Q. What is the difference between HIV and AIDS?
HIV is the virus that
causes AIDS. This virus is passed from one person to
another through blood-to-blood and sexual contact. In
addition, infected pregnant women can pass HIV to their
babies during pregnancy or delivery, as well as through
breast-feeding. People with HIV have what is called HIV
infection. Most of these people will develop AIDS as a
result of their HIV infection. An HIV-infected person
receives a diagnosis of AIDS after developing one of the
CDC defined AIDS indicator illnesses. An HIV-positive person
who has not had any serious illnesses also can receive an
AIDS diagnosis on the basis of certain blood tests (CD4+
counts). A positive HIV test result does not mean that a
person has AIDS. A physician using certain clinical criteria
makes a diagnosis of AIDS.
Is there a connection between HIV and other sexually
A. Yes. Having a sexually transmitted disease (STD) can
increase a person's risk of becoming infected with HIV,
whether the STD causes open sores or breaks in the skin
(e.g., syphilis, herpes, chancroid) or does not cause breaks
in the skin (e.g., chlamydia, gonorrhea). If the STD
infection causes irritation of the skin, breaks or sores may
make it easier for HIV to enter the body during
sexual contact. Even when the STD causes no breaks or open
sores, the infection can stimulate an immune response in the
genital area that can make HIV transmission more likely. In
addition, if an HIV-infected person also is infected with
another STD, that person is three to five times more likely
than other HIV-infected persons to transmit HIV through
having (abstaining from) sexual intercourse is the most
effective way to avoid STDs, including HIV. For those who
choose to be sexually active, the following HIV prevention
activities are highly effective:
Engaging in sex that does not involve vaginal, anal, or
Having intercourse with only one uninfected partner
latex condoms every time you have sex.
How easily is the virus transmitted?
Having contact with infected fluids from an HIV-positive
person doesn't always mean you will become infected
yourself. Whether or not you get infected depends on three
1. The amount of HIV that gets in (it’s not just how much
someone comes people have more virus in their semen, vaginal
secretion, or blood at different times).
2. The concentration of HIV (Viral Load).
3. The ease with which the fluid can get into the bloodstream.
The membranes of the rectum, for example, pass the
virus into the bloodstream more easily than the membranes of
Are some people at greater risk of HIV infection than
not discriminate. It is not who you are, but what you do
that determines whether you can become infected with HIV.
Worldwide, sexual intercourse is by far the most common mode
of HIV transmission, but in the U.S., as many as half of all
new infections are now associated either directly or
indirectly with injection drug use (i.e., using
HIV-contaminated needles to inject drugs or having sexual
contact with an HIV-infected drug user). Overall, HIV
infection is spreading fastest in this country among young
people, women, African-Americans, Hispanic-Americans, and
Are women especially vulnerable?
In western countries, women are four times more likely to
contract HIV through
vaginal sex with infected men than men contracting HIV
through vaginal sex with infected women. This biological
vulnerability is made worse by social and cultural factors
that often undermine women's ability to avoid sex with
partners who are HIV-infected or to insist on condom use. In
the U.S., the proportion of new AIDS cases among women more
than tripled from 7% in 1985 to 23% in 1999.
African-American and Hispanic women, who represent less than
one-quarter of U.S. women, represent nearly 80% of AIDS
cases reported among American women to date.
Are young people at significant risk of HIV infection?
Nearly half of the roughly 40, 000 Americans newly infected
with HIV each year are under the age of 25. Approximately
two young Americans become infected with HIV every hour of
every day, and about 25% of the people now living with HIV
in this country became infected when they were teenagers.
Statistics show that by the age of 19, at least half of
females and 60% of males in this country have engaged in
sexual intercourse, and one in six sexually experienced
teens has contracted one or more STDs. Many young people
also use drugs and alcohol, which can increase the
likelihood that they will engage in high-risk sexual
How effective are
latex condoms in preventing HIV?
