Hesperian Health Guides

What you need to know about HIV

In this chapter:

HIV (Human Immunodeficiency Virus) is a virus which causes AIDS (Acquired Immune Deficiency Syndrome). There is still no cure for HIV, but people with HIV can now live long and healthy lives by taking ART (Anti-Retroviral Therapy) medicines, getting prompt medical care when needed, eating nutritious food, drinking clean water, having decent housing, and getting emotional and spiritual support.

Without treatment, HIV slowly destroys the body’s immune system — the parts of the body that help fight infection and recover from sickness. Overwork, malnutrition, exposure to some chemicals, and illnesses can also weaken the immune system. Without treatment and proper care, people with HIV usually get very sick with health problems and diseases, such as TB (tuberculosis) and pneumonia. When the person’s immune system gets so weak that their body can no longer fight illness or heal, they will die. But AIDS is preventable if HIV is diagnosed and treatment is started.

People with HIV can look and feel strong. And a person who does not have HIV can be sick and have some of the same symptoms as someone with HIV. The only way to know for sure if a person has HIV is to get a test.

a man speaking.
Work keeps us going and enables us to bring home food and medicine. When we are healthy and when we have access to HIV medicines, we can continue to work just as long as workers who do not have HIV.

Signs of HIV

People can have HIV for many years before they have any signs of illness. Often the first signs to appear are:

  • swollen lymph glands in the neck, armpits, or groin
  • frequent fevers and night sweats
  • weight loss
  • tiredness
  • decreased appetite
  • diarrhea
  • white spots (thrush) in the mouth
  • for women, frequent vaginal yeast infections


These signs can also be caused by other problems. Getting tested for HIV when you first notice these signs will help you begin treatment earlier, when you are still strong.

How HIV is passed from one person to another

HIV lives in body fluids — blood, semen, wetness in the vagina, and breast milk. When any of these fluids from an infected person’s body gets inside another person’s body, the virus can spread. This can happen when:

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a person with HIV has sex with another person and does not use a condom. a person’s skin is pierced or cut with a needle or other tool that has not been properly cleaned.
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A woman who is pregnant with HIV or becomes infected during pregnancy can pass the virus to her baby. HIV can also be spread through breastfeeding.
blood from an infected person gets into a cut or open wound on another person’s body. In places where blood is not tested for HIV, people can also get HIV from blood transfusions.

The HIV virus does not live in other body fluids such as sweat, tears, or saliva. It cannot live outside the body, in the air or in the water, for more than a few minutes.

You cannot give or get HIV by:

  • sharing cups, dishes, chairs, tools, workstations, or telephones
  • sharing food and drinks
  • sharing bathrooms
  • touching, hugging, or kissing
  • sneezing or coughing (HIV is not passed like the flu or TB)
  • mosquito bites (HIV is not passed like malaria)

Women are at greater risk than men

It is more difficult for women to protect themselves from HIV and other sexually transmitted infections (STIs) than it is for men. Factory bosses, husbands, and boyfriends expect young women to be obedient. Men are often unwilling to listen to women’s concerns about sexual health. When a man refuses to use a condom, many women feel powerless to refuse sex.

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Using a condom every time you have sex helps protect you and your partner from HIV and other STIs.

Rape and sexual assault harm women more than men. When sex is forced, a woman’s genitals are often injured. If her attacker has HIV, the infection can pass more easily to the woman through cuts in her vagina (see First aid after rape).

Not using a condom increases your risk of getting other STIs. Having an STI increases your chances of getting HIV because they often cause open sores on the genitals. See information about preventing and treating STIs.

The HIV test

The only way to know for sure if you or someone else has HIV is to get tested. There are 2 types of tests. The viral test looks for the virus in your blood, takes longer to give results, and is more expensive but is also more trustworthy. The antibody test (rapid test) looks for your body’s reaction to HIV, gives results in less than 1 hour, and is less expensive.

After the virus has entered the body, it takes 1 to 3 months for it to show on a test. If you think you may have been exposed to HIV but the test does not show any infection, it is a good idea to get tested again after 3 months. Always use a condom. If the virus is in your body, it can pass from one person to another even if it does not yet show up on a test.

Many communities have free rapid testing services. If a person tests positive for HIV on a quick test, the clinic or health worker will usually run a viral test to be certain.

a man speaking.
Respect the privacy of others as you would like your own privacy to be respected. Don’t spread rumors or "news."

HIV tests should be:

  • free or low cost.
  • voluntary — no one should be forced to take an HIV test.
  • confidential — the results should be shared only with the person being tested, not the boss!

Counseling is part of testing

A counselor will explain how the test works and answer your questions about the test before you take it. When the results are ready, the counselor will meet with you in a private space and explain them. If the results show that you have HIV, she will give you information about clinics, treatment, and other services and support groups in your community. Although HIV cannot be cured, you can manage it and lead a healthy and active life.

Getting support from your community

Any person who is ill can feel better and heal better if she or he has support, love, and understanding from family, co-workers, and community. People with HIV need support: treat them with kindness and respect, fight against discrimination and for free treatment, work for better conditions in the workplace, and do not gossip or spread rumors.

Medicines to manage HIV

As soon as you test positive for HIV, look for an HIV care and treatment program. These programs can provide you with the resources you need to stay healthy. Anti-retroviral therapy (ART) medicines can help your body strengthen its immune system to fight HIV infection, but small amounts of the HIV virus will always remain hidden in the body.

Using ART means taking a combination of at least 3 anti-retroviral medicines every day. The medicines available may differ depending on where you live. They might be combined into one pill, or they might come in 3 separate pills. But what is the same everywhere is that once you begin taking ART, the medicines must be taken every day and at the same time. A person taking ART will gain weight, and look and feel healthier. But if he stops taking ART, or misses doses of the medicine, or takes it at the wrong times, then the HIV can become stronger and make him sick again.

Women with HIV who are pregnant should also take ART. It will help them be healthier and protect their babies from being born with HIV.

Another medicine, cotrimoxazole, can be taken daily to help prevent infections. Cotrimoxazole is often a part of HIV treatment programs.

ART is becoming less costly and more available. Government health clinics as well as factory clinics may offer ART at low or no cost.


This page was updated:28 Feb 2021