HIV

HIV is a long-term health condition, but these days it is very easy to manage. The name stands for human immunodeficiency virus. The virus attacks your immune system, and if it isn't treated, it weakens your body's ability to fight infections and disease.

If you think you might have been exposed to HIV, speak to a sexual health service as soon as possible.

Most people with HIV have a short flu-like illness 2 to 6 weeks after they are infected, and it lasts for 2 weeks. This is called primary HIV infection.

The symptoms of primary HIV infection include:

• fever (high temperature)
• sore throat
• body rash

Other symptoms can include:

• tiredness
• joint pain
• muscle pain
• swollen glands

Once these symptoms go away, HIV may not cause any symptoms for many years. But during this time it stays active and keeps damaging your immune system. So many people who have HIV don't know they're infected.

When the immune system becomes severely damaged, symptoms can include:

• weight loss
• chronic diarrhoea
• night sweats
• skin problems
• recurrent infections
• serious life-threatening illnesses

If you think you may have HIV, you should get tested. And if you have ever been sexually active, it's worth considering an HIV test at least once.

Some people are at higher risk and are advised to test regularly. For example:

• gay and bisexual men, or men who have sex with men, should have an HIV test at least once a year, or every 3 months if they have sex without HIV PrEP or condoms with new or casual partners
• women and men from countries with high levels of HIV, especially from sub-Saharan Africa, should have an HIV test if they have sex without using HIV PrEP or condoms with new or casual partners
• people who inject drugs, or who have unprotected sex (sex without condoms or HIV PrEP) with people who inject drugs

Some health conditions turn up more often in people who are living with HIV. So if you're diagnosed with one of the following, a doctor may advise you to have an HIV test:

• hepatitis B
• hepatitis C
• pneumonia
• sexually transmitted infections (STIs) like gonorrhoea and syphilis
• unexplained swollen glands

Most people diagnosed with these conditions will not have HIV, but a test is recommended to make sure. If you have been diagnosed with one of them and nobody has offered you an HIV test, you can:

• speak to your doctor about getting tested for HIV
• get a free test using one of the options above

Testing for HIV when you have any of these conditions can rule HIV out. It also helps with early diagnosis, with treatment, and with stopping HIV being passed on to others.

The test for HIV is straightforward and highly accurate, and it's the only way to know if you're infected. It involves taking a sample from the body for analysis.

There are 4 main types of HIV test.

In the first, a sample of blood is taken and sent to a lab for analysis. Results are usually available within a few days.

In the second, a sample of saliva from your mouth or a small spot of blood from your finger is taken. This sample doesn't need to be sent to a lab, and you get the result within a few minutes. If a point of care test comes back reactive, you still need a confirmed laboratory test.

The third is done at home. You collect a saliva sample or a small spot of blood yourself and send it off in the post for analysis. You'll be contacted by phone or text with your result in a few days. You can buy these kits online or from some pharmacies. If your result from a home testing kit is reactive, you are still required to have a laboratory confirmed test.

In the fourth, you collect a saliva sample or a small spot of blood yourself and test it at home. The result is ready within minutes. Check that any test you buy has a CE quality assurance mark.

Antiretroviral medicines are what doctors use to treat HIV. They stop the virus multiplying in your body, which gives your immune system the chance to repair itself and prevents further damage. The medicines come as tablets, and you must take them every day. Most people with HIV take a combination of medicines.

The goal of HIV treatment is an undetectable viral load. This means the amount of virus in your body is so low that a test can't pick it up.

If you take your treatment and your virus level is undetectable, you can't pass HIV on to others. There is no cure for HIV yet, but people living with HIV who take their treatment should have a normal lifespan and good health.

Without treatment, people with HIV will eventually become unwell. HIV can be fatal if it isn't found and treated in time for the immune system to repair. So if you think you've been exposed to HIV, it's extremely important to get tested.

You can get HIV by having unprotected vaginal or anal sex, which means sex without a condom or without taking HIV PrEP. It may be possible for HIV to be passed on through unprotected oral sex, but the risk is very low.

Other ways of getting HIV include:

• sharing sex toys that aren't washed or covered with a new condom each time they're used
• sharing needles, syringes and other injecting equipment
• from mother to baby before or during birth, when the mother isn't taking HIV medicine
• from mother to baby through breastfeeding, when the mother isn't taking HIV medicine
• blood transfusion (outside of the UK)

Some people face a higher risk of getting HIV, and this applies to those who are not taking HIV PrEP medicine and who are:

• men who have had unprotected anal sex with men
• women who have had unprotected sex with men who have sex with men
• people who have had unprotected sex with a person who has lived or travelled in a high HIV prevalence country
• people who inject drugs
• people who have had unprotected sex with somebody who has injected drugs
• people who have caught another sexually transmitted infection (STI)

The best way to lower your risk of STIs is to practise safer sex. That means using a condom for vaginal, anal and oral sex. If you have anal sex, you also need to use a water-based or silicone-based lubricant.

HIV PrEP means taking medicine before you are exposed to HIV. It protects you by stopping the virus before it can take hold, so you don't become HIV positive.

If you think you may have been exposed to HIV recently, and you haven't taken HIV PrEP medicine or used a condom, you should take PEP medicine.

PEP is emergency HIV medicine. It's for someone who doesn't have HIV but has been, or may have been, very recently exposed to it.

Take PEP as soon as you can. You can still take it up to 72 hours after exposure, but the earlier you take it, the more effective it is.

PEP is available from sexual health services, or out of hours from the hospital emergency department.

If you inject drugs, never share needles or any other injecting equipment. That includes syringes, spoons and swabs, because sharing them is a way of passing on HIV.

You can get free clean needles and other injecting equipment from local injecting equipment providers, which are sometimes called needle exchanges.

If you've been diagnosed with HIV, you should get tested for all STIs and blood borne viruses, including:

• chlamydia
• gonorrhoea
• syphilis
• hepatitis B
• hepatitis C