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HIV and AIDS Content Supplied by NHS Choices
Symptoms of HIV

Most people who are infected with HIV experience a short, flu-like illness that occurs two to six weeks after infection. After this, HIV often causes no symptoms for several years.

The flu-like illness that often occurs a few weeks after HIV infection is also known as seroconversion illness. It's estimated that up to 80% of people who are infected with HIV experience this illness.

The most common symptoms are:

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

Other symptoms can include:

  • tiredness
  • joint pain
  • muscle pain
  • swollen glands (nodes)

The symptoms usually last one to two weeks but can be longer. They are a sign that your immune system is putting up a fight against the virus.

However, these symptoms are most commonly caused by conditions other than HIV, and do not mean you have the virus.

If you have several of these symptoms, and you think you have been at risk of HIV infection within the past few weeks, you should get an HIV test.

After the initial symptoms disappear, HIV will often not cause any further symptoms for many years. During this time, known as asymptomatic HIV infection, the virus continues to be active and causes progressive damage to your immune system. This process can take about 10 years, during which you will feel and appear well.

Once the immune system becomes severely damaged symptoms can include:

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

Earlier diagnosis and treatment of HIV can prevent these problems.

Read more about treating HIV.

It is recommended you should still take an HIV test if you may have been at risk at any time in the past, even if you experience no symptoms.

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Causes of HIV

In the UK, most cases of HIV are caused by having sex without a condom with a person who has HIV.

A person with HIV can pass the virus to others whether or not they have any symptoms. People with HIV are more infectious in the weeks following infection.

HIV treatment significantly reduces the risk of someone with HIV passing it on.

Sexual contact

According to Public Health England, 95% of people diagnosed with HIV in the UK in 2011 acquired HIV through sexual contact.

The main routes of transmission are unprotected vaginal and anal sex. It is also possible to catch HIV through unprotected oral sex, but the risk is much lower.

The risk of HIV transmission through oral sex will be higher if the person giving oral sex has mouth ulcers, sores or bleeding gums and/or if the person receiving oral sex has been recently infected with HIV (and has a lot of the virus in their body) or another sexually transmitted infection.

The type of sex also makes a difference to the level of risk:

  • performing oral sex on a man with HIV carries some risk, particularly if he ejaculates (comes) in your mouth
  • it is possible to catch HIV by performing oral sex on a woman with HIV, particularly if she is having a period, although this is considered to be extremely low risk
  • receiving oral sex from someone who has HIV is also extremely low risk as HIV is not transmitted through saliva

Other risk behaviours

Other ways of getting HIV include:

  • sharing needles, syringes and other injecting equipment
  • from mother to baby before or during birth or by breastfeeding
  • sharing sex toys with someone infected with HIV
  • healthcare workers accidentally pricking themselves with an infected needle (this risk is extremely low)
  • blood transfusion (now very rare in the UK, but still a problem in developing countries)

How is HIV transmitted

HIV is not passed on easily from one person to another. The virus does not spread through the air like cold and flu viruses.

HIV lives in the blood and in some body fluids. To get HIV, one of these fluids from someone with HIV has to get into your blood.

The body fluids that contain enough HIV to infect someone are:

  • semen
  • vaginal fluids, including menstrual blood
  • breast milk
  • blood
  • lining inside the anus

Other body fluids, like saliva, sweat or urine, do not contain enough of the virus to infect another person.

The main ways the virus enters the bloodstream are:

  • by injecting into the bloodstream (with a contaminated needle or injecting equipment)
  • through the thin lining on or inside the anus and genitals
  • through the thin lining of the mouth and eyes
  • via cuts and sores in the skin

HIV is not passed on through:

  • kissing
  • spitting
  • being bitten
  • contact with unbroken, healthy skin
  • being sneezed on
  • sharing baths, towels or cutlery
  • using the same toilets or swimming pools
  • mouth-to-mouth resuscitation
  • contact with animals or insects such as mosquitoes

How HIV infects the body

HIV infects cells of the immune system, the body's defence system, causing progressive damage and eventually making it unable to fight off infections.

The virus enters cells in the immune system called CD4 cells + ve lymphocyte cells, which protect the body against various bacteria, viruses and other germs.

