What is HIV? – Causes, Transmission, Stages, Symptoms in Men and Women, Testing, and More

Sexually Transmitted Diseases are of different types and they are broadly categorized according to the causing agent. STDs like Chlamydia and Gonorrhea are caused by bacteria and are often curable with the help of antibiotics. Some types of STDs are practically incurable as they have viral agents as their causing agent, one such STD is HIV.

What is HIV?

Human Immunodeficiency Virus is a Retrovirus that affects the immune system, especially the white blood cells called CD4+. When too many CD4+ cells are destroyed, the body can no longer defend itself against infection or diseases and can cause changes throughout the body. If HIV is left untreated, it can lead to Acquired Immunodeficiency Syndrome (AIDS). This virus is transmitted by certain bodily fluids like blood, breast milk, vaginal or rectal fluids, and semen.

Currently, there is no effective cure for HIV. But it can be controlled with proper medical care. As per WHO, it is observed that HIV has become a manageable condition as many were able to survive and lead a healthy life.  However, people can live long and healthy lives by taking Antiretroviral Therapy (ART). This therapy helps to prevent transmission to others. HIV can be diagnosed by an affordable rapid diagnostic test.

Causes of HIV

HIV can be transmitted by bodily fluids like:

• Infected blood
• Pre-seminal fluid
• Rectal fluid
• Vaginal fluid
• Breast milk
• Semen

The chance of getting HIV is higher when a person:

• Have many sex partners
• Have unprotected sex
• Shares needle for drugs
• Have other STIs
• Is having non-monogamous sexual intercourse

HIV Transmission

Anal or vaginal intercourse is one of the main causes of HIV transmission in the US. The infection can also be transmitted from the infected mother to her child during pregnancy or delivery and this transmission is known as perinatal or mother-to-child transmission. When an infected mother undergoes treatment for HIV, the risk of transmitting the infection to the baby can be less than 1%. According to WHO, it is said that people who are taking ART do not transmit the infection to their sexual partners.

While anal sex is considered to be the riskiest type of sex for transmitting HIV. As cases reported through anal sex is 10 times higher than vaginal sex. People with untreated STIs are more likely to pass on or acquire HIV during sex.

Rare ways of HIV transmission:

• Tattoos or body piercings
• Pre-chewed food (cases among infants)
• Oral sex
• Blood Transfusion
• Organ or tissue transplants
• Female-to-Female
• HIV contaminated needle (cases among healthcare workers)

HIV can’t be transmitted by air, water, tears, swimming pools, toilet seats, casual contact (shaking hands or hugging), or other activities that don’t involve the exchange of body fluids.

Stages of HIV

If HIV is left untreated, the infection advances in stages and will get worse over time. The signs and symptoms may vary from person to person and some may not have any kind of symptoms for years. Without ART the virus causes more damage to the body and the immune system. The following are the three stages of infection and it describes how HIV infection progresses.

First stage: Acute HIV Infection

This is the earliest stage of HIV infection and it develops within 2 to 4 weeks after infection. Most people might have flu-like illnesses. In this stage, HIV multiplies rapidly & spreads throughout the body, and destroys the CD4 cells of the immune system. The possibility of transmission is higher because the level of infection is high in the blood.

Symptoms:

• fever
• headache
• sore throat
• swollen glands
• joint and muscle pains
• stomach upset
• rashes

As the infected cells are circulated throughout the blood system, the immune system tries to defend the virus by producing antibodies. This process is known as Seroconversion. As these symptoms are quite common among other diseases, the only way to confirm is by testing. In some cases, the infection may not show up in a test. So, testing again is essential to confirm the result. Antibody/ antigen test or Nucleic Acid Test (NATs) can diagnose this acute infection.

Second stage: Chronic HIV Infection

The second stage is also called Asymptomatic HIV infection or clinical latency. As the body’s immune system loses the battle with the virus, the flu-like symptoms will go away. And people may not have any HIV-related symptoms but infection continues to multiply in the body at a lower level. Without ART, the infection may progress to the next stage- AIDS. In this stage, there is a possibility of transmission of infection as most people don’t experience any signs or symptoms. People who take ART as prescribed, remain in this stage for decades may not transmit any sought of infection.

At the end of this stage, the level of HIV in the blood increases, and the count of CD4 cells goes down. The person might have some symptoms as there is an increase in the virus level in the body. When the count of CD4 cells drops, the infected person is more likely to get infected by other diseases and moves into stage 3. Without treatment, people can stay in the stage for about 10-15 years, it might be lesser in few cases.

Third stage: AIDS

Acquired Immunodeficiency Syndrome is the final and severe stage of HIV. It is difficult for the body to fight against opportunistic infections, as the immune system is damaged by the Human Immunodeficiency Virus. People are diagnosed with AIDS when the CD4 count is less than 200 cells/mm3. And they can transmit the infection to others very easily as the viral load is high.

Symptoms:

• serious illness
• persistent cough
• fever
• chronic diarrhea
• weight loss
• purplish spot in the skin
• night sweats
• yeast infection
• neurological symptoms (balance problem, seizures, memory loss, or confusion)

As these symptoms can be related to other diseases or infections, it’s better to get tested and undergo treatment if necessary. Infected people are prone to various kinds of infections and it can cause damage to different parts of the body which include the eyes, brain, liver, lungs, genitals, gastrointestinal tract, mouth & throat, and lymphatic system. Doctors prescribe ART to keep the immune system as healthy as possible. People typically survive about three years without treatment.

