Frequently Asked Questions (FAQ) About HIV and AIDS (With Reference Citations)

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Quick Reference Index of Questions and Answers

Do I Have HIV/AIDS? Personal Counseling and Medical Attention

I may have been exposed to HIV. What should I do?

See a doctor. Explain your sexual history, risk factors for HIV (such as unprotected sex, needle sharing, etc.), and any symptoms. Ask to be tested for HIV, and follow any instructions the doctor gives you (such as follow-up testing at a later date).

I had sex with a sex worker. What's the risk I have contracted HIV?
I had sex with a person who's HIV positive. What's the risk I have contracted HIV?
I had sex with a person and I don't know their HIV status. What's the risk I have contracted HIV?

It's impossible to precisely estimate the risk that a particular person is HIV positive. See our video "What's the Risk That I Have Contracted HIV?" See a doctor, describe your sexual history and risk factors for HIV, get tested for HIV, and follow any instructions the doctor gives you (like follow-up testing). Watch our videos Did I Just Contract HIV? Symptoms of Primary HIV Infection and "Why EVERY Person Should Be Tested for HIV." Go to AIDSvideos dot org and click "Risk" to learn more.

(The "Risk"  link takes you to the standard response we send to people who email us asking the risk that they have HIV.)

I have some symptoms like swollen lymph nodes, night sweats, etc. What's the risk I have HIV/AIDS?

No one can diagnose anything over the Internet. Anyone with symptoms that are persistent, severe, or possible indicators of a serious condition should see a doctor. Describe your sexual history and risk factors for HIV, get tested for HIV, and follow any instructions the doctor gives you (like follow-up testing). Watch our videos "Do I Have AIDS? Symptoms of AIDS" and "Why EVERY Person Should Be Tested for HIV." Go to AIDSvideos dot org and click "Symptoms" to learn more.

(The "Symptoms" link takes you to the standard response we send to people who email us asking whether they are having symptoms of HIV/AIDS.)

How soon after exposure to HIV could I show symptoms of primary HIV infection?

Not everyone who contracts HIV experiences symptoms of primary HIV infection. When they do, it's "usually 2 to 6 weeks after becoming infected with HIV." ["Primary HIV Infection" article at TheBody dot com] I'm not sure what is the soonest that an individual could possibly experience symptoms of primary HIV infection; that's probably difficult to impossible to answer.

What are some hotlines I can call to get answers to my questions?

United States: CDC National Prevention Information Network

Can AIDSvideos.org and/or Dr. Becky Kuhn provide me personal medical advice over the Internet?
I live in a place where it's hard to get to the doctor. Can AIDSvideos.org and/or Dr. Becky Kuhn provide me personal medical advice over the Internet?

No. Neither AIDSvideos.org nor Dr. Kuhn provide a hotline or Internet Q&A service. No one can diagnose conditions or provide personal medical advice over the Internet. For personal medical advice, make an appointment with a medical doctor and be examined. To get answers to your questions, call the CDC National Prevention Information Network hotline.

Definition of AIDS

What is the definition of AIDS for an adult or child 13 or older?

From NIAID "Evidence that HIV Causes AIDS:" The CDC "defines AIDS in an adult or adolescent age 13 years or older as the presence of one of 26 conditions indicative of severe immunosuppression associated with HIV infection, such as Pneumocystis carinii pneumonia (PCP), a condition extraordinarily rare in people without HIV infection .... A diagnosis of AIDS also is given to HIV-infected individuals when their CD4+ T-cell count falls below 200 cells/cubic millimeter (mm3) of blood."

What is the definition of AIDS for a child younger than 13?

From NIAID Evidence that HIV Causes AIDS:" "In HIV-infected children younger than 13 years, the CDC definition of AIDS is similar to that in adolescents and adults, except for the addition of certain infections commonly seen in pediatric patients with HIV."

Are other definitions used elsewhere? Why?

From NIAID: "In many developing countries, where diagnostic facilities may be minimal, healthcare workers use a .... [WHO] AIDS case definition based on the presence of clinical signs associated with immune deficiency and the exclusion of other known causes of immunosuppression .... An expanded WHO AIDS case definition, with a broader spectrum of clinical manifestations ... is employed in settings where HIV antibody tests are available (WHO. Wkly Epidemiol Rec. 1994;69:273)."

