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HIV is a virus that lives in human blood, sexual fluids, and breast milk. It weakens your immune system, so your body has a hard time fighting off common germs, viruses, fungi, and other invaders. It spreads mainly through unprotected sexual contact and sharing needles.
AIDS -- acquired immune deficiency syndrome -- is the condition that comes when your immune system stops working and you get sick because of HIV.
HIV infection happens in three stages. Without treatment, it gets worse over time and eventually overpowers your immune system. Your symptoms will depend on your stage.
The only way you can know for sure if you have HIV is to get tested. Although the virus can cause symptoms, they’re not a reliable way to tell if you’re infected. In fact, some people won’t have any symptoms at all. So even if you don’t have any of the typical signs of an infection, you should always get tested if you think you are at risk.
Some people notice flu-like symptoms 1-4 weeks after they're first infected. These often only last a week or two. This first stage is called acute or primary HIV infection. Then, you may go for 10 years or more without further symptoms. This is called asymptomatic HIV infection. Even though you feel fine, the virus is still active in your body. And you can still give it to someone else.
Once HIV has seriously harmed your immune system, you're at risk for diseases that a healthy body could fight off. In this stage, symptomatic HIV infection, you start to notice problems caused by these "opportunistic" infections.
Most people don't know right away when they've been infected with HIV. But they may have symptoms within 2 to 4 weeks after they’ve gotten the virus. This is when your body's immune system puts up a fight. It's called acute retroviral syndrome or primary HIV infection.
The symptoms are similar to those of other viral illnesses, and they're often compared to the flu. They typically last a week or two and then go away. Early signs of HIV include:
Early testing is important for two reasons. First, at this stage, levels of HIV in your blood and bodily fluids are very high. This makes it especially contagious. Second, starting treatment as soon as possible will help boost your immune system and ease your symptoms.
A combination of medications (called HIV drugs, antiretroviral therapy, or ART) can help fight HIV, keep your immune system healthy, and keep you from spreading the virus. If you take these medications and have healthy habits, your HIV infection probably won’t get worse.
After your immune system loses the battle with HIV, the flu-like symptoms will go away. But there’s a lot going on inside your body. Doctors call this the asymptomatic period or chronic HIV infection.
In your body, cells called CD4 T cells coordinate your immune system’s response. During this stage, untreated HIV will kill CD4 cells and destroy your immune system. Your doctor can check how many of these cells you have with blood tests. Without treatment, the number of CD4 cells will drop, and you’ll be more likely to get other infections.
Most people don't have symptoms they can see or feel. You may not realize that you're infected and can pass HIV on to others.
AIDS is the advanced stage of HIV infection. This is usually when your CD4 T-cell number drops below 200 and your immune system is badly damaged. You might get an opportunistic infection, an illness that happens more often and is worse in people who have weakened immune systems. Some of these, such as Kaposi's sarcoma (a form of skin cancer) and pneumocystis pneumonia (a lung disease), are also considered “AIDS-defining illnesses.”
If you didn't know earlier that you were infected with HIV, you may realize it after you have some of these symptoms:
People with AIDS who don't take medication live about 3 years, or less if they get another infection. But HIV can still be treated at this stage. If you start on HIV drugs, stay on them, follow your doctor’s advice, and keep healthy habits, you can live a long time.
You have HIV. Now, you’re getting symptoms you’ve never had before. Perhaps you’re dropping weight for no reason or can’t seem to shake a nagging cough.
Why are you feeling sick?
It’s possible your HIV isn’t under control. That’s most likely to happen if you’re not on antiretroviral therapy (ART), medicines that fight the virus. However, it can also happen if you aren’t taking ART correctly, or if the drugs aren't working for you.
When HIV grows uncontrollably, the amount of virus in your blood goes up and hurts your immune system. It destroys cells called CD4s. Without enough of these, your body has a hard time fighting common infections and other health problems that it could normally handle easily.
Call your doctor if you get new symptoms. They can get to the bottom of what’s wrong and find ways to help you feel better.
Weight loss: Shedding pounds without trying is an obvious sign that your HIV may be going in the wrong direction. Untreated HIV itself or infections you get because of it can make you lose weight. Plus, if you’re sick, you may not feel like eating.
If you lose 10% or more of your body weight (like 15 pounds if you weigh 150 pounds), you could have what’s called wasting syndrome. You also have diarrhea, weakness, and fever for about a month. This mostly affects people with advanced HIV.
