1. Dee Pritschet, HIV Surveillance Coordinator
HIV/AIDS 101
Dee Pritschet,
HIV Surveillance Coordinator

2. What is HIV HIV stands for human immunodeficiency virus.
It is the virus that can lead to acquired immunodeficiency syndrome, or 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.

3. HIV is a virus spread through body fluids that 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.

5. HIV is a lot like other viruses, but there is an important difference – over time, your immune system can clear most viruses out of your body. That isn't the case with HIV – the human immune system can't seem to get rid of it. That means that once you have HIV, you have it for life.
We know that HIV can hide for long periods of time in the cells of your body and that it attacks a key part of your immune system – your T-cells or CD4 cells. Your body has to have these cells to fight infections and disease, but HIV invades them, uses them to make more copies of itself, and then destroys them.
Over time, HIV can destroy so many of your CD4 cells that your body can't fight infections and diseases anymore. When that happens, HIV infection can lead to AIDS, the final stage of HIV infection.

6. Where did HIV come from?
Scientists identified a type of chimpanzee in West Africa as the source of HIV infection in humans.
They believe that the chimpanzee version of the immunodeficiency virus (called simian immunodeficiency virus, or SIV) most likely was transmitted to humans and mutated into HIV when humans hunted these chimpanzees for meat and came into contact with their infected blood.
Studies show that HIV may have jumped from apes to humans as far back as the late 1800s. Over decades, the virus slowly spread across Africa and later into other parts of the world.
We know that the virus has existed in the United States since at least the mid- to late 1970s.

7. What are the Stages of HIV?
HIV disease 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.

8. 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’s 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, the CD4 count can fall quickly.
Your ability to spread HIV is highest during this stage because the amount of virus in the 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 then begin to increase, but it may not return to pre-infection levels.

9. 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 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 .

10. 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.

11. Wasting Syndrome
Wasting syndrome is the involuntary loss of more than 10% of your body weight, in addition to more than 30 days of either diarrhea or weakness and fever.
Wasting refers to a loss of muscle mass, although part of the weight loss may also be due to loss of fat. HIV-associated wasting syndrome is considered an AIDS-defining condition.
While this is often a sign of late stage disease, wasting syndrome can be treated by:
Proper diet
Medications to stimulate appetite
Medications to control diarrhea
Hormonal therapy to build muscle

12. Symptoms

13. How can you tell if you have HIV?
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:
Fever
Enlarged lymph nodes
Sore throat
Rash

14. What are the signs and symptoms of HIV in infants and children
HIV infection is often difficult to diagnose in very young children.
Many children with HIV infection do not gain weight or grow normally. If left untreated, HIV-infected children are frequently slow to reach important milestones in motor skills and mental development, such as crawling, walking, and talking.
As the disease progresses, many children with untreated HIV develop problems with walking, poor school performance, seizures, and other symptoms of HIV brain encephalopathy (a brain infection).
Children with untreated HIV suffer the usual childhood infections more frequently and more severely than HIV-uninfected children. These infections can cause seizures, fever, pneumonia, recurrent colds, diarrhea, dehydration, and other problems that often result in extended hospital stays and nutritional problems.
Like adults with HIV infection, children with HIV are at risk of developing life-threatening opportunistic infections. Pneumocystis pneumonia (PCP), a severe form of pneumonia that strikes people with weakened immune systems, is common and sometimes deadly in infants who do not receive treatment for their HIV infection

15. HIV Transmission/Risk Factors

16. How is HIV transmitted?
In the United States, HIV is spread mainly by having sex or sharing injection drug equipment such as needles with someone who has HIV.
Only certain fluids—blood, semen, pre-seminal fluid, 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.

17. Less commonly, HIV may be spread by:
Being born to an infected mother. HIV can be passed from mother to child during pregnancy, birth, or breastfeeding.
Being stuck with an HIV-contaminated needle or other sharp object. This is a risk mainly for health care workers.
Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This risk is extremely small because of rigorous testing of the US blood supply and donated organs and tissues.
Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when infected blood from a caregiver’s mouth mixes with food while chewing, and is very rare.
Being bitten by a person with HIV. Each of the very small number of documented cases has involved severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken.
Oral sex—using the mouth to stimulate the penis, vagina, or anus (fellatio, cunnilingus, and rimming). Giving fellatio (mouth to penis oral sex) and having the person ejaculate (cum) in your mouth is riskier than other types of oral sex.
Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids. These reports have also been extremely rare.
Deep, open-mouth kissing if the person with HIV has sores or bleeding gums and blood is exchanged. HIV is not spread through saliva. Transmission through kissing alone is extremely rare.

