What Is AIDS?

AIDS stands for Acquired immunodeficiency (or immune deficiency) Syndrome. It results from infection with a virus called HIV, which stands for human immunodeficiency virus. This virus infects key cells in the human body called CD4-positive (CD4+) T cells. These cells are part of the body’s immune system, which fights infections and various cancers.

When HIV invades the body’s CD4+ T cells, the damaged immune system loses its ability to defend against diseases caused by bacteria, viruses, and other microscopic organisms. A substantial decline in CD4+ T cells also leaves the body vulnerable to certain cancers.

There is no cure for AIDS, but medical treatments can slow down the rate at which HIV weakens the immune system. As with other diseases, early detection offers more options for treatment and preventing complications.

What Is The Difference Between HIV And AIDS?

The term AIDS refers to an advanced stage of HIV infection, when the immune system has sustained substantial damage. Not everyone who has HIV infection develops AIDS.

When HIV progresses to AIDS, however, it has proved to be a universally fatal illness. Few people survive five years from the time they are diagnosed with AIDS, although this is increasing with improvements in treatment techniques.

Experts estimate that about half the people with HIV will develop AIDS within 10 years after becoming infected. This time varies greatly from person to person, however, and can depend on many factors, including a person’s health status and health-related behaviors.

People are said to have AIDS when they have certain signs or symptoms specified in guidelines formulated by the U.S. Centers for Disease Control and Prevention (CDC).

The CDC’s definition of AIDS includes:

  • All HIV-infected people with fewer than 200 CD4+ T cells per cubic millimeter of blood (compared with CD4+ T cell counts of about 1,000 for healthy people)
  • People with HIV infection who have at least one of more than two dozen AIDS-associated conditions that are the result of HIV’s attack on the immune system

AIDS-associated conditions include:

  • Opportunistic infections by bacteria, fungi, and viruses. Opportunistic infections are infections that are rarely seen in healthy people but occur when a person’s immune system is weakened.
  • The development of certain cancers (including cervical cancer and lymphomas).
  • Certain autoimmune disorders.

Most AIDS-associated conditions are rarely serious in healthy individuals. In people with AIDS, however, these infections are often severe and sometimes fatal because the immune system is so damaged by HIV that the body cannot fight them off.

The History Of AIDS

The symptoms of AIDS were first recognized in the early 1980s:

  • In 1981, a rare lung infection called Pneumosystis carinii pneumonia began to appear in homosexual men living in Los Angeles and New York.
  • At the same time, cases of a rare tumor called Kaposi’s sarcoma were also reported in young homosexual men. These tumors had been previously known to affect elderly men, particularly in parts of Africa. New appearances of the tumors were more aggressive in the young men and appeared on parts of the body other than the skin.
  • Other infections associated with weakened immune defenses were also reported in the early 1980s.

Groups most frequently reporting these infections in the early 1980s were homosexuals, intravenous drug users, and people with hemophilia, a blood disorder that requires frequent transfusions. Blood and sexual transmission were therefore suspected as the sources for the spread of the infections.

In 1984, the responsible virus was identified and given a name. In 1986, it was renamed the human immunodeficiency virus (HIV).

Need To Know:

Because many of the first cases of AIDS in the United States occurred in homosexual men and intravenous drug users, some people mistakenly believe that other groups of people are not at risk for HIV infection. However, anyone is capable of becoming HIV-infected, regardless of gender, age, or sexual orientation.

Facts About AIDS

  • As of the year 2000, nearly one million people in the U.S. were confirmed to be HIV-positive.
  • The Centers for Disease Control and Prevention reports that 2.2 million Americans now carry the HIV virus but do not yet have symptoms.
  • Each year, about 40,000 new HIV infections occur in the U.S.
  • AIDS is a leading cause of death for American men and women between the ages of 25 and 44.
  • Through June 2000, 438,795 people in the U.S. had died from AIDS (374,422 men and 64,373 women).
  • By the end of 2000, 36.1 million people worldwide were living with HIV/AIDS, with the vast majority living in developing countries.
  • Through 2000, 21.8 million people worldwide have died from AIDS.
  • Between 1991 and 1996, there were more new cases of AIDS among people older than 50 than those between ages 13 and 49. Today, 11% of all new cases of AIDS in the U.S. are now in people over the age of 50.
  • The HIV carrier rate in the U.S. is now 1 carrier for every 100 to 200 people.

What Causes AIDS?

HIV is a type of virus called a retrovirus. Like all viruses, it must invade the cells of other organisms to survive and reproduce. HIV multiplies in the human immune system’s CD4+ T cells and kills vast numbers of the cells it infects. The result is disease symptoms.

Nice To Know:

There are two forms of HIV:

  • HIV-1 is the more common and more potent form. This form of HIV has spread throughout the world.
  • HIV-2, which is less potent that HIV-1, is found predominantly in West Africa. It is also more closely related to two HIV-like viruses found in monkeys.

