What if I Test HIV Positive?

If you test positive, the sooner you take steps to protect your health, the better. Early medical treatment, a healthy lifestyle and a positive attitude can help you stay well. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. It is important to know that a positive HIV test should always be confirmed, to be sure that it is a true positive. If your test result is positive, there are a number of important steps you can take immediately to protect your health:

• See a doctor, even if you don't feel sick. Try to find a doctor who has experience treating HIV. There are now many new drugs to treat HIV infection. There are important tests, immunizations and drug treatments that can help you maintain good health. It is never too early to start thinking about treatment possibilities.
• Have a tuberculosis (TB) test done. You may be infected with TB and not know it. Undetected TB can cause serious illness. TB can be treated successfully if detected early.
• Recreational drugs, alcoholic beverages and smoking can weaken your immune system. There are programs available to help you stop.
• Consider joining a support group for people with HIV infection or finding out about other resources available in your area, such as HIV/AIDS-knowledgeable counselors for one on one therapy. There are also many newsletters available for people living with HIV and AIDS.
• There is much you can do to stay healthy. Learning as much as you can is a step in the right direction. Local and/or national resources may be available. Many HIV/AIDS organizations provide services free or on a sliding scale, based on ability to pay.

Where did HIV come from?

The most recent presentation on the origin of HIV was presented at the 6th Conference on Retroviruses and Opportunitistic Infections (Chicago, January 1999). At that conference, research was presented that suggested that HIV had "crossed over" into the human population from a particular species of chimpanzee, probably through blood contact that occurred during hunting and field dressing of the animals. The CDC states that the findings presented at this conference provide the strongest evidence to date that HIV-1 originated in non-human primates. The research findings were featured in the February 4,1999 issue of the journal, Nature.

We know that the virus has existed in the United States, Haiti and Africa since at least 1977-1978. In 1979, rare types of pneumonia, cancer and other illnesses were being reported by doctors in Los Angeles and New York. The common thread was that these conditions were not usually found in persons with healthy immune systems.

In 1982 the Centers for Disease Control and Prevention (CDC) officially named the condition AIDS (Acquired Immune Deficiency Syndrome). In 1984 the virus responsible for weakening the immune system was identified as HIV (Human Immunodeficiency Virus).

How long does it take HIV to cause AIDS?

Currently, the average time between HIV infection and the appearance of signs that could lead to an AIDS diagnosis is 8-11 years. This time varies greatly from person to person and can depend on many factors including a person's health status and behaviors. Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS. As with other diseases, early detection offers more options for treatment and preventative health care.

What is the difference between HIV & AIDS?

HIV is the virus that causes AIDS.

H	-	Human: because this virus can only infect human beings.
I	-	Immuno-deficiency: because the effect of the virus is to create a deficiency, a failure to work properly, within the body's immune system.
V	-	Virus: because this organism is a virus, which means one of its characteristics is that it is incapable of reproducing by itself. It reproduces by taking over the machinery of the human cell.
A	-	Acquired: because it's a condition one must acquire or get infected with; not something transmitted through the genes
I	-	Immune: because it affects the body's immune system, the part of the body which usually works to fight off germs such as bacteria and viruses
D	-	Deficiency: because it makes the immune system deficient (makes it not work properly)
S	-	Syndrome: because someone with AIDS may experience a wide range of different diseases and opportunistic infections.

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See Also

How Can I tell if I am affected with HIV?

What is AIDS?

Can I get HIV from Kissing

Casual contact through closed-mouth or "social" kissing is not a risk for transmission of HIV. Because of the potential for contact with blood during "French" or open-mouth, wet 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. In this case both partners had extensive dental problems including gingivitis (inflammation of the gums). It is likely that there was blood present in both partners' mouths making direct blood to blood contact a possibility.

Can I get HIV from Oral Sex?

There is considerable debate within the HIV/AIDS prevention community regarding the risk of transmission of HIV through oral sex. What is currently known is that there is some risk associated with performing oral sex without protection; (there have been a few documented cases of HIV transmission through oral sex). While no one knows exactly what that risk is, cumulative evidence indicates that the risk is less than that of unprotected anal or vaginal sex. The risk from receiving oral sex, for both a man and a woman, is considered to be very low.

Currently, risk reduction options when performing oral sex on a man (fellatio) include the use of latex condoms, but also include withdrawal before ejaculation without a condom (avoiding semen in the mouth) and/or refraining from this activity when cuts or sores are present in the mouth.

When performing oral sex on a woman (cunnilingus), moisture barriers such as a dam (sheet of latex), a cut-open and flattened condom, or household plastic wrap can reduce the risk of exposure to vaginal secretions and/or blood.

