Primary HIV infection
Most people who get HIV don't have any symptoms in the first years after being infected. Some people develop symptoms between one and six weeks after being infected with HIV, which are similar to flu. This is known as primary HIV infection. Symptoms of primary HIV include:
- swollen glands
- sore throat
- a rash on your body
- painful muscles or joints
- a headache
If you have any of these symptoms and think you may have been infected with HIV, see your GP or visit a sexual health clinic.
During this time, you're very infectious because the amount of the virus in your blood is high. Therefore, the risk of passing the infection on to someone else is also high.
The symptoms of a primary HIV infection usually last for a week to a month and then, for most people, they go. You might not have any further symptoms of HIV for years – some people don't have any for 12 years or more. This phase is called asymptomatic HIV infection.
Symptomatic HIV infection
After a period of time you may start to get symptoms again. You may be more prone to getting skin infections, such as warts or fungal infections. Other symptoms may include:
- a fever
- weight loss
- night sweats
- persistent diarrhoea
Advanced HIV infection (AIDS)
Without treatment, most people will go on to develop advanced HIV infection (AIDS). Eventually, you could be at risk of life-threatening illnesses that include:
- fungal infections
- various types of cancer
If you think you may have been infected with HIV, it's important to see your GP or visit a sexual health clinic.
Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical and sexual history.
You will need to have a blood test to check for HIV antibodies (proteins produced by your immune system that fight against the virus). This can be in the form of a rapid finger prick test, which means you get the results very quickly. Alternatively, or if a finger prick test is positive, you may have a sample of blood taken from your arm. This is then sent to a laboratory for testing.
It can take up to three months for HIV to show in your blood so you may need to have the test again.
There is no cure for HIV infection. However, life-long treatment with anti-HIV medicines can stop further damage to your immune system and allow it to restore itself over a period of years. If you take anti-HIV medicines consistently, they will enable you to stay well and live a full life.
HIV treatment is managed at specialist outpatient clinics and it's important to attend all your appointments. At these appointments your health professional will check how well your immune system is working and ask you about your general health.
You probably won’t need to start treatment until your number of CD4 white blood cells has fallen to a low level (350 or lower). You may be advised to start treatment sooner if you develop a serious infection or condition linked to advanced HIV infection, or get pregnant.
Medicines for HIV work in a number of different ways. For this reason, you usually take a combination of medicines together. This is known as antiretroviral therapy, combination therapy or highly active antiretroviral therapy (HAART). The medicines will prevent HIV from reproducing in your body and reduce the amount of virus in your blood. This will allow your immune system to recover.
Combination therapies usually use medicines that attack the virus at different stages of its life cycle. Your doctor will give you advice about the best medicines for you. It's very important to take your medicine regularly, otherwise the virus can become resistant to it and the medicine will no longer be effective.
Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.
You may develop side-effects in the first few months after you start your treatment. These are the unwanted effects you may get after taking a medicine. If you have side-effects, it's important to talk to the doctor who prescribed your medicine before you stop taking it. Side-effects of HIV medicines may include:
- feeling or being sick
- diarrhoea or wind
- feeling tired
- aching muscles
- a rash
- having trouble sleeping or bad dreams
These side-effects should improve as your body gets used to the medicine. If they don’t, see your doctor to discuss other treatment options.
Certain HIV medicines can increase your risk of serious conditions, such as heart disease by causing high levels of cholesterol (fats) in your blood. Therefore, it’s important to see your doctor regularly so that any side-effects can be monitored. Some side-effects can be controlled with other medicines.
Most people with HIV become infected when they have unprotected vaginal or anal sex. Not everyone who is exposed to HIV will be infected with the virus. However, it’s more likely if you have repeated sexual contact with someone who has HIV. There is a small chance of getting infected through unprotected oral sex. It’s particularly risky if you have mouth ulcers or gum disease, and your partner ejaculates in your mouth.
HIV can also be passed on through direct contact with infected blood. For example, if you use infected needles to inject drugs, do piercings or tattoos. If you're a healthcare worker, you can potentially get HIV from an accidental injury with a needle contaminated with infected blood.
If you're pregnant and have HIV, you can pass on the virus to your baby during your pregnancy, when you give birth or when breastfeeding. However, you can prevent this if you take HIV medicines and bottle feed your baby instead of breastfeeding.
