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What is HIV?

The Human Immunodeficiency Virus, commonly known as HIV, is the virus that causes AIDS. It is spread when bodily fluids—semen, vaginal fluids, blood, and breast milk– from a person infected with HIV enter another person’s body.

HIV attacks the very cells which normally defend the body against illness. Left untreated, HIV weakens a person’s immune system so that the body can no longer fight off other diseases and infections. Early diagnosis, ongoing treatment and regular medical care are critical both in improving the health of the individual who is HIV positive as well as in preventing the spread of the virus to others. With medication it is today possible to reduce the amount of virus in the body to levels that are undetectable.

In the U.S. today more than 1.2 million people are living with HIV, more than at any time in the 30 year history of the epidemic.

What is AIDS?

AIDS, or Acquired Immunodeficiency Syndrome, is a clinical diagnosis that indicates the most advanced stage of an HIV infection.

An AIDS diagnosis is determined when the number of healthy immune system cells (also known as one’s CD4 or T cell count) in an HIV positive person’s body drops to a low level or when someone with HIV develops certain illnesses, called opportunistic infections, which result from a weakened immune system. These may include Kaposi’s sarcoma, tuberculosis, lymphoma, pneumonia, and other cancers such as invasive cervical cancer.

Once an AIDS diagnosis is given it is not reversed but that does not mean that an individual’s condition cannot improve.  With antiretroviral treatment and ongoing medical care, it is possible to increase one’s T cell count and reduce the amount of the virus in one’s body (also known as viral load) and even achieve an undetectable viral load.

How does someone get HIV?

Unprotected vaginal or anal sex is the most common way people get infected with HIV in the U.S., followed by sharing needles. HIV can be spread through oral sex, though the risk is lower than for vaginal or anal sex. HIV is not spread through casual contact, like touching or holding hands, sharing glasses or plates, food, swimming pools, toilet seats, or other every day activities. Saliva, tears or sweat have never been shown to cause an HIV infection. Kissing is also safe (open mouth kissing is considered very low risk).

An HIV positive pregnant woman who is not on treatment can pass the virus child during birth, or after birth through breast feeding, however, one of the greatest successes in HIV has been the reduction of mother-to-child infection. HIV positive pregnant women can significantly reduce (by 99%) the chances of passing the virus to their unborn baby by taking antiretroviral therapies prescribed by their doctor during pregnancy. After birth the baby may also be put on treatment for a short period to reduce the chance of infection.

Research also now confirms that HIV positive persons on antiretroviral therapies reduce the chance of spreading the virus to others by as much as 96%, while improving the health of the HIV positive individual.

Who is at risk for HIV?

HIV can and does affect all people, however some groups and parts of the country have been more affected than others. Black Americans and gay and bisexual men of all races are disproportionately affected relative to their share of the population. The South and Northeast of the U.S. also have high rates. One factor contributing to the higher rates among some communities is the increased prevalence of HIV—that’s the percent of those already infected. In other words, the chances of coming in contact with the virus is greater and thus also the risk of infection.

Often, people don’t think of themselves or their partners as being at risk, so they don’t worry about using protection or getting tested. But anyone who has had unprotected sex (that’s without a condom), or who has shared needles, or has had a partner who has done either of these things, or whose partner’s other partners may have done these things, may be at risk.

How would I know if I or someone I know is HIV positive?

The only way to know if you or anyone else is HIV positive is to get tested. As with other sexually transmitted diseases , HIV often has NO symptoms, so many people who are infected don’t know it. The Centers for Disease Control and Prevention (CDC) estimates that one in five people who are HIV positive do not know they are infected. Among some groups this rate is even higher.

The CDC recommends all Americans between the ages of 13 and 64 be tested as part of routine health care. More frequent testing—once or twice a year—may be recommended for higher risk groups, such as gay and bisexual men. It is also recommended that all pregnant women be tested as part of their prenatal care. To know for certain if you are being tested ASK to be tested. See more in HIV Testing.

What is the link between HIV and other STDs?

People with other more common sexually transmitted diseases (STDs),such as chlamydia, gonorrhea, genital herpes or syphilis, are at greater risk of becoming infected with HIV if they have unprotected sex with someone who is positive.

In addition, if someone with HIV is infected with another STD, he or she is more likely to transmit the virus through sexual contact. Having another STD also can negatively affect the health of an HIV positive person. There are an estimated 19 million new STD cases occurring in the U.S. each year. As many as one in two sexually-active Americans will contract an STD by the age of 25.

