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What is AIDS? What causes AIDS?
AIDS stands for Acquired Immune Deficiency Syndrome.
An HIV-positive person receives an AIDS diagnosis after developing one of the CDC-defined AIDS indicator illnesses. An HIV-positive person can also receive an AIDS diagnosis on the basis of certain blood tests (CD4 counts) and may not have experienced any serious illnesses. A positive HIV test does not mean that a person has AIDS. A diagnosis of AIDS is made by a physician according to the CDC AIDS Case Definition.
Over time, infection with HIV (Human Immunodeficiency Virus) can weaken the immune system to the point that the system has difficulty fighting off certain infections. These types of infections are known as opportunistic infections. Many of the infections that cause problems or that can be life-threatening for people with AIDS are usually controlled by a healthy immune system. The immune system of a person with AIDS has weakened to the point that medical intervention may be necessary to prevent or treat serious illness. (Source: Centers for Disease Control - CDC)
What is the Difference Between HIV and AIDS?
HIV is the virus that causes AIDS.
H - Human: because this virus can only infect human beings.
I - Immuno-deficiency: because the effect of the virus is to create a deficiency, a failure to work properly, within the body's immune system.
V - Virus: because this organism is a virus, which means one of its characteristics is that it is incapable of reproducing by itself. It reproduces by taking over the machinery of the human cell.
A - Acquired: because it's a condition one must acquire or get infected with; not something transmitted through the genes
I - Immune: because it affects the body's immune system, the part of the body which usually works to fight off germs such as bacteria and viruses
D - Deficiency: because it makes the immune system deficient (makes it not work properly)
S - Syndrome: because someone with AIDS may experience a wide range of different diseases and opportunistic infections.
(Source: Centers for Disease Control - CDC)
How long does it take for HIV to cause AIDS?
Currently, the average time between HIV infection and the appearance of signs that could lead to an AIDS diagnosis is 8-11 years. This time varies greatly from person to person and can depend on many factors including a person's health status and behaviors. Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS. As with other diseases, early detection offers more options for treatment and preventative health care. (Source: Centers for Disease Control - CDC)
What's the connection between HIV and other sexually transmitted diseases?
Having a sexually transmitted disease (STD) can increase a person's risk of becoming infected with HIV, whether or not that STD causes lesions or breaks in the skin. If the STD infection causes irritation of the skin, breaks or sores may make it easier for HIV to enter the body during sexual contact. Even an STD that causes no breaks or sores can stimulate an immune response in the genital area that can make HIV transmission more likely. (Source: Centers for Disease Control - CDC)
Where did HIV come from?
The most recent presentation on the origin of HIV was presented at the 6th Conference on Retroviruses and Opportunitistic Infections (Chicago, January 1999). At that conference, research was presented that suggested that HIV had "crossed over" into the human population from a particular species of chimpanzee, probably through blood contact that occurred during hunting and field dressing of the animals. The CDC states that the findings presented at this conference provide the strongest evidence to date that HIV-1 originated in non-human primates. The research findings were featured in the February 4,1999 issue of the journal, Nature.
We know that the virus has existed in the United States, Haiti and Africa since at least 1977-1978. In 1979, rare types of pneumonia, cancer and other illnesses were being reported by doctors in Los Angeles and New York. The common thread was that these conditions were not usually found in persons with healthy immune systems.
In 1982 the Centers for Disease Control and Prevention (CDC) officially named the condition AIDS (Acquired Immune Deficiency Syndrome). In 1984 the virus responsible for weakening the immune system was identified as HIV (Human Immunodeficiency Virus).
(Source: Centers for Disease Control - CDC)
How many people have HIV and AIDS?
Worldwide: UNAIDS estimates that as of December 2000, there were an estimated 36.1 million people living with HIV/AIDS (34.7 million adults and 1.4 million children under 15). Since the epidemic began, an estimated 21.8 million people have died of AIDS (17.5 million adults and 4.3 million children under 15).
An estimated 5.3 million new HIV infections occurred in 2000. During 2000, HIV- and AIDS-associated illnesses caused deaths of an estimated 3 million people, including 500,000 children under the age of 15.
In the United States: According to the Centers for Disease Control and Prevention (CDC), there are between 800,000 and 900,000 people living with HIV. Through December 2000, a total of 774,467 cases of AIDS have been reported to the CDC; of this number, 448,060 persons (representing 58% of cases) have died. (Source: Centers for Disease Control - CDC)
Latest U.S. AIDS Trends
Download the most recent CDC HIV/AIDS Surveillance Reports
How can I tell if I'm infected with HIV?
