immune diseases. Without treatment, most people living with AIDS will only live for about three years.

What are the symptoms of HIV?

As early as two weeks after exposure to HIV, people may develop flu-like symptoms such as a sore throat, rash, fever, or chills. During this stage, the virus multiplies rapidly and is most contagious. These symptoms will last for a few weeks.

After the first stage of infection, HIV moves into a latency stage during which there are no symptoms. More severe symptoms of HIV-caused infections and cancers will likely appear years later.

Diagnosing HIV

Typically, the virus is diagnosed through a blood test or by checking oral fluids for the virus or the antibodies that target it. It’s very important to get tested if you’re having symptoms or if you’ve had sex or shared needles with someone who is infected. The CDC recommends that all adults between the ages of 13 and 64 have at least one test in their lifetime, with people who are at higher risk (see more below) getting a test once a year or more frequently.

HIV testing will not detect the virus right after exposure, however. In fact, it may take anywhere from 10 to 90 days for the virus to become detectable, depending on your body and the type of test you take. If you use an at-home antibody test—which may involve swabbing fluids from your gums or pricking your finger—you will need to follow up with your healthcare provider (HCP) for a follow-up test to confirm results.

If you think you’ve been exposed, see your HCP right away so you can discuss the option that is best for you. If it’s within 72 hours of exposure, they may recommend post-exposure prophylaxis (PEP). This is a type of medicine that may prevent you from developing an infection.

Treatment options for HIV

The virus is treated with a type of medication called antiretroviral therapy, which decreases the amount of the virus in your body. Because of the improvements in HIV medicines, people with HIV who receive treatment early can keep the virus suppressed, are able to fight off infections, and can expect nearly the same longevity as someone without the virus.

When treated consistently, you can live a long, healthy life with HIV. Taking antiretroviral medicines also reduces the chance of your infecting others and can lower the chance of spreading it to your baby if you are pregnant.

It’s important to be diagnosed and start treatment as early as possible. Once you start treatment, it's imperative to stay on the treatment as instructed by your HCP.

How is HIV spread?

The virus can be found in the blood, semen, and vaginal fluids of a person who is infected with HIV. Having unprotected sex, especially anal and vaginal intercourse, can put you at risk.

Getting a tattoo or body piercing with contaminated equipment can also theoretically pass on the virus, though the CDC says there are no known cases of this happening in the U.S.

Sharing needles can transmit the virus because blood is present in needles and syringes. A person who is HIV-positive can transmit it to their baby during pregnancy, childbirth, or through nursing, especially if they are not receiving HIV treatment.

Who’s at higher risk of HIV?

Anyone can contract HIV, but there are certain factors that can increase the risk of HIV.

People living in communities with a high HIV infection rate are more likely to contract the virus from an infected person through sex or sharing needles.

The number of new HIV cases in the U.S. is highest among gay and bisexual men. Male-to-male sexual contact accounted for 67 percent of new HIV diagnoses in 2021, according to the CDC. Compared to other racial and ethnic groups, Black people are disproportionately affected, accounting for 40 percent of new HIV diagnoses in 2021. Black men who have sex with men are at particularly heightened risk.

Transgender women are also at elevated risk. Of 1,608 transgender women surveyed by the CDC in 2019 and 2020, 42 percent had positive HIV tests.

There are a number of contributors to these disparities, including structural racism, homophobia, poverty, and stigma and discrimination surrounding HIV. These factors may lead to inequities in access to culturally competent and effective health care and may discourage people from seeking HIV testing and treatment.

Is there a cure for HIV?

While there is no cure for HIV, it is possible to control the virus with proper medical treatment. As soon as a person starts treatment, they’re not only increasing their chances of a longer life for themselves, but they are also lowering the chances of the virus spreading to someone else.

How can I prevent HIV infection?

Practicing safe sex is the most effective way to prevent the spread of HIV. Unless you and your partner are monogamous and have both tested negative for HIV, use a new condom with each sexual encounter and limit sexual contact with multiple partners. Here are some other ways to prevent HIV:

• Avoid sexual practices that could allow HIV-infected fluids, like blood, semen, and vaginal secretions, to pass into your body.
• Stop using injectable drugs. If you do use them, never share needles with others and always use a new needle.
• If you think you’re at risk of contracting HIV, talk to your HCP about the antiviral medication used to lower your risk of becoming infected. For example, pre-exposure prophylaxis (PrEP) is used by people who do not have HIV but have a higher likelihood of getting it, such as through sex or drug use. It involves taking medicine every day to prevent HIV infection, although it won’t guard against other sexually transmitted infections.
• If you are pregnant and have HIV, seek treatment to help prevent transmission to your baby.

How can I stay healthy with HIV?

If you have HIV, maintaining healthy lifestyle habits is important. In addition to taking your antiretroviral medicine as prescribed by your HCP, here are some ways to live better with HIV:

• Eat a healthy diet to boost your immune system, build strength, increase your energy, and maintain a healthy weight. That includes eating a balance of fruits, vegetables, whole grains, proteins, and dairy, while reducing your intake of saturated fat, salt, and added sugars.
• Make sure your meals are safely prepared and your food is stored safely. HIV affects your immune system, so you’re more at risk for foodborne illnesses.
• Limit alcohol, which can hamper your liver’s ability to clear medications out of the body, and thus potentially interfere with treatment. Avoid recreational drugs, which can weaken the immune system and interfere with your HIV treatment.
• Get regular exercise. Talk with your HCP first to make sure your fitness plan works with your HIV treatment program.
• Make sure you’re up to date with all of your recommended vaccinations to help bolster your immune system and prevent infections.

The stigma around HIV/AIDS remains

HIV-related stigma is still very much a worldwide issue. Some of the same fears surrounding HIV that surfaced in the 1980s are prevalent today. Stigma and discrimination are two major barriers to HIV prevention and treatment, according to UNAIDS. They prevent people from seeking information and getting medical care and can discourage people from disclosing their HIV status.

People living with HIV may experience negativity, prejudice, and abuse as a result of their diagnosis. Many people who don't know the facts about AIDS or HIV may still have harmful misconceptions, including:

• HIV is always associated with death.
• HIV is a result only of sexual intercourse.
• HIV is experienced only by gay men. (While most new diagnoses in the U.S. involve male-to-male sexual contact, 22 percent of cases in 2021 involved heterosexual contact.)
• People with HIV deserve consequences for contracting the illness.

If you’re wondering how you can help stop HIV-related stigma, consider viewing accounts from people living with HIV at Positive Spin, a website published by the U.S. Department of Health and Human Services. You can also help raise awareness by participating in educational efforts such as Let’s Stop HIV Together and World AIDS Day.

Another simple way to help: Know the facts about HIV/AIDS so you can have informed discussions with people who may be misinformed.

Support for people living with HIV

There are many resources available to help people who have HIV or for those who know someone who is infected:

• For questions about treatment options, clinical trials related to HIV, support after diagnosis or counseling, AIDSVu has a list of resources to help.
• For employment help, the U.S. Department of Labor provides helpful information about working and finding a job if you have HIV.
• You cannot be discriminated against for having HIV, whether in work, housing, transportation, health benefits, or public accommodations. If you feel you’re being unfairly targeted, file a civil rights complaint with the U.S. Department of Health and Human Services.
• If you’re in need of a substance abuse treatment center, visit SAMHSA.gov or call 1-800-662-4357.