Anyone can become infected with HIV. In the United States, more than 1.1 million people live with HIV. Almost 1 in 5 are unaware of their infection.
Latinos are the largest and fastest-growing ethnic minority in the United States and one of the groups most heavily impacted by HIV. Among Latinos, gay and bisexual men bear the greatest burden of HIV infection.
Latino gay and bisexual men are at risk for HIV. In 2010, among gay and bisexual men, Latinos accounted for an estimated 22% of the new infections. The largest number of new infections occurred among Latino gay and bisexual men between the ages of 25 and 34.
There is reason to be hopeful. You have the power to stop HIV. Knowing if you have HIV or not is important. The only way to know if you have HIV is to get tested. HIV testing is free, fast, and confidential.
Whether you test positive or negative, you can use that knowledge to take better care of yourself and your loved ones. We encourage you to get involved.
HIV stands for human immunodeficiency virus. It is the virus that can lead to acquired immunodeficiency syndrome (AIDS). Unlike some other viruses, the human body cannot get rid of HIV. That means that once you have HIV, you have it for life.
No safe and effective cure currently exists, but scientists are working hard to find one, and remain hopeful. Meanwhile, with proper medical care, HIV can be controlled. Treatment for HIV is often called antiretroviral therapy (ART). It can dramatically prolong the lives of many people infected with HIV and lower their chance of infecting others. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS in just a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can have a nearly normal life expectancy.
HIV affects specific cells of the immune system, called CD4 cells, or T cells. Over time, HIV can destroy so many of these cells that the body can't fight off infections and disease. When this happens, HIV infection leads to AIDS.
Gay and bisexual men are more severely affected by HIV than any other group in the United States. There is no easy answer to explain why Latino gay and bisexual men are being hit hard by the HIV epidemic. Research shows a multitude of societal, economic, and structural factors contribute to the HIV epidemic in Latino gay and bisexual men. Such factors include poverty, homophobia, stigma and discrimination, limited access to health care, immigration status, migration patterns, and language or cultural barriers.
We also know that unemployment, racism, depression, stigma, and having older sex partners (who are more likely to be infected with HIV) are additional factors that may contribute to gay and bisexual men being more likely to get this disease.
Many gay and bisexual men may think they do not have HIV because they feel fine. But if they don't get tested there is no way to know for sure, and they may unknowingly give HIV to their next partner.
Other men may avoid getting tested or not tell you about their HIV status because of the stigma that may come with being HIV positive.
The only way to know if you are infected with HIV is to be tested. You cannot rely on symptoms to know whether you have HIV. Many people who are infected with HIV do not have any symptoms at all for 10 years or more. Some people who are infected with HIV report having flu-like symptoms (often described as "the worst flu ever") 2 to 4 weeks after exposure. Symptoms can include:
These symptoms can last anywhere from a few days to several weeks. During this time, HIV infection may not show up on an HIV test, but people who have it are highly infectious and can spread the infection to others.
However, you should not assume you have HIV if you have any of these symptoms. Each of these symptoms can be caused by other illnesses. Again, the only way to determine whether you are infected with HIV is to be tested. For information on where to find an HIV testing site:
These resources are confidential. You can also ask your health care provider to give you an HIV test.
Two types of home testing kits are available in most drugstores or pharmacies: one involves getting a swab of fluid from your mouth, using the kit to test it, and reading the results in 20 minutes. The other involves pricking your finger for a blood sample, sending the sample to a laboratory, then phoning in for results. Confidential counseling and referrals for treatment are available with both kinds of home tests.
If you test positive for HIV, you should see your doctor as soon as possible to begin treatment.
HIV infection has a well-documented progression. Untreated, HIV is almost universally fatal because it eventually overwhelms the immune system—resulting in acquired immunodeficiency syndrome (AIDS). HIV treatment helps people at all stages of the disease, and treatment can slow or prevent progression from one stage to the next.
A person can transmit HIV to others during any of these stages:
Acute infection: Within 2 to 4 weeks after infection with HIV, you may feel sick with flu-like symptoms. This is called acute retroviral syndrome (ARS) or primary HIV infection, and it is the body's natural response to the HIV infection. (Not everyone develops ARS, however, and some people may have no symptoms.)
During this period of infection, large amounts of HIV are being produced in your body. The virus uses important immune system cells called CD4 cells to make copies of itself and destroys these cells in the process. Because of this, your CD4 count can fall quickly.
Your ability to spread HIV is highest during this stage because the amount of virus in your blood is very high.
Eventually, your immune response will begin to bring the amount of virus in your body back down to a stable level. At this point, your CD4 count will begin to increase, but it may not return to pre-infection levels.
