HIV/AIDS: How Much Do You Know?
By Lauren Cox | Medically reviewed by Rosalyn Carson-DeWitt, MD
Over the last few decades, HIV has changed from a dire prognosis to a chronic condition. A cure has
yet to be found, but dedicated researchers have learned how HIV works and how to conduct rapid
diagnostic tests and have developed ways to prevent HIV from progressing into AIDS.
Today more than 1 million people live with HIV in the United States, and it’s estimated that more than
35 million people worldwide have HIV/AIDS, according to the World Health Organization and the U.S.
Centers for Disease Control and Prevention.
1. What is HIV and AIDS?
Answer: HIV is a virus, and AIDS is the advanced stage of an HIV infection.
HIV, or the human immunodeficiency virus, causes an infection that will eventually progress to acquired
immune deficiency syndrome (AIDS) if left untreated. A person with the immune disorder AIDS is at risk for
dangerous opportunistic infections, complications, and rare cancers.
2. Which bodily fluids can transmit HIV?
Answer: Blood, semen, vaginal fluid, and breast milk.
HIV can be transmitted if the blood, semen, vaginal fluid, or breast milk of an HIV-infected person is introduced
into the system of another person. Sharing needles, sexual intercourse, childbirth, and breastfeeding can all
spread HIV. HIV can also pass through cuts and sores on the skin or in the mouth. This means that while it’s
very rare to contract HIV through kissing and oral sex, it’s not impossible. Mosquito bites or holding hands with,
hugging, or sitting near someone with the virus will not spread HIV.
3. True or false: I don’t have to use protection if my sex partner is also HIV positive.
Answer: False.
Practicing safe sex is still necessary when both partners have HIV. There are different strains and subtypes
of HIV, and an HIV-positive person can contract another, harder-to-treat strain of HIV during unprotected sex.
Unsafe sex can also put you and your partner at risk for contracting another sexually transmitted disease,
which can complicate HIV treatment.
4. How does HIV attack the immune system?
Answer: HIV destroys immune system cells known as CD4 cells (also called T-cells).
HIV infects a CD4 cell and uses the cell to generate copies of HIV. Eventually the CD4 cell dies, and the new
copies of HIV go on to infect and kill more CD4 cells.
5. What do CD4 cells do in the immune system?
Answer: CD4 cells detect viruses or bacteria, then signal the rest of the immune system
to attack.
As HIV invades and kills more CD4 cells, the body has an increasingly difficult time fighting off infections.
©2014 Everyday Health, All rights reserved. www.EverydayHealth.com
HIV/AIDS: How Much Do You Know?
By Lauren Cox | Medically reviewed by Rosalyn Carson-DeWitt, MD
6. How does HIV lead to AIDS?
Answer: HIV eventually kills enough CD4 cells that a person develops the immune
disorder AIDS.
If a person’s CD4 cells drop below 200 cells per cubic millimeter (mm3) of blood, he or she may be diagnosed
with AIDS. A person with a healthy immune system typically has 500 to 1,000 CD4 cells/mm3. Untreated
HIV takes about 10 years to develop into AIDS. Some people develop AIDS much faster without treatment,
however, and about 10 percent of HIV-positive people live for decades without developing AIDS. With
treatment, it’s possible that some people with HIV will live long enough to die from another cause and never
develop AIDS.
7. Someone with HIV should take extra care to do which of the following?
Answer: Wash his or her hands often, keep up to date with vaccinations, and avoid contact
with people who have colds or the flu.
HIV makes a person more susceptible to infections, so it’s important to avoid getting sick in the first place.
Washing your hands frequently and getting routine vaccinations will help keep you healthy.
8. How does having HIV change your exercise requirements?
Answer: HIV makes it even more important for you to exercise.
Exercise can reduce inflammation, improve mood, improve thinking, and strengthen the immune system. All
these benefits are especially important to someone living with HIV. Talk to your doctor about finding an exercise
routine that is safe and effective for you.
9. When should a person with HIV typically start antiretroviral therapy (ART)?
Answer: When diagnosed with HIV.
