HIV/AIDS – Symptoms and Causes
Overview
HIV/AIDS is a chronic condition that weakens the immune system over time. HIV (human immunodeficiency virus) attacks the body’s natural defenses, making it harder to fight off infections and diseases.
Without treatment, HIV can eventually progress to AIDS (acquired immunodeficiency syndrome), though modern treatments have made this progression rare in many countries.
HIV spreads primarily through:
- Sexual contact without protection
- Blood contact (like sharing needles)
- From parent to child during pregnancy, birth, or breastfeeding (when HIV is untreated)
The virus is classified as an STI (sexually transmitted infection) when spread through sexual contact.
While there is no cure for HIV/AIDS, effective treatments exist. Antiviral medications can control the infection, prevent progression to AIDS, and help people live long, healthy lives. These treatments have dramatically reduced deaths worldwide.
Treatment Benefits
- Controls viral replication
- Preserves immune function
- Prevents progression to AIDS
- Reduces transmission risk
Global health initiatives continue working to expand access to HIV prevention and treatment options in regions with limited resources. With proper medical care, most people with HIV can manage their condition effectively.
Signs and Symptoms
Early Stage HIV (Acute Phase)
During the first 2-4 weeks after HIV enters the body, some people experience flu-like symptoms. This early phase may last for several days or weeks, though some individuals show no symptoms at all.
Common symptoms include:
- Fever
- Headache
- Muscle and joint pain
- Skin rash
- Throat pain and mouth sores
- Swollen lymph nodes (especially in the neck)
- Diarrhea
- Weight loss
- Cough
- Night sweats
These symptoms can be mild and easy to miss. During this time, the amount of virus in the blood (viral load) is very high, making it easier to pass HIV to others.
Long-term HIV (Chronic Phase)
In this stage, HIV remains in the body and in immune system cells. Many people have no symptoms during this phase, which can last for many years without treatment.
Some individuals may progress to more serious illness sooner than others. Without antiretroviral therapy (ART), this phase can continue for a long time.
Symptoms as HIV Progresses
As the virus multiplies and destroys more immune cells, you may develop:
- Recurring fever
- Ongoing fatigue
- Swollen lymph nodes
- Persistent diarrhea
- Unexplained weight loss
- Thrush (white patches in the mouth)
- Shingles outbreaks
- Pneumonia
Advanced HIV Disease
With modern treatments, most people with HIV in the United States don’t develop advanced disease. Without treatment, HIV typically progresses to AIDS in about 8-10 years.
Advanced HIV disease seriously damages the immune system. This makes people vulnerable to illnesses that healthy immune systems can fight off, called opportunistic infections or cancers.
Signs of these complications may include:
| Symptom | Description |
|---|---|
| Fever | Recurring and persistent |
| Sweats and chills | Often occurring at night |
| Diarrhea | Lasting for weeks |
| Fatigue | Severe and ongoing |
| Weight loss | Rapid and unexplained |
| Mouth problems | Persistent white spots or sores |
| Skin issues | Unusual rashes or bumps |
| Lymph nodes | Visibly swollen glands |
When Medical Care Is Needed
If you think you might have been exposed to HIV or are at risk for the virus, see a healthcare provider as soon as possible. Early testing and treatment greatly improve outcomes and can prevent transmission to others.
What Causes HIV/AIDS?
How HIV Develops into AIDS
HIV attacks the immune system by targeting CD4 T cells, which are critical for fighting infections. When someone first gets HIV, they may have few or no symptoms for many years.
During this time, the virus slowly destroys these important immune cells. AIDS is diagnosed when the CD4 T cell count falls below 200 or when severe infections or cancers occur in those with weakened immune systems.
Without treatment, HIV typically progresses to AIDS over time.
Ways HIV Spreads
HIV passes from person to person through specific body fluids, including blood, semen, and vaginal fluids. The virus cannot survive for long outside the body.
Several main ways HIV spreads include:
Sexual contact: Vaginal and anal sex with an infected partner carry the highest risk. The virus can enter through tiny tears in the rectum or vagina. Oral sex has a lower risk but isn’t completely safe.
Shared needles: Using needles or syringes that someone with HIV has used puts people at high risk. This commonly happens when people share equipment to inject drugs.
Blood transfusions: This risk is very small in countries that test blood donations. However, in places where blood isn’t thoroughly screened, this remains a concern.
From parent to child: Pregnant people with HIV can pass the virus to their babies during:
- Pregnancy
- Childbirth
- Breastfeeding
How HIV Does Not Spread
HIV doesn’t spread through everyday contact. You cannot get HIV from:
- Hugging or shaking hands
- Casual kissing
- Sharing food or drinks
- Using the same toilet seats
- Swimming in the same pool
- Mosquito bites or other insects
- Donating blood
- Coughing or sneezing
This means you can safely live, work, and socialize with people who have HIV without fear of catching the virus through normal daily activities.
Who is at Risk?
HIV/AIDS can affect anyone regardless of age, race, gender, or sexual orientation. However, certain behaviors and conditions increase risk.
