What is HIV and What is AIDS?
AIDS (Acquired Immune Deficiency Syndrome) is a chronic, life-threatening condition caused by HIV (Human Immunodeficiency Virus). According to the Centers for Disease Control and Prevention (CDC), there are two types of HIV: HIV-1 and HIV-2. Both types of HIV work by attacking the T-Cells or CD4 Helper Lymphocytes, one of the body's defense cells produced by the immune system. The virus invades these T-Cells or CD4 cells to replicate itself (make more copies of the virus) then destroys the healthy part of the cell. Over time, HIV can destroy so many of these CD4 cells that the body can no longer ward of other types of infection. This can cause symptoms, other illnesses, and death. Once the immune system can no longer ward off other, secondary infections, HIV infection becomes a full-blown AIDS diagnosis.
A list, from the University of California San Francisco (UCSF) Medical Center, of specific conditions that are associated with a diagnosis of AIDS can be found here. A thorough listing of the criteria for each stage of HIV infection and AIDS can be found here on the CDC website.
Types of HIV:
There are two types of HIV: HIV-1 and HIV-2.
While both types of HIV work by invading a person’s T-Cells and are associated with AIDS and similar secondary conditions, HIV-2 appears to develop more slowly, to be milder, and less infectious in the early stages of progression.
HIV-1 is the most common type in most parts of the world. HIV-2 is predominantly seen in African countries.
How HIV/AIDS is Transmitted:
HIV cells are found in specific types of bodily fluids; infection occurs when those fluids are exchanged. HIV is known to exist in blood, semen, pre-seminal fluids, vaginal fluids, rectal mucous, as well as in breast milk.
HIV can be transmitted through unprotected sex. Unprotected sex is sex without a condom. Unprotected sex includes oral, anal, and vaginal intercourse.
HIV can be transmitted through sharing needles. This includes needles for IV drugs, acupuncture, or tattoos.
HIV can be transmitted through blood transfusions. Since American blood banks routinely screen for HIV, it's unlikely - but not impossible - that one could become HIV-positive through blood transfusions.
An HIV-positive woman can spread HIV to her unborn baby before and during birth. She may also spread the virus through breast milk. Doctors can prescribe medication that may prevent the spread of HIV to the newborn, which is why it is imperative that all pregnant women undergo HIV testing.
Some factors increase the risk of HIV infection. People with another STI are at a higher risk for becoming infected with HIV during sex with infected partners. Uncircumcised men have an increased risk of heterosexual HIV transmission.
How HIV/AIDS is NOT Transmitted:
HIV/AIDS cannot reproduce outside of the body. A person cannot become infected with HIV through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food, or water. It is not spread by insects.
Symptoms of HIV and AIDS:
The symptoms of HIV and AIDS can, will, and do vary, depending on what stage of infection a person has progressed into. If you have reason to suspect you have been infected with HIV, seek medical treatment immediately.
Often, after becoming infected by HIV, many people develop a flu-like illness within four to eight weeks after the virus enters their body. This illness is known as primary or acute HIV infection and may last for a few weeks. Potential symptoms include headache, diarrhea, muscle aches/soreness, swollen lymph glands, joint pain, sore throat, rash, genital ulcers or mouth ulcers, and night sweats. These symptoms may be mild enough to go unnoticed; however, the viral load in the blood system is very high at this time, increasing the risk of spreading HIV.
Persistent swelling of lymph nodes occurs in some people. Other than this swelling, there are no specific symptoms. However, HIV remains in the body, as free virus and in infected white blood cells. This is known as clinical latent infection and typically lasts 8 to 10 years. A few people stay in this stage even longer, but others progress to more-severe stages at a faster rate.
As the virus progresses, you may or may not develop mild infections or chronic symptoms such as fatigue, diarrhea, swollen lymph nodes, cough and shortness of breath, fever, and weight loss.
If you are infected with HIV and do not undergo treatment, the disease will progress to AIDS. This progression typically takes 10 years, but the time will vary from case to case. Once an HIV infection progresses to a diagnosis of AIDS, the immune system is severely damaged and cannot fight off common infections. The body is then susceptible to diseases that wouldn't trouble a person with a healthy immune system.
Signs of some of these infections include, but are not limited to, chronic diarrhea, headaches, chronic and persistent fatigue, cough and shortness of breath, and weight loss. Additional symptoms can include blurred/distorted vision, night sweats, and skin rashes. These symptoms may be accompanied by chills, fever higher than 100 F (38 C), and/or white spots or unusual lesions on your tongue or in your mouth, lasting for several weeks.