The only way to determine whether you are infected is to be tested for HIV infection. You can't rely on symptoms to know whether or not you are infected with HIV. Many people who are infected with HIV don't have any symptoms at all for many years.
Similarly, you can't rely on symptoms to establish that a person has AIDS. The symptoms associated with AIDS are similar to the symptoms of many other diseases. AIDS is a diagnosis made by a doctor based on specific criteria established by the Centers for Disease Control and Prevention (CDC). (Source: Centers for Disease Control - CDC)
What are the Symptoms of HIV?
Primary HIV infection is the first stage of HIV disease, when the virus first establishes itself in the body. Some researchers use the term acute HIV infection to describe the period of time between when a person is first infected with HIV and when antibodies against the virus are produced by the body (usually 6- 12 weeks).
Some people newly infected with HIV will experience some "flu-like" symptoms. These symptoms, which usually last no more than a few days, might include fevers, chills, night sweats and rashes (not cold-like symptoms). Other people either do not experience "acute infection," or have symptoms so mild that they may not notice them.
Given the general character of the symptoms of acute infection, they can easily have causes other than HIV, such as a flu infection. For example, if you had some risk for HIV a few days ago and are now experiencing flu-like symptoms, it might be possible that HIV is responsible for the symptoms, but it is also possible that you have some other viral infection. (Source: Centers for Disease Control - CDC)
What are the Symptoms of AIDS?
There are no common symptoms for individuals diagnosed with AIDS. When immune system damage is more severe, people may experience opportunistic infections (called opportunistic because they are caused by organisms which cannot induce disease in people with normal immune systems, but take the "opportunity" to flourish in people with HIV). Most of these more severe infections, diseases and symptoms fall under the Centers for Disease Control's definition of full-blown "AIDS." The median time to receive an AIDS diagnosis among those infected with HIV is 7-10 years. (Source: Centers for Disease Control - CDC)
How is HIV Transmitted?
HIV can be transmitted from an infected person to another through:
* Blood (including menstrual blood)
* Semen
* Vaginal secretions
* Breast milk
Blood contains the highest concentration of the virus, followed by semen, followed by vaginal fluids, followed by breast milk.
* Activities That Allow HIV Transmission
* Unprotected sexual contact
* Direct blood contact, including injection drug needles, blood transfusions, accidents in health care settings or certain blood products
* Mother to baby (before or during birth, or through breast milk)
Sexual intercourse (vaginal and anal): In the genitals and the rectum, HIV may infect the mucous membranes directly or enter through cuts and sores caused during intercourse (many of which would be unnoticed). Vaginal and anal intercourse is a high-risk practice.
Oral sex (mouth-penis, mouth-vagina): The mouth is an inhospitable environment for HIV (in semen, vaginal fluid or blood), meaning the risk of HIV transmission through the throat, gums, and oral membranes is lower than through vaginal or anal membranes. There are however, documented cases where HIV was transmitted orally, so we can't say that getting HIV-infected semen, vaginal fluid or blood in the mouth is without risk. However, oral sex is considered a low risk practice.
Sharing injection needles: An injection needle can pass blood directly from one person's bloodstream to another. It is a very efficient way to transmit a blood-borne virus. Sharing needles is considered a high-risk practice.
Mother to Child: It is possible for an HIV-infected mother to pass the virus directly before or during birth, or through breast milk. Breast milk contains HIV, and while small amounts of breast milk do not pose significant threat of infection to adults, it is a viable means of transmission to infants.
The following "bodily fluids" are NOT infectious:
* Saliva
* Tears
* Sweat
* Feces
* Urine
(Source: San Francisco AIDS Foundation)
Can I get HIV from oral sex?
There is considerable debate within the HIV/AIDS prevention community regarding the risk of transmission of HIV through oral sex. What is currently known is that there is some risk associated with performing oral sex without protection; (there have been a few documented cases of HIV transmission through oral sex). While no one knows exactly what that risk is, cumulative evidence indicates that the risk is less than that of unprotected anal or vaginal sex. The risk from receiving oral sex, for both a man and a woman, is considered to be very low.
Currently, risk reduction options when performing oral sex on a man (fellatio) include the use of latex condoms, but also include withdrawal before ejaculation without a condom (avoiding semen in the mouth) and/or refraining from this activity when cuts or sores are present in the mouth.
When performing oral sex on a woman (cunnilingus), moisture barriers such as a dam (sheet of latex), a cut-open and flattened condom, or household plastic wrap can reduce the risk of exposure to vaginal secretions and/or blood.