It uses the CD4 cells to make thousands of copies of itself. These copies then leave the CD4 cells, killing them in the process.

This process continues until eventually the number of CD4 cells, also called your CD4 count, drops so low that your immune system stops working.

This can take about 10 years, during which time you will feel and appear well. Find out more about the symptoms of HIV.

Who is most at risk

People who are at higher risk of becoming infected with HIV include:

  • men who have had unprotected sex with men
  • women who have had sex without a condom with men who have sex with men
  • people who have had sex without a condom with a person who has lived or travelled in Africa
  • people who inject drugs
  • people who have had sex without a condom with somebody who has injected drugs
  • people who have caught another sexually transmitted infection
  • people who have received a blood transfusion while in Africa, eastern Europe, the countries of the former Soviet Union, Asia or central and southern America

HIV testing

The only way to find out if you have HIV is to have an HIV test, as symptoms of HIV may not appear for many years.

HIV testing is provided to anyone free of charge on the NHS. Many clinics can give you the result on the same day and home-testing and home-sampling kits are also available.

Who should get tested

Anyone who thinks they could have HIV should get tested.

Certain groups of people are at particularly high risk and are advised to have regular tests. For example:

  • men who have sex with men are advised to have an HIV test at least once a year, or every three months if they're having unprotected sex with new or casual partners
  • black African men and women are advised to have an HIV test, and a regular HIV and STI screen, if they're having unprotected sex with new or casual partners

Other people at an increased risk of infection include those who share needles, syringes or other injecting equipment. Read more about how you get HIV.

When should I get tested

Seek medical advice immediately if you think there's a chance you could have HIV. The earlier it's diagnosed, the earlier you can start treatment and avoid becoming seriously ill.

Some HIV tests may need to be repeated one to three months after exposure to HIV infection, but you shouldn't wait this long to seek help. Your GP or a sexual health professional can talk to you about having a test and discuss whether you should take emergency HIV medication.

Anti-HIV medication, called PEP (post-exposure prophylaxis) may stop you becoming infected if taken within 72 hours of being exposed to the virus. Read more about treating HIV.

Where can I get an HIV test

There are various places you can go to for an HIV test, including:

  • sexual health or genitourinary medicine (GUM) clinics
  • clinics run by charities such as the Terrence Higgins Trust
  • some GP surgeries
  • some contraception and young people's clinics
  • local drug dependency services
  • an antenatal clinic, if you're pregnant
  • a private clinic, where you will have to pay

Find HIV testing services near you

There are also home-sampling and home-testing kits (see below) you can use if you don't want to visit any of these places.

Types of HIV test

There are four main types of HIV test:

  • Full blood test - where a sample of blood is taken in a clinic and sent for testing in a laboratory. Results are usually available within a few days.
  • "Point of care" test - where a sample of saliva from your mouth or a small spot of blood from your finger is taken in a clinic. This sample doesn't need to be sent to a laboratory and the result is available within a few minutes.
  • Home-sampling kit - where you collect a saliva sample or small spot of blood at home and send it off in the post for testing. You'll be contacted by phone or text with your result in a few days. Visit Test.HIV to check if you're eligible for a free test. If not, you can buy them online or from some pharmacies.
  • Home-testing kit - where you collect a saliva sample or small spot of blood yourself and test it at home. The result is available within minutes. It's important to check that any test you buy has a CE quality assurance mark and is licensed for sale in the UK, as poor quality HIV self-tests are available from overseas.

If the test finds no sign of infection, your result is "negative". If signs of infection are found, the result is "positive".

The full blood test is the most accurate test and can normally give reliable results from one month after infection. The other tests tend to be less accurate and may not give a reliable result for a longer period after exposure to the infection (this is known as the "window period").

For all these tests, a full blood test should be carried out to confirm the result if the first test is positive. If this test is also positive, you'll be referred to a specialist HIV clinic for some more tests and a discussion about your treatment options.

Read more about coping with a positive HIV test.

Preventing HIV

The best way to prevent HIV is to use a condom for sex and to never share needles or other injecting equipment (including syringes, spoons and swabs).