Research in the last few years has shown that it’s best to start ART early. While ART used to be recommended
to people whose CD4 counts fell below 500 CD4 cells/mm3, the National Institutes of Health now encourages
initiating treatment even earlier —
­ at the time of diagnosis. The guidelines were adjusted based on several
factors, including that untreated HIV increases the risk of other conditions, such as heart disease, and that ART
can help reduce the risk of spreading HIV. Studies have also shown that early treatment increases the chances
of boosting CD4 counts to healthier levels and speeds the rate of cell recovery.
10. What can antiretroviral therapy (ART) or highly active antiretroviral therapy (HAART) do
for HIV?
Answer: Antiretroviral therapy can delay the progression of HIV to AIDS, as well as decrease
the chances that you’ll infect another person.
ART and HAART work by reducing the number of HIV copies in your body. This slows the progression of HIV
to AIDS and makes you less infectious than you would be without treatment. However, once you have HIV,
there is always a chance that you can transmit the virus to another person.
©2014 Everyday Health, All rights reserved. www.EverydayHealth.com
HIV/AIDS: How Much Do You Know?
By Lauren Cox | Medically reviewed by Rosalyn Carson-DeWitt, MD
11. True or false: I can skip a few doses of ART medicine without affecting my condition.
Answer: False.
When a person skips doses of ART, he or she increases the chances that HIV will mutate into a drug-resistant
strain, making the condition harder to treat. Call your doctor if you feel that you can’t afford your treatment, if
you are having trouble remembering to take your medicine, or if you are experiencing side effects. Your doctor
can work with you to help you find a way to continue your treatment.
12. Which of the following tests can determine whether your HIV treatment is working?
Answer: A viral load test and a CD4 blood test to see how well your immune system is
fighting HIV.
An antibody test is used to help diagnose HIV, but not to see if treatment is working. People may have HIV for
years without any symptoms, so a physical exam is not enough to determine whether treatment is working.
However, a viral load test and a CD4 blood test can determine whether your immune system is strong and
keeping the HIV virus in check.
13. What does a viral load test measure?
Answer: How many copies of HIV are circulating in a sample of your blood.
The goal of HIV treatment is to get the number of copies of HIV so low that current tests cannot detect the
virus in your blood. This doesn’t mean your body is free of HIV, but it’s a good indicator that you have HIV
under control.
14. What does a CD4 count tell you about your condition?
Answer: How many CD4 cells in general are circulating in a sample of your blood.
A CD4 cell count can give an estimate of how many CD4 cells are circulating in your blood. However, the test
cannot tell whether or not the CD4 cells are healthy.
15. What effect can drinking alcohol have on someone who is HIV positive?
Answer: People with HIV should be extra careful to limit their alcohol intake because they are
at a higher risk for alcohol-related problems.
Antiretroviral therapy can stress the liver, so avoiding further liver damage from alcohol or drugs is important.
People with HIV are also more prone to depression, and are susceptible to HIV-related dementia. Curbing
alcohol use can help keep your mind clear and improve your mood.
16. How does smoking change my ability to fight HIV?
Answer: Smoking can make side effects from ART worse, increase the risk for cancer, and
increase the risk for infections.
Smoking stresses the immune system, and it can make your ability to fight HIV more difficult in many ways.
People with HIV who smoke are at higher risk for several forms of cancer, heart disease, pneumonia, and early
death compared with people with HIV who don’t smoke.
©2014 Everyday Health, All rights reserved. www.EverydayHealth.com
HIV/AIDS: How Much Do You Know?
By Lauren Cox | Medically reviewed by Rosalyn Carson-DeWitt, MD
17. Although ART can lengthen lives, the treatment also increases a person’s risk for
which condition?
Answer: High cholesterol.
Antiretroviral therapy can increase the risk for a number of conditions related to heart disease and diabetes —
including high cholesterol, high triglycerides, and high blood sugar. This makes a healthy diet and lifestyle even
more important for people living with HIV.
18. True or false: Getting emotional support, help with stress, and treatment for depression
will help me live better with HIV.
Answer: True.
Stress and depression are common among people living with HIV. This not only diminishes the quality of
their lives but can also worsen the physical symptoms of HIV. Find a support group or see a mental health
professional if you need help.
©2014 Everyday Health, All rights reserved. www.EverydayHealth.com