In the past, some people were infected with HIV through blood or organ donations. All donations in the UK are now screened for HIV, so the chance of this happening is extremely low.
Other fluids in your body, such as saliva, sweat or urine, don’t contain high enough levels of HIV to cause an infection. HIV can't be passed on through normal day-to-day activities, such as sharing cutlery, sitting on toilet seats or by shaking hands. And it can't be passed on through a mosquito bite or bites from other animals or insects.
You can greatly reduce the risk of getting or passing on HIV by always using a condom when you have sex (including oral sex). However, condoms can't completely eliminate the risk of HIV infection.
If you reduce the number of partners you have sex with, it will reduce your overall risk of getting infected with HIV. It's a good idea to have regular checks for sexually transmitted infections (STIs) too.
If you take intravenous drugs or inject medicines, don't share injection equipment and always use a fresh needle.
Post-exposure prophylaxis treatment
Post-exposure prophylaxis (PEP) is an emergency medicine treatment, which can reduce your chance of getting infected if you’re exposed to HIV. For example, you may be exposed if a condom breaks or if you’re a healthcare worker exposed to HIV. If you suspect you have been exposed to HIV, seek urgent medical attention.
For more information about PEP, see our frequently asked questions.
I’m pregnant and have HIV. Is there a risk that I will pass HIV on to my unborn baby?
In the UK, it's not common for a woman to pass HIV to her baby. This is because the medicines used to treat HIV in the UK are very effective at preventing this from happening.
If you're healthy and living with HIV, your doctor will offer you anti-HIV medicines before you reach the last six months of your pregnancy. If the virus is well controlled with these medicines, you may be able to plan for a vaginal delivery. However, it's possible you may need to have a caesarean. Your baby will usually need to have anti-HIV medicines in the first four weeks of their life to prevent HIV infection.
If you have HIV, don’t breastfeed as you can pass the virus on to your baby this way. Instead, bottle feed your baby to prevent passing the virus on through your breast milk.
If your partner is HIV positive, a process known as sperm washing may reduce the risk of transmission of HIV when you get pregnant. This involves rapidly spinning your partner's semen in a laboratory to allow separation of the virus.
All pregnant women are offered an HIV test during the early part of their pregnancy. Ask your GP for further information about getting pregnant if you have HIV.
Is there a cure for HIV/AIDS?
No, there isn’t a cure for HIV but there are medicines that can help to control its progression.Explanation
The medicines you can take for HIV aren’t a cure. They work in different ways to target the virus and how it multiplies (replicates), so less of the virus is in your body. However, the medicines can’t remove the virus completely.
Medicines can control the virus and help you to have a near-normal life expectancy and live a full and active life.
What is post-exposure prophylaxis treatment?
Post-exposure prophylaxis (PEP) is a course of anti-HIV medicines. This may prevent infection with HIV if you think you have been exposed to the virus. You can have PEP within 72 hours of a possible infection, but it’s best to get it as soon as possible, preferably within one to two hours.
PEP is a course of medicines you can take if you have, or may have, been recently exposed to HIV. This includes if you have had unprotected sex or sex where a condom failed with someone who is HIV-positive. If you're unsure whether or not the person you had sex with is infected with HIV, ask your doctor for advice.
If you’re a healthcare worker and may have been infected with HIV by an infected needle, you may also be offered PEP.
PEP is considered a last resort. It's strictly prescribed because there is a very short period of time (72 hours) after contact with HIV in which it can be effective. After this, the virus isn’t affected by these medicines because it has entered the CD4 cells in your body.
You will need to take medicines for about four weeks. Side-effects of PEP can be severe and include feeling sick, vomiting, diarrhoea and tiredness. You may be offered other medicines to help with these side-effects.
PEP is available at sexual health clinics, particularly specialist HIV clinics, and accident and emergency departments of hospitals.
Even if you take these medicines in the correct way, there is still a chance that you can develop an HIV infection. You can still get HIV (and pass it on to others) while you’re taking PEP and after you have finished your course of treatment. It's important to continue to use condoms to reduce your risk of getting or transmitting HIV or another sexually transmitted infection (STI).
Always ask your doctor for advice and read the patient information leaflet that comes with your medicine. You will need to attend follow-up appointments with your doctor both during and after you finish your treatment to check you haven't become infected.
What is the difference between HIV and AIDS?