There also are different strains of the virus, which makes it difficult to find one single treatment.

About The Immune System

Our bodies use a natural defense system to protect us from bacteria, fungi, viruses, and other microscopic invaders. This system includes general, nonspecific defenses as well as weapons custom-designed against specific health threats:

  • Innate, or nonspecific, immunity is the first line of defense. Our skin, tears, mucus, and saliva, as well as the swelling that occurs after an infection or injury, contain types of immune cells and chemicals that attack disease-causing agents attempting to invade the body.
  • Adaptive, or specific, immunity uses specialized cells and proteins called antibodies to attack invaders that get past the first line of defense. These weapons target specific proteins called antigens, found on the surface of the invading organism. The immune system can quickly rally these custom-tailored defenses if this particular invader attacks again.

There are two types of adaptive immune responses:

  • The humoral immune response involves the action of specialized antibody-producing white blood cells. The antibodies (proteins produced by the immune system to fight infectious agents such as viruses), which circulate in the blood and other body fluids, can recognize specific antigens (substances that stimulate the production of antibodies). They latch onto the viruses, bacteria, toxins, and other substances that bear these antigens, targeting them for destruction.
  • The cell-mediated immune response involves the action of another group of specialized white blood cells that direct and regulate the body’s immune responses or directly attack cells that are infected or cancerous.

How Do White Blood Cells Help Fight Disease?

White blood cells, particularly macrophages and B and T lymphocytes, play central roles in the immune system’s defenses against viruses and other foreign invaders.

  • Macrophages contribute to both nonspecific and specific immune responses. These versatile cells act as scavengers, engulfing and digesting microbes and other foreign material in a cell-eating process called phagocytosis. They also, upon encountering an invading organism, release chemical messengers that alert other cells of the immune system and summon T lymphocytes to the scene.
  • B lymphocytes, or B cells, serve as the body’s antibody factories. Each antibody is targeted to recognize and bind to an antigen from a specific invader. When antibodies circulating through blood and body fluids encounter this invader, they mark it for destruction.
  • T lymphocytes, or T cells, are part of the cellular immune response. Some T cells, like CD4+ T cells (also called “helper” T cells), direct and regulate the body’s immune responses. Others are killer cells that attack cells that are infected or cancerous.

How Does HIV Infection Become Established In The Body?

Researchers have found evidence that immune-system cells called dendritic cells may begin the process of infection. After exposure, these special cells may bind to and carry the virus from the site of infection to the lymph nodes, where other immune system cells become infected.

HIV targets cells in the immune system that display a protein called CD4 on their surface. Such cells are called CD4-positive (CD4+) cells.

Nice To Know:

When HIV encounters a CD4+ cell, a protein called gp120 that protrudes from HIV’s surface recognizes the CD4 protein and binds tightly to it. Another viral protein, p24, forms a casing that surrounds HIV’s genetic material.

HIV’s genetic material contains the information needed by the virus to infect cells, produce new copies of virus, or cause disease. For example, these genes encode enzymes that HIV requires to reproduce itself. Those enzymes are reverse transcriptase, integrase, and protease.


How Is HIV Infection Spread?

HIV infection is spread in three ways:

However, there is much misunderstanding about the ways in which HIV infection is not spread.

Sexual Intercourse

HIV is spread most commonly by sexual contact with an infected partner. The virus can enter the body through the lining of the vagina, penis, rectum, or mouth during sexual relations.

Sexual activities that can result in HIV infection include:

  • Sexual intercourse
  • Anal sex (heterosexual or homosexual)
  • Oral sex (heterosexual or homosexual)

Need To Know:

Q: Can HIV be spread through kissing?

A: Although studies have found tiny amounts of HIV in the saliva of some people with HIV, researchers have found no evidence that HIV is spread to other people through kissing. However, the CDC recommends against “French” or open-mouthed kissing because of the possibility of contact with blood if the people kissing have any cuts or sores in the mouth.

Direct Contact With Infected Blood

HIV can be spread through direct contact with infected blood:

  • Through injected drugs. HIV frequently is spread among users of illegal drugs that are injected. This happens when needles or syringes contaminated with minute quantities of blood of someone infected with the virus are shared.
  • In a health-care setting. Transmission from patient to health-care worker or vice-versa – via accidental sticks with contaminated needles or other medical instruments – can occur, but this is rare.
  • Through a blood transfusion. Prior to the screening of blood for evidence of HIV infection and before the introduction in 1985 of heat-treating techniques to destroy HIV in blood products, HIV was transmitted through transfusions of contaminated blood or blood components. Today, because of blood screening and heat treatment, the risk of acquiring HIV from such transfusions is extremely small.

From An Infected Mother To Her Unborn Child

Women can transmit HIV to their fetuses during pregnancy or birth. Approximately one-quarter to one-third of all untreated pregnant women infected with HIV will pass the infection to their babies.