HIV Symptoms in Men

HIV symptoms differ from person to person. Most of the symptoms are common among men and women but there are a few distinctive symptoms.

• Flu-like symptoms

People can experience skin rashes, ulcers on genitals, nausea, sores, muscles, fever, fatigue, and weight loss.

• Low sex drive

When testicles don’t make enough of the sex hormone testosterone, it is said to be a sign of hypogonadism. This may include infertility, less hair growth on the body and face, breast tissue growth, and depression.

• Pain while peeing

This can also be a symptom of some STIs like chlamydia. Infected men can also experience pain in the bladder or penis and may pee more than usual.

• Sores on the penis

The common symptom of HIV in men is painful sores or ulcers which appear on the mouth or esophagus, anus, or penis.

HIV Symptoms in women

As infected women can pass on the infection to babies during pregnancy, antiretroviral therapy is recommended to HIV-infected women as lowers the risk of transmission.

• Flu-like symptoms

Same as men, women also experience flu-like symptoms which include fever, lack of energy, and headaches.

• HIV rashes

Skin problems like sores, lesions on the anus, genitals may occur. Rashes seem to be itchy, red, or painful. These infections can be subsided with proper treatment. As per the U.S. Department of Health & Human Services,  HIV rashes appear in the early stage which lasts for several days to weeks, and goes away without treatment.

• Menstrual changes

Infected women may experience changes in their menstrual cycle and also experience premenstrual symptoms. In some cases, they may not get their period. Women may also experience more intense menopause side effects and weight loss due to the change in the menstrual cycle.

• PID- Pelvic Inflammatory Disease

This infection is harder to treat and remains for a longer period. It affects the uterus and ovaries and women with this infection may experience pain around the pelvis, heavy and painful periods, unusual vaginal discharge, and pain while peeing. It is estimated that 1 in 10 women with PID becomes infertile due to this condition.

• Vaginal yeast infection

Women with a yeast infection may experience, vaginal bleeding, itching, and irritation on the vagina, pain during sex, and watery vaginal discharge.

• Other infections

Opportunistic infections like pneumonia, tuberculosis, yeast, and bacterial infection. Other areas where people with HIV are prone to infection are the kidney, digestive tract, brain, and skin. People who take antiretroviral medication have less chance of getting opportunistic infections.

Difference between HIV and AIDS

HIV testing

HIV testing is the only way to confirm the infection. Usually, this testing is done on blood, urine, or oral fluid. Test available for HIV testings are:

• Nucleic Acid Test (NAT)
• Antigen/ Antibody test
• Antibody test

Nucleic Acid Test (NAT)

This test looks for Human Immunodeficiency Virus in the blood and not the antibodies to it. NAT can detect the virus sooner than the other test. This test is not recommended unless an individual had a high-risk exposure or early symptoms. Only after 10 to 33 days after exposure, NAT can detect the infection. As it is a laboratory test, the results can take several days to be received.

Antigen/ Antibody test

Antigen/Antibody is common in the US. This test looks for antigens and antibodies in the blood. Antigens are foreign substance that activates the immune system. Whereas antibodies are produced by the immune system when the body is exposed to the virus. This test uses blood from the vein. Only after 18 to 45 days after exposure, this test can detect the infection. Rapid antigen/ antibody test uses a drop of blood from the finger prick. Like NAT, this test will also take several days to be received.

Antibody test

This test is quite similar to the antigen/ antibody test, but it looks only for antibodies in the blood. Testing is done either on the drop of blood from the finger prick or the swab of saliva. Only after 23 to 90 days after exposure, this test can detect the infection. This test provides results within 30 minutes.

The CDC recommends that every individual between the ages 13 to 65 should get tested for HIV at least once. And the sexually active gay and bisexual men should test every three to six months. Earlier the diagnosis results earlier the treatment, which delays the progression to AIDS. HIV testing is essential for pregnant women as the infection can be transmitted to their babies.

Can HIV be cured?

Although there is no cure for HIV, ART (antiretroviral treatment) can reduce the amount of HIV in the body and helps to live long. ART is the only medication that is effective to control the virus as there is no natural or herbal cure for it. Successful treatment can improve life expectancy and quality of life. This infection is considered a chronic condition that can be managed in long term.

Ways to reduce the risk of HIV:

• Getting tested for HIV
• Getting tested and treated for STIs
• Limiting the number of sexual partners
• Consulting the healthcare provider about the PrEP
• Avoid sharing needles

Facts about Human Immunodeficiency Virus

• WHO estimated that 37.7 million people had HIV in 2020
• Globally 27.5 million people received ART in 2020.
• Approximately 1.2 million people have Human Immunodeficiency Virus in the US. And 1 in 7 doesn’t know that they are affected by the virus.
• 69% of HIV diagnoses in the US were men who have sex with men.
• During penis-vagina sex, people with circumcised penises are less likely to get infected.
• Most people affected by HIV are aged between 25 to 34.
• Sexually Transmitted Infection (STIs) increase the chances of spreading and contracting HIV.

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• What is Syphilis STD and its Symptoms?
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• Trichomoniasis STD: Symptoms, Diagnosis, and Treatment
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