Studies have shown that latex condoms are highly effective
in preventing HIV transmission when used correctly and used
every time. These studies looked at uninfected people
considered to be at very high risk of infection because they
were involved in sexual relationships with HIV-infected
people. The studies found that even with repeated sexual
contact, 98%-100% of those people who used latex condoms
correctly, every time they had sex, did not become infected.
condoms will not protect you from infection or re-infection
because they are made from lamb intestines and have pores
that can let the virus through. It is important to
experiment with different sizes, shapes, and brands of
condoms to find out which ones you prefer. Condoms can be
thicker or thinner, have studs, ribs, or colors, and are
lubricated with a broad variety of lubricants. Latex condoms
will tear when used with oil-based lubricants - use only
Does the spermicidal Nonoxynol-9 prevent HIV transmission?
been found that under some circumstances Nonoxynol-9
actually increases a person’s chance of becoming infected
with HIV. The chemicals in the spermicidal gel may at times
irritate the mucous membranes and cause lesions that make it
easier to transmit HIV from an infected partner to a
non-infected partner. Nonoxynol-9 helps prevent pregnancy,
but it does not prevent HIV. Using a plain water-based
lubricant with a condom every time you have sex is effective
against HIV infection.
Is there a vaccine to prevent HIV infection?
continued intensive research, experts believe it will be at
least a decade before we have a safe, effective, and
affordable AIDS vaccine. And even after a vaccine is
developed, it will take many years before the millions of
people at risk of HIV infection worldwide can be immunized.
Until then, it is essential that we use other HIV prevention
methods, such as practicing safer sex and avoiding
non-sterile needles and injection equipment.
How does a person know if he/she is infected with HIV?
The only way to know your HIV status for sure is to be
tested. Immediately after infection, some people may
develop mild, temporary flu-like symptoms or persistent
swollen glands, but even if you look and feel healthy, you
may be infected. The only way to determine for sure whether
you are infected is to be tested for HIV infection. You
cannot rely on symptoms to know whether or not you are
infected with HIV.
Can you tell whether someone has HIV or AIDS?
You cannot tell by looking at someone whether he or she is
infected with HIV or has AIDS. An infected person can appear
completely healthy. But anyone infected with HIV can infect
other people, even if no symptoms are present.
How can a person get tested?
years ago, the only type of antibody test available was a
blood test done through your doctor's office. Today, as
technology has improved, there are now different types of
antibody tests available. Antibody tests can now be done on
blood, mouth swabs, and urine, all based on ELISA and
Western Blot techniques. Many people who don’t like needles
are glad to be able to choose the mouth swab or urine test.
lab tests don’t look for HIV itself. They look for
antibodies to the virus. The HIV antibody test, marketed
under the brand name “OraSure,” actually looks for HIV
antibodies in a fluid in the mouth called "oral mucosal
transudate." But for simplicity sake it is sometimes
referred to as the mouth swab test.
What is “the window period” for testing?
When people are first infected with HIV, it can take up to 6
months, rarely, for their bodies to make enough HIV
antibodies for an HIV test to show they have the disease (to
have a “positive” test result). We call this “the window
period.” To be certain that you don’t have HIV, you must
get tested once, avoid all risky behaviors, and then
have a second test at least 3 months after your first one.
If the second test is also “negative” (no HIV antibodies
found) and you continue to avoid all risks at all times, you
will stay “HIV-free.”
How quickly do people infected with HIV develop AIDS?
some people, the T-cell decline and opportunistic infections
that signal AIDS
develop soon after they first become infected with HIV. But
more often people remain without symptoms for 10 to 12
years, and a few people go even longer. As with most
diseases, early medical care and living a healthy lifestyle
can help prolong the life of a person with HIV disease.
If a person’s test is HIV
negative, does that mean that the person’s partner is HIV
No. The HIV test result reveals only the HIV status of the
person tested. A negative test result does not tell you
whether the person’s partner has HIV. Therefore, taking an
HIV test should not be seen as a method to find out if your
partner is infected. Testing should never take the place of
protecting yourself from HIV infection. If certain behaviors
are putting a person at risk for exposure to HIV, it is
important to reduce the risks. Someone who does get tested
should encourage his or her sex partner(s) to also get
What is the risk to
each person of unprotected sex between two persons who are
research suggests that an HIV infected person can become "reinfected"
with another strain of HIV. This is of particular concern,
because getting reinfected with a strain of HIV that is
resistant to certain medications may cause that person to
fail on medications that previously worked for him. There
are also some concerns that reinfection may accelerate an
infected person's progression to AIDS. Viral load may also
rise through reinfection, increasing the amount of HIV in
is a complicated issue, which clearly needs more research.
