What is HIV?
HIV is a virus that attacks the cells of the body’s immune system. The immune system helps protect you from getting sick. HIV weakens the immune system, which leads to other infections and illnesses. There is no cure for HIV, but there are highly effective treatments that allow people living with HIV to live long and healthy lives. Taking medicine also prevents spreading it to other people. Without treatment, HIV can turn into acquired immunodeficiency syndrome (AIDS) or advanced HIV infection, a life-threatening condition.
How is HIV spread?
Body fluids that can carry and spread HIV include:
- Blood
- Semen and pre-ejaculate (precum)
- Fluids from the vagina
- Fluids from the rectum/anus
- Expressed human milk (breast milk)
HIV can spread through:
- Sharing needles, syringes, or other drug injection equipment (for example, cottons, cookers, or water used to prepare drugs for injection) with someone who has HIV
- Having vaginal or anal sex with someone with HIV without using protection/barriers
- Pregnancy, childbirth, and/or breastfeeding or chestfeeding
To spread from one person to another, body fluids containing HIV (from an infected person) must come into contact with broken skin (damaged tissue), the penis, vagina, mouth, or rectum (mucous membranes) or be injected into veins carrying blood of an uninfected person. HIV is much more likely to spread when the person with HIV is not taking HIV medication and has a high viral load (a high amount of HIV in the body). Additionally, having an untreated sexually transmitted infection (STI) can increase the risk of getting or spreading HIV.
What are the signs and symptoms?
Not every person infected with HIV becomes sick right away. Some people may not have symptoms, and some may have flu-like symptoms such as fever, sore throat, and headaches within 2 to 4 weeks of infection, also called acute retroviral syndrome.
Without treatment for HIV at the acute retroviral syndrome stage, the disease will move to the chronic retroviral syndrome stage, and eventually will turn into acquired immunodeficiency syndrome, known as AIDS. Treatment is the best way to minimize symptoms and prevent the illness from getting worse.
Having HIV can make your immune system weak and make it more likely for you to become sick with other illnesses. These are called opportunistic infections and can include:
- Tuberculosis (infection in the lungs)
- Meningitis (infection of the nervous system)
- Infections from viruses like herpes, shingles, or hepatitis
- Fungal infections, like thrush or pneumonia (infection of the lungs)
- Some cancers
How is HIV diagnosed?
HIV can have no symptoms and is often spread by people who may not be aware that they are infected. Getting tested is the only way to know if you have HIV. The current testing recommendations are that those aged 13-to-64 years old get tested for HIV at least once in their lifetime, and that people whose risk is higher get tested at least once per year, such as anyone who has:
- Shared needles, syringes, or other drug injection equipment (such as cookers)
- Have exchanged sex for drugs or housing, or other things
- Been diagnosed with another STI, hepatitis, or tuberculosis
- Had anal or vaginal sex with someone living with HIV
- Had more than one sexual partner since their last HIV test
- Had sex with someone who fits the description of any of the above risk factors
The CDC recommends that sexually active men who have sex with men (MSM), gay and bisexual men, and persons who inject drugs should be tested for HIV frequently (every 3 to 6 months), due to a higher risk of HIV infection. Social and structural issues—such as HIV stigma, homophobia, discrimination, poverty, and limited access to high-quality health care—influence health outcomes and continue to drive health inequities.
Anyone who is pregnant should be regularly tested for HIV to prevent passing it on to the fetus, even if they were tested in the past. Early identification and treatment of HIV is the best way to prevent passing HIV to the unborn baby.
HIV testing should occur as early as possible in the pregnancy, usually with the first doctor’s visit in the first trimester. People who may be exposed to HIV or who have a sexually transmitted infection (STI) should get tested for HIV again in the last few months of pregnancy (the third trimester) and at the time of birth.
Contact your health care provider to get more information and make an appointment for testing. If you do not have a health care provider, you can get tested at a DPH-supported testing program in Massachusetts.
How is HIV treated?
Though HIV cannot be cured, it can be successfully treated with medications. Antiretroviral therapy (ART), a term that refers to medications used to treat HIV, can reduce the amount of virus in the body to an undetectable level (not having enough HIV in the body to be detected by a lab test) when taken as prescribed. This is also called an undetectable viral load. Having an undetectable viral load means that HIV will not be transmitted during sex or pregnancy.
ART allows people living with HIV to live long and healthy lives. People living with HIV should talk to a health care provider about ART as soon as possible after receiving their diagnosis.
How is HIV prevented?
There is no vaccine to prevent HIV infection. However, you can protect yourself and reduce the risk of HIV infection by:
- Taking a medication before or after a potential exposure (known as pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP))
- Talking to your partners about HIV and STI status before sex and getting tested for HIV and STI.
- Trying sexual activities that have a lower risk of spreading HIV, such as oral sex or masturbation
- Using condoms and water- or silicone-based lube consistently during sex
- Accessing a syringe service program (SSP) or a pharmacy for clean needles or syringes
Getting tested for HIV, viral hepatitis, syphilis, chlamydia, and gonorrhea regularly is important to know your status, and to prevent spreading to others. It is also recommended to get vaccinated for sexual and blood-borne infections that are vaccine preventable, including hepatitis A and B, and mpox.
People who live with HIV can help prevent spreading it to other people by taking their ART medication every day as prescribed, so that the virus becomes undetectable in their blood. When the virus cannot be detected, it cannot be passed to sexual partners.
For pregnant individuals living with HIV, treatment also protects their babies. When taken as prescribed throughout pregnancy, childbirth, and breastfeeding, antiretroviral therapy reduces the likelihood of passing HIV to the baby to less than 1 percent.1 When HIV medicines are taken consistently during pregnancy, vaginal deliveries are generally safe, and cesarean delivery can lower the risk of passing HIV to the baby. People living with HIV can have healthy pregnancies and deliver HIV negative newborns. To learn more about HIV and pregnancy, visit the HIV and Pregnancy fact sheets from the National Institutes of Health (NIH).
Pre-exposure prophylaxis:
PrEP is a medication that can prevent someone from getting HIV if they are exposed to the virus and can be taken as a daily pill or a shot given by a health care provider. If taken as prescribed, PrEP is highly effective at preventing HIV before a potential exposure. For more information on PrEP, visit the mass.gov webpage on PrEP information for the public.
Post-exposure prophylaxis (PEP):
Health care providers may prescribe PEP in emergency situations to people who are not living with HIV but have had a possible exposure. PEP should be taken within 72 hours (3 days) of exposure, and ideally within 24 hours of exposure. Potential situations in which PEP may be prescribed include, but are not limited to:
- Sharing needles, syringes, or other drug injection equipment
- Having sex without a condom or noticing that the condom broke
- Being sexually assaulted
PEP is most effective if taken within 24 hours (1 day) of exposure. Anyone who thinks that they might have been exposed to HIV should talk to a health care provider about PEP immediately (or as soon as possible) after exposure. People who have been sexually assaulted should be referred to the Massachusetts Sexual Assault Nurse Examiner (SANE) Program.
For more information on PEP, visit the mass.gov page on PEP information for the public.
Additional information
- 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 or other sexually transmitted diseases and infections and help them to access testing and treatment, if needed. Learn more about the DPH 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.
- PrEP Drug Assistance Program. The Massachusetts Pre-Exposure Prophylaxis Drug Assistance Program (PrEPDAP) helps eligible Massachusetts residents pay for approved medications that can prevent the spread of HIV.
- PEP Drug Assistance Program. The PEP Drug Assistance Program helps eligible Massachusetts residents pay for PEP medications following an exposure to HIV.