A pregnant woman can greatly reduce the risk of infecting her baby if she takes the anti-HIV drug AZT (also called zidovudine) during her pregnancy. Because the risk of transmission increases with longer delivery times, the risk can be further reduced by delivering the baby by cesarean section, a surgical procedure in which the baby is delivered through an incision in the mother’s abdominal wall and uterus. Combining AZT treatment with cesarean delivery can reduce the infection rate to between 1% and 2%.

HIV also can be spread to babies through the breast milk of mothers infected with the virus.

  • Women who live in countries where safe alternatives to breast-feeding are readily available and affordable can eliminate the risk of transmitting the virus through breast milk by bottle-feeding their babies.
  • In developing countries, however, where such safe alternatives are not readily available or economically feasible, breast-feeding may offer benefits that outweigh the risk of HIV transmission.

How Is HIV Infection Not Spread?

Research indicates that HIV is NOT transmitted by casual contact such as:

  • Touching or hugging
  • Sharing household items such as utensils, towels, and bedding
  • Contact with sweat or tears
  • Sharing facilities such as swimming pools, saunas, hot tubs, or toilets with HIV-infected people
  • Coughs or sneezes

In short, studies indicate that HIV transmission requires intimate contact with infected blood or body fluids (vaginal secretions, semen, pre-ejaculation fluid, and breast milk). Activities that don’t involve the possibility of such contact are regarded as posing no risk of infection.

Need To Know:

Q: Is it safe to share a household with an HIV-infected person?

A: Studies of families of HIV-infected people have found that HIV is not spread through sharing utensils, towels, bedding, or toilet facilities. Behaviors that increase the likelihood of contact with blood from an HIV-infected person, such as sharing a razor or toothbrush, should be avoided.


What Are The Symptoms Of HIV Infection And AIDS?

Most people newly infected with the HIV virus show few, if any, symptoms for a few years. But during this asymptomatic period, HIV is actively multiplying, infecting, and killing cells in the immune system, particularly CD4+ T cells. People are very infectious during this early phase.

As the immune system weakens, symptoms begin to emerge.

Early Symptoms Of HIV Infection

Some people, but not all, develop symptoms within a month or two of exposure to HIV. These people may have a flu-like illness with such symptoms as:

  • Fever
  • Rash
  • Headache
  • Loss of appetite
  • Swollen glands (enlarged lymph nodes)
  • Achy muscles and joints

These early symptoms usually disappear within a week to a month. Most HIV-infected people who experience these early symptoms won’t see any more signs of the infection for at least a few years.

Later Symptoms Of HIV Infection

Usually, it takes about eight to nine years between the time of infection and the appearance of later symptoms, although this varies from person to person. These symptoms signal that immune system function is deteriorating, due to declining numbers of CD4+ T cells.

Not all people with HIV infection develop further symptoms. For those who do, however, symptoms may include:

  • Persistent, enlarged lymph nodes
  • Excessive fatigue
  • Weight loss
  • Frequent fevers
  • Night sweats
  • Chronic or frequent diarrhea
  • Genital sores (sores around the penis or vagina)
  • Thrush (an infection of the mouth caused by Candida, a yeast-like fungus) and mouth lesions
  • Skin rash or flaky skin
  • Joint stiffness and pain
  • Bone pain
  • Blurred vision
  • Short-term memory loss
  • Repeated bacterial, viral, or fungal infections

As the CD4+ T cell count continues to drop and the immune system deteriorates further, individuals may continue to experience the above symptoms as well as develop new ones.

What Symptoms Signal The Onset Of AIDS?

An HIV-infected person receives an AIDS diagnosis when he or she has:

  • A CD4+ T cell count of less than 200, and/or
  • At least one of more than two dozen opportunistic infections and conditions

In the United States, the most common AIDS-defining condition in both women and men is a lung infection called Pneumocystis carinii pneumonia, abbreviated PCP.

Other AIDS-defining conditions include severe body wasting andCandida infection of the esophagus, windpipe, or lungs.


How Is HIV Infection Diagnosed?

A blood test is used to confirm whether a person has been infected with HIV. Anyone who has engaged in risky behavior – such as sharing drug – injecting equipment or having unprotected sexual contact with an infected person or with someone whose HIV status is unknown – should consider being tested.

A positive HIV test result does not mean that a person has AIDS. Not everyone who has HIV infection develops AIDS. Experts estimate that about half the people with HIV will develop AIDS within 10 years after becoming infected.

Early diagnosis of HIV infection is important because:

  • It allows people to seek treatment that will help suppress HIV’s attack on the immune system and prevent opportunistic infections.
  • It helps women at risk for HIV infection who are planning a pregnancy or who are already pregnant take steps to reduce the risk of transmitting the infection to the baby.
  • It alerts those who are infected that they could infect others.

How To Information:

Where is HIV testing available?

HIV testing is available at most hospitals, family planning clinics, sexually transmitted disease (STD) clinics, community health centers, drug treatment facilities, and doctor’s offices. Individuals can contact their local health department for testing centers in their area. In many states, it is possible to be tested anonymously.

