HIV/AIDS

Symptoms

Early in HIV infection, you may have no symptoms. But if the infection is not treated and the immune system gets weak, you will start to have symptoms. These might include:

• Yeast infections and sores in the mouth.

• Fevers.

• Diarrhea.

• Vision changes.

• Headaches.

• Loss of or altered feeling in the hands or feet.

• Many different infections with germs that live in the soil, cat litter, or water .

• Rashes or other skin lesions.

Women may get repeat or lasting yeast infections, a pelvic infection, or an abnormal Pap test.

It can take years for an HIV infection to become AIDS. AIDS is diagnosed when an illness occurs that would rarely happen in a person with a normal immune system. These health problems include PCP (pneumocystis pneumonia), lymphoma, tuberculosis, and Kaposi's sarcoma. AIDS may also be diagnosed if a certain lab test that measures the strength of the immune system (the CD4 T cell count) is very low (less than 200).

If you have a positive HIV test, you can spread the virus to others unless you are taking medicines and completely controlling the HIV infection. This means it'smeasured as an "undetectable" viral load in your blood. This is true even if you do not have any symptoms of HIV or AIDS. HIV is most often transmitted by sexual contact (through semen, rectal or vaginal fluid, or blood) or by sharing needles or syringes during IV drug use. Ordinary, nonsexual contact with other people doesn't transmit the disease.

Without treatment, HIV almost always progresses to AIDS. But now once daily medicines can stop the the virus from duplicating. This prevents infections and allows the body to heal.. Medicines do not cure HIV infection. But they have made it possible for people with HIV to live a normal life span if taken as prescribed. They have also made it possible for HIV+ people to have sexual relations without infecting other people.

In the past, medicine therapy for HIV was started based on 3 factors:

• The amount of virus in your blood (called viral load)

• Your CD4 cell count (a measure of the immune system)

• Your symptoms

But now health care providers know that an untreated HIV infection progressively harms the body. Even from the first days of infection, it can be spread to others by contact with blood, semen, or vaginal or rectal fluids. Also, the higher your CD4 count is when you start treatment, the higher it will stay. This is better for your health. So it is now advised worldwide that in almost all cases treatment be started as soon as possible after HIV is diagnosed. It is critical that people with HIV be diagnosed and begin treatment as soon as possible after getting the infection.

Home care

• If you have been recently diagnosed with HIV, the news can be a shock. Counseling and group support may help you understand your feelings and deal with anxiety and depression, if they occur. Ask for help. A support system is vital for your physical and mental health.

• Develop a take-charge attitude about your own health. Learn the facts about HIV/AIDS. Learn ways to make your immune system stronger through diet, exercise, and stress management.

• Talk to your provider about the medicines used to treat your condition. Also ask about other ways to stay healthy with HIV and prevent complications. Become a participant in your health care. This will help you feel more in control of your health and your life. It will also help you stay healthier.

Preventing the spread of HIV

• It's very important to be tested and diagnosed as early as possible if you think you may have HIV. Then you can take charge of the infection before it hurts you and before it can spread to others.

• Start on HIV therapy (antiretroviral combination therapy) as soon as possible. Take the medicine every day. Get your viral load to "undetectable" and keep it that way. This is the single most important way to prevent the spread of HIV to others. 

• Tell your current and recent sexual contacts about your diagnosis so that they can be tested. For testing, your partners should contact their providers or the public health department. Note: You don't need to do this alone. County health departments can help find sexual or drug-injection partners to let them know of their HIV exposure risk. Health departments can also provide partners with testing, counseling, and resource referrals. Your name will not be revealed unless you want it to be.

• Learn about safer-sex practices and use them. This is most important if the virus is detectable in your blood. If the virus is present, you are contagious. The higher the viral load, the more contagious you are. Use protection for at least the first 6 months you are on antiretroviral medicine or if you are not taking your antiretroviral medicines consistently. Your provider may advise still using safe sex practices even longer than 6 months after the viral load is undetectable. This can help prevent other sexually transmitted infections. Some people also feel more comfortable using protection even if their partner's viral load is undetectable. Be especially wary about not following safe sex practices if your partner is new or if you don't know for certain whether their viral load is undetectable for months and whether they are taking antiretrovirals every day. 

• Tell any future sexual partners of your HIV status.

• HIV is spread through semen, blood, vaginal fluids, rectal fluids, and breast milk. So make sure your partners use "protection" and reduce contact with these body fluids.

• Not having sexual contact is the best way to prevent the spread of HIV. If that's not your choice, follow the guidance elsewhere in this section.

• Latex barriers, such as condoms, offer protection from spreading HIV, if they are used the right way. But they are not a guarantee against transmission. Never use nonlatex barrier methods.

• IUDs, oral or injectable contraceptives, vasectomy, or tubal litigation (having "your tubes tied") do not prevent spread of HIV infection.

• Never share drug-injection equipment. Blood can stay in needles and syringes and spread HIV.

• Never share items that may have your blood on them, such as toothbrushes or razors.

• If you are pregnant or want to become pregnant, talk to your provider as soon as possible. HIV can spread to a baby during pregnancy, labor, breastfeeding, or if the parent pre-chews the baby’s food. Your provider can tell you about ways to lower the risk of transmitting HIV to your baby.

• Finally, talk to your provider about HIV PEP and PrEP if you have had or plan to have unprotected sex with someone who may have an HIV infection or is of unknown HIV status to you. These are other methods that can be used to prevent HIV infection. PEP is antiretroviral medicine taken within 36 to 72 hours after a potentially risky contact. PrEP is antiretroviral medicine taken to prevent the disease.

Follow-up care

Follow up with your provider, or as advised. You will need routine blood testing to check the strength of your immune system. If you are HIV positive without symptoms, watch for the symptoms of HIV disease listed above. Contact your provider if these appear. The following websites offer more information:

• Centers for Disease Control and Prevention website on HIV, www.cdc.gov/hiv/

• HIV.gov website, www.hiv.gov/hiv-basics

If X-rays were taken, a specialist will review them. You'll be told of any findings that may affect your care.

When to contact your doctor

Contact your health care provider or get medical care right away if:

• You have a fever of 100.4ºF (38ºC) or higher, or as advised by your provider.

• You have a lasting cough.

• There's a painful, burning rash on a side of your body.

• You have white spots in your mouth.

• You have vaginal discharge or lower belly pain.

• You have problems with your eyesight.

• You are extremely weak, fatigued, or have unexplained weight loss.

• There are spots on your skin that aren't going away.

Call 911

Call 911 if:

• You are coughing up blood.

• You are short of breath or have trouble breathing.

• You have a severe headache or stiff neck.