18. How well does HIV survive outside the body?
HIV does not survive long outside the human body (such as on surfaces), and it cannot reproduce. It is not spread by:
Air or water.
Insects, including mosquitoes or ticks.
Saliva, tears, or sweat.
There is no documented case of HIV being transmitted by spitting.
Casual contact like shaking hands or sharing dishes.
Closed-mouth or “social” kissing
Toilet seats.

19. Can I get HIV from anal sex?
Yes. In fact, having anal sex is the riskiest type of sex for getting or spreading HIV.
HIV can be found in the blood, semen, preseminal fluid, or rectal fluid of a person infected with the virus.
The bottom or Receiver 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

20. Can I get HIV from vaginal sex?
Yes. In general vaginal sex is not as risky anal sex, but is still a high-risk behavior for HIV infection.
It is possible for either partner to become infected this way. This risk depends on many factors:
If the partners are using condoms,
If the partner with HIV is using antiretroviral therapy (ART) consistently and correctly
Whether the partner who is HIV-negative is using pre-exposure prophylaxis (PrEP) consistently and correctly.
Condoms and HIV medicines can greatly lower the risk of transmitting HIV.

21. 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 disease (STD).
Many barrier methods that women use to prevent pregnancy (e.g., diaphragm, cervical cap) do not protect them against HIV or other STDs because they still allow infected semen 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 STDs.

22. Can I get HIV from oral sex?
Yes, the risk of HIV transmission through oral sex is much less than that from anal or vaginal sex—but it is not zero.
Oral sex involves giving or receiving oral stimulation to the penis, the vagina, or the anus. Most types of oral sex carry little to no risk of HIV.
The highest oral sex risk is performing oral sex with ejaculation in your mouth. However, the risk is still low, and much lower than anal or vaginal sex. Factors that may increase the risk of transmitting HIV through oral sex are oral ulcers, bleeding gums, genital sores, and the presence of other (STDs).
The risk is lower if the partners are using condoms or dental dams, if the partner with HIV is taking antiretroviral therapy (ART) consistently and correctly, and if the partner who is HIV-negative is taking pre-exposure prophylaxis (PrEP) consistently and correctly. Condoms and HIV medicines can greatly lower the risk of transmitting HIV.

23. Is there a connection between HIV and other sexually transmitted diseases?
Having a sexually transmitted disease (STD) can increase the risk of getting or spreading HIV.
If you are HIV-negative but have an STD, you are at least 2 to 5 times as likely to get HIV if you have unprotected sex with someone who has HIV.
There are two ways that having an STD can increase the likelihood of getting HIV.
If the STD 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 STDs that cause no breaks or open sores (e.g., chlamydia, gonorrhea, trichomoniasis) can increase your risk by causing inflammation that increases the number of cells that can serve as targets for HIV.
If you are HIV-positive and also infected with another STD, you are 3 to 5 times as likely as 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 who also are infected with another STD.

24. Increased susceptibility.
There is substantial biological evidence demonstrating that the presence of other STDs increases the likelihood of both transmitting and acquiring HIV.
Increased susceptibility.
STDs appear to increase susceptibility to HIV infection by two mechanisms.
Genital ulcers (e.g., syphilis, herpes, or chancroid) result in breaks in the genital tract lining or skin. These breaks create a portal of entry for HIV.
Additionally, inflammation resulting from genital ulcers or non-ulcerative STDs (e.g., chlamydia, gonorrhea, and trichomoniasis) increase the concentration of cells in genital secretions that can serve as targets for HIV (e.g., CD4+ cells).
Increased infectiousness.
STDs also appear to increase the risk of an HIV-infected person transmitting the virus to his or her sex partners.  Studies have shown that HIV-infected individuals who are also infected with other STDs are particularly likely to shed HIV in their genital secretions.
For example, men who are infected with both gonorrhea and HIV are more than twice as likely to have HIV in their genital secretions than are those who are infected only with HIV.
Moreover, the median concentration of HIV in semen is as much as 10 times higher in men who are infected with both gonorrhea and HIV than in men infected only with HIV.  The higher the concentration of HIV in semen or genital fluids, the more likely it is that HIV will be transmitted to a sex partner.

