What Does HIV Look Like?
The human immunodeficiency virus (HIV) attacks the body's ability to ward off infection. HIV is sexually transmitted and can be passed through anal or vaginal sex but can also be spread by sharing drug injection supplies.
According to the Centers for Disease Control and Prevention (CDC), bodily fluids that can transmit HIV include blood, semen, preseminal fluid, rectal fluid, vaginal fluid and breast milk. HIV is transmitted via fluid to a mucous membrane or directly injected into the bloodstream through drug use equipment.
At the end of 2019, more than 1.2 million people in the United States were living with HIV. However, it's estimated that about 13 percent of them did not know they had it and had not yet received testing.
Science has made tremendous strides in HIV treatment in recent years, including potential medical breakthroughs in a handful of people and a significant decline in reported HIV rates. Since its highest rate of infection in 1984 and 1985, when more than 130,000 infections were recorded each year, HIV incidence has decreased by 73 percent, down to 34,800 in 2019, according to data published by the CDC.
HIV is becoming less common, and no longer a death sentence, but it remains essential to get tested so you can receive proper treatment.
What are the symptoms of HIV?
One of the primary reasons some people living with HIV don't realize they contracted the virus is because symptoms aren't always evident. Symptoms also frequently vary from person to person, according to Debra Laino, Ph.D., a clinical sexologist, sex educator and sex therapist based in Delaware.
"HIV-infected individuals often note no symptoms attributable to HIV," explained Suman Radhakrishna, M.D., an infectious diseases physician at CHA Hollywood Presbyterian Medical Center in Los Angeles.
Reactions to the infection vary depending on the person, making the onset of symptomatology more nebulous. When no one symptom is a red flag, it should be easier to diagnose if the symptoms are seen from a bodywide perspective. Thus, to diagnose an individual, a variety of symptoms are examined.
"Symptomatic individuals often have nonspecific symptoms ranging from mild, flu-like symptoms—body aches, fever, sore throat—[to] swollen lymph nodes, rash, difficulty swallowing, groin-area sores or ulcers, nausea, diarrhea, abdominal pain, weight loss, cough and shortness of breath, headache and fatigue," Radhakrishna explained.
In the initial stage, referred to as acute HIV infection, people might not show any symptoms. Laino said when symptoms arise, they can take a couple of weeks to months to occur. According to Planned Parenthood, people might not feel sick from HIV for an entire decade or more.
"When individuals have very mild symptoms, they might ignore them," Radhakrishna said. "Two to four weeks after exposure, newly infected individuals can have symptoms of fatigue, fever, headache, body aches, rash, sore throat [and] enlarged lymph nodes."
Each of these is easily attributable to the flu and might be easy to dismiss.
"Initial symptoms can last for several weeks," Radhakrishna added.
Look out for these warning signs
A lack of symptoms does not indicate a lack of infection, so it's essential to receive regular HIV testing.
"Look out for the warning signs, such as flu-like symptoms," Laino suggested.
Regardless of whether or not you've noticed physical changes, getting tested after exposure or potential exposure is critical, Radhakrishna said. The CDC recommends everyone get tested for HIV at least once in their lifetime. You should get tested at least once a year if you have risk factors such as sharing drug injection equipment, having anal or vaginal sex with someone who has HIV, having sex with a new partner since your last HIV test, or receiving treatment or diagnosis for a sexually transmitted disease (STD).
"If a person is having unprotected sex, they should be tested regularly," Laino said. "There are many clinics around the country where there is free testing. A person can also visit their medical doctor and ask for an HIV test."
HIV can be diagnosed by a simple saliva or blood test.
Unfortunately, assuming you do not have HIV because you do not show symptoms is not effective and can be potentially harmful to transmission rates and your health. The CDC attributes an estimated 38 percent of new cases to people who are undiagnosed.
"The most important thing about HIV is to prevent it," Laino explained. "The use of condoms is the best way if you are sexually active."
For people who inject drugs, using clean needles is crucial.
Radhakrishna added that pre-exposure prophylaxis (PrEP) is another way to stay protected. PrEP can reduce your chances of getting HIV through sex or injection drug use.
"PrEP includes a once-daily pill to prevent HIV and, more recently, injectable medication administered every two months," Radhakrishna said.
You must be HIV-negative to start PrEP. When taken as prescribed, PrEP reduces the chances of getting HIV through sex by 99 percent, and about 74 percent for people who inject drugs, although more research is needed in this field. People who inject drugs can take the pills but not the shots, according to the CDC.
To receive treatment, you need to first confirm your status.
"[Antiretroviral therapy] is typical for HIV treatment, which stops the virus from replicating," Laino said. "A healthy lifestyle is also highly recommended, such as eating a healthy diet with a lot of antioxidants, and exercise as well as stress management."
Antiretroviral therapy (ART) has significantly reduced mortality rates. Without treatment, the chance of HIV progressing to acquired immunodeficiency syndrome (AIDS) is higher. It's recommended people begin antiretroviral therapy as soon as possible upon receiving their diagnosis.
"Treatment controls HIV and prevents progressive damage and destruction and allows infected individuals to lead a symptom-free life," Radhakrishna explained.
While an infected person with no symptoms can transmit the virus, when HIV is undetectable in the bloodstream, it's untransmittable.
"This will stop the cycle of transmission of new infections," Radhakrishna said. "Treatment of concomitant illnesses, such as hepatitis C, also improves and maintains the quality of life."
HIV symptoms can range in severity and presentation, depending on the person and the stage of the infection.
"No symptoms are most common," Radhakrishna said. "Individuals at risk for acquiring HIV should frequently be screened for HIV and sexually transmitted infections since STIs increase the risk of acquiring HIV."