fbpx HIV and AIDS: The Basics
Two hands hold a black ribbon in their palms with a blotchy, pink background behind.
Two hands hold a black ribbon in their palms with a blotchy, pink background behind.

HIV and AIDS: The Basics

Human immunodeficiency virus is no longer a death sentence, but it's not solved entirely.
Aleck Woogmaster
Written by

Aleck Woogmaster

Editor's note: December is HIV/AIDS Awareness Month. The month-long campaign is intended to raise awareness of the global epidemic of AIDS and the spread of HIV, commemorate the people who have passed, celebrate the victories of innovative treatments and prevention services, and encourage the importance of getting tested.

Talking about HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) requires a delicate balancing act. There's no denying some form of celebration is appropriate: Medical and social advancements have helped pave the way for vast improvements in how HIV and AIDS impact society at large. Similarly, legal protections and a broadly improved attitude have minimized the once torturous level of bigotry toward people living with or at risk of contracting HIV/AIDS.

Still, there is a long way to go toward taking care of people at risk of contracting HIV or living with AIDS.

"It's an important time because I think from the early days when AIDS was everywhere in the news and most people really heard about it pretty much daily to now, it's really faded," said Paul Volberding, M.D., a retired professor from the University of California at San Francisco who has an extensive history in HIV/AIDS research by way of clinical trials and other research efforts. "And it's faded because of good reasons: It's no longer the death sentence that it used to be."

In some sense, the comfort that's been taken in the improved approach to dealing with HIV/AIDS has facilitated a false sense of security toward the disease. Systemic and individual inadequacies still exist in medical and civil arenas, and on an individual level, living with HIV is often summarized as managing a suppressed chronic illness through the simple process of ingesting a once-a-day pill.

Diagnosis can still prove traumatizing, however, as the lack of public awareness can intersect with harsh physical symptoms. The best counteragent to these harmful remnants of misinformation is education.

Early signs

Many people living with HIV do not know they have the virus. Transmission plays out differently in each case and displays varying degrees of severity. The process of seroconversion can also easily be mistaken for more common conditions, such as the flu.

Seroconversion describes the process of HIV taking up residence in the body. As the virus attacks the immune system, patients may experience a wide range of flu-like symptoms, including:

  • Fever
  • Fatigue
  • Sore throat
  • Headaches
  • Rashes
  • Aching muscles
  • Sore joints
  • Loss of appetite
  • Swollen lymph glands

These are some of the symptoms commonly associated with seroconversion, but different people may describe their symptoms differently, which can lead to confusion when seeking a concrete diagnosis.

These symptoms often impact patients for a short period of time before disappearing entirely. Since many people are used to shouldering the burden of minor illness in their day-to-day lives, they may experience seroconversion sickness and move on without realizing they have contracted HIV. This is why regular testing and maintaining open, honest conversations about sexual health practices is vital to the fight to reduce the impact HIV and AIDS have on society.

HIV vs. AIDS

HIV can lead to the development of AIDS. Untreated HIV attacks the immune system, lowering the body's natural defenses to illness. If left unchecked, this degradation eventually leads to a person being diagnosed with the potentially deadly AIDS. Technically referred to as a late stage of the HIV diagnosis, once AIDS has been diagnosed, the immune system has been badly damaged and patients become susceptible to a wide variety of potential infections and health complications.

Advances in medicine have made HIV exceptionally treatable, meaning people diagnosed with HIV today don't necessarily have to fear an eventual diagnosis of AIDS.

"We've also been given some incredible tools, the treatments that work amazingly well: one pill once a day," Volberding said. "And also prevention approaches, again, with one pill once a day. Medicines essentially completely block transmission of the virus that causes AIDS. The story is really very positive.

"But I think the negative side of things is that people are still living with HIV infection and not everybody that's been infected knows they're infected," he added. "Other people know they're infected but haven't decided to be treated and are both progressing with their illness and transmitting the virus to other people. So there's a lot to be done in terms of public education, again, with a goal of getting the advances better known so that they can get in more people's bodies for assembly."

Making inroads against a lack of public awareness is complicated, but one very simple aspect is to normalize the mechanics of how sexual behavior and sexual health intersect with one another.

A sexual and social health issue

Jennifer Brier, Ph.D., is a historian and professor of history at the University of Illinois Chicago. Her research and teaching priorities focus on the intersection of gender, sexuality, race and health policy/practices. Her first book used AIDS as a through point to observe the complexities and, often, inadequacies of public health practices.

"I'm not a psychologist, I don't know a lot about psychosocial things other than what I read in the newspaper," she explained. "But what I do know about is the fact that, and this is true, I think from the beginning, the way homophobia and transphobia and phobia of talking about sexual health and sexual well-being manifests itself is that we never are quite talking about the way people actually have sex."

Different sexual acts with different sexual partners can carry different exposure risks to HIV. For example, statistics indicate men who have sex with men are among the highest-risk groups for contracting HIV. Comparatively, it's statistically uncommon for women to pass HIV to men through sexual intercourse.

"I think the stigma and the fear about sex and intimacy and desire, and what people like to do that feels good, what doesn't feel good and is still OK, what doesn't feel good and isn't OK…when sex is violence—all of these things—we don't talk about it," Brier said. "We don't have a way to talk about it. I don't think that's any different between now and 1985."

On the surface, it may seem more acceptable to talk about sexuality today, but these discussions are often steeped in euphemism and sorely lacking specificity.

The brave, the bold and the best is yet to come

There is a lot to celebrate, as there is a lot less cruelty embedded in our discussions about HIV/AIDS. You're much less likely to hear AIDS zealously described as holy revenge against drug addicts and gay people.

But this thinking still persists in pockets of the country, and there are still major goals to accomplish in the fight against AIDS.

Volberding pointed to the facts that we still don't have a vaccine against HIV and many physicians are sorely lacking information about HIV in general. Brier talked at length about the unfortunate invisibility of women living with HIV experience, despite historically being on the front lines of clinical trials and social change around HIV. Her own efforts have led to the "I'm Still Surviving" archive, which compiles hundreds of excerpts to document the oral history of women living with HIV.

Being willing to soldier through a realm of extreme controversy to document the true history of these conditions or combat their prevalence through labwork and advocacy is still a brave career decision.

Volberding saluted organizations such as the HIV Medicine Association and the American Academy of HIV Medicine for continuing this mission even though HIV and AIDS have faded from the daily news.

Note that taking care of yourself often means, incidentally or intentionally, you end up taking care of someone from your community as well. Education is the No. 1 avenue we have available to eliminate stigma and create more victories for HIV medicine in the future.