If you have HIV, you can pass it on to others if you have sex without a condom, or share needles, syringes, or other injecting equipment.

HIV treatment with ART substantially reduces the risk of passing the virus onto someone else.

Knowing your HIV status and that of your partner is important and if you are at regular risk of potential exposure to HIV you should have a regular HIV test.

Sex

HIV can be transmitted by having vaginal or anal sex without a condom. There is also a risk of transmission through oral sex, but this risk is much lower.

HIV can also be caught from sharing sex toys with someone infected with HIV.

See causes of HIV for more on transmission of HIV.

The best way to prevent HIV and other sexually transmitted infections (STIs) is to use a condom for penetrative sex and a dental dam for oral sex.

Condoms

Condoms come in a variety of colours, textures, materials and flavours. Both male and female condoms are available.

A condom is the most effective form of protection against HIV and other STIs. It can be used for vaginal and anal sex, and for oral sex performed on men.

HIV can be passed on before ejaculation, through pre-come and vaginal secretions, and from the anus.

It is very important that condoms are put on before any sexual contact occurs between the penis, vagina, mouth or anus.

Lubricant

Lubricant, or lube, is often used to enhance sexual pleasure and safety, by adding moisture to either the vagina or anus during sex.

Lubricant can make sex safer by reducing the risk of vaginal or anal tears caused by dryness or friction, and it can also prevent a condom from tearing.

Only water-based lubricant (such as K-Y Jelly) rather than an oil-based lubricant (such as Vaseline or massage and baby oil) should be used with condoms.

Oil-based lubricants weaken the latex in condoms and can cause them to break or tear.

Dental dams

A dental dam is a small sheet of latex that works as a barrier between the mouth and the vagina or anus to reduce the risk of STIs during oral sex.

Find out more about what sexual activities can put you at risk of HIV and other STIs.

Sharing needles and injecting equipment

If you inject drugs, don't share needles or syringes, or other injecting equipment such as spoons and swabs, as this could expose you to HIV and other viruses found in the blood, such as hepatitis C.

Many local authorities and pharmacies offer needle exchange programmes, where used needles can be exchanged for clean ones.

If you are a heroin user, consider enrolling in a methadone programme. Methadone can be taken as a liquid, so it reduces your risk of getting HIV.

A GP or drug counsellor should be able to advise you about both needle exchange programmes and methadone programmes.

If you are having a tattoo or piercing, it's important that a clean, sterilised needle is always used.

Screening for HIV in pregnancy

All pregnant women are offered a blood test to check if they have HIV as part of routine antenatal screening. If untreated, HIV can be passed from a pregnant woman to her baby during pregnancy, birth or breastfeeding. Treatment in pregnancy greatly reduces the risk of passing on HIV to the baby.

Read more about screening for HIV during pregnancy.


Living with HIV

Psychological impact of HIV

Being diagnosed with HIV can be extremely distressing, and feelings of anxiety or depression are common. Your HIV clinic can provide you with counselling so that you can fully discuss your condition and your concerns.

You may find it helpful to talk to a trained counsellor or psychologist, or to someone at a specialist helpline. Your HIV clinic will have information about these.

Some people find it helpful to talk to other people who have HIV, either at a local support group or in an internet chatroom.

Want to know more

Telling people about your HIV

Telling your partner and former partners

If you have HIV, it's important that your current sexual partner or any sexual partners you've had since being exposed to infection are tested and treated.

Some people can feel angry, upset or embarrassed about discussing HIV with their current or former partners. Discuss your concerns with your GP or the clinic staff. They'll be able to advise you about who should be contacted and the best way to contact them, or they may be able to contact them on your behalf. They'll also advise you about disclosing your status to future partners and how you can reduce the risk of transmitting the virus to someone else.

Nobody can force you to tell any of your partners you have HIV, but it's strongly recommended that you do. Left untested and untreated, HIV can have devastating consequences and will eventually lead to death.

Telling your boss

People with HIV are protected under the Equality Act (2010).

There's no legal obligation to tell your employer that you have HIV, unless you have a frontline job in the armed forces or you work in a healthcare role where you perform invasive procedures (as you'll need to be monitored by your occupational health team and HIV doctor to ensure you're not putting your patients at risk of infection).

