What is HIV?

The human immunodeficiency virus (HIV) is a slowly replicating retrovirus that attacks certain cells in the immune system, which is the body’s defense system against infections and diseases. HIV can be treated and controlled by taking medication prescribed by a doctor, even though there is no cure for HIV at this time. People living with HIV can live long and healthy lives if they take medication as prescribed and see their care team regularly for their medical appointments. 

HIV is spread person to person through blood, semen, vaginal secretions, and breast milk from a person who is living with HIV. The most common way HIV spreads from one person to another is unprotected sex, which means vaginal, anal, or oral sex without a condom. The virus enters the body through the lining of the vagina, penis, rectum, or mouth during sex.

HIV can also be passed through needles and syringes shared by people using injection drugs.

HIV is not transmitted by casual contact, such as shaking hands, hugging, or touching toilet seats, telephones, drinking fountains, or doorknobs.

Anyone can become infected with HIV, but a person’s risk is increased if they:

• Have sex with multiple partners
• Have sex without a condom
• Share injection drug equipment (e.g., needles or syringes)
• Have another sexually transmitted infection (STI)

What is AIDS?

If HIV goes untreated or is not treated effectively, the damage to the immune system can lead to acquired immunodeficiency syndrome (AIDS), which is a progressive disease of the immune system that allows infections and cancers to thrive.

Someone living with AIDS can easily contract infections and illnesses that may not make the average person sick. However, these illnesses can be dangerous for someone living with AIDS and can also lead to death.

Signs and symptoms of HIV 

Early stage HIV symptoms

Early in the disease progression of HIV, people often have no symptoms, even though the virus is present and weakening the immune system. Due to lack of symptoms, most do not realize they have HIV until they get tested. However, some people may experience early symptoms of HIV infection.

Symptoms of early-stage HIV may include:

• Fever
• Sore throat
• Fatigue
• Headache
• Swollen glands (e.g., lymph glands, which are in the armpits, neck, and groin)
• Muscle and joint pains
• Rash

Symptoms of HIV in the early stages can last from a few days to several weeks. Because most of these symptoms can be caused by other illnesses, it is important to be aware of any potential exposure to HIV and be tested regularly. 

Late-stage HIV and AIDS symptoms

Later in the HIV disease progression, new symptoms may indicate that the condition is worsening and transitioning from HIV to AIDS. New symptoms could also be a sign that a person’s current HIV medication is not working. 

Symptoms of late-stage HIV and AIDS may include:

• Rapid weight loss
• Extreme tiredness
• Pneumonia
• Recurring fever
• Sores of the mouth, genitals, or anus
• Chronic diarrhea
• Swelling of the lymph glands in the armpits, neck, and groin
• Depression, memory loss, and other neurological conditions
• Colored blotches on or under the skin or inside the mouth, nose, and eyelids

Testing and diagnosis of HIV

The only way for someone to know they have HIV for sure is to get an HIV test.

HIV testing is CONFIDENTIAL. This means anything you discuss with a healthcare professional in an examination room is private — including your test results.

There are a few types of HIV tests available, and this allows people to choose the kind of test they want to get. There are two tests that involve just a swab in the mouth — no needles and no blood:

• Oral Standard HIV Test — results come back in two weeks (requires a second appointment)
• Oral Rapid HIV Test — results come back in 20 minutes

Aside from HIV testing using oral samples, blood tests are also available, which can be conducted in a lab or sometimes as a rapid test.

In most cases, rapid HIV testing is recommended. This way, we can quickly learn the results, and if a positive test result is identified, we can immediately make a connection to the appropriate HIV specialty care clinic.

Setting up an appointment

If you believe you have been exposed to HIV, please contact us by:

• Calling the HIV care clinic at 215-590-3626 to schedule an appointment.
• Calling CHOP Adolescent Medicine at 215-590-3537 to schedule an appointment.

Treatment

There are highly effective medications for HIV that help control the virus, strengthen the immune system, and help fight infections and other illnesses. These medications are called antiretrovirals (ARV or ART for short), and they help people living with HIV live long, healthy lives, even though there is no cure for HIV or AIDS at this time. 

When medication is prescribed and taken appropriately, it can work so well that HIV becomes “undetectable.” This means the virus is not actively replicating and harming the immune system. It also means that it is not possible for the virus to be transmitted to someone else (undetectable=untransmittable, or U=U for short). 

The medications for HIV can be taken every day as a pill, or they can be given on a regular basis by a healthcare provider as a shot (every 1 to 2 months). 

Prevention

To prevent getting HIV and other STIs, people can:

• Not have sex
• Use condoms during sex
• Know the HIV and other STI status of sex partners
• Avoid injecting drugs and sharing injection equipment (e.g., needles and syringes)
• Talk to a trusted medical provider about sexual health and get regular testing and treatment, as needed
• Take a prescription medication called “PrEP” if eligible 

PrEP Medication

HIV pre-exposure prophylaxis (PrEP) is the medication used to prevent HIV for people who don’t already have it. People who test negative for HIV but may be exposed to HIV in the future can talk to a medical provider to find out if PrEP is an option for them. When PrEP is prescribed and taken appropriately, it makes it much more difficult to develop an HIV infection when exposed to the virus.

PrEP can be prescribed as a pill that is taken every day or prescribed as a shot that is given by a medical provider every 1 to 2 months.

Call 215-590-4308 to talk to a PrEP health educator and make an appointment.