Clinical latency (inactivity or dormancy): This period is sometimes called asymptomatic HIV infection or chronic HIV infection. During this phase, HIV is still active, but it reproduces at very low levels. You may not have any symptoms or get sick during this time. People who are on antiretroviral therapy (ART) may live with clinical latency for several decades. For people who are not on ART, this period can last up to a decade, but some may progress through this phase faster. It is important to remember that you are still able to transmit HIV to others during this phase even if you are treated with ART, although ART greatly reduces the risk. Toward the middle and end of this period, your viral load begins to rise and your CD4 cell count begins to drop. As this happens, you may begin to have symptoms of HIV infection as your immune system becomes too weak to protect you.
AIDS (acquired immunodeficiency syndrome): This is the stage of infection that occurs when your immune system is badly damaged and you become vulnerable to infections and infection-related cancers, called opportunistic illnesses. When the number of your CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3), you are considered to have progressed to AIDS. (Normal CD4 counts are between 500 and 1,600 cells/mm3.) You can also be diagnosed with AIDS if you develop one or more opportunistic illnesses, regardless of your CD4 count. Without treatment, people who are diagnosed with AIDS typically survive about 3 years. Once someone has a dangerous opportunistic illness, life expectancy without treatment falls to about 1 year. People with AIDS need medical treatment to prevent death.
Only certain fluids—blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk—from an HIV-infected person can transmit HIV. These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (from a needle or syringe) for transmission to possibly occur. Mucous membranes can be found inside the rectum, the vagina, the opening of the penis, and the mouth.
In the United States, HIV is spread mainly by having unprotected sex (sex without a condom) with someone who has HIV:
Less commonly, HIV may be spread the following ways:
No. HIV is not spread by day-to-day contact in the workplace, schools, or social settings. HIV is not spread through shaking hands, hugging, or casual kissing. You cannot become infected from toilet seats, drinking fountains, door knobs, dishes, drinking glasses, food, cigarettes, or pets.
HIV is not spread through the air, and it does not live long outside the body.
Yes. In fact, having anal sex without using a condom is the riskiest type of sex for getting or spreading HIV. During anal sex, it is possible for either partner—the insertive (top) or the receptive (bottom)—to get HIV.
HIV can be found in the blood, semen (cum), preseminal fluid (pre-cum), or rectal fluid of a person infected with the virus. The bottom is at greater risk of getting HIV because the lining of the rectum is thin and may allow HIV to enter the body during anal sex, but the top is also at risk because HIV can enter through the opening of the penis or through small cuts, abrasions, or open sores on the penis. See the HIV Prevention Questions and Answers for more information.
Yes, vaginal sex without a condom is a high-risk behavior for HIV infection. It is possible for either partner to become infected this way. HIV can be found in the blood, semen (cum), pre-seminal fluid (pre-cum), or vaginal fluid of a person infected with the virus.
During vaginal sex, HIV is passed from men to women much more easily than from women to men. In women, HIV can be directly absorbed through the mucous membranes that line the vagina and cervix. The lining of the vagina can also sometimes tear and possibly allow HIV to enter the body.
In men, HIV can enter the body through the urethra (the opening at the tip of the penis) or through small cuts or open sores on the penis. Men who are not circumcised are at greater risk of HIV infection through vaginal sex than are circumcised men.
Risk for HIV infection increases if you or a partner also has a sexually transmitted infection (STI). See also Is there a connection between HIV and other sexually transmitted infections?
Many barrier methods that women use to prevent pregnancy (e.g., diaphragm, cervical cap) do not protect them against HIV or other STIs because they still allow infected semen (cum) to come in contact with the lining of the vagina.
Oral or hormonal contraceptives (e.g., birth control pills) do not protect women against HIV or other STIs.
Oral sex involves using the mouth to stimulate the penis, vagina, or anus (i.e., fellatio, cunnilingus, and rimming). It is possible for either partner to become infected with HIV through performing or receiving oral sex, though the risk is much less than for anal and vaginal sex.
The highest-risk oral sex activity is giving oral sex to a man, if he ejaculates (cums) in your mouth. There is little to no risk of getting HIV from other types of oral sex. Several factors may increase the risk of HIV transmission through oral sexual contact, including mouth ulcers, bleeding gums, genital sores, and the presence of other sexually transmitted infections.
Although rimming carries little to no risk of transmitting HIV, it comes with a high risk of transmitting hepatitis A and B, parasites, and other bacteria to the partner who is doing the rimming.
For more information, see Oral Sex and HIV Risk.
Yes. Having a sexually transmitted infection (STI) can increase the risk of getting or spreading HIV. If you are HIV-negative but have an STI, you are at least 2 to 5 times more likely to get HIV if you have unprotected sex with someone who has HIV. There are two ways that having an STI can increase the likelihood of getting HIV. If the STI causes irritation of the skin (e.g., from syphilis, herpes, or human papillomavirus), breaks or sores may make it easier for HIV to enter the body during sexual contact. Even STIs that cause no breaks or open sores (e.g., chlamydia, gonorrhea, trichomoniasis) can increase your risk by causing an increase in the number of cells that can serve as targets for HIV.
