What Does "AIDS" Mean? AIDS stands for Acquired Immune Deficiency Syndrome:
Acquired means you can get infected with it.
Immune Deficiency means a weakness in the body's system that fights diseases.
Syndrome means a group of health problems that make up a disease.
AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. If you get infected with HIV, your body will try to fight the infection. It will make "antibodies," special molecules that are supposed to fight HIV.

When you get a blood test for HIV, the test looks for these antibodies. If you have them in your blood, it means that you have HIV infection. People who have the HIV antibodies are called "HIV-Positive."
Being HIV-positive, or having HIV disease, is not the same as having AIDS. Many people are HIV-positive but don't get sick for many years. As HIV disease continues, it slowly wears down the immune system. Viruses, parasites, fungi and bacteria that usually don't cause any problems can make you very sick if your immune system is damaged. These are called "opportunistic infections.

How Do You Get AIDS? You don't actually "get" AIDS. You might get infected with HIV, and later you might develop AIDS.
You can get infected with HIV from anyone who's infected, even if they don't look sick, and even if they haven't tested HIV-positive yet. The blood, vaginal fluid, semen, and breast milk of people infected with HIV has enough of the virus in it to infect other people. Most people get the HIV virus by:

Having sex with an infected person. Sharing a needle (shooting drugs) with someone who's infected.
Being born when their mother is infected, or drinking the breast milk of an infected woman.
Getting a transfusion of infected blood used to be a way people got AIDS, but now the blood supply is screened very carefully and the risk is extremely low.

There are no documented cases of HIV being transmitted by tears or saliva, but it is possible to be infected with HIV through oral sex or in rare cases through deep kissing, especially if you have open sores in your mouth or bleeding gums.

150: Stopping the Spread of HIV
151: Safer Sex Guidelines
152: How Risky Is It?
In the United States, there are about 800,000 to 900,000 people who are HIV-positive. Over 300,000 people are living with AIDS. Each year, there are about 40,000 new infections. In the mid-1990s, AIDS was a leading cause of death. However, newer treatments have cut the AIDS death rate significantly.

What Happens if I'm HIV Positive? You might not know if you get infected by HIV. Some people get fever, headache, sore muscles and joints, stomach ache, swollen lymph glands, or a skin rash for one or two weeks. Most people think it's the flu. Some people have no symptoms.

The virus will multiply in your body for a few weeks or even months before your immune system responds. During this time, you won't test positive for HIV, but you can infect other people.

When your immune system responds, it starts to make antibodies. When this happens, you will test positive for HIV.

After the first flu-like symptoms, some people with HIV stay healthy for ten years or longer. But during this time, HIV is damaging your immune system.

One way to measure the damage to your immune system is to count your CD4+ cells. These cells, also called "T-helper" cells, are an important part of the immune system. Healthy people have between 500 and 1,500 CD4+ cells in a milliliter of blood.

Without treatment, your CD4+ cell count will most likely go down. You might start having signs of HIV disease like fevers, night sweats, diarrhea, or swollen lymph nodes. If you have HIV disease, these problems will last more than a few days, and probably continue for several weeks.
How Do I Know if I Have AIDS? HIV disease becomes AIDS when your immune system is seriously damaged. If you have less than 200 CD4+ cells or if your CD4+ percentage is less than 14%, you have AIDS. If you get an opportunistic infection, you have AIDS. There is an "official" list of opportunistic infections, put out by the Centers for Disease Control (CDC). The most common ones are:

PCP (Pneumocystis pneumonia), a lung infection, KS (Kaposi's sarcoma), a skin cancer,
CMV (Cytomegalovirus), an infection that usually affects the eyes, and Candida, a fungal infection that can cause thrush (a white film in your mouth) or infections in your throat or vagina, AIDS-related diseases also include serious weight loss, brain tumors, and other health problems. Without treatment, these opportunistic infections can kill you.

AIDS is different in every infected person. Some people die soon after getting infected, while others live fairly normal lives for many years, even after they "officially" have AIDS. A few HIV-positive people stay healthy for many years even without taking anti-HIV medications.
Is There a Cure for AIDS? There is no cure for AIDS. There are drugs that can slow down the HIV virus, and slow down the damage to your immune system. But there is no way to get all the HIV out of your body.

There are other drugs that you can take to prevent or to treat opportunistic infections (OIs). In most cases, these drugs work very well. The newer, stronger anti-HIV drugs have also helped reduce the rates of most OIs. A few OIs, however, are still very difficult to treat.

What Is Acute HIV Infection? The amount of HIV in the blood gets very high within a few days or weeks after HIV infection. Some people get a flu-like illness. This first stage of HIV disease is called "acute infection." About half of the people who get infected don't notice anything. Symptoms generally occur within 2 to 4 weeks. The most common symptoms are fever, fatigue, and rash. Others include headache, swollen lymph glands, sore throat, feeling achy, nausea, vomiting, diarrhea, and night sweats.