Information about testing centers is also available by calling the CDC’s National AIDS Hotline. (See Additional Sources Of Information.) Testing centers will also provide counseling about HIV and AIDS and help people understand their test results.

Nice To Know:

Q: Is a home test kit for HIV available?

A: No approved HIV test kit will give you a result at home. There is a kit available that is designed for you to collect a sample of your blood at home. Then you send the sample to a laboratory where it is tested for HIV.

What Kinds Of Blood Tests Are Used?

The blood tests most commonly used to diagnose HIV infection work by measuring the levels of antibodies produced by the body against HIV. Antibody-detecting assays, or tests, include the:

  • Enzyme immunoassay (EIA)
  • Enzyme-linked immunosorbent assay (ELISA)
  • Western blot test

Usually, the first test that laboratories use to detect the presence of HIV antibodies is an EIA or the ELISA. If the first test produces a positive result (HIV antibodies appear to be present), then the more sensitive Western Blot test is used to confirm it.

EIA or ELISA tests take from one to two weeks to complete, depending on where the test is performed.

Why Is It Often Necessary To Repeat An HIV Test?

Although a negative result on an HIV blood test usually means that the person is not infected with the virus, that is not always the case. The body may take three to six months after exposure to the virus to produce enough antibodies to be detectable in the bloodstream.

Because of this delay between infection and the appearance of HIV antibodies, a person should be retested six months after the last possible exposure to HIV. It is also important to remember that a person who has been exposed to HIV can pass the virus to others even before HIV antibodies appear in the bloodstream.


What Treatments Are Available For HIV And AIDS?

When AIDS first surfaced in the United States, no drugs were available to combat the underlying immune deficiency, and few treatments existed for the opportunistic infections that resulted. Over the past 10 years, however, therapies have been developed to fight both HIV infection and its associated infections and cancers.

Although there is no treatment currently available that can cure people of HIV or AIDS, a number of therapies have been developed to help them stay healthier and live longer.

  • Some medications target HIV itself, to reduce the virus’s assault on the immune system, or to even prevent the virus from entering human immune cells.
  • Other treatments are used to treat or prevent specific opportunistic infections that threaten the health of people with HIV-damaged immune systems.

Treatments That Suppress HIV

Drugs that interfere with the activity of a retrovirus such as HIV are generally known as antiretrovirals. Nearly all antiretroviral medications currently approved to treat HIV infection target two viral enzymes used by the virus to replicate itself. These enzymes, reverse transcriptase and protease, are involved in different stages of viral replication. A new treatment approved in the past year works in a completely new way by preventing the virus from entering the human immune cells.

Four classes of antiretroviral drugs have been developed to interfere with the activity of these viral enzymes and slow down the multiplication of the virus. These are:

  • Nucleoside analog reverse transcriptase inhibitors (NRTIs).NRTIs interrupt an early stage of HIV replication by interfering with the activity of reverse transcriptase. AZT (zidovudine), the first drug approved for treating HIV infection, is an NRTI, as arezalcitabine (ddC), didanosine (ddI), stavudine (d4T), lamivudine (3TC), and abacavir.
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs).NNRTIs also work by hindering the action of reverse transcriptase. This class of drugs includes delavirdinenevirapine, and efavirenz.
  • Protease inhibitors. Protease inhibitors interrupt a later stage of viral replication. This class of drugs includes saquinavir, indinavir, ritonavir, nelfinavir, and amprenavir.
  • Fusion inhibitors. Fusion inhibitors prevent HIV from entering human immune cells. The only fusion inhibitor approved to date isenfuvirtide.

Studies have found that various combinations of antiretroviral drugs are more effective in suppressing HIV than antiretroviral drugs used alone. Experts refer to one common treatment approach, usually involving a protease inhibitor combined with two other antiretroviral drugs, as “highly active antiretroviral therapy” or HAART.

Drug combinations, or drug “cocktails,” also can help reduce the risk that drug-resistant HIV will develop. When drug resistance occurs, medications that initially succeeded in suppressing the replication of HIV in the patient’s body loose their effectiveness. Enfuvirtide works in a unique way that reduces the likelihood of cross-resistance with other HIV drugs.

Antiretroviral drugs have side effects that can limit their use in some people.

  • AZT, for example, may result in a loss of blood cells.
  • Protease inhibitors can cause nausea, diarrhea, and other symptoms.