If you have other questions about oral sex and HIV, call the CDC National AIDS Hotline at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY). (Source: Centers for Disease Control - CDC)
Can I get HIV from kissing?
Casual contact through closed-mouth or "social" kissing is not a risk for transmission of HIV. Because of the potential for contact with blood during "French" or open-mouth, wet kissing, CDC recommends against engaging in this activity with a person known to be infected. However, the risk of acquiring HIV during open-mouth kissing is believed to be very low. CDC has investigated only one case of HIV infection that may be attributed to contact with blood during open-mouth kissing. In this case both partners had extensive dental problems including gingivitis (inflammation of the gums). It is likely that there was blood present in both partners' mouths making direct blood to blood contact a possibility. (Source: Centers for Disease Control - CDC)
Can I get HIV from casual contact (shaking hands, hugging, using a toilet, drinking from the same glass, or the sneezing and coughing of an infected person)?
No. HIV is not transmitted by day to day contact in the home, the workplace, schools, or social settings. HIV is not transmitted through shaking hands, hugging or a casual kiss. You cannot become infected from a toilet seat, a drinking fountain, a doorknob, dishes, drinking glasses, food, or pets.
HIV is a fragile virus that does not live long outside the body. HIV is not an airborne or food borne virus. HIV is present in the blood, semen or vaginal secretions of an infected person and can be transmitted through unprotected vaginal, oral or anal sex or through sharing injection drug needles. (Source: Centers for Disease Control - CDC)
Can a woman give HIV to a man during vaginal intercourse?
Yes. If the woman is infected, HIV is present in vaginal and cervical secretions (the wetness in a woman's vagina) and can enter the penis through the urethra (the hole at the tip) or through cuts or abrasions on the skin of the penis. The presence of other STDs can increase the risk of transmission. The correct and consistent use of a latex condom or female condom can reduce the risk of transmitting HIV during vaginal intercourse. For more information, call the CDC National AIDS Hotline at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY). (Source: Centers for Disease Control - CDC)
How effective are latex condoms in preventing HIV?
Several studies have demonstrated that latex condoms are highly effective in preventing HIV transmission when used correctly and consistently. These studies looked at uninfected people considered to be at very high risk of infection because they were involved in sexual relationships with HIV-infected persons. The studies found that even with repeated sexual contact, 98-100% of those people who used latex condoms consistently and correctly remained uninfected. For more on these studies, including free written information, call the CDC National AIDS Hotline at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY). (Source: Centers for Disease Control - CDC)
What if I test HIV positive?
If you test positive, the sooner you take steps to protect your health, the better. Early medical treatment, a healthy lifestyle and a positive attitude can help you stay well. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. It is important to know that a positive HIV test should always be confirmed, to be sure that it is a true positive. If your test result is positive, there are a number of important steps you can take immediately to protect your health:
* See a doctor, even if you don't feel sick. Try to find a doctor who has experience treating HIV. There are now many new drugs to treat HIV infection. There are important tests, immunizations and drug treatments that can help you maintain good health. It is never too early to start thinking about treatment possibilities.
* Have a tuberculosis (TB) test done. You may be infected with TB and not know it. Undetected TB can cause serious illness. TB can be treated successfully if detected early.
* Recreational drugs, alcoholic beverages and smoking can weaken your immune system. There are programs available to help you stop.
* Consider joining a support group for people with HIV infection or finding out about other resources available in your area, such as HIV/AIDS-knowledgeable counselors for one on one therapy. There are also many newsletters available for people living with HIV and AIDS.
* There is much you can do to stay healthy. Learning as much as you can is a step in the right direction. Local and/or national resources may be available. Many HIV/AIDS organizations provide services free or on a sliding scale, based on ability to pay.
* Call the CDC National AIDS Hotline for more information and referrals at 1-800-342-2437 (English), 1-800-344-7432, (Spanish), or 1-800-243-7889 (TTY).
(Source: Centers for Disease Control - CDC)
How long after a possible exposure should I be tested for HIV??
The time it takes for a person who has been infected with HIV to seroconvert (test positive) for HIV antibodies is commonly called the "Window Period."
The California Office of AIDS, published in 1998, says about the window period: "When a person is infected with the HIV virus, statistics show that 95-97% (perhaps higher) of all infected individuals develop antibodies within 12 weeks (3-months)."
The National CDC has said that in some rare cases, it may take up to six months for one to seroconvert (test positive). At this point the results would be 99.9% accurate.
* What does this mean for you?
The three-month window period is normal for approximately 95% of the population. If you feel any anxiety about relying on the 3-month result, by all means you should have another test at 6 months. (Source: San Francisco AIDS Foundation)
When do you know for sure that you are not infected with HIV?
