The symptoms and stages of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) can seem cloaked in mystery for anyone who hasn't updated their knowledge of these sexually transmitted conditions in a while. Many of the initial symptoms associated with HIV are often mistaken for symptoms associated with other conditions, and often the symptoms don't present in any significantly alarming way.
In other words, people can contract HIV without even knowing it. The following information should highlight the importance of frequent testing and transparency regarding sexual health, as well as safest sex practices with new and ongoing partners.
The clearest indicator for determining the chance of HIV transmission to another person is the viral load count in a person’s blood. Viral load is a term used to describe the quantity of a virus within an organism, is typically observed in the bloodstream and is usually described in terms of virus particles per milliliter of fluid. The viral load count generally fluctuates throughout the stages of HIV's progression.
A person’s viral load is considered undetectable if the virus can’t be accounted for in a single milliliter of blood, and it is the goal for all medical teams handling a case of HIV seropositivity. Studies have shown that people with HIV who follow treatment recommendations exactly and who consistently display an undetectable viral load have effectively no chance of transmitting the virus through sex or other means.
On the other hand, a high viral load typically indicates an elevated chance of transmitting the virus to sexual partners or people who inject drugs with a shared needle following a person with HIV.
The chances of virus transmission increase in the presence of lesions, open sores, cuts, abrasions or other conditions that may facilitate a bodily fluid swap. Bodily fluids with a chance of transmitting the virus include semen and preseminal fluids, blood, vaginal fluids, rectal fluids and breast milk.
Along with sex and injection drug use, other aspects considered to be risk factors in regard to contracting HIV include the presence of other STDs, such as syphilis or gonorrhea, and the ways in which a person has sex.
Repeated incidences of unprotected sex with multiple partners increase the likelihood of contracting HIV, as do behaviors common to men who have sex with men. Anal sex is the form of penetrative sex with the highest risk of HIV transmission, due to the high likelihood of the presence of fluids, openings and micro fissures that allow for the transfer of body fluids.
Alcohol and drug use, as well as factors related to mental health and substance abuse, are statistically correlated to the increased chance of an HIV diagnosis, either because of related potential behavior choices—unprotected sex is the best example—or because these factors may point to other aspects of the person's life that can indicate an increased chance of contracting HIV.
Symptoms (by stage)
Let's take a look at the symptoms of HIV during the three main stages.
The acute stage of HIV infection
After exposure to the virus, there is a time period during which the antibodies develop and become detectable in the blood. This process is called seroconversion. Once the virus is detectable, it marks the beginning of the acute stage of an HIV infection, which includes high levels of detectable quantities of HIV in the viral load.
Seroconversion occurs about two to four weeks after infection, though symptoms such as dizziness, nausea or headache can sometimes be light enough to be ignored or simply confused for the flu. Patients experiencing seroconversion or symptoms of acute-stage HIV infection may have difficulty sleeping or may experience exhaustion, along with fluctuating fever and chills. A couple of lesser-known symptoms that might distinguish the HIV infection from other conditions are pressure or pain around the eyes or stiffness and/or swelling in the glands, lymph nodes, throat or other areas.
Because the acute stage is associated with a high viral load, patients should consider themselves contagious and abstain from sex. With early detection and rapid, proper implementation of effective treatment, the virus can be made undetectable in less than six months.
Chronic HIV infection
Without treatment, HIV will advance to the chronic stage. At this time, the virus is present in relatively low amounts but is still transmissible; therefore, abstinence from unprotected sex is advised.
Chronic HIV typically has no visible symptoms and can last for years at a time. Untreated, the virus can be passed to sexual partners or to shared injection drug users. It will eventually progress to the third stage of HIV, which is when the condition is considered to have developed into AIDS. This can happen in about 10 years of unmitigated disease advancement but has been known to happen sooner for a variety of reasons.
If HIV progresses enough and the immune system sustains enough damage, doctors may diagnose the patient with AIDS. The presence of an opportunistic infection, added to a longstanding HIV-positive status, is often the deciding factor in the diagnosis. Opportunistic infections are viruses and infectious cancers that pose unique risks or a higher chance of infection for people with a weakened immune system.
If a person has had HIV for 10 years or longer, has not had access to treatments and develops an opportunistic infection, the chances of an AIDS diagnosis are extremely high. In addition to symptoms experienced during the acute stage, the patient may also observe rashes, lesions or sores, hair or weight loss, or difficulty fighting off other infections or illnesses.
Treatment for HIV and AIDS has come a long way. Antiretroviral therapies (ART) have long been considered the standard approach when it comes to treating HIV, but previously, multiple pills a day were required with strict adherence to treatment protocols and the potential for any number of side effects.
Today's HIV medications combine the methods of the past but eliminate most, if not all, of the side effects. New HIV medications require taking only one pill a day, though timing regularity is strongly advised for the purpose of long-term effectiveness. After a sufficient amount of time of having taken pills consistently, and once an established undetectable viral load has been confirmed, individual days of doses can occasionally be missed without the real possibility of significant consequences or changes in HIV-related numbers.
That said, it's always best (and possibly crucial) to follow your doctor's orders to the smallest detail to achieve the desired results from treatment. Doctors can plan and predict the course of treatment almost down to the day if you can commit to their advised procedures in regard to medicine, follow-up appointments and additional activities like sex or substance use.
Proper treatment can help HIV become undetectable and, for all intents and purposes, untransmittable in less than six months.
Coping and living with HIV/AIDS
HIV today is viewed as a manageable chronic condition, and federal protections (along with healthcare reform efforts) have made it possible for people with HIV to access medication through a number of helpful resources. Still, a new diagnosis can be a scary experience whether a person has a good support network or not.
Some helpful programs to be aware of if you are newly diagnosed with HIV are the Ryan White HIV/AIDS Program, which helps guarantee people access to the HIV services they need, and Medicaid programs that work with state healthcare services and programs to alleviate medical burdens and align patients with a range of services.
In a best-case scenario, a newly diagnosed patient will have access to primary care, mental health and case management services. The ideal support system includes not only a capable doctor and medical team for regular checkups, lab work and other general health needs, but also counselors or other mental health support services. A designated caseworker or social worker can help with access to community services and administrative matters such as billing and insurance.
People with HIV can live long, healthy lives mostly free of directly related health issues, and we can all help save lives by understanding the facts about prevention and treatment. We still have a lot of work to do when it comes to educating the public and making HIV and AIDS less taboo topics of conversation, but a little bit of work from each of us goes a long way.