How Can I tell if I am affected with HIV?

The only way to determine whether you are infected is to be tested for HIV infection. You can't rely on symptoms to know whether or not you are infected with HIV. Many people who are infected with HIV don't have any symptoms at all for many years.

Similarly, you can't rely on symptoms to establish that a person has AIDS. The symptoms associated with AIDS are similar to the symptoms of many other diseases. AIDS is a diagnosis made by a doctor based on specific criteria established by the Centers for Disease Control and Prevention (CDC).

Oppurtunistic Infections

In our bodies, we carry many germs - bacteria, protozoa, fungi, and viruses. When our immune system is working, it controls these germs. But when the immune system is weakened by HIV disease or by some medications, these germs can get out of control and cause health problems.

Infections that take advantage of weakness in the immune defenses are called "opportunistic". The phrase "opportunistic infection" is often shortened to "OI".

TESTING FOR OIs

You can be infected with an OI, and "test positive" for it, even though you don't have the disease. For example, almost everyone with HIV tests positive for Cytomegalovirus (CMV). But it is very rare for CMV disease to develop unless the CD4 cell count drops below 50, a sign of serious damage to the immune system.

To see if you're infected with an OI, your blood might be tested for antigens (pieces of the germ that causes the OI) or for antibodies (proteins made by the immune system to fight the germs). If the antigens are found, it means you're infected. If the antibodies are found, you've been exposed to the infection. You may have been immunized against the infection, or your immune system may have cleared the infection, or you may be infected. If you are infected with a germ that causes an OI, and if your CD4 cells are low enough to allow that OI to develop, your health care provider will look for signs of active disease. These are different for the different OIs.

OIs AND AIDS

People who aren't HIV-infected can develop OIs if their immune systems are damaged. For example, many drugs used to treat cancer suppress the immune system. Some people who get cancer treatments can develop OIs.

HIV weakens the immune system so that opportunistic infections can develop. If you are HIV-infected and develop opportunistic infections, you might have AIDS.

In the US, the Center for Disease Control (CDC) is responsible for deciding who has AIDS. The CDC has developed a list of about 24 opportunistic infections. If you have HIV and one or more of these "official" OIs, then you have AIDS. The list is available at http://www.aidsmeds.com/lessons/StartHere8.htm.

WHAT ARE THE MOST COMMON OIs?

In the early years of the AIDS epidemic, OIs caused a lot of sickness and deaths. Once people started taking strong antiretroviral therapy (ART), however, a lot fewer people got OIs. It's not clear how many people with HIV will get a specific OI.

In women, health problems in the vaginal area may be early signs of HIV. These can include pelvic inflammatory disease and bacterial vaginosis, among others.

The most common OIs are listed here, along with the disease they usually cause, and the CD4 cell count when the disease becomes active:

• Candidiasis (Thrush) is a fungal infection of the mouth, throat, or vagina. CD4 cell range: can occur even with fairly high CD4 cells.
• Cytomegalovirus (CMV) is a viral infection that causes eye disease that can lead to blindness.CD4 cell range: under 50.
• Herpes simplex viruses can cause oral herpes (cold sores) or genital herpes. These are fairly common infections, but if you have HIV, the outbreaks can be much more frequent and more severe. They can occur at any CD4 cell count.
• Malaria is common in the developing world. It is more common and more severe in people with HIV infection.
• Mycobacterium avium complex (MAC or MAI) is a bacterial infection that can cause recurring fevers, general sick feelings, problems with digestion, and serious weight loss. CD4 cell range: under 75.
• Pneumocystis pneumonia (PCP) is a fungal infection that can cause a fatal pneumonia. CD4 cell range: under 200. Unfortunately this is still a fairly common OI in people who have not been tested or treated for HIV.
• Toxoplasmosis (Toxo) is a protozoal infection of the brain. T-cell range: under 100.
• Tuberculosis (TB) is a bacterial infection that attacks the lungs, and can cause meningitis. CD4 cell range: Everyone with HIV who tests positive for exposure to TB should be treated.

PREVENTING OIs

Most of the germs that cause OIs are quite common, and you may already be carrying several of these infections. You can reduce the risk of new infections by keeping clean and avoiding known sources of the germs that cause OIs.

Even if you're infected with some OIs, you can take medications that will prevent the development of active disease. This is called prophylaxis. The best way to prevent OIs is to take strong ART.

TREATING OIs

For each OI, there are specific drugs, or combinations of drugs, that seem to work best. Refer to the Fact Sheets for each OI to learn more about how they are treated.

Strong antiretroviral drugs can allow a damaged immune system to recover and do a better job of fighting OIs.