HIV is a virus that attacks the immune system, our body’s natural defense against illness. If HIV is left untreated, a person’s immune system will get weaker and weaker until it can no longer fight off life-threatening infections and diseases.
Natural History of HIV infection
The typical course of HIV infection can be described in three phases:
- Primary infection -1 to 3 months after HIV virus enter the body
- Clinical latency – on average 8 to 10 years, without antiretroviral treatment
- Late-stage – Acquired immune deficiency syndrome (AIDS)
If HIV is left untreated, it may take up to 10 or 15 years for the immune system to be so severely damaged that it can no longer defend itself at all. However, the rate at which HIV progresses varies depending on age, general health, and background.
HIV Transmission and Prevention
How can you get HIV?
HIV is found in the following bodily fluids of someone living with the virus:
- semen and pre-seminal fluid (‘pre-cum’)
- rectal fluids/anal mucous
- vaginal fluids
For you to get HIV, these bodily fluids need to get into your blood through a mucous membrane (for example, the lining of the vagina, rectum, or the opening of the penis), via shared injecting equipment, or through broken skin (such as cuts or sores in the mouth or tears around the anus).
The main ways you can get HIV are:
- Sex without a condom
- having unprotected sex (meaning sex without a condom, if you are not taking PrEP) with someone who has HIV, particularly unprotected vaginal sex and anal sex.
- Sharing injecting equipment
- sharing needles, syringes or other equipment used to prepare and inject drugs with someone who has HIV.
- Passed from mother-to-baby during pregnancy, childbirth, and breastfeeding
- a mother infected with HIV can pass the virus to her baby via her blood during pregnancy and birth, and through her breast milk when breastfeeding.
- Contaminated blood transfusions and organ/tissue transplants
- receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This risk is minimal because most countries test blood products for HIV first.
If adequate safety practices are not in place, healthcare workers can also be at risk of HIV from cuts made by a needle or sharp object (needlestick injury) with infected blood on it. However, the risk of ‘occupational exposure’, is very low in most countries.
How can’t you get HIV?
There are many myths about HIV. Some people wrongly believe that HIV can be spread through the air (even though HIV can’t survive in air). HIV can’t be spread through saliva, casual contact, touching toilet seats or from mosquito bites either.
How to prevent from HIV infection?
There are a number of ways you can protect yourself from HIV, including:
- using a condom every time you have vaginal, anal or oral sex
- in some countries PrEP is available. This is a course of HIV drugs which if taken consistently as advised by your healthcare professional prevents HIV infection through sex
- avoiding sharing needles, syringes and other injecting equipment
- taking HIV treatment if you are a new or expectant mother living with HIV, as this will dramatically reduce the risk of passing HIV to your baby during pregnancy, childbirth, and breastfeeding
- asking your healthcare professional if the blood product you are receiving (blood transfusion, organ or tissue transplant) has been tested for HIV
- taking precautions if you are a healthcare worker, such as wearing protection (like gloves and goggles), washing hands after contact with blood and other bodily fluids, and safely disposing of sharp equipment
- if you think you have been exposed to HIV you may be able to access PEP, a 4-week course of ARV drugs taken after possible HIV exposure to prevent HIV infection. You must start PEP within 72 hours of possible exposure to be effective.