The Equality Act 2010 also places restrictions on the health questions that employers can ask during a job application process. Employers are allowed to ask health questions only after an offer of employment has been made, to help them decide whether you can carry out tasks that are essential for the job.

If you're asked a question that you think isn't allowed under the Equality Act 2010, you can tell the employer, or you can tell the Equality and Human Rights Commission. The GOV.UK website has more information about questions an employer can ask about health and disability.

If you're an employee with HIV, you may worry that if you tell your employer, your HIV status will become public knowledge or you may be discriminated against. On the other hand, if your boss is supportive, telling them may make it easier for adjustments to be made to your workload or for you to have time off.

The HIV organisations below have lots of information and can advise you on these and other work-related issues.

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Pregnancy

If you have HIV and become pregnant, contact your HIV clinic. This is important because:

  • some anti-HIV medicines can harm babies, so your treatment plan will need to be reviewed
  • additional medicines may be needed to prevent your baby getting HIV

Without treatment, there's a 1 in 4 chance that your baby will develop HIV. With treatment, the risk is less than 1 in 100.

Advances in treatment mean that a normal delivery is now recommended for women who have an undetectable viral count and whose HIV is well managed. For some women, a caesarean section may still be recommended, and may also be indicated for other reasons not related to your HIV.

Discuss the risks and benefits of each delivery method with the staff at your HIV clinic. The final decision about how your baby is delivered is yours and staff will respect that decision.

If you have HIV, don't breastfeed your baby because the virus can be transmitted through breast milk.

If you or your partner has HIV, there may be options available that will allow you to conceive a child without putting either of you at risk of infection. You should ask your HIV doctor for advice.

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Opportunistic infections

If your CD4 count drops below 200, you'll be at risk of developing many different types of infection. Infections that "take advantage" of an HIV-weakened immune system are known as opportunistic infections. However, if you stick to your HIV therapy, the likelihood of developing an opportunistic infection is low.

The four main types of opportunistic infections are:

People with advanced HIV also have a higher risk of developing some forms of cancer, such as lymphoma (cancer of the lymphatic system).

Pneumonia

Bacterial pneumonia is more common in people with HIV, but also occurs in people without HIV, particularly those with chronic respitory conditions. It can develop as a complication of other infections, such as flu. Left untreated, pneumonia can be fatal because the infection can spread through your blood.

Pneumonia can be treated with antibiotics. There's also a vaccine that can protect you against many of the bacteria that can cause pneumonia. Annual flu vaccinations are also recommended for people living with HIV.

Tuberculosis (TB)

Tuberculosis (TB) is another bacterial lung infection. Globally, it's one of the leading causes of death for people who are HIV positive. TB can be treated using antibiotics, but some strains of bacteria have developed antibiotic resistance, and these can be more difficult to treat.

Candidiasis (thrush)

Candidiasis is a fungal infection that's common in people living with HIV. It causes a thick, white coating to appear on the inside of the mouth, tongue, throat or vagina.

Candidiasis is rarely serious but it can be both embarrassing and painful. It can be treated with antifungal creams.

Tell the staff at your HIV clinic if you have repeated bouts of candidiasis because it could be a sign of a low CD4 count.

Pneumocystis pneumonia (PCP)

Pneumocystis pneumonia (PCP) is a fungal infection of the lungs, which can be life-threatening if it isn't treated promptly. Before the advances in anti-HIV medicines, PCP was the leading cause of death among those with HIV in the developed world.

Symptoms of PCP include:

Report any symptoms of PCP straight away because the condition can suddenly worsen without warning. PCP can be treated with antibiotics and, if your CD4 count drops below 200, you may be given antibiotics to prevent a PCP infection.

Cancer

People with advanced HIV have an increased risk of developing some types of cancer. It's estimated that someone with untreated late-stage HIV infection (AIDS) is 100 times more likely to develop certain cancers compared to someone without the condition.

The two most common cancers to affect people with HIV are lymphoma and Kaposi's sarcoma. Lymphoma is a cancer of the lymphatic system (a network of glands that makes up part of our immune system). Kaposi's sarcoma can cause lesions to grow on your skin, and can also affect your internal organs.