25. CDC recommends sexually active gay and bisexual men test for:
HIV.
Syphilis.
Hepatitis B and C.
Chlamydia and gonorrhea of the rectum if you’ve had receptive anal sex, or been a “bottom” in the past year.
Chlamydia and gonorrhea of the penis (urethra) if you have had insertive anal or oral sex in the past year.
Gonorrhea of the throat if you’ve performed oral sex (i.e., your mouth on your partner’s penis, vagina, or anus) in the past year.
Sometimes your health care provider may suggest a herpes test.

26. How can STD treatment slow the spread of HIV infection?
Evidence from intervention studies indicates that detecting and treating STDs may reduce HIV transmission.
STD treatment reduces an individual's ability to transmit HIV. Studies have shown that treating STDs in HIV-infected individuals decreases both the amount of HIV in genital secretions and how frequently HIV is found in those secretions (Fleming, Wasserheit, 1999).
Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious.  It is critical that all individuals, especially those with herpes, know whether they are infected with HIV and, if uninfected with HIV, take measures to protect themselves from infection with HIV.
Among individuals with both herpes and HIV, trials are underway studying if treatment of the genital herpes helps prevent HIV transmission to partners.

27. Can I get HIV from someone with an undetectable viral load?
Yes. Even though having an undetectable viral load greatly lowers the chance that a person with HIV can transmit the virus to a partner, there is still some risk.
Viral load refers to the amount of HIV in the blood. An undetectable viral load is when the amount of HIV in the blood is so low that it can’t be measured. Antiretroviral therapy (ART) reduces viral load, ideally to an undetectable level, when taken consistently and correctly.
A person with HIV can still potentially transmit HIV to a partner even if they have an undetectable viral load, because :
HIV may still be found in genital fluids (e.g., semen, vaginal fluids). The viral load test only measures virus in blood.
A person’s viral load may go up between tests. When this happens, they may be more likely to transmit HIV to partners.
Sexually transmitted diseases (STDs) increase viral load in genital fluids.

28. Can I get HIV from injecting drugs?
Yes. If you share injection drug equipment with someone who has HIV, your risk is high.
Risk also depends on whether the person who has HIV is using antiretroviral therapy (ART) consistently and correctly, and whether the person who is HIV-negative is using pre exposure prophylaxis (PrEP) consistently and correctly.
Sharing drug equipment (or works) can also be a risk for spreading HIV. Infected blood can get into drug solutions by:
Using blood-contaminated syringes to prepare drugs.
Reusing water.
Reusing bottle caps, spoons, or other containers (cookers) to dissolve drugs in water and to heat drug solutions.
Reusing small pieces of cotton or cigarette filters (cottons) to filter out particles that could block the needle.

29. Can I get HIV from using other drugs?
Not directly, but being drunk or high affects your ability to make safe choices and lowers your inhibitions, which may lead you to take risks such as having sex without a condom.
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.
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 men who have sex with men (MSM). MSM who use meth may increase their sexual and drug-use risk factors. They may:
Use condoms less often.
Have more sex partners and have sex over a longer period of time.
Engage in unprotected anal sex—especially as the receptive partner.
Inject meth instead of smoking or snorting it.

30. If I already have HIV, can I get another kind of HIV?
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%.

31. Are healthcare workers at risk for getting HIV on the job?
The risk of health care workers being exposed to HIV on the job (occupational exposure) is very low, especially if they use protective practices and personal protective equipment to prevent HIV and other blood-borne infections.
For health care workers on the job, the main risk of HIV transmission is through accidental injuries from needles and other sharp instruments that may be contaminated with the virus; however, even this risk is small.
Scientists estimate that the risk of HIV infection from being stuck with a needle used on an HIV-infected person is less than 1%.

32. Can I get HIV from receiving medical care?
Although HIV transmission is possible in health care settings, it is extremely rare.
Careful practice of infection control, including universal precautions (i.e., using protective practices and personal protective equipment to prevent HIV and other blood-borne infections) protects patients as well as health care providers from possible HIV transmission in medical and dental offices and hospitals.
The risk of getting HIV from receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV is extremely small because of rigorous testing of the US blood supply and donated organs and tissues.
It is important to know that you cannot get HIV from donating blood/plasma/platelets/organs.
Since 1985, the United States tests all donated blood and organs for HIV; therefore, the risk of getting HIV in this way in the United States is now extremely low

33. Can I get HIV from casual contact of an HIV person?
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 a casual kiss.
You cannot become infected from a toilet seat, a drinking fountain, a door knob, dishes, drinking glasses, food, cigarettes, pets, or insects.
HIV is not spread through the air, and it does not live long outside the body.