It is easy to overlook the signs of acute HIV infection. They can be caused by several different illnesses. If you have any of these symptoms and if there is any chance that you were recently exposed to HIV, talk to your doctor about getting tested for HIV.

Testing for Acute HIV Infection The normal HIV blood test will come back negative for someone who was infected very recently. The test looks for antibodies produced by the immune system to fight HIV. It can take two months or more for these antibodies to be produced. However, the viral load test measures the virus itself. Before the immune system produces antibodies to fight it, HIV multiplies rapidly. Therefore, this test will show a high viral load during acute infection.

A negative HIV antibody test and a very high viral load indicate recent HIV infection, most likely within the past two months. If both tests are positive, then HIV infection probably occurred a few months or longer before the tests. A special "detuned" version of the HIV antibody test detects only those infections that occurred within the last six months. It can be used to help identify cases of acute HIV infection.

Risk of Infecting Others: The number of HIV particles in the blood is much higher during acute HIV infection than later on. Exposure to the blood of someone in the acute phase of infection is more likely to result in infection than exposure to someone with long-term infection. One research study estimated that the risk of infection is approximately 20 times higher during acute infection.

Treating Acute HIV Infection: At first, the immune system produces white blood cells that recognize and kill HIV-infected cells. This is called an "HIV-specific response." Over time, most people lose this response. Unless they use antiviral medications, their HIV disease will progress. Guidelines for using HIV medications recommend waiting until the immune system shows signs of damage. However, starting anti-HIV drugs during acute infection might protect the HIV-specific immune response.

Preliminary research suggests that treatment during acute infection might protect the immune system enough so that it can control HIV without drugs. Researchers have studied people who start treatment during acute infection and then stop taking antiviral drugs. In a few cases, their immune systems controlled HIV without medications.

Pros and Cons of Treating Acute HIV: Starting antiviral medications is a major decision. Anyone thinking about taking anti-HIV drugs should carefully consider the benefits and disadvantages. Taking antiviral drugs changes your daily life. Missing doses of drugs makes it easier for the virus to develop resistance to medications, which limits future treatment options. The medications are very strong. They have side effects that can be difficult to live with for a long time, and they can be very expensive.

Early treatment can protect the immune system from damage by HIV. Immune damage shows up as lower T-cell counts and higher viral loads. These are associated with higher rates of disease. Older people (over 40 years old) have weaker immune systems. They do not respond as well as younger people to antiviral drugs.

However, not everyone with HIV gets sick right away. Someone with a T-cell count over 350 and a viral load under 20,000, even if they don't take antiviral drugs, has about a 50/50 chance of staying healthy for 6 to 9 years. The most important benefit of early treatment is the possibility of discontinuing antiviral medications after a period of controlling HIV. However, newer reports indicate that this may not be possible.

The Bottom Line: It's not easy to identify people with acute HIV infection. Some people have no symptoms. If symptoms do occur, several diseases like the flu might cause them.
If you think you might be in the acute stage of HIV infection, tell your doctor and get tested. There may be a real advantage to starting antiviral treatment during acute HIV infection. Taking anti-HIV medications is a major commitment. Discuss the pros and cons of treatment with your doctor and consider them carefully before making any decisions.

True or False: The HIV Knowledge Test By David Salyer

Information about HIV and AIDS is constantly evolving. It's hard to keep up and it's often overwhelming. Check your current knowledge of HIV with the following test.

According to George W. Bush, current occupant of the White House, "AIDS can be prevented. Antiretroviral drugs can extend life for many years, and the cost of those drugs has dropped from $12,000 a year to under $300 a year." FALSE. Sure, highly active antiretroviral therapy (HAART) is widely believed to extend life. However, there is no HIV antiviral in the United States that costs $300 a year. A combination regimen of three or four drugs (which is the standard of care) still costs at least $12,000 a year -- typically even more. There are some generic drug combinations available in developing countries for much less, but the Bush administration and most American pharmaceutical companies oppose generic manufacturing of anti-HIV meds and don't want you to have access. In fact, thanks to the lobbying efforts of US drug companies, Congress is considering legislation that would prohibit Americans from purchasing drugs produced outside the United States.

Lesbians don't get HIV. FALSE. It's rare, but it happens. Earlier this year, the journal Clinical Infectious Diseases reported a confirmed case of a Philadelphia woman infected by her female partner. Genetic tests showed that the virus in both women was nearly identical, including mutations conveying anti-HIV drug resistance. By thorough investigation, researchers concluded that transmission of HIV was the likely result of sharing sex toys. No matter what they taught you in kindergarten, never share sex toys!