HIV treatment is important in reducing your risk of cancer and long-term conditions, such as cardiovascular and respiratory disease. If you smoke, giving up is also important in reducing this risk.

Money and financial support

If you have to stop work or work part time because of HIV, you may find it difficult to cope financially. However, you may be entitled to one or more of the following types of financial support:

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'Many HIV-positive women assume they'll pass on HIV to their baby, but that's not the case these days'

Sarah has HIV. She describes her pregnancy and the steps she had to take to ensure she'd have a healthy baby.

An expert explains what HIV is and how to avoid passing it on to your unborn child.

More real stories from HIVaware


'Things have moved on a lot since I was diagnosed with HIV'

Michael Edwards contracted HIV in 1990. He's now in his 60s and is still working and leading a healthy life.

"The first sign was a bad dose of flu. Like me, my GP is gay and he suspected that I had contracted HIV. I flew down to St Mary's Hospital and had a test, which was positive. Unusually, I contracted HIV through oral sex, probably because I had bleeding gums.

"I work at the London Lighthouse, an HIV and AIDS charity, and I think because of that I didn't have the same pressures that many people do. The main issue for me was telling my family. My father had died by the time I was diagnosed. I told my sister, but I was worried about telling my mum. Shortly afterwards, however, she got ill and died so she never had to know.

"At that time, before effective medication, people were dying all the time and I didn't have much time to think about my own situation. I started on medication in the late 90s. It took me a year to decide to go on it but I have had no regrets. My CD4 cell count immediately went down and my viral load became undetectable, which meant no virus could be detected in my blood. I was lucky in that I didn't have any major side effects. The only thing I noticed was that if I didn't have breakfast, I felt sick.

"I am now on my second lot of treatment, having had a treatment break of a year, and I am finding adherence more difficult. The main problem is nausea, but I find the more I eat, the better I respond.

"Coping with HIV is very much a matter of attitude. There is still a stigma attached to it, maybe not as much in the 1980s, but it is still there. When I do talks, I always say, 'It's not just a question of sleeping around. It's like getting pregnant: if you have sex, the risk is there.' We have rotten sex education in this country. We need to get better and make sure that kids are informed. Parents need to realise that their children are having sex and to make sure that they are doing it safely and have the information to protect themselves.

"As far as telling sexual partners is concerned, I find it better to tell them I have HIV straight away rather than get a couple of months down the line and have them find out. Some people do reject you and that can be hard, but I still believe it is better to be open. Some people find it easier with internet dating services to put their HIV status on their profile so they don't have to do it face to face. Different things work for different people. As for me, I don't care who knows.

"Things have moved on a lot since I was diagnosed. These days in the West, although not in Africa, people are living with HIV rather than dying from it. In the old days, the main challenge was deciding who to tell. It was difficult, especially as some of my friends didn't want to know when they discovered. As the problem got more widespread and more people had HIV, however, many of those who wouldn't give me the time of day when I was first diagnosed changed their attitude.

"There is still is a certain amount of prejudice within the gay community. Things are getting better, but they haven't changed completely and they won't until people change their attitudes and condom wearing becomes second nature.

"With the advent of medication, a lot of complacency exists. Some people have the attitude that you just take a pill and you are OK. It isn't quite like that. We have to get across the seriousness of HIV and make people realise that it is not just a problem that affects gay men. It's everybody's problem."

'If it wasn’t for HIV, I wouldn’t be where I am today.'

Tina Middleton caught HIV when she was just 20 years old from a partner with haemophilia.

"I had been in a relationship with someone with haemophilia and didn't know he had HIV until I got pregnant. I had a test straight away and, at first, it seemed all right as it came back negative. However, in March 1992 when I was eight months pregnant, I had another test, which was positive. It was the worst possible news.

"I didn't tell anyone. My main focus was just to get through the pregnancy. Not much was known then about HIV in pregnancy and when I came to deliver my baby, the staff were all gowned and masked up. It was horrible. It was not known that a caesarean birth is safer so I had a normal delivery and I was then put in a ward on my own, away from the other mothers. I had to tell my mother and my best friend as they wanted to know why the nurses were all wearing masks. They were shocked and I wasn't able to reassure them as I knew so little myself. The attitude was, 'Keep it quiet and don't tell anyone else'.