The only way to know if you have any STD, including HIV, is to ask to be tested. All STDs, including HIV, are treatable, and many other STDs are curable. Getting treated for an STD can help prevent more serious health effects and reduce the risk of contracting HIV if exposed.

How do I reduce my risk of getting HIV?

Condoms are a highly effective, readily available and inexpensive option for reducing the risk of contracting HIV through vaginal, anal and oral sex. According to the Centers for Disease Control and Prevention (CDC), male latex condoms when used consistently and correctly are highly effective in preventing the sexual transmission of HIV and many other STDs.

In addition, it is also now known that an HIV positive person who is ongoing antiretroviral treatment and regular care can significantly reduce –by as much as 96%–the chances of passing the virus on to others.

The Food and Drug Administration also recently approved the first daily antiretroviral agent for pre-exposure prophylaxis, often referred to as PrEP, for use by those who are negative to reduce the risk of contracting HIV. According to the Centers for Disease Control and Prevention, PrEP is intended to be used in combination with, not to replace, other prevention methods such as condoms. Strict adherence to the daily regimen and regular HIV testing are critical.

HIV can also be spread by sharing needles. To find a drug treatment program near you using the locator. If you are using injection drugs and believe you cannot stop, reduce your risk of infection by never sharing needles, syringes or other drug preparation equipment. You can get clean needles from pharmacies or needle-exchange programs. Only use syringes that come from a reliable source.

See more in Protect.

If I am HIV positive what are my options?

Antiretroviral treatment is recommended for all people living with HIV, according to guidelines from the Department of Health and Human Services. Antiretroviral medications work to lower the levels of the virus in the bloodstream – viral load – which helps to prevent the progression of HIV to AIDS, the most advanced stage of HIV, and keep you healthier if you already have an AIDS diagnosis.

Even if you do not feel sick or show symptoms, it’s important to consult a health care provider as soon as possible to get on treatment. In addition to benefiting your own health and well-being, people who begin medication early and take it regularly reduce the risk of transmitting HIV to sexual partners by as much as 96 percent. Also, treatment significantly reduces the likelihood of an HIV-positive pregnant woman transmitting HIV to her baby. See more in Treat.

Is there a vaccine or cure for HIV and/or AIDS?

There is no vaccine to prevent HIV or a cure for those who are already infected, but there are highly effective medications– called antiretrovirals or ARVs- that help people with HIV to live long and healthy lives.

Antiretroviral treatments work to lower the amount of HIV in the body which, when taken regularly, means better health, a longer life, and less chance of spreading the disease to others. Early diagnosis and treatment can also delay the progression of HIV to AIDS. The Department of Health and Human Services recommends anyone who is HIV positive go on antiretroviral treatment as soon as they are diagnosed.

Are some types of sex riskier than others?

Unprotected sex of all kinds (anal, vaginal and oral) is the most common way people get infected with HIV in the U.S. “Unprotected” means sex without barrier protection, like a condom. Remember that HIV can be present in pre-cum so pulling out early may not decrease risk. For gay and bisexual men, anal sex is the most common way HIV is transmitted.

It is possible to get HIV and other STDs—including herpes, syphilis, gonorrhea and genital warts– during oral sex if your partner is infected, although the risk is generally lower from unprotected oral sex than from unprotected anal or vaginal sex. Still, it’s a good idea to use a barrier when giving oral sex to prevent fluids (like semen, blood, vaginal fluids) from entering your mouth. For oral sex on a penis, you should use a non-lubricated latex or polyurethane (plastic) condom.

For oral sex on the anus (“rimming”), the risk of getting infected with HIV is lower; however, rimming may expose you to other infections, such as hepatitis or parasites. To reduce risk while rimming, use a latex barrier (like a natural rubber latex sheet, dental dam or cut-open condom that makes a square) between your mouth and your partner’s anus.

What does it mean to have an undetectable viral load?

An undetectable viral load means that the level of HIV present in a patient’s blood has been pushed to a very low level. Having an undetectable viral load, also referred to as being virally suppressed or having one’s virus “under control,” means better health for the HIV positive individual and also reduces the chances that he/she will pass the virus on to others. Someone who is undetectable is still HIV positive, and it is still possible for them to pass HIV on to others.

However, according to the Centers for Disease Control and Prevention (CDC), only one in four Americans with HIV today has their virus “under control” either because they don’t know they are HIV positive or otherwise are not on treatment. As of 2012, guidelines from the Department of Health and Human Services recommend that anyone diagnosed with HIV begin treatment immediately.

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