It’s important to try to put weight back on. In addition to taking your HIV medications, a few things can help:
Skin problems: Dry, itchy skin is a common issue for people whose immune systems are damaged from HIV. Skin infections like impetigo or tinea can be a problem, too.
Treatments include:
Molluscum contagiosum is a viral infection that causes small, flesh-colored bumps on the skin. The virus can grow out of control in people with HIV, so see a dermatologist for treatment right away.
Painful, blistering rash: It could be shingles if you’ve ever had chickenpox -- the same virus causes both. Usually, shingles affect people over age 60. But if you have HIV, you can get it even if you’re younger.
It’s important to see your doctor if you think you have shingles. Antiviral medicines can help you get over it more quickly -- but you need to start taking them as soon as possible.
Other treatments include:
Fever: Running a temperature usually means your body is fighting an infection. Your doctor may do some tests to figure out what’s causing your fever so they can decide how to treat the problem.
In addition to following your doctor's advice, do these things to bring down a fever:
Nagging cough: A cough isn’t always a sign of something serious. But one that hangs around for weeks can be.
People with low CD4 counts are more likely to get a lung infection called pneumocystis pneumonia (PCP). It can cause a dry cough, shortness of breath, and make you feel very tired.
Be sure you talk to your doctor if you have the symptoms of this infection -- without treatment, it can be deadly. You may need to be admitted to the hospital for diagnosis and treatment.
People with weak immune systems are more likely to get tuberculosis (TB). You may bring up lots of phlegm when you cough and have chest pain, fever, and weight loss, too. If tests show that you have TB, you’ll need to take antibiotics for several months.
Night sweats: Do you wake up in the middle of the night drenched in sweat? It can be a symptom of HIV itself or other infections (like TB). The sweating will stop when your doctor figures out what’s causing the problem and treats it.
What else can you do in the meantime?
Long-lasting diarrhea: People with weak immune systems can get infections that cause diarrhea. It can last for a few weeks. Your doctor will do a thorough workup to figure out the problem.
To control symptoms, your doctor may suggest:
If you’re not on ART or you’re not taking it exactly as you’re supposed to, now is the time to start taking it correctly. These medications will lower the amount of the virus in your blood so your immune system can recover. Even people with uncontrolled HIV can get the right treatment and go on to live a healthy life. Make sure to follow your doctor’s advice regarding your HIV medicine and other medicines prescribed for your specific conditions.
You may need to change your meds if you can’t stand the side effects or if they’re not controlling your disease well. But don’t stop taking them before you talk to your doctor.
Let your doctor know if your diarrhea gets worse or you get a fever, vomiting, or pain.
The symptoms and illnesses described above are likely the result of advanced HIV, which means that the virus has been growing unchecked in your body for months to years.
Mouth problems: It’s not unusual for people with HIV to have sores in their mouths. Infections can cause problems like thrush or cold sores as the disease gets worse.
These conditions can make it painful to chew and swallow your food. Your doctor may suggest medicines to fight the infection and the pain.
HIV testing, also called HIV screening, is the only way to know if you have the virus.
Several types of tests check your blood or other body fluids to see whether you're infected. Most can't spot HIV right away because it takes time for your body to make antibodies or for enough of the virus to grow inside you.
If you have the virus, finding out quickly means you can start treatment right away so you can feel better and live a long, full life. You can also take steps so you don't pass HIV to other people.
Pregnant women should get tested because early treatment means you probably won’t pass it to your baby.
The CDC recommends that everyone in the United States between the ages of 13 and 64 get tested for HIV at least once.
You should be tested more often -- at least once a year -- if you’re at higher risk of getting HIV, including if you:
There are two basic ways to get HIV test results:
Laboratory tests. For these tests, a technician takes a sample of your blood and tests it. You’ll get results within a few days.
Rapid tests. These tests provide results in about 20-30 minutes. You can get them done in a community clinic or take them at home.
If you’ve had a high-risk exposure to HIV very recently, go to the emergency room or call your doctor right away. Examples include unsafe sex with someone who has HIV or if you were sexually assaulted. Emergency drugs called post-exposure prophylaxis (PEP) may prevent HIV infection. You need to take them within 72 hours (3 days) after exposure. The sooner you start, the better.