HIV is a virus called the human immunodeficiency virus. If you have HIV, you have this virus in your body. AIDS (acquired immunodeficiency syndrome) is the general name given to the condition that HIV causes once your immune system is weakened.
If you have HIV, you may have no symptoms and feel well. After a number of years (the length of time differs between people), you may start to get infections. This is because your immune system, which usually fights these off, isn't working properly.
HIV weakens your body’s ability to fight illnesses. It does this by destroying the CD4 cells in your body that usually fight infections. The number of these cells greatly decreases so your body is more vulnerable because it can’t defend itself. If you develop certain life-threatening illnesses, such as pneumonias and certain cancers, this is known as advanced HIV infection or acquired immunodeficiency syndrome (AIDS).
- HIV testing. Map of Medicine. www.mapofmedicine.com, published 25 January 2013
- HIV infection. BMJ Clinical Evidence. www.clinicalevidence.bmj.com, published 31 July 2008
- HIV disease. Medscape. www.emedicine.medscape.com, published 11 February 2014
- HIV in the United Kingdom: 2012 report. Health Protection Agency. www.hpa.org.uk, published November 2012
- What is the immune system? National Institute of Allergy and Infectious Diseases. www.niaid.nih.gov, published 19 December 2011
- HIV/AIDS. National Institute of Allergy and Infectious Diseases. www.niaid.nih.gov, published 28 April 2009
- HIV infection and AIDS. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published March 2010
- Human immunodeficiency virus (HIV) infection. The Merck Manuals. www.merckmanuals.com, published August 2013
- Tattooing and body piercing guidance toolkit. Chartered Institute of Environmental Health. www.cieh.org, published July 2013
- Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. World Health Organization. www.who.int, published June 2013
- Increasing the uptake of HIV testing among men who have sex with men. National Institute for Health and Care Excellence (NICE), March 2011. www.nice.org.uk
- HIV positive – clinical assessment and treatment. Map of Medicine. www.mapofmedicine.com, published 25 January 2013
- British HIV Association. British HIV Association guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy 2012. HIV Med 2014; 15(Suppl 1):1–85. doi: 10.1111/hiv.12119
- Management of HIV. Map of Medicine. www.mapofmedicine.com, published 15 January 2014
- Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 17 February 2014
- Post-exposure prophylaxis for HIV. Map of Medicine. www.mapofmedicine.com, published 25 January 2013
- Benn P, Fisher M, Kulasegaram R, et al. UK guideline for the use of post-exposure prophylaxis for HIV following sexual exposure (2011). Int J STD AIDS 2011; 22(12):695–708. doi: 10.1258/ijsa.2011.171011
- Taylor GP, Clayden P, Dhar J, et al. British HIV Association guidelines for the management of HIV infection in pregnant women 2012. HIV Med 2012; 13(Suppl 2):87–157. doi: 10.1111/j.1468-1293.2012.01030_2.x
- Fakoya A, Lamba H, Mackie N, et al. British HIV Association, BASHH and FSRH guidelines for the management of the sexual and reproductive health of people living with HIV infection 2008. HIV Med 2008; 9:681–720. doi: 10.1111/j.1468-1293.2008.00634.x
We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.
Let us know what you think using our short feedback form Ask us a question
Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, March 2014.
Let us know what you think using our short feedback form Ask us a question
About our health information
At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.
Information StandardWe are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.
Plain English CampaignWe hold the Crystal Mark, which is the seal of approval from the Plain English Campaign for clear and concise information.
What our readers say about us
But don't just take our word for it; here's some feedback from our readers.
“Simple and easy to use website - not alarming, just helpful.”
“It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.”
“Good information, easy to find, trustworthy.”
Our core principles
All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.
In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.
We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.
We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.
Here are just a few of the ways in which the quality of our information has been recognised.
The Information Standard certification scheme
You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.
It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.
Certified by the Information Standard as a quality provider of health and social care information.
We comply with the HONcode (Health on the Net) for trustworthy health information. Certified by the HONcode for trustworthy health information.
Plain English Campaign
Our website is approved by the Plain English Campaign and carries their Crystal Mark for clear information. In 2010, we won the award for best website.
Website approved by Plain English Campaign.
British Medical Association (BMA) patient information awards
We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.
If you have any feedback on our health information, we would love to hear from you. Please contact us via email: email@example.com. Or you can write to us:
Health Content Team
15-19 Bloomsbury Way