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HIV is a virus which attacks the immune system, and weakens your ability to fight infections and disease. It's most commonly caught by having sex without a condom.

It can also be passed on by sharing infected needles and other injecting equipment, and from an HIV-positive mother to her child during pregnancy, birth and breastfeeding.

HIV stands for human immunodeficiency virus. The virus attacks the immune system, and weakens your ability to fight infections and disease.

There is no cure for HIV, but there are treatments to enable most people with the virus to live a long and healthy life.

AIDS is the final stage of HIV infection, when your body can no longer fight life-threatening infections. With early diagnosis and effective treatment, most people with HIV will not go on to develop AIDS.

How do you get HIV?

HIV is found in the body fluids of an infected person, which includes semen, vaginal and anal fluids, blood, and breast milk. It is a fragile virus and does not survive outside the body for long. 

HIV cannot be transmitted through sweat or urine.

The most common way of getting HIV in the UK is by anal or vaginal sex without a condom. According to statistics from the Health Protection Agency, 95% of those diagnosed with HIV in the UK in 2011 acquired HIV as a result of sexual contact.

Other ways of getting HIV include:

  • using a contaminated needle, syringe or other injecting equipment
  • tranmission from mother to baby during pregnancy, birth or breastfeeding
  • through oral sex or sharing sex toys (although the risk is significantly lower than for anal and vaginal sex) 

Getting tested

If you think you have put yourself at risk of HIV, you should seek medical advice and have a test as soon as recommended. The earlier HIV is diagnosed, the earlier you can start treatment and avoid becoming ill.

There are a number of places you can get an HIV test, including your GP surgery and sexual health clinics and clinics run by charities including the Terrence Higgins Trust.

Most HIV tests in the UK involve taking a small sample of blood and sending this to a laboratory for analysis. These tests can provide a reliable result from four weeks after possible infection and results are usually available within a few days. It is also possible to test using a saliva sample or pin-prick (blood-spot) test, and many sexual health clinics now use these tests routinely as the result is available within a few minutes and do not need to be sent to the lab. However, these tests do not reliably detect HIV if you have been infected within the past few weeks.

You may get the results in hours, days or weeks, depending on the type of test you take.

If your test is positive, you will be referred to a specialist HIV clinic where you'll have more blood tests to show what effect HIV is having on your immune system and be able to discuss treatment options.

Anyone who has sex without a condom or shares needles is at risk of HIV infection. However, the two groups with highest rates of HIV in the UK are gay and bisexual men and African men and women.

NICE recommends that annual HIV tests be offered to all men who have sex with men, and more frequent testing be offered to those at higher risk due to multiple partners or unsafe sexual practices.

Living with HIV

Although there is no cure for HIV, treatments are now very effective, enabling people with HIV to live long and healthy lives.

Medication, known as antiretrovirals, work by stopping the virus replicating in the body, allowing the immune system to repair itself and preventing further damage. These medicines come in the form of tablets, which need to be taken every day.

HIV is able to develop resistance to a single HIV drug very easily, but taking a combination of different drugs makes this much less likely. Most people with HIV take a combination of three antiretrovirals and it is vital that the medications are taken every day as recommended by your doctor.

You will be encouraged to take regular exercise, eat a healthy diet, stop smoking and have yearly flu jabs and five-yearly pneumococcal vaccinations to minimise the risk of getting serious illnesses.

Without treatment, the immune system will become severely damaged and life-threatening illnesses such as cancer and severe infections can occur. This is known as late-stage HIV infection or AIDS.

Preventing HIV

Anyone who has sex without a condom or shares needles is at risk of HIV infection.

The best way to prevent HIV is to use a condom for sex and to never share needles or other injecting equipment (including syringes, spoons and swabs). Knowing your HIV status and that of your partner is also important.

How common is HIV?

At the end of 2012, there were an estimated 98,400 people in the UK living with HIV. The majority were infected through sex (41,000 gay and bisexual men and 53,000 heterosexuals).

More than one in five people with HIV (over 20,000) do not know they are infected.

Around one in every 650 people in the UK has HIV, but the two groups with highest rates of HIV are gay and bisexual men and African men and women, where the rates are approximately one in 20 and one in 25 respectively.

The World Health Organization estimates that around 34 million people in the world are living with HIV.

The virus is more common in sub-Saharan African countries, such as South Africa, Zimbabwe and Mozambique.

Symptoms of HIV 

Most people who are infected with HIV experience a short, flu-like illness that occurs two to six weeks after infection. After this, HIV often causes no symptoms for several years.

The flu-like illness that often occurs a few weeks after HIV infection is also known as seroconversion illness. It's estimated that up to 80% of people who are infected with HIV experience this illness.

The most common symptoms are:

  • fever (raised temperature)
  • sore throat
  • body rash

Other symptoms can include:

  • tiredness
  • joint pain
  • muscle pain
  • swollen glands (nodes)

The symptoms usually last one to two weeks but can be longer. They are a sign that your immune system is putting up a fight against the virus. 

However, these symptoms are most commonly caused by conditions other than HIV, and do not mean you have the virus.

If you have several of these symptoms, and you think you have been at risk of HIV infection within the past few weeks, you should get an HIV test.

