HIV and AIDS

Human immunodeficiency virus and acquired immunodeficiency syndrome

Key points about HIV and AIDS

  • HIV is a virus that damages your immune system and weakens your ability to fight infection and disease.
  • It's transmitted via sexual activity and sharing of needles.
  • Left untreated, HIV can cause AIDS.
  • A person with AIDS has a severe deficiency of their immune system, which increases their risk of severe infections.  
  • There's no cure for HIV, but it can be controlled with a combination of medicines, known as antiretroviral therapy (ART). 
  • Most people living with HIV who are on ART will never develop AIDS.
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Infection with the human immunodeficiency virus (HIV) causes damage to your immune system, affecting your ability to fight disease. Without treatment, some people with HIV develop the potentially life-threatening condition, acquired immunodeficiency syndrome (AIDS).

  • HIV is the name of the virus that causes an infection that damages your immune system and weakens your ability to fight infection and disease.
  • Left untreated, HIV can cause AIDS – the most advanced stage of HIV infection. This means that you can be infected with HIV (a virus) without having AIDS (an illness).  
  • A person with AIDS has a severe deficiency of their immune system, which increases their risk of severe infections.  
  • HIV is a sexually transmitted infection and can also be spread by sharing needles.
  • While there is no cure for HIV, it can be controlled with a combination of medicines, known as antiretroviral therapy (ART). Most people living with HIV who are on ART will never develop AIDS.

(external link)

Image credit: AIDS Info 

HIV is found in some of the body fluids of an infected person, such as semen, vaginal and anal fluids, blood and breast milk. It can be spread by having unprotected sex (without a condom) with an infected person or by sharing infected needles and other injecting equipment. It can also be passed on from mother to baby during pregnancy and delivery.

You can't become infected through ordinary day-to-day contact such as kissing, hugging, shaking hands or from sharing personal objects, food or water. 

Behaviours and conditions that put you at greater risk of contracting HIV
  • Having unprotected anal or vaginal sex.
  • Having another sexually transmitted infection (STI) such as syphilis, herpes, chlamydia, gonorrhoea or bacterial vaginosis.
  • Sharing contaminated needles, syringes and other injecting equipment and drug solutions when injecting drugs.
  • Receiving unsafe injections, blood transfusions and tissue transplantation, and medical procedures that involve unsterile (dirty) cutting or piercing.
  • Experiencing accidental needle-stick injuries, a risk particularly for healthcare workers.

If you get HIV and don’t get treatment, you usually progress through 3 stages of disease. Medicine to treat HIV, known as antiretroviral therapy (ART), helps you at all stages of the disease if you take it as prescribed. It can slow or prevent progression of HIV from one stage to the next.

If you take HIV medicine as prescribed and get to and keep an undetectable viral load, you effectively have no risk of passing on HIV to an HIV-negative partner through sex.

Stage 1: Acute HIV infection

Within 2–4 weeks after infection with HIV, you may experience a flu-like illness, which may last for a few weeks. This is your body’s natural response to infection.

When you have acute HIV infection, you have a large amount of virus in your blood and you are very contagious. But people with acute infection are often unaware of being infected, because you may not feel sick right away or at all.

To know whether you have acute infection, you need to have blood tests. If you think you have been exposed to HIV through sex or drug use and you have flu-like symptoms, see your doctor and ask for an HIV test.

Stage 2: Clinical latency (HIV inactivity or dormancy)

This stage is sometimes called asymptomatic HIV infection or chronic HIV infection.

During this phase, HIV is still active but reproduces at very low levels. You may not have any symptoms or get sick during this time. If you aren’t taking medicine to treat HIV, this period can last a decade or longer, but you may move through this phase faster.

If you take ART as prescribed, you may be in this stage for several decades. You can still pass on HIV to others during this phase. However, if you take HIV medicine as prescribed and get to and keep an undetectable viral load (or stay virally suppressed), you effectively have no risk of transmitting HIV to your HIV-negative sexual partners.

At the end of this phase, your viral load starts to go up and your CD4 cell count begins to go down. You may begin to have symptoms as the virus levels increase in your body and you move into Stage 3.

Stage 3: Acquired immunodeficiency syndrome (AIDS)

AIDS is the most severe phase of HIV infection. People with AIDS have such badly damaged immune systems that they get an increasing number of severe illnesses, called opportunistic illnesses, such as tuberculosis (TB), cryptococcal meningitis and severe bacterial infections.

You are diagnosed with AIDS when your CD4 cell count drops below 200 cells/mm or if you develop opportunistic illnesses. People with AIDS can have a high viral load and be very infectious.

Without treatment, people with AIDS typically live about 3 years. Common symptoms of AIDS include chills, fever, sweats, swollen lymph glands, weakness and weight loss.

The only way to know for sure whether you have HIV is to get tested. Knowing your status is important because it helps you make healthy decisions to prevent getting or transmitting HIV. If HIV infection is found in your blood, you are said to be HIV positive.

How often you should get tested (the frequency of testing) depends on who you have sex with and what type of sex you have. Use the 'Testing frequency calculator'(external link) (Burnett Foundation NZ) to get a recommendation on how often you should be tested. 

If you think you may have been exposed to HIV, you can use the 'Been exposed tool(external link)' (Burnett Foundation NZ) to find out the likely risk of a specific event or encounter. If you were at risk of HIV exposure you will also get a recommendation for next steps. 