Treating AIDS-Related Conditions

Other drugs and therapies are used to prevent or treat opportunistic infections and other AIDS-related conditions:

  • Pneumocystis carinii pneumonia. People who develop this lung infection are generally treated with TMP/SMX (a combination of antibiotic drugs) or pentamidine. Doctors also prescribe these medications as preventive therapy for adult patients whose CD4+ T cell counts fall below 200.
  • Yeast infections in women. Physicians often prescribe a drug called fluconazole to treat yeast and other fungal infections.Fluconazole also can safely prevent vaginal and esophageal candidiasis without development of drug resistance.
  • Severe skin ulcers caused by herpes simplex virus infection.Skin ulcers sometimes respond to an antiviral medication,acyclovir.
  • Pelvic inflammatory disease. PID is treated with antibiotics. Women with mild cases may be treated on an outpatient basis. HIV-positive pregnant women suspected of having PID are usually hospitalized, treated with intravenous antibiotics approved for use during pregnancy, and monitored closely.
  • HIV-related wasting.Megestrol acetate (Megace) is often prescribed for HIV-associated wasting, but it can cause significant irregular vaginal bleeding in women. Another drug, nandrolone, may not have these side effects and is currently undergoing drug trials.
  • Kaposi’s sarcoma and other cancers. Cancers are treated with radiation, chemotherapy, or injections of alpha interferon, a genetically engineered, naturally occurring protein.
  • CMV Retinitis. Improvements in anti-HIV treatments as well as preventive and therapeutic approaches to managing CMV have resulted in a decreased incidence of CMV retinitis. Today, the incidence of CMV retinitis is about one quarter what it was previous to the introduction of HAART. While early CMV retinitis therapies were delivered intravenously, current treatments include medications in pill form for all stages of CMV retinitis.

For further information about radiation go to Radiation Therapy

What Are Some Of The Problems With AIDS Drug Therapy?

AIDS drugs do not cure the condition, but they help to manage it and postpone life-threatening complications. However, there are problems with AIDS drug therapy:

  • Side effects of drugs are a major concern in treatment.
  • Another major problem is the cost of the drugs used in treating AIDS. AIDS patients in the United States depend on insurance and government grants to obtain them. The high price of these drugs makes it difficult for third-world countries, which have major AIDS epidemics, to afford to distribute them.

Since antiviral drugs have so far not been curative, the hope is to find a vaccine. The technology for vaccine development is present, and serious efforts are being made to find one.

How Can The Psychological Impact Of AIDS Be Managed?

When people learn they have tested positive for the HIV virus, they may experience a number of stressful psychological reactions. Depression and anxiety leading to panic attacks may require the help of an adviser or psychological therapist. Counseling services are available in most HIV clinics. Group therapy sessions with other HIV-positive people may also be helpful in managing feelings of stress and guilt.

People with AIDS who show signs and symptoms of organic central nervous system involvement, such as confusion and memory loss, need particular support. In their cases there is a need for additional medical and psychiatric intervention.

Antidepressant drugs should be used under the advice of a specialist in case of a severe depressive episode. HIV-infected people may take antidepressant drugs, but they are usually more sensitive to their side effects.


How Can I Learn about New Treatments for HIV and AIDS?

Medical researchers are working to develop new drugs to keep HIV replication in check, as well as medications and methods to treat or prevent opportunistic infections and other HIV-related conditions.

Some people with HIV and AIDS choose to participate in clinical trials of new medications. Clinical trials are research studies that help doctors find better ways to prevent, diagnose, and treat illnesses.

Clinical trials are conducted in humans only after they are tested in laboratories and in animal studies. They are designed to develop better treatments for people while giving current patients a chance to benefit from new treatments that may be more effective.

  • For information about studies of new HIV therapies, call the AIDS Clinical Trials Information Service at 1-800-TRIALS-A (1-800-243-7012 for TDD/deaf access).
  • For federally approved treatment guidelines on HIV/AIDS, call the HIV/AIDS Treatment Information Service at 1-800-HIV-0440 (1-800-243-7012 for TDD/deaf access).

How Can The Spread Of AIDS Be Prevented?

Since no vaccine for HIV is available, the only way to prevent infection by the virus is to avoid behaviors that place a person at risk for infection, such as sharing needles and having unprotected sex.

Prevention is the key to personal protection against HIV and AIDS. Being aware of behaviors that increase the risk of infection and taking preventive measures can substantially reduce a person’s likelihood of becoming infected with HIV.

Prevention involves:

Safer Sex Practices

The CDC recommends complete sexual abstinence as a foolproof way to prevent sexually transmitted HIV. A monogamous sexual relationship between two uninfected individuals also limits the risk of HIV exposure through sex – as long as both partners are completely faithful and avoid nonsexual exposure to HIV, such as through injection drugs.

Safer sex practices should be followed during sexual contact with any partner, male or female, who is HIV-positive or whose sexual history is unknown. An individual who is infected with HIV is able to transmit the virus:

  • Even if he or she has no symptoms of the infection
  • Immediately after he or she has become infected

How To Information:

Safe sex practices involve creating a barrier between a person’s mucous membranes (or any cuts or breaks in the skin) and his or her partner’s blood, semen, or vaginal secretions. Such barriers include:

  • Condoms, with or without spermicide
  • Dental dams (squares of latex, originally used for dental work, now commonly recommended for safe oral sex)
  • Latex gloves

Most condoms are made from latex rubber. Using latex condoms, correctly and consistently, can greatly reduce a person’s chance of acquiring or transmitting HIV and most STDs. There is no scientific evidence demonstrating that spermicides (which are used for their contraceptive properties) offer protection against HIV infection.

