Human Immunodeficiency Virus (HIV) is a viral infection that targets the immune system’s CD4 cells, leading to a weakend ability to fight off bacterial infections, fungal infections, and certain cancers.
The transmission of HIV occurs through contact with infected bodily fluids such as blood, semen, vaginal fluids and breast milk. Hugging, kissing, and sharing food do not pose a risk of infection.
The initial symptoms of HIV infection include fever, headache, rash and a sore throat which may go unnoticed in the first few weeks. However, as HIV progresses, symptoms such as swollen lymph nodes, weight loss, fever, diarrhoea and cough may develop.
Globally, an estimated 38 million people were living with HIV by the end of 2021.
Although there is currently no cure for HIV, effective treatments are available to manage the virus and improve quality of life. Treatment focuses on suppressing the virus to undetectable levels so that the immune system damaged by the virus can recover and it becomes impossible for the virus to spread during sex.
What are the symptoms of HIV?
Symptoms of HIV can vary from person to person and may not always be noticeable in the early stages of the infection. Often people develop a flu-like illness which can be caused by many different viruses including HIV.
Symptoms of HIV include:
- Swollen glands
- Sore throat
- Muscle aches
- Joint pain
- Skin rash
- Night sweats and/or drenching sweats
- Weight loss
How soon will I be able to notice any symptoms?
Most patients who have been exposed to HIV will experience flu-like symptoms within 2-6 weeks after infection occurs. After this, HIV may not cause any noticeable symptoms for many years. It is essential to get tested as soon as possible if you have been exposed to HIV.
Can you have HIV without any symptoms?
Most individuals may experience a short, flu-like, illness within 2 to 6 weeks after acquiring a HIV infection. This is often referred to as ‘primary HIV infection’ or ‘seroconversion illness’. Many patients do not experience any symptoms or signs of HIV but can still pass on the infection to their partners.
After these initial symptoms have passed, it is possible for HIV to remain without symptoms even though the virus will continue to damage and weaken your immune system.
It is essential to get tested if you are concerned about having HIV or you think you have been exposed to it.
How can I get HIV?
HIV can be transmitted through infected body fluids such as semen, vaginal fluid, rectal fluid, blood, and breast milk. HIV can occur If these fluids come into contact with:
- The penis, vagina, mouth and rectum.
- Damaged tissue that has been cut or scraped.
- The blood stream.
HIV cannot be transmitted through non-sexual contact such as hugging, kissing, holding hands, sharing household items such as bedding, towels, plates or utensils.
What increases my risk of getting HIV?
Your risk for HIV can be increased by:
- Having unprotected anal sex (highest risk) or vaginal sex (second highest risk) with someone who is living with HIV and is not on appropriate treatment, or has a high-viral load.
- The risk of contracting HIV from unprotected oral sex is low, however, it can be increased if the person performing oral sex has mouth ulcers, sores, or bleeding gums.
- Having unprotected sex with a current or previous partner who has HIV and is not on medication.
- Not using condoms when having sex with new partners who have not been recently tested for HIV.
- Engaging in chem-sex.
- Using intravenous drugs or sharing needles.
- Having other STI’s such as Syphilis, Herpes, Chlamydia, Gonorrhoea, and Bacterial vaginosis.
- Receiving unsterile body piercings
- Receiving a blood transfusion which is infected with HIV but has not been properly screened before use.
- Sharps or needle-stick injury.
Can I get HIV even if I wear a condom?
Condoms are very effective in preventing HIV transmission if they are used correctly. However, condoms can sometimes split or come off during sex. The risk of condoms splitting is increased when using certain creams or vaginal pessaries, such as thrush treatment.
Will my HIV-positive partner be able to give me HIV?
If your HIV-positive partner is not on effective treatment, it is highly possible that they will pass HIV onto you.
Your partner cannot pass HIV onto you if they have an undetectable HIV viral load and are on effective treatment. It is important that your partner strictly follows their treatment plan as laid out by their clinician in order for their HIV viral load to remain undetectable. If your partner does not follow their treatment plan, it is possible for their virus level to become detectable again and put you at risk of getting HIV.
How can I prevent getting HIV?
HIV can be prevented by:
- Wearing a condom during anal, vaginal, and oral sex with all new partners.
- Using a water-based lubricant can help to prevent condom splitting. Condoms are up to 98% effective if they are used correctly. However, some creams and vaginal pessaries, such as thrush treatment can make condoms less effective.
- Taking PrEP (pre-exposure prophylaxis) to prevent HIV transmission from injectable drugs or sex.