Once an infected person meets certain criteria, they are diagnosed with AIDS. The CDC's definition for AIDS includes a multitude of “AIDS-defining” conditions; the list is updated as more is learned about the disease.
Prevention of HIV/AIDS:
HIV has no cure. While there are drugs that can slow the disease process, HIV/AIDS is a chronic, eventually life-threatening illness. That is why prevention of HIV is so important. There are things you can do to reduce the risk of becoming infected with HIV.
Have safe sex every time you have sex. Condoms are safer sex. Use them when you engage in sexual activity of any variety. Latex condoms are very effective against HIV. If you have a latex allergy, you can use polyurethane or polyisoprene condoms. Lambskin condoms will not protect you against HIV because the virus can slip through the condom. Oil-based lubricants will damage condoms, so use a water-based lubricant when you have sex. Condoms with Nonoxynol-9 are not recommended for STI/HIV prevention because the spermicide irritates the vaginal/rectal walls, thereby increasing the risk for HIV infection if the infected fluids come into contact with them.
Get tested. Make sure you and your partner get tested. Know your partner's HIV-status. It is not shameful to ask your partner about STIs.
Be monogamous or limit your number of sexual partners. Know who you are having sex with.
Being under the influence of drugs or alcohol can make you take sexual risks.
If you are pregnant and HIV-positive, tell your doctor so you can be started on an antiretroviral therapy (ART) during pregnancy, labor, and delivery. Antiretroviral drugs can reduce the likelihood of spreading HIV to your infant.
Ensure that all needles you use, or that are used on you, are clean. If you are an IV drug user, use clean needles. If you go to an acupuncturist or tattoo/piercing artist, make sure they use sterilized needles.
ART, or anti-retroviral therapy, can help prevent the spread of HIV from mother to fetus, as well as reduce the risk of an infected person transmitting HIV to an uninfected person. Post exposure prophylaxis, which can help prevent infection after exposure, includes immediate use of ART within 72 hours of accidental exposure to HIV.
Diagnosis of HIV/AIDS:
HIV is usually diagnosed through a blood test, which looks for antibodies that indicate HIV is present in the body of an infected person. If you think you may have been infected with or exposed to HIV, get tested. It is advised that you get tested about three months after possible exposure to HIV to get an accurate result because it can take anywhere from a few weeks to several months to develop antibodies. Early testing is important because, if you are HIV-positive, you can work with your doctor to develop a treatment plan. By testing early, you can take steps to prevent spreading the virus to others.
Because it can take a while to develop antibodies, your doctor may need to perform follow-up tests. You will be asked about your symptoms, medical history, and risk factors and may undergo a physical examination.
The tests for diagnosing HIV and AIDS include:
- ELISA Test — The enzyme-linked immunosorbent assay (ELISA) is a blood test used to detect HIV antibodies. If the test is positive, the Western Blot test is typically given to confirm the diagnosis.
- Western Blot — A blood test usually used to confirm other positive test results, using the same sample.
- Saliva Tests — Saliva is collected from the inside of the cheek. Results may be available in about three days. A positive result should be confirmed with a blood test.
- Viral Load Test — The amount of HIV in the blood is measured by DNA sequences that attach specifically to those in HIV. This kind of test is typically used to keep an eye on treatment progress or identify early HIV infection.
- Urine Tests – The accuracy of a urine test may be lower than a blood test. Urine tests also test samples for antibodies and require a Western Blot test to confirm the results.
- Rapid Tests – These tests produce results in about 20 minutes and use blood from a vein or finger stick – samples are tested for HIV antibodies. Results must be confirmed with a follow-up test in order to make a final diagnosis.
- Home Tests — The U.S. Food and Drug Administration (FDA) has approved only one home collection test for HIV. The tests are sold either as The Home Access HIV-1 Test System or The Home Access Express HIV-1 Test System. People collect blood samples at home, and the sample must then be sent to a lab for testing.
Treatment for HIV/AIDS:
There is no cure for HIV/AIDS. It is a chronic condition that may be managed through a combination of drugs known as antiretroviral drugs. Antiretroviral drugs are prescribed in "cocktails" that are combinations of three or more ART medications. Each of the drug types blocks the virus differently. These ART medications do not cure the HIV infection; rather, they control viral replication, thus allowing a person's immune system to retain the power to fight off common infections.