Not all condoms are alike.

  • Lambskin condoms, which are porous and may allow HIV and other viruses to pass through them, are not recommended for protection against HIV and other STDs.
  • Polyurethane condoms, on the other hand, may provide an alternative for people who are allergic to latex.

The female condom, a thin sheath of polyurethane that is placed in the vagina, has recently been approved as a birth control method and is thought to offer protection against STDs as well. But it has not yet been proven to reduce the risk of HIV infection.

Need To Know:

Experts caution that oil-based lubricants should never be used with latex condoms or the other latex barriers, as these may erode the material and destroy the barrier. Recommended “condom-compatible” lubricants are water-based, such as K-Y Jelly lubricant.

Sexual activities that do not involve contact with blood or other bodily fluids, such as hugging, “dry” or closed-mouth kissing, and use of non-shared sex toys, are considered safe.

Drug Use And Limiting HIV Exposure

People who use injection drugs risk exposure to HIV if they share needles and syringes with others. HIV in the blood residue from an infected person can be transmitted directly into the bloodstream of the next person using the injecting equipment.

Health authorities recommend that people who use illegal drugs seek treatment to help them stop. Those who cannot end their drug use are advised to avoid sharing drug injection equipment with others.

Programs that distribute clean needles to injecting drug users have helped to lower the incidence of HIV infection among these people.

Minimizing HIV Exposure From Medical Procedures

HIV has been transmitted through transfusions of contaminated blood and blood components. In the United States, several thousand surgical patients and others became HIV-infected through receiving contaminated blood, most of them early in the AIDS epidemic.

Since 1985, however, blood banks have added new safeguards to their procedures to ensure that donated blood does not present an HIV risk. These measures include various heat-treating techniques and screening donated blood for evidence of HIV. Blood from potential donors who are determined to have risk factors for HIV transmission is also discarded.

Today, the risk of acquiring HIV infection from blood transfusions is extremely small. People who are scheduling elective surgery can reduce the risk even further by banking some of their own blood before the surgery. This is known as autologous blood donation.

HIV transmission as a result of other medical procedures is rare, although accidental sticks with contaminated needles have occurred, mostly among healthcare workers.

Dentists, hygienists, and other healthcare professionals are required to wear protective latex gloves to avoid the transmission of viral infections such as HIV.


Frequently Asked Questions: AIDS

Here are some frequently asked questions related to AIDS.

Q: What if I’m attracted to someone I don’t really know? What should I do?

A: Know the sexual history and health status of partners. Avoid anonymous sexual contact and learn about safe sex practices, such as the use of condoms.

Q: Are my children going to get AIDS if other children in the school have it?

A: No. Casual contact, even over a long period of time, is not regarded as dangerous. This includes all typical sports and activities.

Q: What if I eat at a restaurant where a cook or a waiter has AIDS? Am I at risk?

A: No. Eating in restaurants does not increase the AIDS risk. There are no cases of AIDS transmitted from food preparations or handling.

Q: Is an AIDS test required of new job applicants and/or employees?

A: Probably not. In fact, under most state laws, employers cannot ask whether applicants or employees have AIDS – only if they can do the job.

Q: Should I avoid sharing personal hygiene items, like razors or toothbrushes?

A: Yes. These devices might be contaminated with blood. However, this is an unlikely mode of transmission for the AIDS virus.

Q: Does everyone who has AIDS die from it?

A: When scientists first recognized AIDS in 1981, most people died within a year or two. Now, with numerous drugs available to help suppress HIV’s attack on the immune system and prevent or treat AIDS-related opportunistic illnesses, many people with AIDS are living longer and healthier lives. However, AIDS still is considered a fatal illness. Few people survive five years from the time they are diagnosed with AIDS, although this is increasing with improvements in treatment techniques.

Q: How can a person tell if she is infected with HIV?

A: A blood test can determine whether or not a person is infected with HIV. The most commonly used test detects antibodies (disease-fighting proteins) against HIV. It may take as long as three to six months for HIV antibodies to reach levels that are measurable in standard blood tests.

Q: Can I keep my test results private?

A: People can have the procedure done at HIV testing centers that offer anonymous HIV testing.

Q: How safe is a blood transfusion?

A: The risk of acquiring HIV through a blood transfusion in the United States is very small. All donated blood in the U.S. is routinely screened for HIV.

Q: Can HIV be spread by casual contact, such as touching or hugging?

A: HIV is not transmitted by casual contact such as touching, caressing, hugging or massaging a person with the infection. Studies indicate that HIV transmission requires intimate contact with infected blood or body fluids (vaginal secretions, semen, pre-ejaculation fluid, and breast milk).

Q: Can HIV be spread through kissing?

