HIV information for the public

You can learn about HIV infection, include how it can be prevented and how it is treated.

What is HIV?

Human immunodeficiency virus (HIV) weakens a person’s immune system by destroying important cells that fight disease and infection. There is no cure for HIV, but it can be controlled with treatment. People with HIV infection who are treated can live long and healthy lives. 

How is HIV spread?

HIV is spread by direct contact with blood, vaginal fluid, or semen of a person who has HIV infection. This can happen through:

• Sexual contact
• Sharing needles, syringes, and other equipment to inject drugs
• During pregnancy, birth, or breast/chestfeeding

HIV cannot be spread by:

• Casual contact such as hugging or handshakes
• Sharing food or drinks, or using toilets
• Coughing or sneezing
• Insects or pets

How is HIV treated?

Antiretroviral therapy

• There are many medications that are highly effective at controlling HIV and preventing complications. These medications are called antiretroviral therapy (ART).
• ART is usually a combination of two or more medications from different classes. When taken as prescribed, these medications stop HIV from making more viral copies and reduce the amount of HIV in the bloodstream. 
• Everyone diagnosed with HIV should take ART as soon as possible after diagnosis.
• The goal of ART is to have an undetectable viral load. Keeping an undetectable viral load will help to keep you healthy.  
• People with HIV infection who achieve and maintain an undetectable viral load reduce the chances of passing HIV infection to sex and/or drug injection partners.

Tests to monitor infection and treatment

• If you’ve been diagnosed with HIV, your healthcare provider will perform testing to evaluate your overall health and to determine which treatment is right for you. These tests will include:
  • CD4 T-cell count: CD4 T-cells help protect the body from infection. These are the cells that are targeted and destroyed by HIV.  The CD4 T-cell count measures the volume of CD4 T-cells in your blood and indicates the strength of your immune system.
  • Viral load (HIV RNA): This test measures the amount of HIV virus in your blood. 
  • Drug resistance. Some strains of HIV are resistant to some medications. This test helps your healthcare provider select the right medications for you. 
  • Your healthcare provider may also recommend other tests to check for other infections, or to evaluate liver or kidney function.
• Your healthcare provider will also do periodic testing to help manage your health, and to monitor your viral load. 

How is HIV diagnosed?

• HIV infection is diagnosed by performing tests, usually on a sample of your blood taken from a vein or from your finger.
• It’s important to note that no HIV test can detect the virus immediately after infection. It may take several weeks after exposure before a test can detect HIV infection. 
• You can get tested for HIV in most clinics and hospitals. Contact your healthcare provider to get tested. If you do not have a healthcare provider, you can get tested at a testing program supported by MDPH. HIV tests that you can perform in your home may be purchased online or at a pharmacy. 
• HIV screening tests are usually considered a preventive service. In most cases the cost of screening is covered by health insurance without patient/client cost-sharing.
• If you are on someone else’s insurance policy, like a spouse or parent, it may be possible to keep billing information associated with HIV testing private. Learn about privacy in billing and find tools that can help you keep health information private when you’re on someone else’s insurance.   

Who should be tested for HIV?

CDC recommends that everyone between the ages of 13 and 64 years get tested for HIV at least once during their lifetime. Testing at least one time every year is also recommended if:

• You’re a man who has sex with other men
• You’ve had anal or vaginal sex with a partner who has HIV infection
• You’ve had more than one sex partner since your last HIV test
• You’ve shared needles, syringes, or other drug injection equipment
• You’ve been diagnosed or treated for another sexually transmitted disease, hepatitis, or tuberculosis
• You’ve ever had sex with someone whose sexual history and HIV status you do not know

You might benefit from more frequent testing if you do things that might increase your chance of getting HIV. Talk to your healthcare provider about how often you should get tested for HIV. 

If you’re pregnant or planning to get pregnant, you should talk to your healthcare provider about HIV testing before and during pregnancy.

How can I prevent HIV?

