Department of Health and Human Services
Public Health Service
Centers for Disease Control and Prevention
Atlanta, Georgia 30333
This booklet is for people who are infected with the human immunodeficiency virus (HIV) and for their friends and families. HIV is the virus that causes acquired immunodeficiency syndrome (AIDS).
Although infection with HIV is serious, people with HIV and AIDS are living longer, healthier lives today, thanks to new and effective treatments. This booklet will help you understand how you can live with HIV and keep yourself healthy.
You probably have many questions about HIV, such as
This booklet will give you answers to these questions. You can also ask your doctor any questions you have about HIV. Other sources of information about HIV are listed at the back of this booklet.
What is HIV and how did I get it?
HIV is the virus that causes AIDS. The first cases of AIDS were identified in the United States in 1981, but the virus probably existed here and in other parts of the world for many years before that. In 1984, scientists proved that HIV causes AIDS.
Ways you might have gotten HIV:
- having unprotected sex (sex without a condom) with someone who has HIV
- sharing a needle to inject drugs or sharing drug works with someone who has HIV
- having a mother who was infected with HIV when you were born
- from a blood transfusion (However, it is unlikely you got infected that way because all blood in the United States has been tested for HIV since 1985.)
Ways you did NOT get (and no one else can get) HIV:
- just working with or being around some one who has HIV
- being stung or bitten by an insect
- sitting on toilet seats
- doing everyday things like sharing a meal
What is the difference between HIV and AIDS?
HIV is the virus that causes the disease AIDS. Although HIV causes AIDS, a person can be infected with HIV for many years before AIDS develops.
When HIV enters your body, it infects specific cells in your immune system. These cells are called CD4 cells or helper T cells. They are important parts of your immune system and help your body fight infection and disease. When your CD4 cells are not working well, you are more likely to get sick.
Usually, CD4 cell counts in someone with a healthy immune system range from 500 to 1,800 per cubic millimeter of blood. AIDS is diagnosed when your CD4 cell count goes below 200. Even if your CD4 cell count is over 200, AIDS can be diagnosed if you have HIV and certain diseases such as tuberculosis or
Pneumocystis carinii [NEW-mo-SIS-tis CA-RIN-nee-eye] pneumonia (PCP).
There are general stages of HIV infection that you may go through before AIDS develops.
Infection. The earliest stage is right after you are infected. HIV can infect cells and copy itself before your immune system has started to respond. You may have felt flu-like symptoms during this time.
Response. The next stage is when your body responds to the virus. Even if you don’t feel any different, your body is trying to fight the virus by making antibodies against it. This is called seroconversion, when you go from being HIV negative to HIV positive.
No symptoms. You may enter a stage in which you have no symptoms. This is called asymptomatic infection. You still have HIV and it may be causing damage that you can’t feel.
Symptoms. Symptomatic HIV infection is when you develop symptoms, such as certain infections, including PCP.
AIDS. AIDS is diagnosed when you have a variety of symptoms, infections, and specific test results. There is no single test to diagnose AIDS.
How long does it take to go from HIV infection to a diagnosis of AIDS?
There is no one answer to this question because everyone is different. Estimates of the average length of time for progression from HIV to AIDS are being developed. Before antiretroviral therapy became available in 1996, scientists estimated that AIDS would develop within 10 years in about half the people with HIV. Since 1996, new medical treatments have been developed that can prevent or cure some of the illnesses associated with AIDS, though they cannot cure AIDS itself.
Various factors, including your genetic makeup, can influence the time between HIV infection and the development of AIDS.
Time between HIV infection and AIDS
- older age
- infection with more than one type of HIV
- poor nutrition
- severe stress
- closely adhering to your doctor’s recommendations
- eating healthy foods
- taking care of yourself
What is clear is that you have some control over the
progression of HIV infection.
How can I stay healthy longer?
There are many things you can do for yourself to stay healthy. Here are a few.
Make sure you have a health care provider who knows how to treat HIV. Begin treatment promptly once your doctor tells you to.
Keep your appointments. Follow your doctor's instructions. If your doctor prescribes medicine for you, take the medicine just the way he or she tells you to because taking only some of your medicine gives your HIV infection more chance to fight back.
If you get sick from your medicine, call your doctor for advice; don’t make changes to your medicine on your own or because of advice from friends.
Get immunizations (shots) to prevent infections such as pneumonia and flu. Your doctor will tell you when to get these shots. Practice safe sex to reduce your risk of getting a sexually transmitted disease (STD) or another strain of HIV.
If you smoke or use drugs not prescribed by your doctor, quit.
Eat healthy foods. This will help keep you strong, keep your energy and weight up, and help your body protect itself.
Get enough sleep and rest.
Take time to relax. Many people find that meditation or prayer, along with exercise and rest, help them cope with the stress of having HIV or AIDS.
