What is human immunodeficiency virus (HIV)?
Human immunodeficiency virus (HIV) is a sexually transmissible infection (STI) and blood borne virus (BBV). HIV attacks white blood cells (called CD4 cells) in the immune system and uses these cells to replicate (make copies of itself). This weakens the immune system, making a person more vulnerable to other infections, diseases and conditions. In Australia, HIV more commonly affects men who have sex with men (MSM).
HIV is different to acquired immunodeficiency syndrome (AIDS). AIDS occurs in the late stage of untreated HIV, when there are very few CD4 cells and the immune system is severely damaged. AIDS is a set of infections, diseases and conditions.
How do you get HIV?
HIV is passed on through blood and sexual fluids, from a person infected with HIV, entering the bloodstream of a person not infected with HIV.
HIV is mainly passed on during unprotected sexual contact or though sharing drug injecting equipment (needles, syringes, spoons, swabs, tourniquets, water and filters). It may also be passed on through sharing sharp equipment (e.g. razors or nail clippers), tattoos, body piercing or needle stick injuries (usually with healthcare workers).
Transmission of HIV through sexual contact can affect anyone who is sexually active. It can be passed on whether your sexual partner/s are the same sex as you or a different sex. Sexual contact may be vaginal or anal sex and rarely oral sex or sharing sex toys. Infected sexual fluids or blood (including menstrual blood) must enter the bloodstream for HIV infection to occur.
HIV can also be passed on from a pregnant person to a baby in the uterus (womb), during delivery (birth) or during breastfeeding (through breastmilk or – if nipples are cracked or bleeding – through blood).
How would I know if I have HIV?
Regular STI and BBV testing is the best way to know if you have HIV.
Some people with HIV do not know because they do not have symptoms, do not notice symptoms or believe the symptoms to be a different illness.
Some people develop a flu-like illness (called a seroconversion illness) around 2 – 4 weeks after infection with HIV. This may last from a few days to weeks. Symptoms may include:
- sore throat
- swelling of the lymph glands
- muscle aches
- a rash
- weight loss
- night sweats.
When symptoms resolve, a person may have no visible signs or symptoms for several years.
What does a test involve?
Testing for HIV involves a blood test. The most common test is a blood sample (usually from your arm) taken in a clinic which is sent to be processed at a laboratory. The blood test checks for HIV antibodies – proteins that the immune system makes in response to HIV infection. Most laboratory tests now also check for HIV antigens – proteins that are a part of the virus.
Most people who have been infected with HIV will test positive within 6 weeks after exposure but it can take up to 12 weeks after exposure for a blood test to detect antibodies to HIV. The time between HIV exposure to an accurate blood test result (when antibodies can be detected) is called the window period.
If your test result is negative and you have been at risk of HIV in the last 12 weeks or have symptoms, you may need to repeat the test in a couple of weeks. It may be too early in the infection for a blood test to detect antibodies to HIV.
If your test result is positive, you will need another blood test to confirm you have HIV and measure the level of infection.
Occasionally a test result with be inconclusive – which means it is neither negative nor positive. If your test result is inconclusive, you will need another blood test.
For some people, there is the option of a rapid HIV test. A rapid HIV test involves drawing a small amount of blood, usually via a finger prick, in a clinic. It can return a result in around 20 minutes. In Victoria, rapid HIV testing is only available to people at greater risk of HIV and only offered by some sexual health clinics.
The first HIV self-test is now approved for sale in Australia. A HIV self-test is a finger-prick blood test that you can perform on yourself, at home or a location of your choice. It can return a result in around 20 minutes. The testing kit comes with directions and can be ordered online. Australia has only one test approved for sale. For more information and to purchase the HIV self-testing kit see Atomo HIV self test.
Rapid HIV tests and HIV self-tests are not as reliable as standard HIV blood tests taken in a clinic and they have a longer window period. Rapid HIV test and HIV self-test results are only preliminary. If you receive a reactive result, you will need a blood test taken in a clinic (usually from your arm) and sent to a laboratory to confirm the result.
If you are considering self-testing for HIV, see below for where to get more information and support, including confirmation testing, if the test is positive.
