What Does It Mean to Be HIV-Positive?

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Being HIV-positive means someone has signs of the human immunodeficiency virus (HIV) in their bodies. This is discovered through an HIV test.

Approximately 1.2 million people are living with HIV in the United States today. Of them, 14% (one in seven) don't know they have it.

An initial HIV-positive test result is preliminary. That means the person who tests positive needs a follow-up test to confirm the result.

Some people who initially test negative for HIV could test positive in the follow-up test. That's because it takes time for the body to produce a detectable amount of antibodies.

There is currently no cure for HIV. But you can control the infection with medical treatment.

This article explains what it means to be HIV positive, what to expect from HIV testing, and what treatment is available.

HIV is a virus that attacks cells in the immune system, killing them and leaving the body defenseless against infection. It is transmitted through contact with infected blood, semen, or vaginal fluids.

How HIV Is Spread

HIV is spread through sexual contact or sharing drug equipment with someone who is infected with the virus. It can also be transmitted from parent to child through breast milk.

The following can put someone at higher risk of becoming infected with HIV:

  • Unprotected sex
  • Anal sex
  • Sharing drug needles and syringes
  • Having other sexually transmitted diseases like syphilis, chlamydia, and gonorrhea
  • Unsafe injections for blood transfusions
  • Accidental needle stick injuries (more common among healthcare workers)

HIV Positive Meaning

If someone tests positive for HIV, it's considered a preliminary positive result. A confirmation test is used to confirm an initial HIV-positive diagnosis.

The only way to know if someone has HIV is through testing. An HIV-positive diagnosis is made after HIV antibodies or antigens are detected in the body.

Once HIV enters the body, the immune system produces antibodies (proteins that help fight off infection) in response to the virus. However, an HIV antigen called p24 is produced even before antibodies develop.

The presence of antibodies or antigens in a blood, saliva, or a urine sample is detected through an HIV test. This indicates that HIV has entered the bloodstream and that someone is HIV-positive.

The CDC recommends antibody and antigen combination tests. These can check for HIV antibodies as well as the p24 protein.

Everyone between the ages of 13 to 64 should get tested for HIV at least once.

Stages of HIV

HIV is categorized by severity. The three stages differentiate between early infection and progression to AIDS.

Stage 1: Acute HIV Infection

Stage 1 of the HIV infection is known as acute HIV infection. At this stage, the immune system attempts to attack the virus by producing HIV antibodies. This process is called seroconversion.

Seroconversion usually takes place within a few weeks of infection. These antibodies will stick around and remain detectable for many years.

As a result, someone who is living with HIV will continue to test positive on HIV tests. That is true even if their viral load (the amount of HIV in the blood) is undetectable.

Within two to four weeks of being infected, those with HIV may experience:

  • Fever
  • Night sweats
  • Joint pain
  • Headache
  • Sore throat
  • Muscle aches
  • Fatigue
  • Swollen lymph nodes
  • Mouth ulcers

Symptoms may be absent in some people, however. 

Stage 2: Clinical Latency

When the body enters stage 2, it is called clinical latency. At this stage, the virus still multiplies but at very low levels.

Infected individuals begin to feel better with little to no symptoms. HIV can still be transmitted to other people, however, during this stage.

Stage 3: AIDS

If an HIV infection is left untreated, it will progress to stage 3, acquired immunodeficiency syndrome (AIDS). At this stage, the body's immune system is badly damaged and becomes vulnerable to other infections as well.

A doctor will diagnose whether someone has AIDS through CD4 cell testing.

At this stage, someone with HIV may experience recurrent fever, extreme fatigue, chronic diarrhea, depression, and memory loss. Other symptoms of AIDS include: 

HIV Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Man

HIV vs. AIDS

HIV and AIDS are often incorrectly described as the same disease. But, in fact, HIV is a virus, and AIDS is a condition. 

AIDS is the late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus. Most people with HIV do not develop AIDS. That's because taking HIV medicine as prescribed stops the progression of the disease.

