Since then, scientists have made astonishing progress in their understanding of AIDS and its underlying cause, HIV — the human immunodeficiency virus. But many people still have misconceptions about HIV/AIDS, and this breeds confusion, fear, and stigma. Ignorance, unfortunately, has consequences. “There are a lot of reasons why people need to know the facts about HIV/AIDS, from determining whether they are at risk themselves to knowing how to speak sensitively to someone who has HIV or AIDS,” says Steven Santiago, MD, the chief medical officer of Care Resource, a nonprofit HIV/AIDS organization in southern Florida. Read on for essential info about HIV and AIDS that everyone should understand.
1. Fact: Anyone Can Get HIV
One misconception that stubbornly endures is that only gay men can get HIV. It’s true that in the United States, gay, bisexual, and other men who have sex with men (MSM) continue to have the greatest risk of HIV infection. In 2020, MSM accounted for an estimated 71 percent of new HIV diagnoses, according to the federal government website HIV.gov. But many individuals acquire HIV through heterosexual contact. In 2020 these cases accounted for more than one in five new HIV infections — 22 percent. Drug users who became infected with HIV by sharing needles made up an estimated 7 percent of new 2020 HIV infections, while transgender people accounted for around 2 percent of new HIV diagnoses.
2. Fact: Black and Hispanic/Latino People Have Been Hit Especially Hard by HIV
HIV has had an outsize impact on communities of color in the United States. Black Americans make up only about 12 percent of the population but accounted for 42 percent of new HIV cases in 2020. Racism, HIV stigma, homophobia, poverty, and barriers to healthcare are powerful forces driving this disparity, according to the Centers for Disease Control and Prevention (CDC). Hispanic/Latino individuals have also been disproportionately impacted by HIV, representing 19 percent of the U.S. population yet making up 27 percent of new HIV diagnoses in 2020.
3. Fact: Women and Babies Can Get HIV
Approximately one-quarter of people with HIV in the United States are female, and most were exposed to the virus through heterosexual sex. A person who is pregnant and has HIV/AIDS can pass HIV to their unborn child, and can also transmit the virus during childbirth and when breastfeeding, the CDC says.
4. Fact: HIV Rates Are Astronomical in Some Parts of the World
Since 1981, more than 84 million people worldwide have contracted HIV, and approximately 40 million have died of AIDS, including more than 700,000 in the United States. In some countries, HIV is ubiquitous. The prevalence of HIV in the population in some sub-Saharan African countries currently exceeds 30 percent. An estimated 1.2 million people in the United States have HIV, according to HIV.gov. But the rate of new infections and diagnoses is dropping, likely thanks to prevention efforts, the CDC reports. Still, progress has been uneven. Certain groups, such as Hispanic/ Latino gay and bisexual men, are experiencing rising numbers of infections and diagnoses.
5. Fact: You Can Have HIV and Not Know It
It’s estimated that about one in eight people with HIV don’t know they have it. Within the first two to four weeks of an HIV infection, a person may experience flu-like symptoms such as fatigue, fever, headache, sore throat, and muscle and joint pain. Other HIV symptoms can include painful, swollen lymph nodes and a skin rash with small bumps. But in some cases people won’t experience any symptoms at all during this early (acute) stage of infection, the CDC reports, and they can spread the virus without realizing it. The only way to know for sure whether you or a partner is HIV positive is to get tested.
6. Fact: You Can’t Get HIV From Insect Bites or Toilet Seats
Myths still abound about HIV transmission. You can’t get HIV from insect bites or stings, hugging, shaking hands, or sharing toilets or dishes, according to the CDC. You can’t get HIV from a closed-mouth kiss or contact with an infected person’s sweat or tears, nor can you get it by simply working or hanging out with someone who is HIV-positive or has AIDS. HIV transmission from one woman to another woman through sexual contact is also rare, per the U.S. Department of Health and Human Services.
7. Fact: There Are Several Ways to Prevent HIV Transmission
Because HIV is transmitted by the exchange of bodily fluids such as semen (including pre-seminal fluid), rectal fluids, vaginal fluids, and blood, the best way to stave off infection is to always practice safer sex and avoid sharing drug paraphernalia like needles. “Condom use is an effective way to prevent HIV, and it’s also the only way we have to prevent sexually transmitted infections,” says Omar Harfouch, MD, MPH, an assistant professor at the Institute of Human Virology at the University of Maryland School of Medicine in Baltimore, and a physician and researcher who specializes in HIV treatment and prevention. If you’re at very high risk of infection — for example, because your current sexual partner has HIV — you should talk to a healthcare provider about taking a medication called pre-exposure prophylaxis, or PrEP. This preventive treatment lowers your chances of becoming infected by stopping the virus from gaining a foothold in your body. The catch is that you have to take PrEP very consistently and exactly as your doctor prescribes it. The U.S. Food and Drug Administration (FDA) has approved three PreEP treatments: two oral medications (taken daily) and one injectable medication (administered every two months). The CDC says PrEP can lower your risk of HIV infection from sex by about 99 percent; if you use intravenous drugs recreationally, it can cut the risk of transmission by more than 74 percent. The CDC does not recommend injectable PrEP for the latter group.
8. Fact: Medications Can Protect You After a Possible HIV Exposure
PEP (post-exposure prophylaxis) is medicine to prevent HIV after a possible exposure. The CDC advises you to alert a healthcare provider or an emergency room doctor and begin PEP within 72 hours. The sooner you start, the better. PEP is not meant to replace other HIV prevention methods. If you may be exposed to HIV frequently, talk to your healthcare provider about PrEP.
9. Fact: HIV Treatment Can Make Your Viral ‘Load’ So Low It’s Undetectable
Before 1996, HIV was basically a death sentence. But over the course of the next two decades, a lifesaving regimen of drugs known as antiretroviral therapy (ART) came into use. ART is a combination of HIV medicines taken every day. This treatment regimen helps prevent the virus from replicating, which reduces the viral load (the amount of HIV in the body). This gives the immune system a chance to recover so that it’s strong enough to fight off infections and certain HIV-related cancers. A primary goal of HIV treatment is to reduce a person’s viral load until it is undetectable in the blood, as measured in a viral load test. “Undetectable is untransmittable,” says Dr. Harfouch. “So for anybody who is known to have HIV and is taking their medication as prescribed and their HIV viral loads are undetectable, their risk of transmitting the virus is nonexistent; we’ve learned this from big studies done in Africa.”
10. Fact: There Are a Few Ways to Get Tested for HIV, Including an At-Home Test
The CDC recommends that everyone between ages 13 and 64 get an HIV test at least once, and seek out testing as often as every six months if they have multiple sexual partners, have unprotected sex, or use needles to inject drugs. You can see your doctor for a conventional blood test or visit almost any health department or sexual health clinic for a blood or saliva test (usually free). These centers also offer confidential on-site counseling. You can also test yourself. The FDA has approved several home HIV tests now sold online or at drugstores. Many of these tests require you to prick your finger with a needle, place a few drops of blood on a blotter pad, and then mail the sample to a lab. The CDC notes that if you get a positive result from any home test, you’ll have to get another test to confirm the results. Additional reporting by Andrea Peirce.