Beginning highly active antiretroviral therapy (HAART) when CD-4 cell counts are above 350 provides better immune system recovery. FALSE. This kind of thinking is, like, so 1996 -- back when the AIDS "cocktail" was new and the mantra seemed to be "Hit Hard, Hit Early." Last spring, the Journal of Acquired Immune Deficiency Syndromes released an analysis of twenty separate studies showing that patients who began HAART when their CD-4 cell counts were above 350 had identical CD-4 cell rebounds, as did those who started the drugs with counts between 201 and 350.

In the United States, HIV/AIDS is the number one cause of death for both Black males and females between the ages of 22-45. TRUE. African-Americans make up about 13% of the US population, yet they comprise over 50% of those newly infected with HIV. According to a six-city study by the Centers for Disease Control and Prevention (CDC), as many as three in ten African-American MSM (men who have sex with men) age 23 to 29 are infected with HIV -- around four times the rate of Caucasian MSM that age. The rate of HIV infection among African-American women, ages 20 to 44, is more than 16 times higher than the rates among white women. The CDC reports that higher death rates among African-Americans are the result of challenges in accessing health care, prevention services and treatment.

Women now account for half of all the world's HIV cases. TRUE. UNAIDS and the World Health Organization reported late last year that the number of women living with HIV equals the number of men. In many African countries, women have outnumbered men for years. Now, the statistics are rising for women of Latin America, Asia and the Caribbean.

In the United States, 25% of all new HIV cases now occur among people under the age of 21. TRUE. According to countless reputable studies conducted all over the country and much to the dismay of rabid, abstinence-crazed tyrants everywhere, TEENAGERS ARE HAVING SEX! One in five teens have sex by age 15. The older they get, the more sexually active they become. So why do more than 50% of schools continue to teach abstinence as the only option, denying teenagers information about contraception and sexually transmitted diseases? Our government prefers it that way and withholds funding from states that want to offer comprehensive sexual education. Our elected leaders habitually tell us a good education is the key to success in life -- why then do so many insist that our teenagers remain ignorant about sex and its consequences?


Of the 25 cities nationwide with the highest concentration of HIV infection, 18 are in the South. TRUE. Most Americans still think HIV exists only in major urban centers with large populations like San Francisco, Los Angeles or New York City. The Kaiser Family Foundation, independent researchers of major health care issues, delivered a report prepared for the November 2002 Southern States Summit on HIV/AIDS and STDs showing that 40% of people living with AIDS and 46% of new AIDS cases are in the South -- despite that region being home to only slightly more than one third of the US population.


The spermicide known as nonoxynol-9 can protect you against HIV and other sexually transmitted diseases. FALSE. Nonoxynol-9 is present in most spermicides on the market today. It has been used over the past half-century in vaginal gels, creams, foams, suppositories, sponges and films. It's been used alone or with other contraceptive devices, such as the diaphragm. It kills sperm and is useful if you're trying to prevent pregnancy. In the '80s, some lame, questionable laboratory experiments revealed that N-9 inactivated organisms that cause gonorrhoea, chlamydial infections and other sexually transmitted infections, as well as HIV -- in a test tube. Suddenly, and without appropriate intervention from the Food and Drug Administration, N-9 started showing up in sexual lubricants and lubricated condoms. People were led to believe that N-9 would protect them from disease. Wrong. In the late '90s, a number of studies involving sexually active human beings revealed that N-9 is a big lie. It's so irritating and toxic to the vaginal and rectal linings that it can actually increase your chances of getting infected. Just say no to nonoxynol-9. Avoid condoms and lubricants containing this crap.

HIV rates are 8 to 10 times higher for prisoners than for the general population.
TRUE. Most positive inmates got HIV before sentencing, but many others are exposed in jail, through consensual sex, rape, IV-drug use and tattooing. Yeah, all of those things happen behind bars -- not just on an episode of HBO's prison saga Oz. Prisoners in several countries around the world have free access to condoms, but in the US only five county jail systems and two state systems, Vermont and Mississippi (how did that happen?!?) offer them. Federal prison administrators officially object to condom distribution, fearing inmates will use them as balloons to smuggle drugs. The federal fix for all this? Congress passed legislation making sex among inmates illegal in all US jails and prisons. Uh-huh, that should fix everything.

A vaccine to prevent HIV infection already exists. FALSE. According to surveys recently conducted by the National Institute of Allergy and Infectious Diseases (NIAID), many Americans wrongly believe that a preventive vaccine for HIV/AIDS has already been developed. Preliminary findings from a national survey of 3,500 people found nearly half of African-Americans surveyed (48%) and more than a quarter of Hispanics (28%) believe that an HIV vaccine already exists and is being kept a secret. Twenty percent of adults in the general population share that belief. A secret HIV vaccine? Where are Scully and Mulder when you need them?

Back to top of page