Without HIV medicine, people with AIDS typically survive about three years. However, once someone has an opportunistic infection, life expectancy without treatment falls to about one year.

HIV medicine can still help people at this stage. But those who start ART soon after they get HIV experience more benefits.

HIV Testing

If you suspect exposure to HIV, you can get tested at a clinic. Alternately, you can purchase an at-home test from a pharmacy or online.

If you receive a test at a medical office, they will offer you pre-test and post-test counseling about a positive result and transmission risk reduction. However, some people prefer at-home testing for privacy and rapid results.

The HIV Services Locator, run by the U.S. Department of Health and Human Services, can help someone find an HIV testing site near them.

Besides testing for HIV antibodies and antigens, healthcare providers also look at how a person's immune system functions and examine the level of HIV in the body. One measure they look at is the CD4 test counts. This is the number of CD4 immune cells in the blood.

CD4 cells are vital to the proper functioning of the immune system. A healthy CD4 count is between 500 and 1,600 cells per cubic millimeter. The more CD4 cells a person has, the healthier they are.

A low CD4 count, defined as 200 or fewer cells per cubic millimeter, indicates AIDS. In addition, it indicates a high risk of life-threatening opportunistic infections. These infections occur more frequently and are more severe in people with weakened immune systems like those with HIV.

Antiretroviral Therapy

Antiretroviral therapy (ART) is not a cure. But it can control HIV by stopping the virus from making copies of itself. ART can reduce the viral load of a person with HIV and result in viral suppression.

When a person has less than 200 copies of HIV per milliliter of blood, the virus is considered suppressed. This can help protect the immune system, which the virus attacks, and make it less likely for the infected individual to become sick.

There are eight classes of ART. Within those classes, there are dozens of different antiretroviral drugs.

ART can also reduce the risk of HIV transmission by keeping the viral load low. This can help someone achieve an undetectable viral load, which means the amount of HIV in their blood is so low that you can't pass it on through sex.

A study found that serodiscordant couples (where one person is HIV-positive and the other is HIV-negative) who were on ART were 96% less likely to infect their partners.

Doctors recommend that people start ART immediately once an HIV-positive diagnosis is confirmed. Starting treatment early can stop the progression of HIV and keep the infected individual healthy for many years.

People who have undetectable viral loads within a year of therapy are more likely to have a normal life expectancy compared with those who failed to achieve viral suppression.

Other Supportive Measures

Other lifestyle changes to consider after an HIV-positive result include: 

  • Staying up-to-date on vaccines
  • Quitting smoking
  • Lowering alcohol intake
  • Taking over-the-counter pain relievers

It is important to maintain ongoing therapy and regular doctor's visits to monitor the progression of HIV infection properly.

An HIV diagnosis often makes people feel distressed and anxious. So it’s important to have a support system that can help you cope healthily with a new HIV-positive diagnosis.

Summary

An HIV diagnosis is made after a positive test and a confirmation test. Stages categorize HIV. Stage 1 is acute infection, stage 2 is latent infection, and stage 3 is AIDS.

Most people with HIV will not go on to develop AIDS. That's because antiretroviral therapy drugs work well to suppress the virus and prevent it from developing into AIDS.

HIV and AIDS are not the same things. HIV is a virus, and AIDS is a condition that results from the body's immune system being badly damaged by the virus.

A Word From Verywell

Getting an HIV-positive diagnosis can be overwhelming. But finding out early can allow you to access treatment and prevent the infection from getting worse. Many people living with HIV manage to keep their infection under control with the latest treatment options.

If you’ve been diagnosed with HIV, locate your HIV care service, your state’s HIV hotline, an HIV health provider, and an HIV specialist. In addition, the CDC offers a large list of resources for housing, mental health care, traveling, and combating the stigma surrounding HIV. 

For those feeling alienated or confused, join an HIV support group. In addition, be sure to stay up-to-date on HIV therapy and focus on your well-being.

An HIV-positive diagnosis isn’t the end of your future. Maintaining a positive mindset and taking proactive steps toward controlling the infection can help you live a healthy life. 

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