By killing or damaging cells of the body's immune system, HIV progressively destroys the body's ability to fight infections and certain cancers. People diagnosed with AIDS may get life-threatening diseases called opportunistic infections. These infections are caused by microbes such as viruses or bacteria that usually do not make healthy people sick.

Who should get tested for HIV?

Read on to find out if you are at risk for HIV.

If you answer YES to any of the following questions, you should definitely get an HIV test. If you continue with any of these behaviors, you should be tested every year.

• Have you injected drugs or steroids or shared needles, syringes, works with others?
• Have you had unprotected vaginal, anal, or oral sex with men who have sex with men, multiple partners, or anonymous partners?
• Have you exchanged sex for drugs or money?
• Have you been diagnosed with or treated for hepatitis, tuberculosis (TB), or a sexually transmitted disease (STD), like syphilis?
• Have you had unprotected sex with someone who could answer yes to any of the above questions?

If you have had sex with someone whose history of sex partners and/or drug use is unknown to you or if you or your partner has had many sex partners, then you are risk of being infected with HIV. Both you and your new partner should get tested for HIV, and learn the results, before having sex for the first time.

For women who plan to become pregnant, testing is even more important. If a woman is infected with HIV, medical care and certain drugs given during pregnancy can lower the chance of passing HIV to her baby. All women who are pregnant should be tested during each pregnancy.

What HIV Does

HIV destroys CD4 positive (CD4+) T cells, which are white blood cells crucial to maintaining the function of the human immune system. As the virus attacks those cells, the person infected with HIV is less equipped to fight off infection and disease ultimately resulting in the development of AIDS.

Transmission

HIV is primarily found in the blood, semen, or vaginal fluid of someone who is infected with the virus and is transmitted in four ways:

• Having unprotected sex (anal, oral or vaginal) with someone infected with HIV
• Sharing needles and syringes with someone infected with HIV
• Being exposed to the virus as a fetus or infant before or during birth or through breastfeeding from an HIV-infected mother
• Receiving a transfusion of HIV-infected blood or blood products. In the United States, all donated blood and blood products have been screened for HIV since 1985

Signs & symptoms

Many people will not have any symptoms when they first become infected with HIV. They may, however, have a flu-like illness within a month or two after exposure to the virus. This illness may include

• Fever
• Headache
• Tiredness
• Enlarged lymph nodes (glands of the immune system easily felt in the neck and groin)

These symptoms usually disappear within a week to a month and are often mistaken for those of another viral infection. During this period, people are very infectious, and HIV is present in large quantities in genital fluids.

More persistent or severe symptoms may not appear for 10 years or more after HIV first enters the body in adults, or within 2 years in children born with HIV infection. This period of asymptomatic infection varies greatly in each person. Some people may begin to have symptoms within a few months, while others may be symptom-free for more than 10 year.

Diagnosis

Because early HIV infection often causes no symptoms, a healthcare provider usually can diagnose it by testing blood for the presence of antibodies (disease-fighting proteins) to HIV.

The most common test for AIDS is the ELISA (Enzyme-Linked Immuno-Sorbent Assay), which is performed on a blood sample. This test is very sensitive and detects almost all persons infected with the human immunodeficiency virus (HIV) except during the first few weeks of infection. The ELISA test detects the body's immune response to HIV.

Treatment

• In the early 1980s when the HIV/AIDS epidemic began, people with AIDS were not likely to live longer than a few years. With the development of safe and effective drugs, however, people infected with HIV now have longer and healthier lives.
• Currently, there are 30 antiretroviral drugs approved by the Food and Drug Administration to treat people infected with HIV.
• The best way of self-protection is to learn as much as possible about HIV infection, avoid risky behavior, and follow guidelines for protection. Abstinence, non-penetrative sex or a stable relationship between mutually faithful partners is optimal.