HIV infection and AIDS

16-minute read

Key facts

Human immunodeficiency virus (HIV) is a sexually transmitted infection (STI) that affects your immune system by destroying CD4 cells.
You are at a higher risk of getting HIV if you have unprotected sex, share needles, already have another STI and get a piercing or tattoo with unsterile equipment.
Untreated HIV usually leads to acquired immunodeficiency syndrome (AIDS) within 10 years.
HIV can be diagnosed by doing a blood test.
Antiretroviral therapy is very effective treatment for HIV; if you take your treatment properly, you can live a long and healthy life with HIV.

What are HIV and AIDS?

Human immunodeficiency virus (HIV) is a virus that affects your immune system. It gradually destroys a type of immune cell known as CD4. These cells help your body stay healthy by fighting off disease.

Untreated HIV usually leads to acquired immunodeficiency syndrome (AIDS) within 10 years.

If you have AIDS, your immune system is severely weakened, so your body is unable to fight infections and stop certain cancers from developing.

What are the symptoms of HIV infection?

Some people who catch HIV first develop an symptoms of 'seroconversion illness', such as:

fever
fatigue
headache
sore muscles and joints
sore throat
swollen lymph glands in the neck, underarm or groin areas
rash

Females often report gynaecological issues as their first HIV symptoms, including:

'Seroconversion illness' usually starts around 2 – 4 weeks after you are infected with HIV. Symptoms may be mild and similar to a flu-like illness, or you may not experience any symptoms.

Since symptoms may be mild or absent, it can take time to be diagnosed with HIV.

After the initial illness, people with HIV infection usually have no other symptoms, although the virus remains in the body and can be transmitted to others.

If you do not receive treatment for HIV, you may develop some general symptoms over time, such as:

loss of appetite
diarrhoea
weight loss
fever
lethargy and fatigue

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

Why do some people with HIV infection develop AIDS?

Untreated HIV usually leads to acquired immunodeficiency syndrome (AIDS) within 10 years. Females generally transition to AIDS quicker than males.

HIV damages your immune system and makes it difficult for it to fight infections and stop some cancers from developing.

Today, if you are living with HIV and take your treatment as prescribed, you are unlikely to develop AIDS and are likely to live a long and healthy life. This is because these medicines keep the amount of virus in your blood ('viral load') under control and protect your immune system.

What are the effects of AIDS?

If you have AIDS, your immune system is weakened, so you are at a higher risk of developing:

infections not usually seen in healthy people — brain infection (meningitis), tuberculosis (TB), cytomegalovirus (CMV), systemic (whole body) candidiasis, toxoplasmosis, bacterial pneumonia, cryptosporidiosis
some cancers — Kaposi sarcoma, lymphoma
some neurological problems, such as dementia
kidney disease
wasting syndrome (weight loss, often with a fever or diarrhoea)
skin infections such as oral thrush and herpes zoster

Females with progressing AIDS may develop uterine or cervical cancer.

How do people become infected with HIV?

You can catch HIV if body fluids containing the virus enter your bloodstream by:

having unprotected oral, anal or vaginal sex
sharing drug injection equipment
having body piercings or tattoos in an unsterile environment
having unsafe medical or dental procedures
the natural transfer of fluids to an unborn baby during pregnancy, birth or breastfeeding
accidental injuries from a contaminated needle (sharps injuries), for example, in a healthcare environment

Body fluids that carry HIV include:

blood
semen
rectal fluids
vaginal fluids
breast milk

HIV is not spread by:

kissing
sharing cups and cutlery
toilet seats
insect or animal bites
everyday social contact, such as shaking hands and hugging
saliva, tears, sweat or urine

Who is at risk of HIV?