34. Can I get HIV from a tattoo or body piercing?
Tattooing or body piercing present a potential risk of HIV transmission, but no cases of HIV transmission from these activities have been documented.
Be sure that only new needles, ink, and other supplies are used and that the person doing the procedure is properly licensed.

35. Can I get HIV from being spit on or scratched by an HIV infected person?
No. HIV cannot be spread through saliva, and there is no documented case of transmission from an HIV-infected person spitting on another person.
There is no risk of transmission from scratching because there is no transfer of body fluids between people

36. Can I get HIV from mosquitoes?
No. There is no evidence of HIV transmission from mosquitoes or any other insects—even in areas where there are many cases of HIV and large populations of mosquitoes.
Unlike organisms that are transmitted by insect bites, HIV does not reproduce (and does not survive) in insects.

37. Can I get HIV from food?
Except for rare cases in which children consumed food that was pre-chewed by an HIV-infected caregiver, HIV has not been spread through food.
The virus does not live long outside the body. You cannot get it from consuming food handled by an HIV-infected person; even if the food contained small amounts of HIV-infected blood or semen.
Exposure to the air, heat from cooking, and stomach acid would destroy the virus.

38. Are lesbians or other women who have sex with other women at risk for HIV?
Case reports of female-to-female transmission of HIV are rare.
The well-documented risk of female-to-male transmission shows that vaginal fluids and menstrual blood may contain the virus and that exposure to these fluids through mucous membranes (in the vagina or mouth) could, potentially, lead to HIV infection.

39. Is the risk of HIV different for different people?
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.
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.

40. Diagnosis and Testing

41. How many people become infected with HIV in the U.S. each year?
 About 50,000 people get infected with HIV each year.  In 2010, there were around 47,500 new HIV infections in the United States.

42. Testing for HIV CLIA waived rapid test
Confirmatory testing begins with a combination immunoassay that detects HIV-1 and HIV-2 antibodies and HIV-1 p24 antigen (Architect).
All specimens reactive on this initial assay undergo supplemental testing with an immunoassay that differentiates HIV-1 from HIV-2 antibodies.
Specimens that are reactive on the initial immunoassay
Nonreactive or indeterminate on the antibody differentiation assay proceed to HIV-1 nucleic acid testing for resolution.

43. How do healthcare providers diagnose HIV?
The most common tests examine a blood sample for evidence that a person's body is fighting an HIV infection. These tests detect HIV antibodies, which are substances the body creates in response to being infected with HIV.
However, during the first several weeks of infection, these tests may not reveal the infection. This is because it takes some time for the immune system to produce enough antibodies for the antibody test to detect. This is a time when it is very easy for a person with the virus to pass it on to someone else.
Ninety-seven percent of people will develop detectable antibodies in the first 3 months after infection, but for a small percentage of people it can take longer). In these cases, different tests can directly look for pieces of the virus's genetic material in the blood.

44. How do you diagnose HIV in children and youth?
There are special challenges in diagnosing HIV in infants and youth.
Because the HIV antibody from HIV-infected mothers passes to their infants, finding the HIV antibody in an infant does not indicate that the infant has become HIV-infected. Maternal HIV antibody in an uninfected infant can persist as long as 12 to 18 months before it disappears. Therefore, an HIV antibody test cannot be used to diagnose HIV infection in infants younger than age 18 months.
Scientists have developed highly accurate blood tests for diagnosing HIV infection in infants. One laboratory test, called polymerase chain reaction, can detect extremely small quantities of HIV's genetic material in an infant's blood and allow a diagnosis to be made in the first few months of life.

45. New testing recommendations 6-27-14
Sequence of appearance of laboratory markers for HIV-1 infection
Recommended Laboratory HIV Testing Algorithm for Serum or Plasma Specimens

46. What does a negative HIV test mean?
A negative result does not necessarily mean that you don't have HIV.
That's because of the window period—the period after you may have been exposed to HIV but before a test can detect it.
The window period depends on the kind of test that was used on your blood or oral fluid.
For antibody tests, if you get a negative result within 3 months of your most recent possible exposure, you need to get tested again at the 3-month mark.
For RNA tests or antibody/antigen tests, that timeframe may be shorter.

