HIV and AIDS
HIV is a virus that settles into the cells of the immune system and wears it down from the inside over years, giving almost no warning.
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Medicines commonly prescribed for HIV and AIDS
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 600 mg/300 mgActive substance: lamivudine and abacavirManufacturer: Macleods Pharma Espana S.L.U.Prescription requiredDosage form: TABLET, 600 mg/200 mg/245 mgActive substance: emtricitabine, tenofovir disoproxil and efavirenzManufacturer: Glenmark Arzneimittel GmbhPrescription requiredDosage form: TABLET, 200 mg/245 mgActive substance: tenofovir disoproxil and emtricitabineManufacturer: Glenmark Arzneimittel GmbhPrescription required
HIV is a virus that settles into the cells of the immune system and wears it down from the inside over years, giving almost no warning. We still cannot clear it from the body, but in four decades the conversation has moved from survival to ordinary life: one tablet a day holds the virus down so reliably that a person with HIV lives as long as anyone else and does not pass the virus to a partner. AIDS is not a separate illness but the name for the late stage reached by people who never learnt their diagnosis or were left without treatment. When treatment starts in good time, that stage simply does not arrive.
If the risk happened in the last 72 hours
This is the one part of the page that cannot wait until tomorrow. Post-exposure prophylaxis (PEP) is a course of antiretroviral medicines lasting about four weeks. It only works if it is started within the first 72 hours, and the sooner the better: the difference between two hours and two days is real.
It is worth asking for it if:
- you had sex without a condom, or the condom broke, and the other person's status is unknown or they have HIV with a detectable viral load;
- you used someone else's needle or syringe, or a shared drug solution;
- you have been sexually assaulted;
- you work in healthcare and have had a needlestick injury from a used needle.
Go where urgent care is available: a hospital emergency department, an infectious diseases service, or a clinic dealing with sexually transmitted infections. The route differs from country to country, but the principle is the same — the same day, not an appointment later in the week. If the 72 hours have already passed, prophylaxis will not help, but testing is still essential.
How the virus travels, and how it does not
The virus lives in blood, semen, pre-ejaculate, vaginal and rectal fluids and breast milk. Saliva, sweat, tears and urine do not carry enough of it to infect anyone. That single fact explains the whole list of routes:
- sex without a condom — anal sex carries the greatest risk, vaginal sex less, oral sex little but not none if there are sores in the mouth or bleeding gums;
- shared needles, syringes, filters, spoons and the liquids used to prepare drugs;
- sex toys passed from one person to another without a condom or cleaning;
- passing to a baby in pregnancy, at birth or through breastfeeding, if the mother is not on treatment.
What there is no reason to fear: handshakes, hugs, kisses, shared crockery and towels, lavatory seats, swimming pools, coughs and sneezes, mosquito bites. Living and working alongside someone with HIV is safe, and they do not need a separate cup. Donated blood is screened everywhere, so the risk from a transfusion today is vanishingly small.
Testing on a schedule rather than once in a lifetime makes sense for anyone whose partner has HIV, who changes partners, who has sex with men, who injects drugs, who does sex work, or who has recently had another sexually transmitted infection. That is a list of situations, not of reproaches.
The first weeks, and the quiet years that follow
Two to six weeks after the virus arrives, roughly half of people have a short flu-like illness: fever, sore throat, swollen glands in the neck, a rash on the trunk, aching muscles, sometimes mouth ulcers and loose stools. It clears on its own within a week or two, and that is the trap — the episode gets put down to a cold. Yet this is exactly when there is most virus in the blood and the chance of passing it on is at its highest.
Then comes a long silence. People feel well for an average of eight to ten years while their immune defences quietly drain away. Symptoms are therefore a poor way of finding out about HIV, and most late diagnoses are made in people who had no complaints at all.
The late stage announces itself when the body stops coping with the ordinary: a low fever that lasts months, weight falling away, night sweats, stubborn thrush in the mouth and on swallowing, prolonged diarrhoea, shingles, tuberculosis, a dry cough with growing breathlessness. Tumours appear that are rare in people with intact immunity — Kaposi's sarcoma and lymphomas.
Do not wait for an appointment but call an ambulance (in Europe, 112) for breathlessness at rest, confusion, seizures, a severe headache with vomiting and a stiff neck, or an inability to swallow. These point to conditions that unfold over hours.
A test is the only way to know
The laboratory blood test taken from a vein looks for antibodies and for a protein of the virus itself at the same time. It picks up most infections about four to six weeks after the risk; to rule out a recent exposure with confidence it is repeated at around three months. A rapid test on a drop of blood from the finger or a swab of the gums answers in minutes, but its blind window is longer.