You are at higher risk of HIV infection if:

you are a male (cis or trans), a transgender female or a person who identifies as gender-diverse who has sex with males
you have sex or share needles with someone else at risk of HIV
you have sex with people from a country with a high rate of HIV infection
you inject drugs and share needles
you have had tattoos or other piercings overseas using unsterile equipment
you have had a blood transfusion in a country where the blood supply is not safe (blood transfusion is very safe in Australia)
you have another sexually transmitted infection (STI)

It's possible to be infected with several different STIs at the same time. Having an STI can increases your risk of catching HIV and pass it on to your sexual partners.

Some people are at a higher risk of HIV infection because they are generally exposed to more people with HIV or are more frequently involved in high-risk behaviour. These include:

Aboriginal or Torres Strait Islander people
people who have been in prison
people who use drugs (even drugs that are not injected)
people who receive healthcare in places with poor infection control practices
people from countries with a high rate of HIV infection

When should I get tested for HIV?

If you think you could have HIV or are at risk of HIV, talk to your doctor or sexual health clinic about having a test. Some people at high risk should to be tested regularly.

You should get tested for HIV if:

you have had unprotected sex (vaginal or anal) with a partner whose HIV status is unknown or who has with a detectable viral load
you have had unprotected sex (vaginal or anal) with a person from a country that has a high rate of HIV infection
your sexual partner has recently travelled to a country that has a high rate of HIV infection, and may have had unprotected sex there
you have had unprotected sex with a sex worker in Africa, Eastern Europe, Southeast Asia or Papua New Guinea
you have ever shared injecting equipment
you are starting pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP)

Early diagnosis is important and can improve the long-term course of the illness.

Talk to your doctor or sexual health clinic about testing for other STIs at the same time.

How is HIV diagnosed?

You can test for HIV via a blood test, rapid test or a self-test in your home.

Blood tests

Your doctor or sexual health clinic can refer you for a blood test for HIV. Your blood is sent to a laboratory. You will get results within a few days.

Rapid HIV tests

Your health professional may use a rapid test to screen for HIV. It uses either a pinprick of blood from your finger or a small sample of your saliva. You can get results within 10 – 20 minutes.

Rarely, a rapid test can give a false result, so your doctor will always confirm your result with a blood test.

HIV self-testing

Self-testing uses the same technology as a rapid HIV test. It is a finger-prick blood test that you can do at home or anywhere you feel comfortable. You can get results in less than 15 minutes.

If you get a positive result, you should see your doctor to do a blood test to confirm your results.

The Atomo HIV Self-Test is only self-test test approved by the Therapeutic Goods Administration (TGA). It's important to only use HIV self-tests approved by the TGA, so you know that the test is accurate and safe to use.

Your diagnosis will be kept confidential unless there are major concerns for your safety or the safety of others.

Whatever type of test you do, it can take 6 weeks after exposure (sometimes longer) for blood to show positive for infection with HIV.

This means that you could get a negative result despite having HIV (known as a 'false negative'). You may need more than one test over time to know for sure whether you have HIV.

It is important to practice safe sex and use safe injecting practices while waiting for your test results. Maintaining these practices after testing, even if you get a negative result, will reduce your risk of future exposure and infection.

HIV is a nationally notifiable disease. This means that your doctor must tell the Department of Health if you're diagnosed with HIV. The Department needs to monitor and track all cases of HIV in order to identify outbreaks and improve healthcare responses.

How is HIV treated?

HIV is treated with antiretroviral therapy (ART). There is no vaccine or cure for HIV. Prompt treatment (as soon as possible after diagnosis) increases your chance of good long-term outcomes.

ART is a combination of medicines taken together to stop HIV from reproducing in your body.

If you take ART exactly as your doctor recommends, you can have an undetectable viral load. This means that you will not develop AIDS and should be able to live a long and healthy life. If you maintain an undetectable viral load for over 6 months, you also cannot transmit HIV to others. This is known as 'U = U' — 'undetectable equals untransmittable'.

There are many antiretroviral treatment options for people living with HIV. Your doctor will discuss with you which is the best option for you. They will consider your disease progression, how your body responds to the treatment and your general health.

Most people who take ART every day have minimal side effects.

You should see your doctor regularly to check how well your treatment is working.