"The months following my son Adam's birth were awful. Looking back now, I don't know how I got through it. I was suicidal. I had split up with my partner by then (not because of the HIV) and all I used to do was cry. I would look over the balcony of my flat and think about jumping off. Other people found out without me telling them and some of my friends didn't want to know me. Others asked if I was a sex worker.

"When I went to the HIV clinic, the staff were fantastic, really supportive, but at that time HIV was considered to be a disease of gay men and I was the only woman there. I felt very isolated and low.

"Five months after my son was born, I met up with Andrew, who I'd known for a long time. He knew about my HIV status and he and his family were accepting. We got married and three years later I had my second son, Mark, through self-insemination to avoid passing the virus on to my husband. Life became better, but I was still being told I only had eight to 10 years to live, so I put my life on hold.

"Things started to change in 2001 when I split up with Andrew. I realised I had to be independent, for myself and for my sons. And by then, HIV treatment had changed. There was medication, and I was healthy. People were more aware that it wasn't a death sentence.

"For years, I didn't want to talk about having HIV, but today I am much more open and I no longer feel isolated. I have had a couple of bouts of serious illness and have disclosed my HIV status to friends, who have been accepting and wanted to know how best to support me.

"After I split up with Andrew, I had to learn how to make new relationships. The way I approach it is to get to know potential partners as friends first so they get to know me as a person. I have never had sex without telling them first but that is a huge pressure. It is hard and it never gets any easier. The week before I tell them, I hardly sleep for fear of how they will react. I always worry they are going to turn nasty, although, in fact, I have been very lucky and none of them has rejected me.

"I'm now in another long-term relationship and my current partner, Martin, is great. Before we slept together, I gave him information and leaflets and told him about PEP (post-exposure prophylaxis).

"HIV is part of our lives but we don't really talk about it much, although he does nag me if I'm late taking my tablets. It's a nuisance having to use condoms all the time. It means that every time we have sex, it comes to mind and we both wish it didn't have to. But apart from that, it doesn't affect our lives that much.

"I've been on medication since 2001, but have struggled a lot with side effects. After a couple of years, I found I was resistant to most of the drugs I was taking. Last year, I decided to have a treatment break, which was originally to be three months but ended up being six months.

"During that time, I became ill with bronchitis and subsequently a type of pneumonia, called pneumocystis pneumonia or PCP, which often affects people with HIV. My life was touch and go for a while but I'm better now, although my energy levels can be low and I have had continued problems with breathing.

"I'm now on new medication, and the side effects have stabilised. My CD4 count has improved, although it is still on the low side, and my viral load is better. Having said that, I don't go by my CD4 levels but by how I feel. I know myself better than any doctors do, and today I feel healthy and fine.

"My sons still don't know I have HIV so that is the next hurdle. Part of me wants to pre-plan it so there is someone there who is supportive, but part of me thinks I will just tell them when the time seems right. I have worked for the Terrence Higgins Trust for four years now, which means they are both well aware of HIV and the issues surrounding it and are very accepting, so I don't think telling them will be a problem.

"I'm really optimistic about the future. I have got my own mortgage and I love my life and the work I do. I know there are still lots of challenges to overcome, but I have a lot to live for and a lot still to do. It's good to be able to share my experiences with other people.

"I often go out and give talks about HIV as part of my work and people are frequently surprised when I say I have been living with it for 15 years. But it's true that you can't put a face on HIV. In a strange way, if it wasn't for my HIV, I wouldn't be who and where I am today."

Treating HIV

There is no cure for HIV, but there are treatments to enable most people with the virus to live a long and healthy life.

Emergency HIV drugs

If you think you have been exposed to the virus within the last 72 hours (three days), anti-HIV medication may stop you becoming infected.

For it to be effective, the medication, called post-exposure prophylaxis or PEP, must be started within 72 hours of coming into contact with the virus. It is only recommended following higher risk exposure, particularly where the sexual partner is known to be positive.

