At Freddie, we want to give everyone the tools they need to have safer sex. That means friendly, judgment-free information about taking care of your health – including HIV and STIs. Read on for our guide to HIV/AIDS.
What are HIV and AIDS?
HIV is short for Human Immuno-deficiency Virus. It’s a virus that affects the body’s immune system, making someone more vulnerable to illness and disease.
If HIV is left untreated, it can progress to AIDS. AIDS is short for Acquired Immuno-Deficiency Syndrome. AIDS is not the name of a virus or infection, but it refers to what happens when HIV has damaged someone’s immune system so much that they are experiencing severe illness. Without treatment, AIDS is fatal.
There is currently no cure for HIV. However, modern HIV treatment is very effective at controlling the virus in someone’s body. It can stop HIV from progressing to AIDS and can effectively treat AIDS in people with severe immune dysfunction (however, they will still be living with HIV).
HIV treatment is so effective that someone today who is diagnosed and starts on treatment early can live just as long as an HIV-negative person. HIV treatment can also prevent the transmission of HIV through sex when the virus is suppressed in their body – this is known as undetectable.
What are the symptoms of HIV and AIDS?
Many people with HIV will not have symptoms. In some people, they may have symptoms within the first few weeks after infection. Symptoms include:
- Fever
- Chills
- Headache
- Fatigue
- Muscle aches
- Sore throat
- Swollen lymph nodes (neck, armpit and/or groin)
- Rash
- Weight loss
- Night sweats
These early HIV symptoms will usually resolve on their own. However, HIV is still present in someone’s body.
AIDS symptoms
It can be many years before someone living with HIV progresses to AIDS. An AIDS diagnosis can be made when someone has a very low T cell count, which refers to the amount of a certain type of white blood cell in their system. A low T cell count shows that the immune system is very damaged.
An AIDS diagnosis can also be made if someone has a certain type of infection (or infections) that relate to a weakened immune system. These include Kaposi’s sarcoma (a rare cancer) and pneumocystis pneumonia (a type of lung infection).
Symptoms of severe immune weakness can include:
- Sores in the mouth, genitals or anus
- New rashes
- Bruises or bleeding
- Memory problems
- Fever, chills or night sweats
- Weight loss
How is HIV transmitted?
HIV is transmitted when an infectious bodily fluid gets into the bloodstream of another person. Bodily fluids that can transmit HIV include:
- Semen (including pre-cum)
- Blood
- Breast milk
- Vaginal fluid
- Anal fluid
These fluids need to get inside the bloodstream. This happens through mucous membranes (moist areas of the body like the anus or vagina), broken skin (open cuts or wounds) or contaminated tools that go inside the body (like needles).
Activities that can transmit HIV this way include:
- Condomless anal, vaginal or oral sex1
- Sharing equipment to inject drugs
- Tattoos, body piercings or medical procedures with unsterilized equipment
- Blood transfusions with un-tested blood2
1 HIV transmission through oral sex requires the presence of open wounds or sores in the mouth (e.g. from recent dental work). In normal cases, oral sex is low risk for HIV transmission. To learn more, check out our article on HIV and oral sex.
2 In developed countries like Canada and the United States, donated blood is rigorously tested for HIV and other infections.
How is HIV not transmitted?
HIV is not transmitted through bodily fluids like saliva or urine. You cannot transmit HIV through mutual masturbation, kissing, hugging, coughing or sneezing, and sharing drinks or food. You cannot get HIV if an infectious fluid like semen gets on unbroken skin (e.g. your hands).
What is undetectable?
When someone is living with HIV, the amount of the virus in their blood is measured by something called a “viral load”. When someone takes HIV treatment and it’s working properly, their viral load can become so low that it wouldn’t be picked up by most kinds of HIV test. This state is known as “undetectable”.
When someone has an undetectable viral load they cannot pass on HIV through sex. The risk isn’t low or very low – it’s zero. This is great news for people living with HIV and their partners!
Reaching undetectable also has benefits for someone’s long-term health. The sooner the virus is suppressed through treatment, the better these benefits are. It can reduce the risk of other health conditions that can come when someone has been living with HIV for a long time.
What should I do if I’ve been exposed to HIV?
If someone you have had sex with lets you know they are living with HIV, your level of risk varies depending on a few factors. You won’t need to worry if:
- Your partner is undetectable or
- You are on PrEP or
- You used a condom correctly and it did not break
Using a condom correctly means using it for the entire time you were having sex. Condoms should also be used with silicone-based or water-based lube, especially for anal sex. Oil-based lube or lube alternatives (like vaseline or coconut oil) are not compatible with condoms – this can degrade them and make them ineffective, which poses a risk for HIV transmission.
HIV PEP
If it has been less than 72 hours since your HIV exposure, you can take HIV PEP. HIV PEP is short for HIV Post-Exposure Prophylaxis. It is where you take a course of medications to prevent HIV from establishing an infection in your body. The sooner you start HIV PEP after your exposure, the more effective it is. It must be started within 72 hours.
You can usually get HIV PEP from sexual health clinics, some specialist pharmacies and emergency departments. It is best to call ahead to confirm, because PEP is time-sensitive.
How do I get tested for HIV?
HIV testing is available at sexual health clinics, public health clinics, family doctors, and community health centres. Some community organizations run pop-up HIV testing events at gay bars and sex venues like bathhouses.
There are different ways to test for HIV. These are:
- Lab test – Blood is taken from your arm and sent to a laboratory for testing. Your clinic will reach out if there is a positive result. Some clinics will not reach out if the result is negative, but others may notify you.
- Dried blood spot test – This is a less common type of lab test. You drop a small amount of your blood from your finger onto a piece of card that is then sent to a laboratory for testing. Your clinic will reach out if there is a positive result, but may not reach out if it is negative.
- Rapid blood test – These take some drops of blood from your finger and use a testing device to give you your result in a few minutes. The length of time can vary depending on what model is used. These tests are administered by a clinician or trained community worker.
- Rapid oral test – You take a swab from your gums and use a testing device to give you results in around 20 minutes. You can perform these tests yourself.
What are window periods?
For an HIV test to be accurate, you need to be outside the window period. The window period refers to the time between getting HIV and when it would produce a positive test result. This can be up to three months, depending on the type of test used. If you have a negative result within three months after a potential exposure, it’s recommended to re-test again after three months has passed to confirm the result.
Treatments for HIV
Treatment for HIV has come a long way since the 1980s! Today’s treatments have fewer side effects and involve fewer medications. It can be as simple as one daily pill, or even an injection every one or two months.
HIV cannot be cured, so someone living with HIV must be on treatment for life. There’s a whole bunch of benefits to starting treatment early and staying on track with it – it can keep you healthy, minimise the risk of other health conditions, and prevent transmitting HIV to your partners through sex.
How do I prevent HIV?
When it comes to preventing HIV, there are multiple options depending on your HIV risk factors and your personal preferences. These include:
- PrEP – medication an HIV-negative person takes to prevent getting HIV
- Condoms
- HIV treatment – if an HIV-positive person becomes undetectable, they can’t pass on HIV
- Not sharing equipment to inject drugs
- Only getting tattoos and piercings from licensed, professional providers
Regular HIV testing is also a great way to prevent HIV. By knowing your HIV status you can make informed decisions for you and your partners about what safer sex strategies you use!