If you are HIV-positive and also infected with another STI, you are 3 to 5 times more likely than other HIV-infected people to spread HIV through sexual contact. This appears to happen because there is an increased concentration of HIV in the semen and genital fluids of HIV-positive people.
For more information about the connection between HIV and other STIs, see the CDC fact sheet, The Role of STD Detection and Treatment in HIV Prevention. To get tested for HIV or other STIs, find a testing site near you.
Yes. At the start of every injection, blood gets into the needle and syringe, and some remains there after use. HIV can be found in the blood of a person infected with the virus. The reuse of a blood-contaminated needle or syringe by another drug injector (sometimes called direct syringe sharing) carries a high risk of HIV transmission because infected blood can be injected directly into the bloodstream.
Sharing drug equipment (or works) can also be a risk for spreading HIV. Infected blood can get into drug solutions by
"Street sellers" of syringes may repackage used syringes and sell them as sterile syringes. For this reason, people who continue to inject drugs should get syringes from reliable sources of sterile syringes, such as pharmacies or needle-exchange programs.
It is important to know that sharing a needle or syringe for any use, including skin popping and injecting steroids, hormones, or silicone, can put you at risk for HIV and other blood-borne infections. For more information, see Can I get HIV from using other kinds of drugs?
Not directly, but drinking alcohol or taking drugs that are not injected can increase your risk for HIV. Being drunk or high affects your ability to make safe choices and lowers your inhibitions, which may lead you to take risks you are less likely to take when sober, such as having sex without a condom.
Methamphetamine (meth) is a very addictive stimulant that can be snorted, smoked, or injected. Even though using meth is an HIV risk factor for anyone who does it, there is a strong link between meth use and HIV transmission for gay and bisexual men. Gay and bisexual men who use meth may increase their sexual and drug-use risk factors. They may:
Drinking alcohol, particularly binge drinking, and using "club drugs" like Ecstasy, ketamine, GHB, and poppers can alter your judgment and impair your decisions about sex or other drug use. You may be more likely to have unplanned and unprotected sex or use other drugs, including injection drugs or meth. Those behaviors can increase your risk of exposure to HIV. If you have HIV, this can also increase your risk of spreading HIV to others.Treatment programs can help people stop using drugs or alcohol. Find a treatment facility near you or call 1-800-662-HELP (1-800-662-4357).
Yes. This is called HIV superinfection. The new strain of HIV can replace the original strain or remain along with the original strain. The effects of superinfection differ from person to person. For some people, superinfection may cause them to get sicker faster because they become infected with a new strain of the virus that is resistant to the medicines they are currently taking to treat their original HIV infection. Research suggests that the kind of superinfection where a person becomes infected with a new strain of HIV that is hard to treat is rare, less than 4%.
Although HIV risk factors and routes of transmission apply to everyone equally, some people are at higher risk because of where they live and who their sex partners are.
The percentage of people living with HIV (prevalence) is higher in major metropolitan areas, so people who live there are more likely to encounter an HIV-positive person among their possible sex partners. (This atlas shows the prevalence of HIV for all U.S. communities.) In the same way, because the prevalence of HIV is higher among gay and bisexual men and among black and Latino men and women, members of these groups are more likely to encounter partners who are living with HIV.
There is no cure for HIV, but there are ways to prevent getting the virus.
HIV can be prevented through abstinence, mutual monogamy, and condom barriers you can use when you have oral, vaginal, or anal sex to protect yourself and your partner from HIV and other sexually transmitted infections (STIs). Barriers include male condoms, which are for oral, vaginal, and anal sex; female condoms, which are for vaginal and anal sex; and dental dams, which are for oral sex. Sometimes condoms break or slip during sex. To help prevent this from happening, use water-based lubricant.
HIV can also be prevented by not sharing needles and drug works (commonly referred to as paraphernalia), and by limiting the use of substances (i.e. alcohol and other non-injecting drugs) that impair judgment.
If you think you are at a high risk for infection, you may want to talk to your health care provider about ways to protect yourself, including something called Pre-exposure Prophylaxis (PrEP). PrEP is when people who don't have HIV take HIV medications (antiretroviral therapy [ART]) daily to lower their chances of getting HIV. These are the same medications that people take if they have HIV. PrEP is only meant for people who may be at high risk for getting HIV. For example, someone who is HIV-negative but has an HIV-positive partner may be at high risk for getting HIV.
Learn more by reviewing CDC's PrEP Guidance, and consider printing a copy to bring to your next health care provider's appointment to discuss whether PrEP may be the right option for you.
Post-exposure prophylaxis (or PEP) means taking antiretroviral therapy (ART) after being exposed to HIV to prevent becoming infected. PEP can help prevent getting HIV, but it must be started within 72 hours of the exposure to be most effective. PEP can only be prescribed by a health care provider and should be taken for 28 days as directed.
Learn more by reviewing CDC's PEP Guidance, and consider printing a copy to bring to your next health care provider's appointment to discuss whether PEP may be the right option for you.
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