HIV stands for human immunodeficiency virus. It is the virus that can lead to acquired immunodeficiency syndrome, or AIDS. Unlike some other viruses, the human body cannot get rid of HIV. That means that once you have HIV, you have it for life.
No safe and effective cure currently exists, but scientists are working hard to find one, and remain hopeful. Meanwhile, with proper medical care, HIV can be controlled. Treatment for HIV is often called antiretroviral therapy or ART. It can dramatically prolong the lives of many people infected with HIV and lower their chance of infecting others. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS in just a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can have a nearly normal life expectancy.
HIV affects specific cells of the immune system, called CD4 cells, or T cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. When this happens, HIV infection leads to AIDS.
Background
At the end of 2009, an estimated 1,148,200 persons aged 13 and older were living with HIV infection in the United States, including 207,600 (18.1%) persons whose infections had not been diagnosed. CDC estimates that approximately 50,000 people are infected with HIV each year.
HIV testing is entering a new era in this country as lawmakers, health care and insurance executives, and public health officials are making changes in their respective fields to ensure that more people will know their HIV status – an important consideration for maintaining health and reducing the spread of the virus.
Rationale for Routine Screening for HIV Infection
People who are infected with HIV but not aware of it are not able to take advantage of the therapies that can keep them healthy and extend their lives, nor do they have the knowledge to protect their sex or drug-use partners from becoming infected. Knowing whether one is positive or negative for HIV confers great benefits in healthy decision making. Cohort studies have demonstrated that many infected persons decrease behaviors that help transmit infection to sex or needle-sharing partners once they are aware of their positive HIV status. HIV-infected persons who are unaware of their infection do not reduce risk behaviors. Persons tested for HIV who do not return for test results might even increase their risk for transmitting HIV to partners. Because medical treatment that lowers HIV viral load might also reduce risk for transmission to others, early referral to medical care could prevent HIV transmission in communities while reducing a person's risk for HIV-related illness and death.
Risk Behavior
The most common ways HIV is transmitted in the United States is through anal or vaginal sex or sharing drug injection equipment with a person infected with HIV. The following steps can reduce your risk:
- Know your HIV status. Everyone between the ages of 13 and 64 should be tested for HIV at least once. If you are at increased risk for HIV, you should be tested for HIV at least once a year.
- If you have HIV, you can get medical care, treatment, and supportive services to help you stay healthy and reduce your ability to transmit the virus to others.
- If you are pregnant and find that you have HIV, treatments are available to reduce the chance that your baby will have HIV. Locate an HIV testing site.
- Abstain from sexual activity or be in a long-term mutually monogamous relationship with an uninfected partner.
- Limit your number of sex partners. The fewer partners you have, the less likely you are to encounter someone who is infected with HIV or another STD.
- Use condoms correctly and consistently. Latex condoms are highly effective at preventing transmission of HIV and some other sexually transmitted diseases. “Natural” or lambskin condoms do not provide sufficient protection against HIV infection.
- Get tested and treated for STDs and insist that your partners do too. Locate an STD testing site.
- Male circumcision has also been shown to reduce the risk of HIV transmission from women to men during vaginal sex.
- Do not inject drugs. If you inject drugs, you should get counseling and treatment to stop or reduce your drug use. If you cannot stop injecting drugs, use clean needles and works when injecting. Locate resources on substance abuse treatment.
- Obtain medical treatment immediately if you think you were exposed to HIV. Sometimes, HIV medications can prevent infection if they are started quickly. This is called post-exposure prophylaxis.
- Participate in risk reduction programs. Programs exist to help people make healthy decisions, such as negotiating condom use or discussing HIV status. Your health department can refer you to programs in your area.
Living With HIV
Today, an estimated 1.1 million people are living with HIV in the United States. Thanks to better treatments, people with HIV are now living longer—and with a better quality of life—than ever before. If you are living with HIV, it’s important to make choices that keep you healthy and protect others.
Stay healthy.
It’s very important for you to take your HIV medicines exactly as directed. Not taking medications correctly may lower the level of immune system defenders called CD4 cells and cause the level of virus in your blood (viral load) to go up. The medicines then become less effective when taken. Some people report not feeling well as a reason for stopping their medication or not taking it as prescribed. Tell your doctor if your medicines are making you sick. He or she may be able to help you deal with side effects so you can feel better. Don’t just stop taking your medicines, because your health depends on it.
Do tell.
Be sure that your partner or partners know that you have HIV. Then they will know it’s important to use condoms for all sexual activity and to be tested often for HIV. Health departments offer Partner Services to help you tell your partners about their exposure. Partner Services provides many free services to people with HIV or other STDs and their partners. Through Partner Services, health department staff help find sex or drug-injection partners to let them know of their risk of being exposed to HIV or another sexually transmitted disease (STD) and provide them with testing, counseling, and referrals for other services. Partner Services will not reveal your name unless you want to work with them to tell your partners.
Don’t take risks.
HIV is spread through body fluids such as blood, semen (cum), vaginal fluids, and breast milk. In the United States, HIV is most commonly passed from one person to another through unprotected anal or vaginal sex and through sharing needles or other drug equipment. In addition, a mother can pass HIV to her baby during pregnancy, during labor, through breastfeeding, or if by pre-chewing her baby’s food.
Viral load can range from undetectable levels of 40 to 75 copies per milliliter of blood to millions of copies. The higher your viral load, the greater the risk of spreading HIV to others. Protect your partners by keeping yourself healthy. Take all of your medicines and get tested and treated for other STDs. If you have HIV plus another STD or hepatitis, you are 3 to 5 times more likely to spread HIV than if you only have HIV. Your viral load goes up and your CD4 count goes down when you have an STD.
Although having a low viral load greatly decreases your chance of spreading HIV, some risk remains, even when your viral load is lower than 3,500 copies per milliliter. You can avoid spreading the virus to others by making sure they do not come into contact with your body fluids.
- Abstinence (not having sex) is the best way to prevent the spread of HIV infection and some other STDs. If abstinence is not possible, use condoms whenever you have sex—vaginal, anal, or oral.
- Do not share drug equipment. Blood can get into needles, syringes, and other equipment. If the blood has HIV in it, the infection can be spread to the next user.
- Do not share items that may have your blood on them, such as razors or toothbrushes.