If you don't get to a doctor in time to get PEP, ask your doctor about getting tested for HIV. For most types of HIV tests, you’ll need to wait 2 weeks or more after exposure to get an accurate result. You can infect others soon after you're exposed, so practice safe sex and take other precautions in the meantime.
Almost everyone who is HIV-positive has detectable levels of antibodies at 3 months. So if you test negative a month or two after your exposure, your doctor may want you to retest after 3 months to be sure.
Every HIV test has a different “window period.” That’s how long you need to wait after exposure until you can expect an accurate result. No HIV test can tell if you have the virus just after you’ve been exposed.
If you get tested too soon, you may get faulty results. But if you wait too long to learn if you’re HIV-positive, you can miss out on early treatment and also unknowingly spread the virus to others.
Standard HIV blood test. This test uses blood that a technician takes from your vein and sends to a lab. It can find antibodies (proteins your immune system makes when you’ve been exposed to the virus) 23-90 days after infection.
Rapid blood test. This test looks for antibodies using a drop of blood from a prick of your fingertip. It’s about as accurate as the original antibody test, but its window period could be longer -- between 18 and 90 days. Your health care provider can do this test, or you can buy a kit that lets you mail your sample in for testing.
Antibody/antigen test. These tests look for both antibodies and an antigen, a substance the virus makes before your immune system can start making antibodies. An antibody/antigen test that uses blood taken from a vein can find HIV 18-45 days after you’re exposed to the virus.
Newer antigen/antibody combination tests (you might hear them called “fourth generation” tests) can find HIV in 99% of people who are tested within 13-42 days of exposure. This test has become the standard HIV blood test in most labs.
A rapid antibody/antigen can also be done using blood from a prick of your fingertip. A health care provider can do this test. Or you can use a mail-in kit. The window period for this test is 18 to 90 days.
Rapid oral test. You can do this quick, easy test at home. Just swab the area between your gums and teeth to collect a sample of oral fluid (it isn’t the same as saliva) for antibodies against HIV. If you’ve had the virus for a while, the rapid oral test is highly accurate. But if you have a new infection, even if you got it in the past few months, the test won’t be as reliable. The window period is 23 to 90 days.
Urine test. These also look for HIV antibodies, but they aren’t as accurate as other tests that check either your blood or oral fluid. Because it’s an antibody test, its window period is similar to that of a standard HIV test.
Nucleic acid tests (NAT). These tests look for HIV at around 10-33 days after infection. They screen for signs of the virus itself, not antibodies to it. You may also hear this called an HIV RNA or a viral load test. It uses blood taken from a vein. You probably won’t get this expensive test unless you have symptoms and the doctor thinks you have a recent infection. It’s most often used to see how people who already have HIV respond to treatment.
For a lab test, you might need to call your doctor to schedule it. Some public health clinics take walk-ins.
A technician will take a small blood sample and send it to a lab. Some immunoassay tests check your urine or fluids from your mouth (not saliva), but there aren't as many antibodies in these, so you may get false negatives.
With home blood tests, you prick your finger to get a small blood sample that you send to a lab. You call to get your result, and you don't have to give your name. If it's positive, the lab will also do a follow-up test to double-check.
With home oral fluid tests, you swab your upper and lower gums and test the sample in a vial. About 1 in 12 people who are infected get a false negative from this test. If it’s positive, get a lab test to confirm.
How long does it take to get HIV results? This depends on what kind of test you had. Rapid tests provide answers in less than a half-hour. With a standard blood test or antibody/antigen test, you should expect results in a few days. It may take several days to get results from an NAT test. Urine test results could take up to 2 weeks.
Some tests are anonymous, meaning your name isn’t tied to the result. Others are confidential: Your information is attached to the result, but it’s protected by privacy laws.
Positive test results. A positive test result means there are traces of HIV in your body. Health care providers never diagnose HIV based on a single test result. If you had a rapid test, get a standard lab test to confirm it. If you had a lab test, more detailed tests of your blood can confirm your diagnosis:
A positive HIV test doesn’t mean you have AIDS, the most advanced stage of the disease. HIV treatment can keep you from getting AIDS, so talk to your doctor right away about starting medications called antiretroviral therapy (ART). These drugs lower the amount of the virus in your body, sometimes to a point where a test can’t spot it. They also protect your immune system so your HIV infection doesn’t become AIDS.