Origin of HIV

When did HIV-1 originate?

"[A]nalysis of the molecular divergence of SIV and HIV genes .... establishes 1931 as the date of origin of the HIV-1 M-group viruses (the principal cause of the AIDS pandemic)." [David Hillis, "AIDS: Origins of HIV," Science 9 June 2000, v288, #5472, p1757-1759. See also Korber et al, "Timing the Ancestor of the HIV-1 Pandemic Strains," Science 9 June 2000, v288, #5472, p1789-1796.]

(Sources: http://www.sciencemag.org/cgi/content/summary/288/5472/1757 and http://www.sciencemag.org/cgi/content/short/288/5472/1789)

Where did HIV-1 come from?

HIV-1 jumped to humans from the related SIV in chimpanzees. [Reeves JD, Doms RW. "Human immunodeficiency virus type 2." J Gen Virol. 2002 Jun;83(Pt 6):1253-65.]

Where did HIV-2 come from?

HIV-2 jumped to humans from the related SIV in the sooty mangabey monkey. [Reeves JD, Doms RW. "Human immunodeficiency virus type 2." J Gen Virol. 2002 Jun;83(Pt 6):1253-65.]

How did HIV jump from primates to humans?

The most likely explanation is that a hunter in the bush meat trade (in which wild animals are killed for food) probably contracted SIV from a primate he killed. For example, if the hunter had an open cut and chimpanzee blood with SIV got on the cut, that would be blood-to-blood contact enabling contagion. The SIV then evolved into HIV-1.

Since SIV has existed for a long time, why did HIV-1 only jump to humans in 1931?

You could ask the same question about why H5-N1 bird flu, SARS, or Ebola infected humans recently. Viruses evolve in animals & humans all the time. It's impossible to say for sure why a virus jumps to humans at a particular moment and why it does/doesn't become permanently established within the human population. It may have mutated making it more capable of infecting humans, or humans may have had increased contact with source animals due to population growth, and travel may help it spread.

HIV Transmission

Can I contract HIV through oral sex?
Can I contract HIV through performing oral sex on a man?
Can a man contract HIV by receiving oral sex?
Can HIV be transmitted through oral sex if a condom is used?

"Yes, it is possible for either partner to become infected with HIV through performing or receiving oral sex. There have been a few cases of HIV transmission from performing oral sex on a person infected with HIV .... Studies have shown that latex condoms are very effective, though not perfect, in preventing HIV transmission when used correctly and consistently." [CDC, "Can I get HIV from oral sex?"] See our video "Some Ways You Can Contract HIV and the Risk of Each One" for details.

Can I contract HIV by performing oral sex on a woman?
Can a woman contract HIV by receiving oral sex?

Yes. "The risk of HIV transmission during cunnilingus is extremely low compared to vaginal and anal sex. However, there have been a few cases of HIV transmission most likely resulting from oral-vaginal sex." [CDC, Preventing the Sexual Transmission of HIV, the Virus that Causes AIDS: What You Should Know about Oral Sex]

Can HIV be spread through heterosexual sex?

Yes. Either partner can contract HIV through heterosexual sex. This is true whether or not a condom is used. Condoms greatly reduce but do not eliminate the risk of HIV transmission. See our video "Some Ways You Can Contract HIV and the Risk of Each One" for details.

Can I contract HIV through vaginal sex?

Yes. Either partner can contract HIV through vaginal sex. This is true whether or not a condom is used. Condoms greatly reduce but do not eliminate the risk of HIV transmission. See our video "Some Ways You Can Contract HIV and the Risk of Each One" for details.

Can I contract HIV through anal sex?

Yes. Either partner can contract HIV through anal sex. This is true whether or not a condom is used. Condoms greatly reduce but do not eliminate the risk of HIV transmission. See our video "Some Ways You Can Contract HIV and the Risk of Each One" for details.

Can I contract HIV even if we use a condom?

