Basics of HIV

The Human Immunodeficiency Virus (HIV) is a virus that attacks the immune system, or the part of your body that works to keep you healthy by fighting off infections. Over time, and without treatment, HIV can cause Acquired Immunodeficiency Syndrome (AIDS), as the virus gradually destroys the body’s defenses against disease. Without these defenses, the body becomes vulnerable to many infections and cancers that do not normally develop in someone with a healthy immune system.

HIV can be transmitted from an infected person to another through direct contact with four bodily fluids: blood (including menstrual blood), semen (including both pre–cum and cum/ejaculate), vaginal fluids, and breast milk. “Direct contact” means that one of these four HIV–infected fluids has to come into contact with a person’s bloodstream. HIV can enter the body through open cuts or sores on the skin, or through mucous membranes (such as the eyes, mouth, digestive tract or “gut,” head of the penis, vagina, and anus).

For example, a person could be exposed to HIV during sex, direct blood contact—particularly through sharing injection drug needles or “works” (cotton, cookers, etc.)—or transfusions with HIV–infected blood. Mother–to–child transmission of HIV is also possible, either before or during birth, or through breastfeeding. Skin–to–skin contact with an infected individual cannot transmit HIV. Other bodily fluids—like saliva, tears, sweat, feces, or urine—do not contain HIV and therefore cannot transmit the virus. Because of this, oral sex is much less risky for HIV transmission than anal or vaginal sex: HIV could still enter the bloodstream through open cuts and sores in the mouth, or through the gums or tonsils, but once it moves past the mouth, enzymes in the esophagus and acid in the stomach kill the virus.

HIV can cause symptoms within weeks of infection, but these symptoms generally go away in a few days to weeks. People can also live with HIV for years with no symptoms at all. It is still possible to transmit HIV when someone does not have symptoms. If someone does experience early symptoms, they can last from a few days to a few weeks and can include: fever, fatigue, a non-itchy rash, swollen glands or lymph nodes, muscle aches, sore throat, night sweats, or sores or ulcers in the mouth. Any combination of these symptoms is referred to as Acute Retroviral Syndrome. If someone does not have symptoms, tests can still detect HIV infection; in fact, this is one of the reasons that it is important for people to get tested regularly, regardless of whether they are currently having symptoms, and especially if they are sexually active or have other potential exposures to HIV.

After the acute phase, the virus typically becomes less active in the body, sometimes taking as long as 10 years before health problems begin. However, some people may rapidly develop severe health problems associated with AIDS.

AIDS is a late stage of HIV infection, characterized by serious damage to the body’s immune system. By the time someone is diagnosed with AIDS, it is likely they will already have experienced life–threatening infections or cancers because their body is unable to mount a strong defense.

Medications called antiretrovirals can significantly slow down HIV and prevent further weakening of the immune system. Some people living with HIV may never develop AIDS thanks to the medical treatment we have available today, and many people can live a normal life span. Studies have shown that starting treatment with antiretroviral medications as soon as possible after someone tests positive for HIV substantially improves their long-term health.

There is no functional cure for HIV or AIDS, because no medication has been able to eliminate the virus from a person’s body or reverse the damage HIV has done to the immune system. A number of investigators are working on developing a cure. However, there have been huge advances in HIV treatment and prevention in recent years – we now have tools to prevent infection and to keep people who are infected healthy for many years. There are also people whose bodies naturally suppress the virus without needing to use antiretroviral medication – these people are rare, but they have inspired studies to develop new ways to prevent HIV, like the AMP study. At BridgeHIV, we focus our research on HIV prevention, testing new products like vaccines and pre-exposure prophylaxis (PrEP) to assess their safety and effectiveness at preventing HIV infection.