The quicker PEP is started the better, ideally within hours of coming into contact with HIV. The longer the wait, the less chance of it being effective.

PEP has been misleadingly popularised as a "morning-after pill" for HIV - a reference to the emergency pill women can take to prevent getting pregnant after having unprotected sex.

But the description is not accurate. PEP is a month-long treatment, which may have serious side effects and is not guaranteed to work. The treatment involves taking the same drugs prescribed to people who have tested positive for HIV.

You should be able to get PEP from:

  • sexual health clinics, or genitourinary medicine (GUM) clinics
  • hospitals - usually accident and emergency (A&E) departments

If you already have HIV, try your HIV clinic if the PEP is for someone you've had sex with.

Want to know more

If you test positive

If you are diagnosed with HIV, you will have regular blood tests to monitor the progress of the HIV infection before starting treatment.

This involves monitoring the amount of virus in your blood (viral blood test) and the effect HIV is having on your immune system. This is determined by measuring your levels of CD4+ve lymphocyte cells in your blood. These cells are important for fighting infection.

Treatment is usually recommended to begin when your CD4 cell count falls towards 350 or below, whether or not you have any symptoms. In some people with other medical conditions, treatment may be started at higher CD4 cell counts. When to start treatment should be discussed with your doctor.

The aim of the treatment is to reduce the level of HIV in the blood, allow the immune system to repair itself and prevent any HIV-related illnesses.

If you are on HIV treatment, the level of the virus in your blood is generally very low and it is unlikely that you will pass HIV on to someone else.

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If you have another condition

If you have also been diagnosed with hepatitis B or hepatitis C, it is recommended that you start treatment when your CD4 count falls below 500.

Treatment is recommended to begin at any CD4 count if you are on radiotherapy or chemotherapy that will suppress your immune system, or if you have been diagnosed with certain other illnesses, including:

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Antiretroviral drugs

HIV is treated with antiretrovirals (ARVs), these work by stopping the virus replicating in the body, allowing the immune system to repair itself and preventing further damage.

A combination of ARVs is used because HIV can quickly adapt and become resistant to one single ARV.

Patients tend to take three or more types of ARV medication. This is known as combination therapy or antiretroviral therapy (ART).

Some antiretroviral drugs have been combined into one pill, known as a "fixed dose combination". This means that the most common treatments for people just diagnosed with HIV involve taking just one or two pills a day.

Different combinations of ARVs work for different people so the medicine you take will be individual to you.

Once HIV treatment is started, you will probably need to take the medication for the rest of your life. For the treatment to be continuously effective, it will need to be taken regularly every day. Not taking ARVs regularly may cause the treatment to fail.

Many of the medicines used to treat HIV can interact with other medications prescribed by your GP or bought over-the-counter. These include herbal remedies such as St John's Wort, as well as recreational drugs.

Always check with your HIV clinic staff or your GP before taking any other medicines.

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Pregnancy

ARV treatment is available to prevent a pregnant woman from passing HIV to her child.

Without treatment, there is a one in four chance your baby will become infected with HIV. With treatment, the risk is less than one in 100.

Advances in treatment mean there is no increased risk of passing the virus to your baby with a normal delivery. However, for some women, a caesarean section may still be recommended.

If you have HIV, do not breastfeed your baby because the virus can be transmitted through breast milk.

If you or your partner has HIV, speak to an HIV doctor as there are options for safely conceiving a child without putting either of you at risk of infection.

Missing a dose

HIV treatment only works if you take your pills regularly every day. Missing even a few doses will increase the risk of your treatment not working.

You will need to develop a daily routine to fit your treatment plan around your lifestyle.

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Side effects

HIV treatment can have side effects. If you get serious side effects (which is uncommon) you may need to try a different combination of ARVs.

Common side effects include:

  • nausea
  • diarrhoea
  • skin rashes
  • sleep difficulties

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People with HIV get treatment at a specialist HIV clinic which is usually part of a sexual health or infectious diseases clinic at your local hospital.

Services, including support organisations, may work together to provide specialist care and emotional support.

Find out more about living with HIV.


 
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