A: Although studies have found tiny amounts of HIV in the saliva of some people with HIV, researchers have found no evidence that HIV is spread to other people through kissing. However, the CDC recommends against “French” or open-mouthed kissing because of the possibility of contact with blood if the people kissing have any cuts or sores in the mouth.

Q: Is it safe to share a household with an HIV-infected person?

A: Studies of families of HIV-infected people have found that HIV is not spread through sharing utensils, towels, bedding, or toilet facilities. Behaviors that increase the likelihood of contact with blood from an HIV-infected person, such as sharing a razor or toothbrush, should be avoided.

Q: Is it safe to share a sauna, swimming pool, hot tub, or toilet with an HIV-infected person?

A: Using such facilities does not put a person at risk for HIV infection. Only activities that cause intimate contact with blood, vaginal secretions, semen, pre-ejaculation fluid, or breast milk of an HIV-infected person can transmit HIV.

Q: Can HIV be transmitted through a cough or a sneeze?

A: Although some viruses (such as the common cold or influenza) are spread through aerosol droplets when an infected person sneezes or coughs, HIV is not transmitted in this manner.

Q: Can HIV be transmitted during oral sex?

A: Although the risk of infection during oral sex is considered lower than during vaginal or anal intercourse, HIV may be transmitted during oral sex through contact with vaginal secretions, semen, pre-ejaculation fluid, and blood.

Q: Can HIV be spread by mosquitoes?

A: Studies have found that HIV is not spread by biting insects, such as mosquitoes or bedbugs.

Q: Is a home test kit for HIV available?

A: No approved HIV test kit will give you a result at home. There is a kit available that is designed for you to collect a sample of your blood at home. Then you send the sample to a laboratory where it is tested for HIV.

Q: I’ve read on the Internet stories about people getting HIV after being stuck by needles in phone booth coin returns and movie theater seats. Is this true?

A: t’s true that discarded needles are sometimes found in public, probably from people who use insulin (to treat diabetes) or illegal drugs. Occasionally someone is stuck from discarded needles – but the risk of transmission of HIV in this case is extremely low. The Centers for Disease Control is not aware of any cases where HIV has been transmitted by a needle-stick injury outside of a health-care setting. However, anyone who is injured in this manner should contact their physician or go to an emergency room as soon as possible.


Putting It All Together: AIDS

Here is a summary of the important facts and information related to AIDS.

  • AIDS (acquired immunodeficiency, or immune deficiency, syndrome) is an advanced stage of a viral infection that attacks the body’s disease-fighting immune system.
  • HIV (the human immunodeficiency virus) is the infectious agent that is the cause of AIDS.
  • HIV/AIDS testing is available anonymously through clinics and requires a blood sample.
  • Not everyone who has HIV infection develops AIDS.
  • The U.S. Centers for Disease Control and Prevention’s definition of AIDS includes all HIV-infected people who have a very low level of key immune cells and/or one of a number of medical conditions that are the result of HIV’s attack on the immune system.
  • A number of drugs are available to help HIV-infected individuals live longer and healthier lives.

Glossary: AIDS

Here are definitions of medical terms related to AIDS.

AIDS: Acquired immunodeficiency (or immune deficiency) syndrome, an advanced stage of a viral infection caused by the human immunodeficiency virus (HIV)

Antibodies: Proteins produced by the immune system to fight infectious agents, such as viruses

Antigen: A substance that stimulates the production of antibodies

Antiretroviral drugs: Chemicals that inhibit the replication of retroviruses, such as HIV

Asymptomatic: Having no symptoms

Autoimmune disorder: Illness that results when the immune system attacks an individual’s own tissues or cells

AZT: An antiretroviral drug used to treat HIV infection; also called zidovudine

B lymphocytes: White blood cells that mature in the bone marrow and produce antibodies; also called B cells.

Bisexual: A person who is attracted to and/or has sex with both men and women

Cesarean section: The delivery of a baby through a surgical incision through the abdominal wall and the uterus

Candidiasis: An infection, usually caused by the yeastlike fungusCandidaalbicans, that occurs in the mouth, vagina, and other moist areas of the body

CD4: A protein displayed on the surface of a certain human immune cells. HIV recognizes, attaches to, and infects cells bearing CD4 on their surface

Condom: A sheath, usually made of latex, designed to cover the penis during sexual intercourse to help prevent pregnancy and reduce the risk of sexually transmitted diseases, including HIV

Dendritic cells: Immune cells that may bind to HIV after sexual exposure and carry the virus from the site of infection to the lymph nodes

Dental dams: Squares of latex, originally used for dental work, now commonly recommended for safe oral sex

Dildo: A sex toy, usually made of silicone or rubber, that is inserted into the vagina or the anus

Enzyme immunoassay (EIA): A test used to detect HIV antibodies in a blood sample

Enzyme-linked immunosorbent assay (ELISA): A test used to detect HIV antibodies in a blood sample