Finding the right combination of medications from the different classes of ART drugs is key to treating HIV. With treatment, many infected individuals live healthy, productive, normal lives.
The different classes include:
Protease Inhibitors (PIs) disable protease, a protein HIV requires to replicate.
Integrase Inhibitors disable integrase, a protein HIV requires to insert its own genetic material into CD4 cells.
Entry/Fusion Inhibitors block HIV entry into CD4 cells.
Nucleoside Reverse Transcriptase Inhibitors (NRTIs) block reverse transcriptase, an enzyme HIV requires to replicate.
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) attach to and modify reverse transcriptase, an enzyme HIV requires to replicate.
When to Begin HIV/AIDS Treatment:
The CDC advises that anyone infected with HIV should regularly see their health care provider.
You should especially seek treatment if you are pregnant, being treated for Hepatitis B, suffering HIV-related kidney disease, suffering other severe symptoms, or have a CD4 count under 500.
If you think you have been infected with HIV or are at risk of infection, see a health care professional, who has experience treating HIV infection, as soon as possible.
AIDSinfo (hotline to help navigate government-approved resources):
Outside U.S.: 1-301-315-2816
The Access Project (hooks up those in need of resources with available resources):
Hemophilia AIDS Network/National Hemophilia Foundation: 1-800-424-2634
HIV Health InfoLine by Project Inform (staffers provide valuable insight and support to callers): 1-888-HIV-INFO (1-800-822-7422)
National Association of People With AIDS Hotline: 1-240-247-0880
Toll Free: 1-866-846-9366
National Prevention Information Network: 1-800-458-5231 (English and Spanish)
HIV/AIDS Testing Resources:
Visit HIVtest.org. Enter your ZIP code and you'll get a list of HIV testing sites, including those that offer free HIV tests.
Call 1-800-CDC-INFO (1-800-232-4636) for more information about HIV/AIDS and testing.
Text your ZIP code to KNOWIT (566948) and you'll receive a message in reply that lists the nearest testing locations.
Contact your state or local health department. Click here to find a list of HIV/AIDS hotlines by state.
Additional Resources for HIV/AIDS:
AIDS Healthcare Foundation: a non-profit organization based in Los Angeles that seeks to rid the world of AIDS and provides HIV/AIDS medical services and advocacy services around the globe.
AIDS Info: a website from the U.S. Department of Health and Human Services that offers information on HIV treatment and research, customized clinical trial searches, and referrals to a host of other useful, government-approved resources. Health information specialists can confidentially answer questions in both English and Spanish.
AIDS Research Alliance: an independent research organization dedicated to finding a cure for HIV and AIDS. ARA also offers information about clinical trials.
Aids.Gov: a cross-agency effort working to educate people about Federal HIV/AIDS programs and resources and increase HIV testing and care among those most at-risk for or living with HIV.
AIDS.org: a non-profit organization that provides extensive information on HIV and AIDS and seeks to help prevent infection and to better the lives of those infected with and affected by HIV and AIDS.
amfAR: the Foundation for AIDS Research provides information about AIDS research, HIV prevention and treatment, and advocacy of comprehensive AIDS-related public policy.
AVAC: a non-profit that offers information on AIDS research and advocates the development and delivery of HIV prevention options.
Avert: a UK-based, international HIV/AIDS non-profit that is dedicated to eliminating HIV/AIDS worldwide.
CDC HIV/AIDS: provides information about HIV and AIDS research, prevention, and evaluation.
Elizabeth Glaser Pediatric AIDS Foundation: a non-profit devoted to preventing and stopping pediatric AIDS infection through research, advocacy, and prevention and treatment programs.
I Know HIV from Project Kindle: offers programs serving children and adolescents living with or affected by HIV and AIDS. Programs include one-week summer camps, mini-camp sessions, a peer-to-peer speakers’ group where participants share their stories, scholarships, and much more.
San Francisco AIDS Foundation: by focusing on HIV/AIDS prevention and care, the group seeks to reduce new HIV infections and ensure access to medical care to those who need it most.
UNAIDS: the Joint United Nations Programme on HIV/AIDS works to achieve universal access to HIV prevention, treatment, and care and to break down the stigmas surrounding HIV/AIDS through collaborative, international efforts.
WHO HIV/AIDS: the World Health Organization aims to increase the availability and quality of HIV- and AIDS-related medications and health care and promotes health care system progress toward universal access to HIV services.
Women, Children, and HIV: shares information and training resources on how to prevent mother-to-child transmission of HIV.