- Taking PEP (post-exposure prophylaxis) to prevent HIV infection after possible exposure. PEP should be taken as soon as possible after exposure but certainly within 72 hours after being exposed to be effective.
- Not sharing or using shared equipment when injecting or taking drugs.
Want to be protected against HIV?
Think you might have HIV?
Tested positive for HIV?
What is the long term prognosis for someone who has HIV?
With access to a new generation of HIV drugs and proper medical care, patients with HIV can live a normal life in terms of both quality of life and life span.
There are a few restrictions that HIV-positive individuals currently face, such as not being accepted for blood and organ donation.
Aside from this, patients with HIV can virtually do anything they wish to, including marrying and having children and grandchildren.
What complications can HIV lead to, if untreated?
If left untreated, HIV can lead to several health complications, including the development of AIDS (Acquired Immunodeficiency Syndrome) which is the most severe stage of HIV.
Individuals with HIV may experience other health issues, such as wasting and diarrhoea, which may be a result of an advanced HIV infection or an opportunistic infection. There is also an increased risk of developing bone disease, such as osteoporosis, and cardiovascular disease.
Neurological problems such as HIV-associated dementia may occur as a direct result of HIV or as a side effect of taking antiretroviral therapy (ART). Mental health problems, such as depression and anxiety, are also common among individuals with HIV.
Although HIV can lead to several health complications, with early diagnosis and appropriate treatment many people living with HIV can manage their infection and prevent these complications from occurring.
Can HIV be cured?
While a cure for HIV is currently unavailable, significant progress has been made in managing the virus.
Effective treatment options allow individuals living with HIV to lead fulfilling and vibrant lives without having to worry about their HIV infection.
Occasionally you may have come across news reports of HIV infection being cured. These are the cases where patients had certain types of blood cancers, and their treatment required wiping out and replacing their native immune system using the immune system from other individuals who had a built-in resistance to HIV.
Such treatment to treat blood cancer is very specialised and risky, and eradication of HIV in these patients is an additional benefit rather than main reason for the treatment.
Can my genetic make-up protect me from HIV?
5-10% of the population has a mutation called Delta 32 mutation. People with single Delta 32 mutation get partial protection against HIV whilst those with double Delta 32 mutation get almost complete protection from HIV. The test to identify one's Delta 32 mutation is currently not available in the UK.
Will my children also get HIV?
There is a risk of passing HIV onto your children but there are effective ways to lower this risk.
It is essential to speak to your clinician if you are planning to become pregnant as you can pass HIV onto your baby through the placenta, during birth, and through breastfeeding if you are not on an effective HIV treatment.
The risk of mother to child transmission of HIV in the absence of medical care is 30-50%. In the early years of the HIV epidemic, a caesarean section was routinely undertaken. This reduced the risk of transmission to 1-2%.
With the availability of effective HIV drugs, an undetectable HIV viral load can dramatically reduce the risk of transmission of HIV to the newborn baby, thus making the option of being able to give birth to their baby by vaginal delivery possible for HIV positive mothers.
If you acquire HIV after all your children have been born and breastfed, you will not pass on HIV to them.
Can I still donate blood?
Unfortunately, you will no longer be able to donate blood if you have HIV.
If you are a former or current partner of someone living with HIV you may not be able to donate blood until 3 months have passed since the last sexual contact and you have tested negative for HIV.
Can I still have unprotected sex?
We recommend only having unprotected sex when your HIV treatment is working successfully and your viral load is undetectable. An undetectable viral load means you will not be able to transmit HIV to your partners. Undetectable = Untransmittable (U=U).
In the meantime, you should use a condom.
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Reviewed by: Dr. Manoj Malu (Clinical Director)
Last reviewed date: 19 October 2023
Next review due: 19 October 2026
Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.
References & Further Reading
- UNAIDS: Global HIV & AIDS statistics — Fact sheet
- WHO: HIV and AIDS.
- National Institutes of Health: The Stages of HIV Infection
- WHO: HIV/AIDS
- NHS: HIV and AIDS – Causes
- CDC: About PEP | PEP | HIV Basics | HIV/AIDS
- CDC: PrEP | HIV Basics | HIV/AIDS
- Terrence Higgins Trust: Preventing vertical transmission
- National AIDS Trust: Changes to blood donation rules explained
- Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee: HIV
- UCSF: AIDS Signs and Symptoms
- Office on Women’s Health: Pregnancy and HIV
- Royal College of Obstetricians and Gynaecologists: HIV and pregnancy patient information leaflet