47. What does a positive HIV test mean?
If you had a rapid screening test, the testing site will arrange a follow-up test to make sure the screening test result was correct.
If your blood was tested in a lab, the lab will conduct a follow-up test on the same sample.
If the follow-up test is also positive, it means you are HIV-positive.

48. Treatment

49. Treatment of HIV
There are currently more than 30 drugs approved to fight HIV.
However, these drugs:
Do not cure HIV or AIDS
Do not stop the virus from spreading from person to person, although they do make transmission less likely

50. More HIV medications

51. Prevention

52. What are the implications for HIV prevention?
Strong STD prevention, testing, and treatment can play a vital role in comprehensive programs to prevent sexual transmission of HIV.
Furthermore, STD trends can offer important insights into where the HIV epidemic may grow, making STD surveillance data helpful in forecasting where HIV rates are likely to increase.
Better linkages are needed between HIV and STD prevention efforts nationwide in order to control both epidemics.

53. CDC estimates that 1,144,500 persons aged 13 years and older are living with HIV infection, including 180,900 (15.8%) who are unaware of their infection1. Over the past decade, the number of people living with HIV has increased, while the annual number of new HIV infections has remained relatively stable.
Courtesy of AIDS.gov

54. To help prevent the spread of HIV:
Use a new condom every time you have sex. Consistently use male latex or female polyurethane condoms if you have sex.
Use only water-based lubricants.
Use a clean needle.
Do not share needles.
Consider male circumcision.
If you're pregnant, get medical care right away.
Consider the drug Truvada.
Unlike many other infections, like measles and polio, there is not yet a vaccine for HIV.

55. Preventing Mother-to-Child HIV transmission
Without any interventions, a newborn is at high risk of getting HIV from its infected mother. Specifically:
The risk is between 15% and 30% without breastfeeding.
The risk can go up to 45% if the mother breastfeeds her child.
Prevention strategies can reduce this risk to less than 2%. If you are a pregnant woman concerned about HIV, experts recommend that you:
Get an HIV test. If you know you have HIV, you can take steps to lower your baby's risk for infection.
If you have HIV, take anti-HIV drugs for yourself and your child. You should take anti-HIV drugs during pregnancy, labor, and birth, and your child should take them for the first weeks of life.
If you have HIV, avoid breastfeeding. HIV can pass from you to your child through your breast milk. If you live in the United States or another country with safe water, formula feeding is best for prevention of HIV.

56. PeP (Post-exposure Prophylasis)
PEP is the use of antiretroviral drugs after a single high-risk event to stop HIV from making copies of itself and spreading through your body.
You take PEP for 4 weeks if you may have been recently exposed to HIV and are not on PrEP.
PEP keeps HIV from making copies of itself and turning into infection.
To be effective, PEP must begin as soon as possible, but always within 72 hours (3 days) of a possible exposure.
You should continue to use condoms with sex partners while taking PEP.

57. PrEP (Pre-Exposure Prophylaxis)
The goal of PrEP is to prevent HIV infection from taking hold if you are exposed to the virus. This is done by taking one pill every day. These are some of the same medicines used to keep the virus under control in people who are already living with HIV.
Truvada is a combination of two drugs (tenofovir and emtricitabine). If you take PrEP daily, the presence of the medicine in your bloodstream can often stop HIV from taking hold and spreading in your body.
Truvada must be taken daily, exactly as prescribed, and you'll need follow-up HIV and kidney function testing every few months. Truvada should only be used along with other prevention strategies such as condom use every time you have sex.

58. Is there a cure for HIV? For most people, the answer is no.
Most reports of a cure involve HIV-infected people who needed treatment for a cancer that would have killed them otherwise. But these treatments are very risky, even life-threatening, and are used only when the HIV-infected people would have died without them.
Antiretroviral therapy (ART), however, can dramatically prolong the lives of many people infected with HIV and lower their chance of infecting others.
It is important that people get tested for HIV and know that they are infected early so that medical care and treatment have the greatest effect.

59. Elite Controller Positive Antibody Negative Viral Load
Are able to maintain a negative viral load without medication
1 in 300 HIV infected individuals
Elite Controller