The tests commonly used to determine HIV infection actually look for antibodies produced by the body to fight HIV. According to the Centers for Disease Control and Prevention (CDC), most people will develop detectable antibodies within 3 months after infection. In rare cases, it can take up to six months. Therefore, the CDC recommends testing at 6 months after the last possible exposure. (unprotected vaginal, anal or oral sex or sharing injecting drug needles). It would be extremely rare to take longer than six months to develop detectable antibodies. It is important, during the six months between exposure and the 6-month test, to protect yourself and others from further exposures to HIV. The CDC National AIDS Hotline can provide more information and referrals to testing sites in your area. The hotline can be reached at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
(Source: Centers for Disease Control - CDC)
Where can I get tested for HIV infection?
Many places provide testing for HIV infection. It is important to seek testing at a location that also provides counseling about HIV and AIDS. Common locations include local health departments, private physicians, hospitals, and test sites specifically set up for HIV testing.
In addition to traditional testing procedures, there are other options. For those who prefer not to have blood drawn, many sites now offer oral fluids testing, which involves testing of a sample of fluid taken from inside the mouth with a cotton swab. The OraSure Test is currently only available through a health care provider or clinic. Some clinics may also offer urine testing as an alternative to blood tests.
There is also testing which can be performed anonymously in the privacy of your own home. There are many home tests advertised through the internet, but only the Home Access Test has been approved by the FDA. The Home Access test kit can be found at most local pharmacies. The testing procedure involves pricking your finger with a special device, placing a drop of blood on a specially treated card, then mailing the card in for testing. You are given an identification number to use when you phone in for the test results-- 3 days or 2 weeks later, depending on the test kit purchased.
The CDC National AIDS Hotline can answer questions about testing and can refer you to testing sites in your area. The hotline numbers are 1-800-342-2437 (English), 1-800-344-7432, (Spanish), or 1-800-243-7889 (TTY).
(Source: Centers for Disease Control - CDC)
What is the difference between an Anonymous and a Confidential Test?
Anonymous and Confidential use the same testing method. The only difference is one does not have your name attached to the results.
Anonymous antibody testing is available at Anonymous Test Sites in most California counties. Anonymous testing means that absolutely no one has access to your test results since your name is never recorded at the test site.
Confidential antibody testing means that you and the health care provider know your results, which may be recorded in your medical file.
(Source: San Francisco AIDS Foundation)
Which test should I have done: Anonymous or Confidential?
It is recommended that one have an anonymous test. The results will only be known to you and will not appear on any records.
Some reasons that one would need a confidential test would be: a result is required for immigration purposes or for some international travel visas; a pregnant woman who is clearly at risk might choose to be tested through her doctor, rather than anonymously, since the result is of key importance to the course of her medical care. (Source: San Francisco AIDS Foundation)
I have heard there are many different types of HIV tests. How do I know which one I should take?
The combination of an Eliza/Western Blot HIV Antibody Test is the accepted testing method for HIV infection. This combination test is looking for the antibodies that develop to fight the HIV virus. There are two ways to conduct this test. Either through a blood draw or through the "Orasure" method (a sample of oral mucus obtained with a specially treated cotton pad that is placed between the cheek and lower gum for two minutes). Both forms, by blood draw or orally, have the same accuracy with their results.
Other tests that you will hear about are Viral Load tests. These tests are used by physicians to monitor their patients who have already tested positive for HIV antibodies. Viral Load tests are very costly and should not be used to determine if one is HIV positive.
(Source: San Francisco AIDS Foundation)
What do test results mean?
A positive result means:
* You are HIV-positive (carrying the virus that causes AIDS).
* You can infect others and should try to implement precautions to prevent doing so.
A negative result means:
* No antibodies were found in your blood at this time.
A negative result does NOT mean:
* You are not infected with HIV (if you are still in the window period).
* You are immune to AIDS.
* You have a resistance to infection.
* You will never get AIDS.
(Source: San Francisco AIDS Foundation)
If I test positive, does that mean that I will die?
Testing positive for HIV means that you now carry the virus that causes AIDS. It does not mean that you have AIDS, nor does it mean that you will die. Although there is no cure for AIDS, many opportunistic infections that make people sick can be controlled, prevented or eliminated. This has substantially increased the longevity and quality of life for people living with AIDS.
(Source: San Francisco AIDS Foundation)
If I test HIV negative does that mean that my partner is HIV negative also?
No. Your HIV test result reveals only your HIV status. Your negative test result does not tell you about the HIV status of your partner(s). HIV is not necessarily transmitted every time there is an exposure.