Unprotected Sexual Activity
- Using a new latex or polyurethane condom during each sexual encounter reduces risk
- Anal sex carries a higher risk than vaginal sex
- Having multiple sexual partners increases risk
Sexually Transmitted Infections (STIs)
- Open sores from STIs create entry points for HIV
- Getting tested and treated for STIs helps reduce risk
Injection Drug Use
- Sharing needles or syringes exposes users to potentially infected blood
- Using clean, unused equipment for each injection reduces risk
Health Issues Related to HIV/AIDS
People with HIV/AIDS have weakened immune systems that struggle to fight off germs. This makes certain infections more likely and more severe.
- Pneumocystis Pneumonia (PCP) remains the most common type of pneumonia in people with HIV, though modern treatments have reduced its frequency in the United States. This fungal infection affects the lungs and can become very serious.
- Thrush (Candidiasis) frequently appears in people with HIV. It creates thick, white patches in the mouth, on the tongue, in the esophagus, or in the vagina.
- Tuberculosis (TB) poses a significant threat to people with HIV/AIDS. While less common in the U.S. due to HIV medicines, TB remains a leading cause of death among people with AIDS worldwide.
| Infection | Affects | Symptoms |
|---|---|---|
| Cytomegalovirus | Eyes, digestive system, lungs | Varies by affected organ |
| Cryptococcal Meningitis | Brain and spinal cord | Inflammation, headache, fever |
| Toxoplasmosis | Multiple organs, brain | Heart problems, seizures |
Cytomegalovirus spreads through body fluids and remains dormant in healthy people but becomes active when the immune system weakens.
Cancer Types Common with HIV/AIDS
HIV significantly increases the risk of developing certain cancers:
- Lymphoma begins in white blood cells and often shows up as painless swelling in the lymph nodes of the neck, armpit, or groin
- Kaposi Sarcoma creates colored skin lesions (pink to purple in light skin, dark brown or black in darker skin) and can affect internal organs
- HPV-Related Cancers including anal, oral, and cervical cancers occur more frequently in people with HIV
These cancers develop more easily because the immune system cannot effectively fight early cancer cells or control viruses that cause cancer.
Additional Health Problems
HIV/AIDS can lead to several other serious health complications:
- Wasting syndrome involves significant weight loss, often accompanied by:
- Ongoing diarrhea
- Extreme weakness
- Persistent fever
- Brain and nervous system issues range from mild to severe. People might experience:
- Confusion and memory problems
- Depression and anxiety
- Difficulty walking
- In severe cases, dementia with significant weakness
- Kidney disease particularly affects Black and Hispanic individuals with HIV. HIV-associated nephropathy causes inflammation of the kidney filters that remove waste from the blood.
- Liver complications are especially common in people who also have hepatitis B or hepatitis C infections. The combination of HIV and hepatitis can speed up liver damage.
Preventing HIV
HIV has no vaccine or cure, but several effective prevention methods exist. Taking these steps helps protect yourself and others from infection.
Medication Options for Prevention
Pre-exposure prophylaxis (PrEP) offers significant protection for those at high risk.
PrEP comes in two forms:
Oral PrEP pills:
- Emtricitabine-tenofovir disoproxil fumarate
- Emtricitabine-tenofovir alafenamide fumarate
Injectable PrEP:
- Cabotegravir (given as a shot)
PrEP can reduce sexual transmission risk by about 99% and injection-related transmission by at least 74%.
The injectable option requires initial monthly shots, then moves to a schedule of one shot every two months.
Before starting PrEP, you need a negative HIV test. Regular testing continues while using PrEP every three months for pills or before each injection.
Prevention Strategy Comparison
| Prevention Method | Effectiveness | Requirements | Best For |
|---|---|---|---|
| PrEP (pills) | ~99% for sexual transmission | Daily pill, testing every 3 months | High-risk individuals |
| PrEP (injectable) | ~99% for sexual transmission | Shots every 2 months after initial doses | Those who prefer not taking daily pills |
| TasP | Near 100% when viral load undetectable | Strict medication adherence | People living with HIV |
| Condoms | Highly effective when used correctly | New condom for each sex act | Everyone engaging in sex |
| PEP | Effective if started quickly | Must begin within 72 hours of exposure | Emergency situations after potential exposure |
Treatment as Prevention (TasP)
People living with HIV can prevent transmission by taking HIV medications as prescribed. When viral load becomes undetectable, the virus cannot spread to sexual partners.
This approach requires strict medication adherence and regular medical checkups.
Post-Exposure Prevention (PEP)
If you think you’ve been exposed to HIV, seek medical help immediately.
PEP must start within 72 hours of exposure to be effective. The treatment lasts 28 days and greatly reduces infection risk.
Safe Sex Practices
Always use new condoms during anal or vaginal sex. Both male and female condoms provide protection. Some important tips:
- Use water-based lubricants only
- Oil-based products can damage condoms
- For oral sex, use dental dams or cut-open condoms
- Disclose HIV status to all sexual partners
Needle Safety
If you inject drugs, never share needles. Use only sterile equipment and take advantage of needle exchange programs in your community.
Seeking help for substance use is an important step in HIV prevention.
Pregnancy and HIV
Pregnant women with HIV need immediate medical care. With proper treatment during pregnancy, the risk of transmitting HIV to the baby drops significantly.
Male Circumcision
Research shows that circumcision can help lower the risk of HIV infection in men. This is one of several prevention options to consider.