Yes. Condoms, if used correctly and every time, GREATLY reduce your risk of contracting HIV and significantly reduce your risk of contracting other STDs as well, but they do not GUARANTEE you won't contract HIV or other STDs. So yes, there's a risk.

Can I contract HIV through masturbation?

No. HIV is a virus. You have to contract it through intimate exposure to a person who has been exposed to HIV or exposure to their bodily fluids like blood, semen, or vaginal secretions. You can't "give HIV to yourself" or "cause HIV to develop" through masturbation.

Can I contract HIV through sex with a person who tests "HIV negative" on an HIV test?

Yes, if they are in the "window period" soon after contracting HIV. After a person is exposed to HIV and becomes infected, there is a "window period" during which their body has not yet developed antibodies to HIV. If a person takes a typical HIV test during this "window period," they will receive a "false negative" test result of "HIV negative," but in reality they are infected with HIV, it is present in their bodily fluids, and they can infect others.

Can I contract HIV through sex with a person who hasn't been exposed to HIV?

No. HIV is a virus. You have to contract it through intimate exposure to a person who has been exposed to HIV or exposure to their bodily fluids like blood, semen, or vaginal secretions.

Can I contract HIV through eating food or drinking?

"There is no known risk of HIV transmission to co-workers, clients, or consumers from contact in industries such as food-service establishments" [CDC, "HIV and Its Transmission"]

Can I contract HIV by living in the same household as an HIV+ person?

Not through ordinary social contact. "Although HIV has been transmitted between family members in a household setting, this type of transmission is very rare. These transmissions are believed to have resulted from contact between skin or mucous membranes and infected blood .... [Precautions] should be taken .... to prevent exposures to the blood of persons who are HIV infected, at risk for HIV infection, or whose infection and risk status are unknown." [CDC, "HIV and Its Transmission"]

Can I contract HIV by sharing shaving razors or toothbrushes?

There is one documented case where HIV is believed to have been transmitted between brothers in the same household by sharing a shaving razor. "Practices that increase the likelihood of blood contact, such as sharing of razors and toothbrushes, should be avoided." [CDC, "HIV and Its Transmission"]

Can I contract HIV from light / social / closed-mouthed kissing?

"Casual contact through closed-mouth or "social" kissing is not a risk for transmission of HIV." [CDC, "HIV and Its Transmission"]

Can I contract HIV from deep / "french" / open-mouthed kissing?

"Because of the potential for contact with blood during "French" or open-mouth kissing, CDC recommends against engaging in this activity with a person known to be infected. However, the risk of acquiring HIV during open-mouth kissing is believed to be very low. CDC has investigated only one case of HIV infection that may be attributed to contact with blood during open-mouth kissing." [CDC, "HIV and Its Transmission"]

Can I contract HIV from insect bites?

"[S]tudies conducted by researchers at CDC and elsewhere have shown no evidence of HIV transmission from mosquitoes or any other insects--even in areas where there are many cases of AIDS and large populations of mosquitoes .... HIV lives for only a short time inside an insect ... the insect does not become infected and cannot transmit HIV to the next human it bites ...." [CDC, "HIV Transmission"]

Can I contract HIV from a toilet seat?

"Scientists and medical authorities agree that HIV does not survive well in the environment, making the possibility of environmental transmission remote .... drying of HIV-infected human blood or other body fluids reduces the theoretical risk of environmental transmission to that which has been observed--essentially zero .... no one has been identified as infected with HIV due to contact with an environmental surface." [CDC, "HIV and Its Transmission"]

HIV Testing

How accurate are HIV tests?

Testing is specific & accurate. "A large study of HIV testing in 752 U.S. laboratories reported a sensitivity of 99.7% and specificity of 98.5% .... and studies in U.S. blood donors reported specificities of 99.8% and greater than 99.99% (46, 47). With confirmatory Western blot, the chance of a false-positive identification in a low-prevalence setting is about 1 in 250 000 (95% CI, 1 in 173 000 to 1 in 379 000) (48)." [Chou et al, Annals of Internal Medicine, 5 July 05, vol 143, #1, p 55-73]

If I contract HIV, how soon after exposure will I test HIV positive on an HIV test?
How long is the "window period"?

