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In this lesson, we're going to look at more details and facts about HIV and AIDS than you may have thought even existed. We'll look more closely at what these acronyms actually refer to, who is most at risk, some HIV and AIDS statistics, how the disease is transmitted, signs and symptoms, and the period of communicability.

What is HIV and AIDS?

HIV stands for human immunodeficiency virus. The virus can lead to acquired immunodeficiency syndrome (AIDS) if not properly treated.

HIV attacks the body's immune system, specifically the CD4 cells (also known as T cells) which help the immune system fight off the infection.

Warning: Unlike other viruses, the human body cannot completely rid itself of HIV, even with treatment. Once you get it, you have it for life.

When untreated, HIV reduces the number of T cells in the body, making it more likely that the person infected will get other infections or infection-related cancers. Over time, HIV can destroy so many cells that the body cannot fight off future infections and diseases.

Opportunistic infections or cancers then take advantage of a very weakened immune system and signal that the person has AIDS – the last and most advanced stage of HIV infection. It can take from two to 15 years to develop depending on the individual.

AIDS is actually defined by the development of certain cancers or infections or other severe clinical manifestations.

Who is Most at Risk of Contracting HIV or AIDS?

There are a number of behaviors and conditions that put an individual at a greater risk of contracting HIV and these include:

  • Unprotected anal and vaginal sex
  • Having another sexually transmitted infection such as syphilis, herpes, chlamydia, gonorrhea, and bacterial vaginosis
  • Sharing contaminated needles, syringes, and other injecting equipment and drug solutions when injecting drugs
  • Receiving unsafe injections, blood transfusions, tissue transplantation, and medical procedures that involve unsterile cutting or piercing

HIV and AIDS Statistics

At the end of 2015, it's estimated that 1.1 million people aged 13 or older were living with HIV infection in the U.S., including an estimated 162,500 people (around 15 percent) whose infection had not been diagnosed. See stats from 2018.

Some statistics for 2016 include:

  • The number of new HIV diagnoses in the U.S. was 39,782
    • 32,131 diagnoses among adult and adolescent males aged 13 or older
    • 7529 diagnoses among adult and adolescent females
    • 122 diagnoses among children younger than 13 years old
  • There were 1.8 million new cases of HIV discovered worldwide
  • There were 36.7 million people living with HIV worldwide
  • There were 19.5 million people receiving medications to treat HIV, known as antiretroviral therapy (ART)
  • There were one million deaths from AIDS-related illnesses

Sub-Saharan Africa bears the heaviest burden of HIV and AIDS cases worldwide, with around 64 percent of all new HIV infections. Other regions significantly affected include:

  • Asia and the Pacific
  • Latin America and the Caribbean
  • Eastern Europe and Central Asia

How is HIV Transmitted?

HIV is mostly transmitted through sexual behaviors and needle or syringe use, though as you'll soon see, there are a few other less common modes of transmission.

Transmission via Sexual Behaviors

Transmission through sexual activities includes:

  • Having anal or vaginal sex with someone who has HIV without using a condom or taking medications to prevent HIV
  • For the HIV negative partner, receptive anal sex (bottoming) is the highest risk behavior, but you can also get HIV from insertive anal sex (topping)

Pro Tip #1: Either partner can get HIV through vaginal sex, though it's less risky than receptive anal sex.

Transmission via Needle or Syringe Use

Transmission through needle or syringe use is most commonly seen with people sharing needles/syringes, rinse water, or other equipment used to prepare drugs for injection with someone who has HIV.

Pro Tip #2: HIV can live in a used needle or syringe for up to 42 days depending on the temperature and other factors.

Transmission via Bodily Fluids

Only certain body fluids from an infected person can transmit HIV, such as:

  • Blood
  • Semen
  • Pre-seminal fluid
  • Rectal fluids
  • Vaginal fluids
  • Breast milk

These fluids must come in contact with mucous membranes or damaged tissue or be directly injected into the bloodstream from a needle or syringe for transmission to occur.

Mucous membranes can be found, as you already have learned, in the mouth, ears, nose, and eyes, but also inside the rectum, vagina, and penis. These various mucous membranes also offer routes of transmission.

Transmission via Less Common Modes

HIV can be spread less commonly from mother to child during pregnancy, birth, or breastfeeding, and also through needle stick injuries.

In extremely rare cases, HIV has been transmitted by:

  • Oral sex
  • Receiving blood transfusion, blood products, or organ or tissue transplants that have been contaminated with HIV
  • Eating food that has been pre-chewed by an HIV infected person, usually among infants
  • Being bitten by a person with HIV
  • Contact between broken skin, wounds, or mucous membranes and HIV infected blood or body fluids contaminated with blood
  • Deep open mouth kissing if both people have sores or bleeding gums and blood from the HIV-positive partner gets into the bloodstream of the HIV-negative partner

Pro Tip #3: The average HIV/AIDS incubation period is 10 years!

Signs and Symptoms of HIV and AIDS

About 40 to 90 percent of those infected have flu-like symptoms within two to four weeks after becoming infected. While other people don't feel sick at all during this stage, which is also known as acute HIV infection.

These flu-like symptoms can include:

  • Fever
  • Chills
  • Rash
  • Night sweats
  • Muscle aches
  • Sore throat
  • Fatigue
  • Swollen lymph nodes
  • Mouth ulcers

These symptoms can last anywhere from a few days to several weeks.

Warning: During this time, HIV infection may not show up on some types of HIV tests, but people who have it are highly infectious and can spread the infection to others.

The Period of Communicability

Some things to keep in mind as it relates to communicability are:

  • All antibody positive people carry the HIV virus
  • Infectiousness is presumed to be lifelong, although successful treatment with combination antiretroviral therapy (cART) can lower the viral load in the blood and semen to undetectable levels
  • Treatment can slow the progression from one stage to the next
  • Treatment can also dramatically reduce the chance of transmitting HIV to someone else