People living with HIV can take medications called antiretroviral therapy (ART) to protect their immune system and also avoid passing HIV to partners. ART should be started as soon as possible after HIV diagnosis and must be taken for your whole life. Fortunately many people with HIV only need to take one or two pills each day to effectively reduce their virus to below detectable levels (also known as an “undetectable viral load”). This means that the amount of HIV in your blood is so low that it doesn’t show up in certain tests. Once you have had an undetectable viral load for at least six months, you are unable to transmit HIV to your sex partners as long as you continue to take the daily medications and your viral load stays undetectable.

The current HIV medications have few side effects. Most insurance companies cover the cost, and there are programs to help if you are uninsured.

HIV is usually spread through genital fluids during vaginal and anal sex. HIV can also be transmitted from blood during sex and sharing needles or other injection-drug equipment. Women with HIV can pass HIV to their babies during pregnancy, childbirth, and breastfeeding if they are not on HIV medications.

HIV is not spread through saliva, sweat, tears, urine, feces (poop), or if someone’s blood or genital fluid comes into contact with skin that doesn’t have a cut or sore.

Most people who become infected with HIV do not experience any symptoms. This is why regular HIV testing (every three months) is so important if you are at risk. Some people experience flu-like symptoms a few weeks after getting infected with HIV—which can include fever, extreme tiredness, sore throat, headache, swollen lymph nodes, and rash. These symptoms can take days or weeks to appear after you’ve been infected with HIV and are called “acute retroviral syndrome.” These symptoms will go away on their own even without HIV medications, but you will still have HIV.

If HIV is not treated with medications, it can damage a certain part of your immune system called CD4 cells or T-cells. When your CD4 cell count goes down, it becomes easier to get illnesses such as pneumonia and other serious infections that your body would normally be able to fight off. These types of illnesses are called “opportunistic infections.” If someone with HIV has a CD4 count below 200 or is diagnosed with an opportunistic infection, they are said to have AIDS. It can take 2-10 years, or more, from the time someone gets HIV to the time they develop AIDS. 

No test is good enough to detect if you were infected with HIV until at least one week from the time you were exposed. This time from when you are infected with HIV until a test result is positive is called the “window period.” If you are diagnosed with HIV before antibodies develop, it is known as “acute infection.”

It is recommended that everyone get at least one HIV test in their lifetime. Some people with certain risk factors should get tested more often.

There are several types of HIV tests currently available.

HIV Ag/Ab test

• Looks for both virus particles and the antibodies your body makes in response to HIV
• Detects HIV 2-6 weeks from the time you were exposed
• Blood test
• Results are available in 5-7 business days

Rapid HIV test

• Looks for the antibodies that your body makes in response to HIV
• Detects HIV anywhere from two weeks to three months after you were exposed, depending on the specific type of rapid test used
• A fingerstick blood test or oral swab test
• Results are available within 20-30 minutes

HIV viral load test

• Looks for HIV virus in your blood
• Detects HIV 7-10 days from the time you were exposed
• Blood test
• Results are available in 5-10 business days

Skipping HIV medicines allows HIV to multiply, which increases the chances that the virus will become resistant to the medications. When that happens, the medications will not be able to suppress the viral load. When there is detectable HIV virus in your blood, HIV can damage your immune system. This makes it hard for your body to fight off infections and certain cancers. 

Because HIV requires lifelong treatment, it’s important for people with HIV to regularly visit their healthcare provider and make sure the medications are keeping the virus under control.

Get more resources and information about living with HIV from the San Francisco AIDS Foundation.

PEP is medication that can prevent HIV infection after you are exposed. It should be started within 72 hours of a possible exposure to HIV so it is important to come to the clinic quickly if you think you could have been exposed. You’ll need to take PEP for 28 days.

PrEP is medication taken before a possible exposure to HIV. It is a highly effective way to reduce the risk of HIV infection through sex or sharing needles. PrEP needs to be taken on an ongoing basis if you have a continued risk of exposure to HIV.

Clean injection equipment prevents HIV being passed through intravenous drug use.

Condoms can prevent the spread of HIV if you use them consistently and correctly for anal and vaginal sex.

Undetectable = Untransmittable (U=U) means that there is no risk of HIV being passed during sex if the person living with HIV has been undetectable on HIV medications for at least six months. We don’t have enough data to know if being undetectable prevents HIV transmission from sharing injection equipment.