On average, it takes 25 days for a person to develop antibodies to HIV that are detectable using the ELISA test. “Most people will develop detectable antibodies within 2 to 8 weeks .... Ninety-seven percent of persons will develop antibodies in the first 3 months following the time of their infection. In very rare cases, it can take up to 6 months to develop antibodies to HIV.” [CDC, "Deciding If and When to Be Tested"] See our video "The Top Ten Questions About HIV Tests" for more details.

What's the chance of a "false positive" result on an initial ELISA HIV Test?

If a person gets an ELISA test result of "HIV positive," there's a 98.5% chance that their test result is correct. The chance that it was a "false positive" result is 1.5%. [Chou et al, Annals of Internal Medicine, 5 July 05, vol 143, #1, p 55-73] See our video "The Top Ten Questions About HIV Tests" for more information.

What's the chance of getting a "false positive" result on both the initial ELISA and confirmatory Western Blot Test?

If a person gets an test result of "HIV positive" on the initial ELISA test AND the confirmatory Western Blot Test, there's a 99.9996% chance that their test result is correct. The chance of getting a "false positive" result on both tests is 0.0004%, or about 1 in 250,000. [Chou et al, Annals of Internal Medicine, 5 July 05, vol 143, #1, p 55-73] See our video "The Top Ten Questions About HIV Tests" for more information.

Where can I be tested for HIV?

In the U.S., go to hivtest dot org and type in your ZIP code to find a testing location. Elsewhere, visit your doctor, public health clinic, or STD testing center.

When I take an HIV test, how long does it take to get my result?

Oral tests for HIV can give you a result within as little as 20 minutes. See our video "The Top Ten Questions About HIV Tests" for more information.

To be tested for HIV, do I have to provide my real name?

No. In the U.S., some states allow "Anonymous Testing," which means you don't have to give any name. Other U.S. states require “Confidential, Name-Based Testing," which means that you have provide a name, but you don't have to give your real name. See our video "The Top Ten Questions About HIV Tests" for more information.

Can I take an HIV test at home?

Yes. You can buy a home-based test kit for HIV-1 (the most common strain of HIV outside of Africa) at any pharmacy in the U.S. and in many other countries as well. See our video "The Top Ten Questions About HIV Tests" for more information.

To be tested for HIV, do I have to give blood or be stuck with a needle?

Not for the first test. The first test is usually done today with a simple oral swab or a finger stick. If you test positive on the first test, you will need to give blood for the second test, which is a Western Blot. But you only have to give a little bit of blood. See our video "The Top Ten Questions About HIV Tests" for more information.

I tested HIV negative on my first HIV test, but I'm stressed out waiting until I can take a follow-up test to be SURE I'm HIV negative. What do I do?

It's understandable that you would feel stress while you wait for final confirmation of your HIV test status. If stress is causing you problems like difficulty concentrating on work or studies, difficulty sleeping, or depression, consider seeing a licensed mental health professional for counseling to help you manage the stress during this period. If you can't sleep, ask a doctor whether a prescription sleeping aid would be right to help you through this period. Regular exercise may also help.

If You're Diagnosed with HIV/AIDS

"If I'm diagnosed with HIV/AIDS, I'm going to kill myself!"

Don't kill yourself if you're diagnosed with HIV/AIDS! See our videos "Is HIV a Death Sentence?" and "'If I'm HIV Positive, I'm Going to Commit Suicide!' (Don't)" and "Personal Testimonial of Cory Norlund" for details. If people with HIV follow their doctor's instructions and take care of their general health, with a little luck they can live a normal lifespan and have good quality of life.

Rather than killing yourself if you test HIV+, how about you (1) discuss your concerns with your doctor, (2) follow their instructions, (3) get counseling from a licensed mental health provider to help you deal with the understandable stress of an HIV+ diagnosis, and (4) see how things go for a while, talk with trusted friends and family, and not make any drastic and irreversible decisions? Just take life one day at a time. If you feel suicidal now, go to the nearest emergency room right away.

HIV's Connection to AIDS

How do we know that HIV is the cause of AIDS?