There are also many things you can do to protect your health when you prepare food or eat, when you travel, and when you’re around pets and other animals. You can read more about these things in the brochures in the CDC Opportunistic Infection series. You can get these brochures and other information about HIV by calling CDC-INFO at 1-800-232-4636 or by going to the CDC Internet address,
What can I expect when I go to the doctor?
During your first appointment your doctor will ask you questions, examine you, take a blood sample, and do some other tests. Your doctor also may do a skin test for tuberculosis and give you some immunizations (shots).
Tell your doctor about any health problems you are having so that you can get treatment. You also should ask your doctor any questions you have about HIV or AIDS, such as
- what to do if your medicine makes you sick
- where to get help for quitting smoking or using drugs
- how to create a healthier diet how to minimize
the chance that you will spread HIV to your partners
Your blood sample is used for many tests, including
the CD4 cell count and viral load. Your CD4 cell
count tells you how many CD4 cells you have in your
blood. If you are getting treatment, your CD4 cell
counts indicate how well it is working. If your CD4 cell
count rises, your body is better able to fight
infection. Viral load testing measures the amount
of HIV in your blood. Your viral load helps predict what
will happen next with your HIV infection if you don’t
Keep your follow-up appointments with your doctor. At these appointments you and your doctor will talk about your test results, and he or she may prescribe medicine for you.
What is the treatment for HIV or AIDS?
- Antiretroviral medicines. Because HIV is a certain type of virus called a retrovirus, the drugs used to treat it are called antiretroviral medicines. These powerful medicines control the virus and slow progression of HIV infection, but they do not cure it. You need to take these medicines exactly as your doctor prescribes.
- HAART. The current recommended treatment for HIV is a combination of three or more medicines. This regimen of medicines is called highly active antiretroviral therapy (HAART).
How many pills you will need to take and how often you will take them depends on which medicines your doctor chooses for you. Remember, each HAART regimen is tailored to each individual patient. There is no one best regimen. You can read more about specific HAART regimens at
HAART may cause some side effects. You and your doctor should discuss potential side effects so that you will know if they occur. If you experience any side effects, even those that may seem minor, you should talk about them with your doctor.
- Other medicines. Your doctor may also prescribe other medicines for you, depending on your CD4 cell count. Always discuss any side effects with your doctor. Never change the way you are taking any of the medicines
without first talking with your doctor. If you don’t take your medicines the right way, they may not be as effective as they should be.
- Treating other infections. If your HIV infection gets worse and your CD4 cell count falls below 200, you are more likely to get other infections. Your doctor may prescribe medicines
to prevent particular infections, such as PCP.
The most important thing you can do after you learn that you have HIV is to work closely with your doctor. because HIV and HIV-related illnesses vary from person to person, your doctor will design a medical care plan specifically for you. To help your doctor make the best choices for you, you must tell your doctor about any side effects or symptoms you have.
What are some of the other diseases I could get?
Because HIV damages your immune system, you may have a higher chance of getting certain diseases, called opportunistic infections. They are so named because an HIV-infected person’s weakened immune system gives these diseases the opportunity to develop. Fortunately, people with HIV who are taking HAART can go a long time before their immune system is damaged enough to allow an opportunistic infection to occur. That’s why it is so important to get tested and start treatment early. Many people may not know they have HIV until AIDS and an opportunistic infection develop. Many germs can cause opportunistic infections.
Examples of common opportunistic infections
||Pneumocystis carinii pneumonia
||NEW-mo-SIStis CA-RIN nee-eye
||Mycobacterium avium complex
||my-ko-bakavium TEER-i-um AYE-vee-um
||Human papilloma virus
||HU-man PAP-i-LO-ma VI-res
Certain symptoms can occur with opportunistic
- Breathing problems
- Mouth problems, such as thrush (white spots), sores, change in
taste, dryness, trouble swallowing, or loose teeth
- Fever for more than 2 days
- Weight loss
- Change in vision or floaters (moving lines or spots in your
- Skin rashes or itching
Tell your doctor right away if you have any of these
problems. Your doctor can treat most of your HIV-related
problems, but sometimes you may need to go to a
specialist. Visit a dentist at least twice a year, more
often if you have mouth problems.
You can learn more about how to prevent the most
serious opportunistic infections by reading the
brochures in the CDC Opportunistic Infections series.
You can get these brochures by calling CDC-INFO at
How do I protect other people from my HIV?
Things you SHOULD do
- Abstain from sex. The surest way to avoid transmission of STDs,
including a different strain of HIV, is to not have sexual
- Use condoms correctly and consistently. Correct and consistent use
of the male latex condom can reduce the risk for STD transmission.
However, no protective method is 100% effective. Condom use cannot
guarantee absolute protection against any STD.
- If you are allergic to latex, you can use polyurethane
- Condoms lubricated with spermicides are no more effective than
other lubricated condoms in protecting against the transmission of
HIV and other STDs.
