Understanding HIV/AIDS
A Doctor’s Guide to Prevention, Testing, and Treatment
HIV (Human Immunodeficiency Virus) is a virus that attacks the body’s immune system, specifically CD4 cells (T cells), which help fight infections. Without treatment, HIV can progress to AIDS (Acquired Immunodeficiency Syndrome), the most severe stage of HIV infection.
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Approximately 1.2 million people in the US and 39 million globally live with HIV. About 13% don’t know they have it. Modern treatment has transformed HIV from a fatal disease to a manageable chronic condition.
How HIV Is Transmitted
HIV spreads through blood, semen, rectal/vaginal fluids, and breast milk via unprotected sexual contact, sharing needles, mother-to-child transmission during pregnancy/childbirth/breastfeeding, or occupational exposure. HIV Cannot Spread Through: Casual contact, hugging, kissing, sharing food, toilet seats, or insect bites.
Stages of HIV Infection
Stage 1
Acute Infection (2-4 weeks): Flu-like symptoms, high viral load, extremely contagious.
Stage 2
Chronic Infection: Few symptoms for years, virus reproducing at low levels. Without treatment, lasts about a decade; with treatment, can remain in this stage indefinitely.
Stage 3
AIDS: CD4 count below 200 cells/mm³, severe immune damage, opportunistic infections. Without treatment, survival is approximately 3 years.
Common Symptoms
- Early Stage (2-4 weeks after infection): Fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and mouth ulcers.
- Advanced Stage (AIDS): Rapid weight loss, recurring fever, extreme fatigue, prolonged lymph node swelling, persistent diarrhea, pneumonia, memory loss, and skin discolorations.
Testing and Diagnosis
- When to Get Tested: After unprotected sex, if sharing needles, after potential exposure, during pregnancy, if diagnosed with another STI, or annually if sexually active.
- Types of Tests: Antibody tests (3-12 weeks), antigen/antibody tests (18-45 days), and nucleic acid tests (10-33 days after exposure).
Treatment Options
Antiretroviral Therapy (ART): Daily combination of HIV medicines that control the virus, allowing people to live long, healthy lives. ART reduces viral load to undetectable levels—meaning “Undetectable = Untransmittable” (U=U), preventing sexual transmission and progression to AIDS. Common ART Drug Classes: NRTIs, NNRTIs, Protease Inhibitors, Integrase Inhibitors, and Entry/Fusion Inhibitors.
Prevention Strategies
Pre-Exposure Prophylaxis (PrEP):
Daily medication for HIV-negative people at high risk—reduces risk from sex by 99% and injection drug use by 74%
Post-Exposure Prophylaxis (PEP):
Emergency medication taken within 72 hours of exposure for 28 days to prevent infection
Other Prevention:
Other Prevention: Use condoms consistently, get tested for STIs, never share needles, and if pregnant and HIV-positive, receive treatment to prevent mother-to-child transmission.
Living with HIV
With proper treatment, people with HIV can live normal life spans, maintain healthy relationships, have children without transmitting HIV, and achieve undetectable viral loads.
Dr. Julia Rosebush, DO
Dr. Julia Rosebush is a board-certified pediatric infectious disease specialist and Associate Professor of Pediatrics at the University of Chicago Medicine. As Medical Director of Care2Prevent (C2P), the university's Pediatric and Adolescent HIV Program, she leads the largest provider of pediatric HIV care on Chicago's South Side, serving nearly 800 individuals annually.
- Expert HIV Care: Comprehensive testing, diagnosis, and personalized ART treatment plans
- Prevention Services: PrEP and PEP counseling and prescriptions for high-risk individuals
- Ongoing Support: Regular monitoring, viral load testing, and treatment optimization for optimal health outcomes