Herpes simplex virus: Human viruses responsible for blister-like lesions around the mouth and lips, the anus, or the genital area

Heterosexual: A person who is sexually attracted to and/or has sex with someone of the opposite sex

HIV: The human immunodeficiency virus, a retrovirus recognized as the cause of AIDS

Homosexual: A person who is sexually attracted to and/or has sex with someone of the same sex

Immunity: The body’s ability to resist infection

Injection drugs: Drugs such as heroin or morphine that are injected through a syringe and needle into a vein

Kaposi’s sarcoma: A cancerous tumor that arises from blood vessels in the skin, which occurs in some people with HIV and AIDS

K-Y Jelly: A water-based lubricant used with latex materials such as condoms

Latex: A synthetic rubber used in products such as gloves and condoms, to provide a barrier to infection

Lymph nodes/lymph glands: Small, round or oval bodies connected by a network of vessels; they help remove bacteria and foreign particles from the circulation, and play a role in the body’s immune defenses

Lymphocytes: White blood cells that play a key role in the body’s disease-fighting immune response

Lymphocytes: White blood cells that play key roles in the body’s immune defenses; The two main types of lymphocytes are B lymphocytes (also called B cells) and T lymphocytes (also called T cells)

Macrophages: Specialized white blood cells that play many roles in the immune response, including engulfing and digesting bacteria and other microbes, alerting other immune cells, and producing chemicals needed for immune responses to disease threats

Opportunistic infections: Infections (rarely seen in healthy people) that that occur when a person’s immune system is weakened due to HIV, cancer, or drugs that suppress the body’s immune response

Pelvic inflammatory disease (PID): A gynecologic condition caused by infection of a woman’s reproductive organs; it may cause severe abdominal pain and sterility

Phagocytosis: The process by which macrophages and other specialized cells engulf and digest of bacteria and other foreign particles

Pneumocystis carinii pneumonia: A type of pneumonia (lung inflammation) caused by a microbe called Pneumocystiscarinii, seen in people with impaired immunity

Protease inhibitors: Drugs that suppress HIV replication by interfering with an HIV enzyme called protease

Reverse transcriptase: An HIV enzyme that the virus requires to reproduce itself

Sex toys: Devices used for sexual pleasure, such as vibrators and dildos

Sexually transmitted diseases (STDs): Diseases caused by infectious agents that are transmitted through sexual contact, such as HIV/AIDS, chlamydia infection, syphilis, and gonorrhea

Spermicide: A substance that deactivates sperm cells and is used for birth control

T lymphocytes: A family of specialized white blood cells that help orchestrate the body’s immune responses and attack cells that are infected or cancerous

Thrush: Oral candidiasis, an infection of the mouth caused by caused by the yeast-like fungus Candidaalbicans

Transfusion: The injection of whole blood, plasma, or another solution into a patient’s bloodstream

Virus: A disease-causing microbe that can replicate only in the living cells of other organisms

Western blot: A test used to diagnose HIV infection by detecting antibodies to HIV in a person’s blood; this test is commonly used to confirm a less-sensitive HIV antibody test


Additional Sources Of Information: AIDS

Here are some reliable sources that can provide more information on AIDS.

The U.S. Centers for Disease Control and Prevention


U.S. National Library of Medicine Web site

Project Inform, a national, nonprofit, community-based organization that provides treatment information, advocacy and inspiration to people living with HIV/AIDS, their caregivers and their healthcare providers, a nonprofit organization designed to inform and educate using the Web

AIDS Legislative Update and Resources, a Web site designed to provide the latest information about legislative action related to AIDS.

For People Over 50

American Association of Retired Persons (AARP) Social Outreach and Support (SOS) 
Phone: (202) 434-2260

The AARP/SOS program has information on HIV and AIDS and its impact on midlife and older adults.

Social Security Administration

Contact local office or call (800) SSA-1213

Social Security has two disability benefit programs that provide financial assistance to eligible AIDS patients.

Seniors in a Gay Environment (SAGE) 
Phone: (212) 741-2247

SAGE provides HIV/AIDS information and referrals for men and women over the age of 50.

Information About HIV Testing Centers

National AIDS Hotline operated by the Centers for Disease Control


1-800-344-SIDA (for Spanish)

1-800-AIDS-889 (TTY)

The hotline operates 24 hours a day, seven days a week. It offers general information and local referrals.

Centers for Disease Control AIDS Clearinghouse 
Phone: 1-800-458-5231

The clearinghouse offers free government publications and information about resources.

National Institute of Allergy and Infectious Diseases (NIAID)

The NIAID, which is part of the National Institutes of Health, will respond to written requests for information on AIDS research and clinical trials of promising therapies.

Information About Studies Of New HIV Therapies

HIV/AIDS Clinical Trials Information Service


1-800-243-7012 (TDD/Deaf Access)

HIV/AIDS Treatment Information Service


1-800-243-7012 (TDD/Deaf Access)


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