- If you use condoms incorrectly, they can slip off or break, which
reduces their protective effects. Inconsistent use, such as not
using condoms with every act of intercourse, can lead to STD
transmission because transmission can occur with just one act of
- Use protection during oral sex. A condom or dental dam (a square
piece of latex used by dentists) can be used. Do not reuse these items.
- Tell others that you have HIV.
- Tell people you’ve had sex with. This can be difficult, but they
need to know so they can get the help they need. Your local public
health department may help you find these people and tell them they
have been exposed to HIV. If they have HIV, this may help them get
care and avoid spreading HIV to others.
- Tell people you are planning on having sex with. Practicing safe sex
will help protect your health and that of your partners.
- If you are a man and had sex with a woman who became pregnant, you
need to tell the woman that you have HIV, even if you are not the father
of the baby. If she has HIV, she needs to get early medical care for her
own health and her baby’s health.
Things you should NOT do
- Don’t share sex toys. Keep sex toys for your own use only.
- Don’t share drug needles or drug works. Use a needle exchange
program if one is available. Seek help if you inject drugs. You can
fight HIV much better if you don’t have a drug habit.
- Don’t donate blood, plasma, or organs.
- Don’t share razors or toothbrushes. HIV can be spread through
fresh blood on such items.
Is there special advice for women with HIV?
Yes. If you are a woman with HIV, your doctor should
check you for STDs and perform a Pap test at least once
As a woman with HIV, you are more likely to have
abnormal Pap test results. Infection with HIV means your
body is less effective in controlling all types of
viruses. The human papilloma virus (HPV) is a specific
virus that can infect cervical cells (the cells that the
Pap test looks at). Your doctor may recommend a special
test that can look for HPV as part of your exam. If your
Pap test result is abnormal, your doctor may need to
repeat it or do other tests. If you have had an abnormal
Pap test result in the past, tell your doctor.
If you are thinking about avoiding pregnancy or
becoming pregnant, talk with your doctor. You might ask
some of the following questions:
- What birth control methods are best for me?
- Will HIV cause problems for me during pregnancy or delivery?
- Will my baby have HIV?
- Will treatment for my HIV infection cause problems for my baby?
- If I choose to get pregnant, what medical and community programs
and support groups can help me and my baby?
If you become pregnant, talk to your doctor right
away about medical care for you and your baby. You also
need to plan for your child’s future in case you get
Your HIV treatment will not change very much from
what it was before you became pregnant. You should have
a Pap test and tests for STDs during your pregnancy.
Your doctor will order tests and suggest medicines for
you to take. Talk with him or her about all the pros and
cons of taking medicine while you are pregnant.
Talk with your doctor about how you can prevent
giving HIV to your baby. It is very important that you
get good care early in your pregnancy. The chances of
passing HIV to your baby before or during birth are
about 1 in 4, or 25%, but treatment with antiretroviral
medicines has been shown to greatly lower this risk.
Your doctor will want you to take these medicines to
increase your baby’s chance of not getting HIV.
Although you are pregnant, to avoid catching other
diseases and to avoid spreading HIV, you should still
use condoms each time you have sex. Even if your partner
already has HIV, he should still use condoms.
After birth, your baby will need to be tested for
HIV, even if you took antiretroviral medicines while you
were pregnant. Your baby will need to take medicine to
prevent HIV infection and PCP. Talk with your doctor
about your baby’s special medical needs. Because HIV
infection can be passed through breast milk, you should
not breast-feed your baby.
Where can I find help in dealing with HIV?
If you are living with HIV or AIDS, you may need many
kinds of support: medical, emotional, psychological, and
financial. Your doctor, your local health and social
services departments, local AIDS service organizations,
and libraries can help you in finding all kinds of help,
such as the following:
- Answers to your questions about HIV and AIDS
- Doctors, insurance, and help in making health care decisions
- Food, housing, and transportation
- Planning to meet financial and daily needs
- Support groups for you and your loved ones
- Home nursing care
- Help in legal matters, including Americans with Disabilities Act
- Confidential help in applying for Social Security disability
You can also get help by calling CDC-INFO at
Many people living with HIV feel better if they can
talk with other people who also have HIV. Here are some
ways to find support.
- Contact your local AIDS service organization. Look under “AIDS” or
“Social Service Organizations” in the yellow pages of your telephone
- Contact a local hospital, church, or American Red Cross chapter
- Read HIV newsletters or magazines.
- Join support groups or Internet forums.
- Volunteer to help others with HIV.
- Be an HIV educator or public speaker, or work on a newsletter.
- Attend social events to meet other people who have HIV.
Today, thousands of people are living with HIV or
AIDS. Many are leading full, happy, and productive
lives. You can too if you work with your doctor and
others and take the steps outlined in this booklet to
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