Your biggest concern is the transmission of a drug-resistant
strain from one HIV positive partner to the other HIV
positive partner. Again, no one could predict if there would
be complications for either of you in that scenario. It's a
difficult decision. Many experts suggest that positive
partners use condoms until more information is available.
What Is “viral load” and how is it measured?
Viral load is the quantity of HIV-RNA (HIV) in the blood.
RNA is the genetic material of HIV that contains the
information needed to make more virus. Viral load tests
measure the amount of HIV-RNA in a small amount of blood
(one milliliter, ml).
Are there treatments for
many years, there were no effective treatments for AIDS.
Today, people in the United States and other developed
countries can use a number of drugs to treat HIV infection
and AIDS. Some of these are designed to treat the
opportunistic infections and illnesses that affect people
with HIV/AIDS. In addition, several types of drugs seek
to prevent HIV itself from reproducing and destroying the
body's immune system:
transcriptase inhibitors attack an HIV enzyme called reverse
transcriptase. They include abacavir, delavirdine,
didanosine (ddI), efavirenz, lamivudine (3TC), nevirapine,
stavudine (d4T), zalcitabine (ddC), and zidovudine (AZT). Protease
inhibitors attack the HIV enzyme protease and include
amprenavir, indinavir, nelfinavir, ritonavir, and
HIV patients are taking several of these drugs in
combination -- a regimen known as highly active
antiretroviral therapy (HAART). When successful,
such combination or "cocktail" therapy can reduce the level
of HIV in the bloodstream to very low, even undetectable,
levels and sometimes enables the body's CD4 immune cells to
rebound to normal levels. These therapies are costly and
can have serious side effects, so preventing HIV is always
our best choice.
Researchers are working to develop new drugs known as
fusion inhibitors and entry inhibitors that can prevent HIV
from attaching to and infecting human immune cells. Efforts
are also underway to identify new targets for anti-HIV
medications and to discover ways of restoring the ability
of damaged immune systems to defend against HIV and the
many illnesses that affect HIV-infected individuals.
Ultimately, advances in rebuilding the immune systems of
HIV patients may benefit people with other serious
illnesses, including cancer, Alzheimer's disease, multiple
sclerosis, and immune deficiencies associated with aging
and premature birth.
Is there a cure for AIDS?
There is still no cure for AIDS. And while new drugs are
helping some people with HIV/AIDS live longer, healthier
lives, there are many problems associated with them:
Existing treatments do not work for many people with
Anti-HIV drugs are highly toxic and can cause serious
side effects, including heart damage, kidney failure,
and osteoporosis. Many (perhaps even most) patients
cannot tolerate long-term treatment with HAART.
mutates constantly. In as many as 40% of people on HAART,
HIV mutates into new viral strains that have become
highly resistant to current drugs, and as many as 10% of
newly infected Americans are acquiring drug-resistant
strains of the virus.
Because treatment regimens are unpleasant and complex,
many patients occasionally miss doses of their
medication. Failure to take anti-HIV drugs on schedule
and in the prescribed dosage can encourage the
development of new viral strains that are resistant to
current HIV drugs.
among those who do respond well to treatment, HAART does
not eradicate HIV. The virus continues to replicate at
low levels and often remains hidden in "reservoirs" in
the body, such as the lymph nodes and brain.
roughly 95% of all people with HIV/AIDS live in the
developing world, where there is virtually no access to
antiretroviral treatments. In the U.S., HAART contributed to
a significant decline in the annual number of AIDS-related
deaths between 1996 and 1998. But the rate of this decline
has now slowed markedly, and some communities have begun
reporting an increase again in AIDS deaths.