Self-test kits are useful if bought from a pharmacy or a trusted supplier: seal unbroken, expiry date valid, and the kit genuinely intended for self-testing. And the crucial point — a positive self-test is not yet a diagnosis, it is a reason to have blood drawn in a laboratory. False positives do happen, and people sometimes spend a week carrying a diagnosis that turns out not to be theirs.
A negative result taken too early guarantees nothing either, so it is repeated. A positive one is confirmed by a second test, after which viral load and the CD4 count are measured: together they show how much virus is in the blood and how far the immune system has been damaged. Pregnant women are offered the test as part of routine antenatal care, and it is not one to decline — it is precisely what allows the baby to be protected.
Treatment, and what an undetectable viral load means
HIV is treated with antiretroviral therapy, a combination of several medicines that now usually fits into one tablet a day; long-acting injectable forms also exist. Treatment begins as soon as the diagnosis is confirmed, without waiting for the immune count to fall.
The aim is to bring the amount of virus in the blood below the level any instrument can measure. That normally takes three to six months. And here is the fact of recent years that is still slow to spread: a person with a steadily undetectable viral load does not pass the virus on sexually. This is not a softened phrase or a matter of reduced risk — large studies of thousands of couples recorded not a single transmission. Hence the rule usually put as "undetectable equals untransmittable".
There is one condition: the tablet, every day. Missed doses let the virus return and develop resistance, and resistance narrows the choice of regimens for years ahead. Modern combinations are tolerated well, and if something does not suit — nausea, poor sleep, changes in blood tests — the regimen is changed rather than endured. Tell the doctor about any other medicines and supplements: St John's wort and some indigestion remedies weaken the treatment.
Protection before the risk arrives
The condom remains the simplest measure and the only one that also protects against other sexually transmitted infections. Use it with a water-based or silicone-based lubricant: petroleum jelly, creams and oils damage latex. For oral sex there are thin latex squares that are placed between the mouth and the partner.
The second measure is recent and has changed the picture. Pre-exposure prophylaxis (PrEP) is medication taken by an HIV-negative person at high risk, either continuously or on a schedule around expected sex. Taken properly it protects extremely well. A doctor prescribes it: before starting, HIV has to be excluded and kidney function checked, and reviews follow. It does not protect against other infections or against pregnancy, and it does not replace a condom.
For anyone injecting drugs, one plain rule helps: own syringe, own needle, own filter, own spoon, nothing shared. Where needle exchange programmes operate, spread of the virus falls sharply. And finally, treatment is prevention too: if a partner with HIV is on therapy with an undetectable load, you are safe.
Pregnancy, birth and feeding
A woman with HIV can have a healthy baby, and in the great majority of cases she does. With treatment started in good time and an undetectable viral load, the chance of passing the virus on falls to a fraction of a per cent; without treatment it runs into tens of per cent. The gap between those two figures is what a single blood test at the booking appointment is worth.
Treatment continues throughout pregnancy, viral load is monitored, and closer to term the mode of birth is decided: with an undetectable load vaginal birth is possible, with a high load a caesarean is discussed. The baby is given a preventive medicine over the first weeks and has blood taken several times. An ordinary antibody test is useless in an infant, because the mother's antibodies persist in the baby's blood for up to eighteen months, so the virus itself is looked for instead.
Feeding is discussed in advance. With a steadily undetectable load the risk is very low but, unlike the sexual route, not zero, so where formula and clean water are easily available formula is usually advised.
Online consultation
Conversations about HIV get postponed out of embarrassment, and remote care helps here more than in most subjects: asking is easier when you need not meet anyone's eye in a corridor. Online, a doctor will go through your particular situation and say whether there really was a risk, advise which test you need and when to take it, read a result you already have and explain what viral load and CD4 mean. The same appointment can cover pre-exposure prophylaxis, side effects and how the treatment interacts with other medicines, questions about pregnancy, how to talk to a partner, and how medical confidentiality works. Two exceptions are worth remembering: if the risk was within the last 72 hours, do not wait for a consultation — go straight for post-exposure prophylaxis; and if breathlessness, confusion or a headache with vomiting and a stiff neck appear, call an ambulance.
This material is for information only and does not replace medical advice.
Consult with a doctor about HIV and AIDS
Discuss your symptoms and possible next steps with a doctor online.
Online doctors for HIV and AIDS
Discuss your symptoms and possible next steps for HIV and AIDS with a doctor online.