After the initial symptoms disappear, HIV will often not cause any further symptoms for many years. During this time, known as asymptomatic HIV infection, the virus continues to be active and causes progressive damage to your immune system. This process can take about 10 years, during which you will feel and appear well.

Once the immune system becomes severely damaged symptoms can include:

  • weight loss
  • chronic diarrhoea
  • night sweats
  • skin problems
  • recurrent infections
  • serious life-threatening illnesses

Earlier diagnosis and treatment of HIV can prevent these problems.

Causes of HIV 

In the UK, most cases of HIV are caused by having sex without a condom with a person who has HIV.

A person with HIV can pass the virus to others whether or not they have any symptoms. People with HIV are more infectious in the weeks following infection.

HIV treatment significantly reduces the risk of someone with HIV passing it on.

Sexual contact

According to Public Health England, 95% of people diagnosed with HIV in the UK in 2011 acquired HIV through sexual contact.

The main routes of transmission are unprotected vaginal and anal sex. It is also possible to catch HIV through unprotected oral sex, but the risk is much lower.

The risk of HIV transmission through oral sex will be higher if the person giving oral sex has mouth ulcers, sores or bleeding gums and/or if the person receiving oral sex has been recently infected with HIV (and has a lot of the virus in their body) or another sexually transmitted infection.

The type of sex also makes a difference to the level of risk:

  • performing oral sex on a man with HIV carries some risk, particularly if he ejaculates (comes) in your mouth
  • it is possible to catch HIV by performing oral sex on a woman with HIV, particularly if she is having a period, although this is considered to be extremely low risk
  • receiving oral sex from someone who has HIV is also extremely low risk as HIV is not transmitted through saliva

Other risk behaviours

Other ways of getting HIV include:

  • sharing needles, syringes and other injecting equipment 
  • from mother to baby before or during birth or by breastfeeding
  • sharing sex toys with someone infected with HIV
  • healthcare workers accidentally pricking themselves with an infected needle (this risk is extremely low)
  • blood transfusion (now very rare in the UK, but still a problem in developing countries)

How is HIV transmitted

HIV is not passed on easily from one person to another. The virus does not spread through the air like cold and flu viruses.

HIV lives in the blood and in some body fluids. To get HIV, one of these fluids from someone with HIV has to get into your blood.

The body fluids that contain enough HIV to infect someone are:

  • semen
  • vaginal fluids, including menstrual blood
  • breast milk
  • blood
  • lining inside the anus

Other body fluids, like saliva, sweat or urine, do not contain enough of the virus to infect another person.

The main ways the virus enters the bloodstream are: 

  • by injecting into the bloodstream (with a contaminated needle or injecting equipment)
  • through the thin lining on or inside the anus and genitals
  • through the thin lining of the mouth and eyes
  • via cuts and sores in the skin

HIV is not passed on through:

  • kissing
  • spitting
  • being bitten
  • contact with unbroken, healthy skin
  • being sneezed on
  • sharing baths, towels or cutlery
  • using the same toilets or swimming pools
  • mouth-to-mouth resuscitation
  • contact with animals or insects such as mosquitoes

How HIV infects the body

HIV infects cells of the immune system, the body’s defence system, causing progressive damage and eventually making it unable to fight off infections.

The virus enters cells in the immune system called CD4 cells + ve lymphocyte cells, which protect the body against various bacteria, viruses and other germs.

It uses the CD4 cells to make thousands of copies of itself. These copies then leave the CD4 cells, killing them in the process.

This process continues until eventually the number of CD4 cells, also called your CD4 count, drops so low that your immune system stops working.

This can take about 10 years, during which time you will feel and appear well.

Who is most at risk?

People who are at higher risk of becoming infected with HIV include:

  • men who have had unprotected sex with men
  • women who have had sex without a condom with men who have sex with men
  • people who have had sex without a condom with a person who has lived or travelled in Africa
  • people who inject drugs
  • people who have had sex without a condom with somebody who has injected drugs
  • people who have caught another sexually transmitted infection
  • people who have received a blood transfusion while in Africa, eastern Europe, the countries of the former Soviet Union, Asia or central and southern America

Treating HIV 

There is no cure for HIV, but there are treatments to enable most people with the virus to live a long and healthy life.

Emergency HIV drugs

If you think you have been exposed to the virus within the last 72 hours (three days), anti-HIV medication may stop you becoming infected.

For it to be effective, the medication, called post-exposure prophylaxis or PEP, must be started within 72 hours of coming into contact with the virus. It is only recommended following higher risk exposure, particularly where the sexual partner is known to be positive.

The quicker PEP is started the better, ideally within hours of coming into contact with HIV. The longer the wait, the less chance of it being effective.

PEP has been misleadingly popularised as a “morning-after pill” for HIV – a reference to the emergency pill women can take to prevent getting pregnant after having unprotected sex.

But the description is not accurate. PEP is a month-long treatment, which may have serious side effects and is not guaranteed to work. The treatment involves taking the same drugs prescribed to people who have tested positive for HIV.

You should be able to get PEP from:

  • sexual health clinics, or genitourinary medicine (GUM) clinics
  • hospitals – usually accident and emergency (A&E) departments

If you already have HIV, try your HIV clinic if the PEP is for someone you’ve had sex with.


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HUGE thanks to  The  NHS