Thanks to the improvements in treatment, HIV infection is no longer a terminal illness. It is now a chronic disease for many people in countries such as Australia.

How do I protect myself from getting infected with HIV?

Here's how you can reduce your chance of catching HIV:

Always use condoms with water-based lubricant for anal or vaginal sex.
Never share needles, syringes or other injecting equipment.
Make sure all tattooing, piercing and other procedures are done with sterilised equipment.
Make sure you and your partner have been tested and are aware of each other's HIV status.
Get regular STI checks if you are having casual sex with different people on a regular basis.
Avoid sharing personal items that could have blood on them, such as your toothbrush or razors.
Use pre-exposure prophylaxis (PrEP) or post exposure prophylaxis (PEP) effectively.

Pre-exposure prophylaxis

Pre-exposure prophylaxis (PrEP) is a pill you can take if you are at high risk of getting HIV. It is highly effective at preventing HIV infection. It does not protect you from other STIs.

There are different regimens available. Depending on your sexual practices, you can take PrEP daily, on-demand or periodically. Ask your doctor or sexual health clinic if you should take PrEP.

Post-exposure prophylaxis

Post-exposure prophylaxis (PEP) is medicine you can take to prevent getting a HIV infection after you may have been exposed to it.

It is best to start PEP as soon as possible, ideally within 72 hours (3 days) of HIV exposure. You should continue taking it for 4 weeks after your exposure.

Some doctors can provide PEP. Otherwise, you can get PEP by vising your local emergency department.

You can find out more about PEP by talking to a doctor or calling a HIV PEP hotline in your state or territory. You can call healthdirect on 1800 022 222 or visit the Get PEP website for details on local PEP services across all states and territories.

Needle and syringe programs

Needle and syringe programs (NSPs) help reduce your risk of transmitting HIV and other blood-borne diseases, such as hepatitis B and hepatitis C.

NSPs can offer you:

clean needles or syringes if you inject drugs
sharps disposal containers and facilities
information and education

There are different types of NSPs. They can include pharmacies and even special vending machines. Find an NSP in your state or territory:

You can also find a local needle and syringe program using the healthdirect Service Finder. Select 'By name' and type 'needle' into the search bar. NSPs are also sometimes called 'needle exchange'.

How do I avoid passing HIV on to someone else?

If you are infected with HIV, the best way to prevent spreading HIV infection to others is to:

Take your medicine as prescribed — you have a very low risk of passing on HIV if your own infection is under control.
Use condoms and a water-based lubricant for anal and vaginal sex.
Never share needles, syringes and other injecting equipment.

Contact tracing

If you have HIV, you should tell anyone who is at risk of exposure from you:

Tell people you have had sex or taken drugs with via contact tracing.
Tell anyone you intend to have sex with about your HIV status (even when you use a condom). This is required by law in some states.

If you are pregnant, talk to your doctor about starting antiretroviral treatment. This can prevent you from passing the infection to your baby during pregnancy, childbirth or breastfeeding.

Living with HIV

If you have HIV or AIDS, it is very important to stick to your treatment plan. Take precautions so you don't infect anyone else.

General healthy eating, exercise and living a healthy lifestyle are important if you are living with HIV. A healthy lifestyle can help to reduce symptoms, side effects from medicine and improve your resistance to infections.

Ensure you're up-to-date with your vaccinations.

If you are living with HIV, you should talk to your doctor about getting screened for anal cancer.

For advice on living with HIV, visit the Health Equity Matters website.

Resources and support

Ending HIV has a practical guide to everything about testing for HIV and STIs.
The Let Them Know website helps you send free, anonymous text messages or emails to sexual partners to help with contact tracing.
If you are struggling with a new HIV diagnosis, visit Ending HIV's 'Getting support for HIV' to help you manage during this challenging time.
If you don't have Medicare, and aren't eligible to enrol in Medicare, you may be able to access HIV treatment. Visit the Australasian Society for HIV Medicine (ASHM) for details.