No one's test result can be used to determine another person's HIV status. (Source: Centers for Disease Control - CDC)
I'm HIV positive. Where can I go for information about treatments?
The CDC National AIDS Hotline can offer practical information on maintaining health and general information about a wide variety of treatments, including antiretrovirals and prophylaxis for opportunistic infections. The hotline numbers are 1-800-342-2437 (English), 1-800-344-7432, (Spanish), or 1-888)-480-3739 (TTY). The CDC National AIDS Hotline can also provide referrals to national treatment hotlines, local AIDS Service Organizations and HIV/AIDS-knowledgeable physicians.
Detailed information on specific treatments is available from the HIV/AIDS Treatment Information Service (ATIS) at 1-800-448-0440. Information on enrolling in clinical trials can be obtained from the AIDS Clinical Trials Information Service at 1-800-874-2572 (English and Spanish) and 1-888-480-3739 (TTY). (Source: Centers for Disease Control - CDC)
Go to the HIV/AIDS Treatment Information Service website
Is there anything I can do to stay healthy?
The short answer is yes. There are things that you can do to stay healthy.
Emotional support may be very important for HIV-positive people because it breaks the isolation and provides a safe way of sharing both feelings and practical information.
Medical Care: Once you find a doctor or clinic, your main objective is to get an evaluation of your general health and immune function.
Many doctors do the following:
* Administer lab tests to evaluate your immune system.
* Determine if you have other diseases that might become problematic in the future, including syphilis, TB, hepatitis-B, and toxoplasmosis.
If you are already infected with one or more of these other illnesses, there may be treatments or prophylaxis available to prevent it from becoming more serious or recurring in the future. If you're not already infected, doctors may be able to prevent future infection by:
* Administering vaccines. Many HIV positive people get a hepatitis-B vaccine and bacterial pneumonia vaccines, since contracting these diseases could be dangerous for immune suppressed people.
* Prescribing antiviral treatments and protease inhibitors when tests show immune system impairment.
* Scheduling regular checkups. Checkups may be scheduled every three to six months. Some people need more frequent check-ups, particularly when they are starting new antiviral drugs.
(Source: San Francisco AIDS Foundation)
How safe is the U.S. blood supply?
The U.S. blood supply is among the safest in the world. Nearly all people infected with HIV through blood transfusions received those transfusions before 1985, the year it became possible to test donated blood for HIV.
The Public Health Service has recommended a multifaceted approach to blood safety in the United States that includes stringent donor selection practices and the use of screening tests. Blood donations in the United States have been screened for antibody to HIV-1 since March 1985 and HIV-2 since June 1992. Blood and blood products that test positive for HIV are safely discarded and are not used for transfusion
An estimated one in 450,000 to one in 660,000 donations per year are infectious for HIV but are not detected by current antibody screening tests. In August of 1995 the FDA recommended that all donated blood and plasma also be screened for HIV-1 p24 antigen. Donor screening for p24 antigen is expected to reduce the number of otherwise undetected infectious donations by approximately 25 percent per year. The improvement of processing methods for blood products has also reduced the number of infections resulting in the use of these products. Currently the risk of infection with HIV in the United States through receiving a blood transfusion or through the use of blood products is extremely rare and has become progressively more infrequent, even in areas with high HIV prevalence rates. (Source: Centers for Disease Control - CDC)
Do the new drugs I hear about cure you?
The new drugs you are referring to are a class of anti-HIV drugs known as protease inhibitors. There is NO cure for AIDS, but these drugs are helping to prolong the lives of many people with AIDS and delaying the onset of AIDS in many people with HIV. You should consult your own health care provider surrounding treatment issues. There is no standard treatment for everyone. Your health care provider will discuss your individual options. (Source: Centers for Disease Control - CDC)
Where can I get printed materials for my school project or organization?
The CDC National AIDS Hotline can help you with requests for printed materials. Call them and tell them who you are and what you need. If you are doing a school project, tell them. If you are giving a presentation to some other kind of group, tell them that. The more they know about what you need, the better they can help you. They are available 24 hours a day, 365 days of the year toll-free at (800) 342-2437. (Source: AIDS.ORG)
I still have more questions. Can I talk to someone?
You most certainly can! You can call the CDC National AIDS Hotline at (800) 342-2437 anytime, 24 hours a day, 365 days of the year. They are there to help you with your questions, to provide you with further information, and to listen. Additionally, most states also provide their own state AIDS hotlines - although their hours of operation may vary. Click here for our listing of available state AIDS hotlines. (Source: AIDS.ORG)
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