• Get tested and treated for HIV and other sexually transmitted infections (STIs) like gonorrhea or chlamydia.
  • Learning your HIV infection status is the first step to making decisions about how to protect yourself and others, and how to stay healthy.
  • If you have HIV infection, getting prompt treatment will help keep you healthy.  Consistent use of HIV medications can help keep your viral load undetectable.
  • If you have an STI you are more likely to get HIV infection if you are exposed. Getting treatment for an STI can lower your chances of getting HIV.
  • Talk to your healthcare provider about getting tested for HIV and STIs.  If you do not have a healthcare provider, you can get tested at an MDPH-supported testing program, located throughout Massachusetts.
• Choose sexual activities that have a lower risk of transmission, like oral sex or masturbation.
• Use condoms correctly and every time you have anal or vaginal sex.
  • Condoms are highly effective at preventing HIV and other STIs. 
  • Learn the right way to use a condom.
  • Use only water-based or silicone-based lubricants to prevent condoms from breaking or slipping. 
• If you inject drugs, use only new needles, syringes, and other injection equipment every time you inject.
  • You can get new needles, syringes and other injection equipment, and safely dispose of used ones at a syringe service program (SSP).
  • Pharmacies also sell needles, and in Massachusetts you don’t need a prescription to buy them. 
  • If you do share needles, syringes, or other drug injection equipment, use bleach to clean them. Learn more about how to clean your syringes.  
• Take HIV Pre-Exposure Prophylaxis (PrEP). 
  • PrEP is a medication that can prevent HIV infection, when taken as prescribed. 
  • PrEP is for people who don’t have HIV infection but may be at risk for becoming infected.
  • Talk to your healthcare provider to find out if PrEP is right for you. If you don’t have a healthcare provider, consider an MDPH-supported PrEP program.  
• Talk to your sex and/or injection partners about their HIV status. This will help you both make decisions about the best way to protect yourself and to stay healthy.
  • If your partner has HIV infection, encourage them to stay connected to healthcare and adhere to their HIV treatment. 
  • If your partner is taking HIV medication regularly it will help keep their viral load undetectable. This will reduce your risk for getting HIV. 
• If you have HIV infection, find a healthcare provider you trust, stay engaged in care, and take ART medications as prescribed. This will help keep you healthy, and by keeping your viral load undetectable will help to reduce the risk for passing HIV infection to others. 

Where can I get more information?

• Testing for HIV and STIs. Getting tested for HIV and other STIs is an important first step to access treatment and to protect your partners.  Contact your healthcare provider to get more information and make an appointment for testing.  If you do not have a healthcare provider, you can get tested at an MDPH-supported testing program, located throughout Massachusetts.
• HIV Pre-Exposure Prophylaxis (PrEP). Contact your healthcare provider to find out if PrEP is right for you. If you don’t have a healthcare provider, you can find a provider here If you don’t have a healthcare provider, consider an MDPH-supported PrEP program. 
• Syringe Service Programs (SSPs). The Massachusetts Department of Public Health supports syringe service programs where people who inject drugs can access sterile needles and syringes free of cost, dispose of used needles and syringes, and get connected to other services such as testing for hepatitis C, HIV and other sexually transmitted infections, overdose education, and access to Narcan (naloxone).
• Partner Services Program. If you are diagnosed with HIV, the Massachusetts Department of Public Health offers free, voluntary, and confidential assistance to answer your questions about HIV, help you get medical treatment for HIV infection and testing for other STIs, help tell your sex and/or drug injection partners that they may have been exposed to HIV and help them to access testing and treatment, if needed.  Learn more about the MDPH Partner Services Program.
• Sexually transmitted infections. Sexually transmitted infections, like chlamydia and gonorrhea, can increase your risk for HIV infection. Learn more about STIs.
• HIV Drug Assistance Program. The Massachusetts HIV Drug Assistance Program (HDAP) helps eligible Massachusetts residents living with HIV to pay for medications and health insurance. HDAP can help pay for out-of-pocket prescription costs and insurance premiums. 
• HIV information from CDC