Because HIV infection is a serious condition that is incurable and usually develops into clinical AIDS which is frequently fatal, it would not be ethical to perform an experiment where a person was deliberately, knowingly infected with HIV to demonstrate the progression to clinical AIDS. However, there are multiple independent lines of evidence proving that HIV is the cause of AIDS by other means. For full details with references, see "The Evidence That HIV Causes AIDS" and "The Relationship Between Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome" among many other sources. Here are a few quick summaries:

Course of the Disease in an Individual

Does everyone who contracts HIV develop clinical AIDS?

No. Some will die of other unrelated causes (e.g. a car accident) or natural causes before HIV progresses to clinical AIDS. Some have natural resistance to HIV that may greatly slow or totally prevent the progression from HIV to clinical AIDS. Some go on antiretroviral medication before their HIV disease meets the criteria for clinical AIDS and as a result never get the opportunistic infection or CD4 cell count that would lead to a diagnosis of clinical AIDS. However, all but a few HIV positive individuals progress to AIDS within 20 years. ["Course of HIV Infection", NIH, 1995]

How long does it take for HIV to progress to clinical AIDS?

From NIAID "Evidence:" "The median period of time between infection with HIV and the onset of clinically apparent disease is approximately 10 years in industrialized countries, according to prospective studies of homosexual men .... Similar estimates ... have been made for HIV-infected blood-transfusion recipients, injection-drug users and adult hemophiliacs." [Alcabes et al. Epidemiol Rev 1993;15:303] All but a few progress to AIDS within 20 years. ["Course of HIV Infection", NIH, 1995]

Why don't people infected with HIV immediately develop clinical AIDS?

HIV is only one of many viruses that produce an acute symptomatic infection, then may have a long period where the infected person experiences few no symptoms, then later in life develops symptoms again. Examples include: chicken pox, which causes an acute infection and then after decades without symptoms leads to shingles in about 1/7 of infected people; recurring oral herpex simplex ("cold sores') which may go a long time with no symptoms and then recur; etc.

The reasons for these asymptomatic periods can be completely different. The chicken pox virus (varicella-zoster virus) and herpes simplex virus type 1 remain dormant in the nerves and can reactivate causing localized shingles or cold sores respectively. HIV usually appears asymptomatic because the body's immune system is holding it at bay, generating new CD4 cells as fast as HIV kills them. When the body falls behind in this running battle, HIV can progress to clinical AIDS.

Treatment and Antiretroviral Medications (ARVs)

How long can a person who is HIV+ on ARVs remain healthy?

If a person who is on ARVs takes them exactly as prescribed, it appears that they may be able to prevent the progression from HIV+ to clinical AIDS indefinitely. (We don't know how long for sure since ARVs have only been in use since the 90s.) However, if they miss doses, it's likely that HIV will develop resistance to their ARVs and they'll need to change medications. So rigorous compliance is critical.

How long will a person who is HIV+ live?

It's impossible to accurately predict how long a particular HIV+ individual will live. It depends on their HIV strain(s), genetic makeup, treatment compliance, and general health. If an HIV+ person follows their doctor's instructions, takes any prescribed medications as directed, and takes care of their general nutrition, health, and sleep, they may be able to live a normal quality & quantity of life and die of natural causes.

Is there a cure for HIV?

There is no cure for HIV. Recently, a single HIV+ person who needed a bone marrow transplant for leukemia had his HIV put into "functional remission" by receiving a bone marrow transplant from a person who had a natural genetic resistance to HIV. However, this option is not appropriate as general therapy for HIV alone because of the risk of dying from a bone marrow transplant is generally higher than the risk of dying from HIV that's being managed correctly.

Course of the Pandemic

Why didn't an epidemic occur immediately after the first known HIV infections?

"HIV did not become epidemic until 20 to 30 years later [after known infection in 1959], perhaps because of the migration of poor and young sexually active individuals from rural areas to urban centers in developing countries, with subsequent return migration and, internationally, due to civil wars, tourism, business travel and the drug trade" (NIAID citing Quinn, "Population migration and the spread of types 1 and 2 human immunodeficiency viruses," Proc Natl Acad Sci USA 1994;91(7):2407-14.)

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