You may choose to test for other STIs or BBVs at the same time as testing for HIV.
Family Planning Victoria (FPV) provides expert, confidential STI and BBV testing to Victorians. We also provide expert information, healthcare and support on a range of reproductive and sexual health matters. For more information on FPV clinical services, see our clinics or you can book an appointment online.
How is HIV treated?
There is no cure for HIV. However, there are effective treatment options that can be used to control HIV. Starting HIV treatment as soon as possible after being newly diagnosed has significant health benefits.
HIV can be treated with daily antiretroviral tablets that prevent the virus from replicating (making copies of itself). Antiretroviral tablets keep the level of virus in the body low, minimising damage to the immune system. With effective treatment and medical care people living with HIV can manage symptoms and have the same lifespan as people not living with HIV.
HIV treatment can also be used to prevent transmitting the virus to others. This is known as treatment as prevention (TASP). Taking antiretroviral tablets consistently can lower the level of virus in the body so it cannot be detected with a blood test. This is called an undetectable viral load. If a person living with HIV has an undetectable viral load and they have been taking antiretroviral tablets consistently for six months and accessing regular monitoring, they cannot transmit HIV to others. This includes any sexual partner/s, injecting equipment sharing partner/s or their baby (if pregnant or breastfeeding).
Where do I get treatment?
Your doctor or nurse will give you the antiretroviral medications or a script which you can take to the pharmacy. You cannot buy medications to treat HIV over the counter without a script.
It is recommended you see a health care professional experienced in HIV care for regular treatment, monitoring and review. This may be at specialist clinic, sexual health service or general practice.
What if I do not get treated?
HIV can cause serious health complications if not treated.
Without treatment, HIV continues to attack white blood cells (CD4 cells) and replicate (make copies of itself), weakening the immune system. As the immune system weakens, it becomes more difficult for the body to respond to other infections, diseases and conditions. In the late stage of untreated HIV (usually years after initial infection), the immune system is severely damaged and acquired immunodeficiency syndrome (AIDS) may occur.
Untreated HIV during pregnancy and breastfeeding can cause serious health complications for both you and your baby.
If you do not get treated for HIV, you can pass the infection to your sexual partner/s and/or injecting equipment sharing partner/s — even if you do not have symptoms.
Having HIV can increase the risk of getting or spreading other sexually transmissible infections.
Will HIV come back?
There is no cure for HIV yet. Once you have HIV, it lives in the body for life.
Antiretroviral medications, taken every day, can control HIV, manage symptoms and have the same lifespan as people not living with HIV.
Do I need to let my sexual partner/s know I have HIV?
To protect your sexual partner/s it is helpful to understand how HIV can be passed on and what you and your partner/s can do to reduce or stop the risk of passing on HIV.
If you have recently been diagnosed with HIV it is recommended you let your past and current sexual partner/s know so they can make informed decisions about ways to lower the risk of passing it on and be tested and treated if needed. It is recommended you contact any partner/s you have had since any possible HIV risk behaviour or your last known negative HIV test result.
If you are living with HIV, you are not obligated to let your new sexual partner/s know if they are not at risk of being infected with HIV. This means using prevention methods such as barrier protection (external condoms, internal condoms) and antiretroviral treatment (and not sharing equipment where there is a risk of blood exposure). You may choose to let your new sexual partner/s know so they are informed and can make choices about reducing the risk of getting HIV.
There are some great websites to support you informing your sexual partners via a phone call, text message, letter or email. There are ways of doing this either personally or anonymously.
- Let Them Know
- The Drama Downunder - for men who have sex with men
- Better to know – for Aboriginal and Torres Strait Islander people
Your doctor or nurse can assist with informing your current or previous sexual partner/s.
What should I do if my sexual partner has been diagnosed with an STI or a BBV?
You may be notified that a sexual partner of yours has been diagnosed with an STI or a BBV. Notification may be in person or via a phone call, text message, letter or email. You too may have an infection and be unaware as you may not have symptoms. See your doctor or nurse to discuss ways to lower the risk of transmission get tested and treated, if needed.
Will HIV affect my pregnancy or breastfeeding?