False-positive test results. Some HIV tests have a very slight chance of giving you false results. A “false-positive” result means the test shows you have HIV when you don’t. This occasionally happens when your test detects antibodies but they’re antibodies to another infection or substance – not to HIV. Rarely, a false positive can result from a lab mix-up or misinterpretation.
The rapid oral fluid test is more likely to give you a false-positive result than other tests. If you get a positive result on a rapid oral test, your doctor will give you a blood test to confirm your diagnosis.
Negative test results. If your result is negative, you can take steps to protect yourself from HIV. They include practicing safe sex and taking medicine called pre-exposure prophylaxis (PrEP).
Even if your test is negative, your partner can still have the virus. Talk with them about getting tested.
It could take as long as 6 months for you to have enough antibodies to get a positive result on some tests. If it’s been 3 months or less since you might have been infected and your test result is negative, get another test at 6 months to be sure.
False-negative test results. It’s also possible to get a “false-negative” result. That means the test says you don’t have HIV, but you do. This may happen if you get tested before or early in the window period for your particular test.
It also sometimes happens in people taking antiretroviral medicine for PrEP or PEP. Otherwise, it’s very rare to get a false negative after the window period.
Where you get tested for HIV depends on what’s available in your area, how much you can spend, and your preferences. Among the places that offer testing are:
Testing through local health departments and college health centers is often free. Some nonprofits also offer free or low-cost testing.
If you test positive, these organizations can help you get treatment. If you test negative, they can tell you about ways to prevent HIV infection.
At-home testing kits are available online and at pharmacies without a prescription. They generally offer you access to telephone counseling before and after testing.
To find out where you can get tested, check hiv.gov or gettested.cdc.gov, or call 800-CDC-INFO (800-232-4636).
Research has shown that some people avoid getting an HIV test because they fear others’ negative attitudes about HIV. This stigma results largely from fear, outdated beliefs about how HIV is transmitted, and value judgments about people who have it.
People may think an HIV diagnosis could:
Other barriers to HIV testing include economic, cultural, and social issues such as:
And, of course, it’s common to be afraid of getting a positive test result. But learning your status can relieve the anxiety of uncertainty.
If you don’t feel comfortable going to your regular doctor, consider testing by a nonprofit group or community health center. Some serve particular populations, such as LGBTQ+ people. They may even offer mobile testing vans. Or you may prefer to self-test in the privacy of your home.
You can also take the test at home yourself. Here’s how to do it and what you should know about self-testing.
HIV Home Test Kits
Home Access HIV-1 Test System: With this over-the-counter kit, you prick your finger and put a drop of blood on special paper. You then mail the sample to a testing lab. You need to wait about a week before you call a toll-free phone number for your results using your anonymous personal identification number. You’ll also be offered counseling by telephone if you need it.
OraQuick In-Home HIV Test: You can buy this test online or at a pharmacy. This quick-result test checks for HIV antibodies in a sample of saliva. You swab your upper and lower gums with a test stick. You then insert the sample into a vial filled with a fluid and wait 20-40 minutes and read the result.
HIV Home Test Accuracy
The Home Access HIV-1 Test System is extremely reliable. Studies show that it will detect HIV antibodies more than 99.9% of the time. When your sample gets a positive result, the lab will confirm it with another test before you can call for your result.
The test is also 99.9% accurate if your results are negative, meaning that you don’t have HIV. So you can be highly confident of either answer.
The OraQuick In-Home HIV Test is less accurate. This test will find HIV antibodies 92% of the time. That means it will miss an HIV infection in 1 of 12 people who have it. OraQuick rarely gives false positive results, meaning that it’s unlikely to say you have HIV if you don’t.
But experts recommend that if you test positive on OraQuick, you should view the results as preliminary. You should confirm it with a second test from your doctor or a medical clinic so that you can get the care you need.
For both of these tests, if you test negative, you may want to get tested again if you’ve done anything recently that could have exposed you to the virus. That’s because it can take 3-6 months for your body to make HIV antibodies, so taking a test before or during this window period may miss an infection.
Best HIV Test for You
Should you get screened for HIV at a clinic or your doctor’s office, or take the test yourself? And which home test is best for you? The answers to these questions may help you decide:
If you’re at risk for HIV, any test is better than no test. A study of men who have sex with men who received self-tests in the mail found that they were likely to be screened for HIV more often. So the tests caught more HIV infections. The men who tested positive also shared the information with others they knew.