WHO IS AT RISK FOR HIV?

WHO IS AT RISK FOR HIV?

HIV infection is usually acquired through sexual intercourse or exposure to infected blood or body fluids. This may occur:

• During sexual contact with an infected person, especially if you have unprotected vaginal or anal sex
• By sharing needles or syringes used by an infected person.

Transmission from a pregnant woman to her baby may occur during pregnancy, birth, or breastfeeding, although this is uncommon with the use of HIV medications during and after pregnancy.

HIV infection is NOT spread by casual contact.

Certain individuals may have an increased risk of HIV infection, including the following:

• People with a history of a sexually transmitted disease
• Sexual partners of people who are infected with HIV
• Victims of sexual assault (see "Patient information: Care after sexual assault")
• Men and women who have unprotected sex with multiple partners
• Men and women who exchange sex for money or drugs or have sex partners who do
• Men who have sex with men
• Injection drug users who share needles or "works"
• Anyone who is accidentally stuck with a needle or sharp in a healthcare facility

HIV SYMPTOMS

Symptoms of early HIV infection — Early symptoms of HIV infection develop in 50 to 90 percent of people who are infected, usually beginning two to four weeks after exposure to HIV. The initial group of signs and symptoms is referred to as primary or acute HIV infection.

Because the signs and symptoms of primary HIV may be similar to other common illnesses such as the flu, most people do not initially realize that they have HIV. However, HIV infection is highly contagious at this early stage because there are large amounts of the virus in the blood and other bodily fluids. Recognizing symptoms early, being tested for HIV, and starting HIV treatment as soon as possible can help to decrease the risk of transmitting HIV to another person.

Body-wide symptoms — The most common body-wide signs and symptoms of primary HIV include fever (temperature above 100.4ºF or 38ºC), sore throat, headache, and muscle and joint pain. These flu-like symptoms last approximately two weeks.

During the second week of the illness, most people also have painless swelling of certain lymph nodes, including those in the armpits and in the neck. Although the lymph nodes decrease in size after the first few weeks, swelling can linger.

Skin, mouth, genital symptoms — A characteristic feature of primary HIV infection is open sores or ulcers. These sores or ulcers can develop in the mouth, the esophagus (the tube that extends from the mouth to the stomach), the anus, or the penis. The ulcers are usually painful.

Many people also develop a rash of the skin about two to three days after fever. The rash usually affects the face, neck, and upper chest or may be more widespread. The rash usually lasts approximately 5 to 8 days.

Digestive symptoms — Many people with primary HIV infection develop nausea and vomiting, diarrhea, lack of appetite, and weight loss.

Respiratory symptoms — A dry cough is usually the only respiratory symptom associated with primary HIV infection.

Symptoms of advanced HIV infection — If HIV is not treated, the virus will cause progressive weakening of the immune system, a process which occurs at different rates in different people. Once significant damage to the immune system has occurred, which typically takes at least several years, patients with HIV can become infected with other organisms that usually don’t cause illness in people with normal immunity. These “opportunistic infections” can cause serious disease in patients with advanced HIV infection. Depending on the opportunistic infection, symptoms may include shortness of breath, blurred vision, fevers, and weight loss.

One of the most common opportunistic infections is yeast infection of the mouth or esophagus. Yeast infections are caused by Candida, a fungal organism that is normally found on the skin and in the mouth, intestinal tract, and vagina in healthy individuals. Certain yeast infections can occur in people without HIV, (eg, vaginal yeast infections) although people with HIV are at a higher risk for this and other types of opportunistic infections. (See "Patient information: Vaginal yeast infection".)

• Candidiasis of the mouth, also known as thrush, causes cream-colored, slightly raised patches in the mouth, soreness, and easy bleeding.
• Candidiasis of the esophagus may cause difficulty swallowing.

However, with diagnosis and treatment of HIV, the immune system can improve. Then the risk of opportunistic infections goes down. While the immune system is recovering, certain medications can help prevent any opportunistic infections from occurring in the first place. (See "Patient information: Preventing opportunistic infections in HIV".)