People who are pregnant or breastfeeding can be infected with the same STIs and BBVs as people who are not pregnant or breastfeeding.
If you are infected with an STI or BBV during pregnancy it can cause serious health complications for both you and your baby. Complications can include:
- Infection in the uterus (womb).
- Passing the infection to the baby (during pregnancy, birth or breastfeeding) causing health conditions.
- Premature (early) delivery.
- Low birth weight.
If you have HIV during pregnancy or breastfeeding, there are medications that can be used to help reduce the chance of passing on HIV to your baby.
If you are pregnant or breastfeeding and considering treatment for an STI or BBV, ask your doctor, nurse or midwife about the possible effects of the treatment and/or medicine on your baby or breastfeeding.
If you are planning a pregnancy or already pregnant, it is recommended you and your sexual partner/s (and/or injecting equipment sharing partner/s) have STI and BBV screening tests, even if you have been tested in the past. HIV testing should be part of a routine antenatal screen. You can speak to your doctor, nurse or midwife for more information.
How can I lower my risk of getting STIs and BBVs?
You can lower your risk of getting STIs and BBVs by using barrier protection (external condoms, internal condoms or dental dams) correctly during any type of sex (vaginal, anal or oral sex) and when sharing sex toys.
Barrier protection is not 100% effective at preventing STIs and BBVs.
You can also lower your risk of getting a BBV by:
- not sharing injecting equipment, razors, nail clippers
- only getting tattoos and piercing in regulated places
- talking to your doctor or nurse about HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) if you are at risk of HIV exposure.
Pre-exposure prophylaxis (PrEP) is an antiretroviral tablet that reduces the risk of getting HIV. PrEP can be taken by people who do not have HIV but who are at risk of HIV exposure. For example – men who have sex with men (MSM) and do not use condoms, people who have a sexual partner who has HIV and is not on treatment and people who inject drugs. PrEP can be taken daily or on-demand (periodically). For more information, you can talk to your doctor or nurse or see PAN.
Post-exposure prophylaxis (PEP) is a 28-day course of antiretroviral tablets that can be taken if you may have been exposed to HIV. To be effective, PEP must be started as soon as possible (and within 72 hours) after the possible exposure to HIV. For more information, visit GET PEP.
If your sexual partner/s and injecting equipment sharing partner/s are living with HIV you can talk to them about treatment as prevention (TASP). This means taking antiretroviral tablets consistently to lower the level of HIV virus in the body so it cannot be detected with a blood test. This is called an undetectable viral load. If a person living with HIV has an undetectable viral load and they have been taking antiretroviral tablets consistently for six months and accessing regular monitoring, they cannot transmit HIV to others. For more information you can talk to your doctor or nurse.
You can also lower your risk of getting an STI or BBV by both you and your sexual partners having regular STI and BBV testing. To get an STI or BBV test at Family Planning Victoria, see our clinics or you can book an appointment online.
Where to get more information and support
- Family Planning Victoria
- Better Health Channel
- The Centre Clinic – a safe and friendly general practice, providing care for LGBTI community members as well as specialist medical care for people living with HIV, and expert sexual health screening and treatment.
- Ending HIV – for information on STI and HIV testing, treatment and staying safe.
- DirectLine 1800 888 236 – support for people affected by alcohol and other drugs including information on where to obtain new needles and syringes.
- Equinox – for transgender services
- Melbourne Sexual Health Centre – a specialist sexual health clinic.
- Minus 18 – for young lesbian, gay, bisexual, transgender and intersex (LGBTI) people.
- Multicultural Centre for Women’s Health – for culturally and linguistically diverse women.
- PAN (PrEPaccessNOW) – a community-driven HIV prevention not-for-profit organisation advocating for equal and affordable PrEP access Australia wide.
- PrEP'D For Change – a volunteer organisation providing PrEP information and support for everyone in Australia.
- PRONTO! – a peer-led service for men who have sex with men.
- Thorne Harbour Health (formerly Victorian AIDS Council)
- TouchBase – information, support and services for LGBTI people.
- A doctor or nurse.
- Your local community health service
If you are using the internet for information, only use reliable and reputable websites. Be aware of websites containing inaccurate and harmful information and imagery.