  • If you think you may have been exposed to HIV, your doctor, Sexual Wellbeing Aotearoa clinic, sexual health clinic or the Burnett Foundation can arrange a blood test. The result is confidential.
  • If your first test suggests you have HIV, a further blood test will needed to confirm the result.
  • If this is positive, you'll be referred to a specialist HIV clinic for some more tests and a discussion about your treatment options. 
  • There is a short period just after being infected with HIV when the virus cannot be detected. If you have been exposed to HIV, you may need a follow-up test 3 months later.  
  • Note: HIV is a notifiable disease which means that it is a legal responsibility for your healthcare provider to notify public health authorities of a HIV positive result. In the notification, you will not identified by name or address (it is anonymous).  

While there is no cure for HIV, it can be controlled with a combination of medicines, known as antiretroviral therapy (ART). These work by stopping the virus replicating (spreading) in your body, allowing your immune system to repair itself and preventing further damage. Taking these medicines can reduce the amount of virus in your body and help you stay healthy, and can also help prevent you passing the virus on to others.

You will also be encouraged to have regular exercise, eat a healthy diet, stop smoking and have the flu vaccine every year to lessen the risk of getting serious illnesses. Without treatment, your immune system will become severely damaged and life-threatening illnesses such as cancer and severe infections can occur. Read more about antiretroviral therapy.

There are a few things you can do to protect yourself from HIV.

  • Practice safe sex: Using condoms and water-based lubricant correctly every time you have vaginal or anal sex reduces the risk of getting HIV by around 95%. In New Zealand, HIV is most commonly caught by having unprotected sex with an infected person.  
  • Don't share needles: If you inject yourself with drugs, it’s important to use new needles and syringes. Blood is left on syringes and needles every time they’re used. If you share injecting equipment, you can catch HIV from another person’s blood if they are infected.
  • Have HIV antenatal screening: Women with HIV can pass it on to their babies during pregnancy, birth and while breastfeeding. If you’re pregnant, you’ll be offered a screening test for HIV at the same time as you have your other blood tests, as a routine part of your antenatal care. The screening programme is run by the National Screening Unit. If you’re found to have HIV, you’ll be offered treatment that reduces the chance of your baby becoming infected from about 25% to less than 2%.
  • Use pre-exposure prophylaxis (PrEP): This is an HIV prevention method for people who do not have HIV but who are at risk. By taking a pill every day you can reduce your risk of becoming infected with HIV. Read more about PrEP.
  • Use post-exposure prophylaxis (PEP): This is an emergency medication for people who do not have HIV but are likely to have been exposed to the disease (eg, from a needle-stick injury or sexual assault). 

If you are HIV positive, you can take precautions to avoid spreading the infection to others.

  • Take your antivirals. It can suppress your viral load to being undetectable and there is almost no risk of sexual transmission if your viral load stays undetectable. 
  • Tell your sex partner or partners about your relevant behaviour and whether you are HIV-positive. Read more about partner notification(external link).
  • Follow safer sex practices, such as using condoms. Read more about safer sex 101 for HIV(external link).
  • Don't donate blood, plasma, semen, body organs or body tissues.
  • Don't share personal items, such as toothbrushes, razors or sex toys, that may be contaminated with blood, semen or vaginal fluids.

Video: More than HIV - Jewel's Story

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(NZ AIDS Foundation, NZ, 2015)

Video: I Am

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(external link)
(TVNZ, NZ, 2018)

Video: Josh Robbins is sharing his story about HIV

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(NZ AIDS Foundation, NZ, 2015)

Video: More than HIV - Jan's Story

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(NZ AIDS Foundation, NZ, 2015)

Video: More than HIV - Judith's Story

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(NZ AIDS Foundation, NZ, 2015)

Video: More than HIV - Lance's Story

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(NZ AIDS Foundation, NZ, 2015)

Video: HIV - My Story - Florence | NHS

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(NHS, UK, 2021)

Video: CDC: Chris's Story, Let's Stop HIV Together

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(CDC, US, 2014)

Body Positive NZ(external link) is a peer support organisation for all people living with HIV in New Zealand
Toitu te Ao Inc(external link) offers support, advocacy, information and education for Māori 
Positive Women NZ(external link) support organisation for women and families living with and affected by HIV
Pamoja (external link)- an HIV prevention and support programme for Africans, by Africans, living in Aotearoa New Zealand

All about testing(external link) Burnett Foundation, NZ 
Living well with HIV(external link) Burnett Foundation, NZ 
Information and support(external link) Burnett Foundation, NZ
Partner notification(external link) STI Management Guidelines, NZ
HIV/AIDS(external link) Ministry of Health, NZ
HIV(external link) Healthy Sex, NZ

Resources

HIV testing in pregnancy Ministry of Health, NZ, 2008 Available in the following languages: English(external link), te Reo Māori,(external link) Chinese (simplifed),(external link) Chinese (traditional),(external link) Hindi,(external link) Korean(external link), Sāmoan,(external link) Swahili,(external link) Tongan(external link)
Voluntary counselling and testing for diagnosis of HIV infection(external link) Ministry of Health and Health Promotion Agency, NZ, 2008

References

  1. HIV basics(external link) Centers for Disease Control and Prevention (CDC), US
  2. General practitioners and HIV(external link) Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM), 2020

Brochures

hiv testing in pregnancy part of antenatal blood tests

HIV testing in pregnancy
Ministry of Health, NZ, 2008
English, te Reo Māori, Chinese (simplifed), Chinese (traditional), Hindi, Korean, Sāmoan, Swahili, Tongan

voluntary counselling and testing for diagnosis of hiv infection

Voluntary counselling and testing for diagnosis of HIV infection

Ministry of Health and Health Promotion Agency, NZ, 2008

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