WHAT YOU NEED TO KNOW:

What is HIV? HIV (human immunodeficiency virus) is a viral infection that slowly weakens your immune system. The virus kills a type of white blood cell called CD4. A normal CD4 count ranges from 500 to 2,000. You have HIV when your CD4 count ranges from 200 to 500. You have AIDS (acquired immune deficiency syndrome) when your CD4 count is less than 200. AIDS is the final stage of HIV infection. AIDS means your immune system cannot fight off infections and disease. This can become life-threatening. Seek care immediately if you think you may have been exposed to HIV. Drug treatments are available after exposure to HIV.

What are the first signs and symptoms of an HIV infection? You may have no signs or symptoms at first. Many people have flu-like symptoms in the first few weeks after infection. You may have any of the following symptoms for about 2 weeks:

• Fever or headache
  
  
• Rash, often on the face or abdomen
  
  
• Muscle pain
  
  
• Sore throat
  
  
• Swollen lymph nodes in your neck or armpits
  
  
• Upset stomach, diarrhea, or vomiting

What are the later signs and symptoms of an HIV infection? You may feel well for months or years. As your CD4 count drops and your immune system weakens, you may develop signs such as oral thrush. An infection from a past virus, such as herpes or chickenpox, may come back. As your immune system continues to weaken, you can get more serious infections. You may develop the following:

• Chronic diarrhea or weight loss without trying
  
  
• White spots or hairy patches inside your mouth
  
  
• Trouble breathing, or a cough, with or without blood
  
  
• Fevers and night sweats
  
  
• Rash, blisters, bruises, or other skin changes
  
  
• Hair loss or vision loss
  
  
• Confusion and memory loss

How is an HIV infection diagnosed? Your healthcare provider will examine you and ask about your signs and symptoms. He will ask questions to find out how you became infected and who else may be at risk. Tell him about your illnesses or infections, including sexually transmitted infections (STIs). Tell him if you received any vaccines or were tested for HIV or tuberculosis. Tell him how many sexual partners you have had, if they were male or female, and if you used condoms. Tell him if you inject illegal drugs and share needles. You may need any of the following tests:

• HIV screening tests are used to look for HIV antibodies and antigens in your blood. Your body creates these substances after it has been infected with HIV. If your HIV test is positive, you will need a second test to confirm it. If your HIV test is negative, you may need a follow-up test in 3 months. It can take up to 3 months for your body to develop antibodies to HIV that will show up on a test.
  
  
• Blood tests measure your CD4 count and viral load. If your CD4 count is lower than the normal range, your immune system has been affected by HIV. Viral load is the amount of HIV in your blood at any given time.
  
  
• Tests for STIs and other infections, including syphilis, gonorrhea, and chlamydia, may be done. You are more likely to have HIV if you have other STIs. Tests may also be done to see if you have tuberculosis, hepatitis, or toxoplasmosis.
  
  
• A pelvic exam or genital exam is done to check for signs of an STI. Your healthcare provider will also look for tears in your skin, unusual discharge, lumps, and warts.
  
  
• A chest x-ray is done to look for signs of infection, or any other reason for your symptoms.
  
  
• A CT scan may be used to look for signs of infection in your abdomen or skull. You may be given contrast liquid to help healthcare providers see infection better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.

How is an HIV infection treated? There is no cure for HIV. The main goal of treatment is to improve your health. The second goal is to slow the progression from HIV to AIDS. Your healthcare provider will decide your treatment based on your CD4 cell and viral load counts. You may need any of the following:

• Antiretroviral medicines slow the progression of HIV. They are given in different combinations called highly active antiretroviral therapy (HAART). Your healthcare provider will decide what kind of HAART you need. You may need to make HAART changes if you have severe side effects or develop resistance to a medicine.
  
  
• Antimicrobial medicines kill or prevent bacterial, viral, or fungal infections.
  
  
• Preventative medicines may be given to protect you from opportunistic infections. These are illnesses that develop because your immune system cannot fight the bacteria or viruses that cause them. Examples include toxoplasmosis, Pneumocystis pneumonia (PCP), and tuberculosis.
  
  
• Vaccines may help prevent the flu, pneumonia, hepatitis, and other infections.

How can I improve my quality of life? Early treatment and good management can help you live for years with an HIV infection. You will need to learn about HIV and manage your health to improve your quality of life. Do the following to help keep your immune system strong:

• Keep all follow-up visits. You will need to visit your healthcare provider for blood tests and frequent physical exams.
  
  
• Eat a variety of healthy foods. A dietitian can help you learn about nutrition. You need to eat enough calories to prevent weight loss caused by HIV. You also need protein and iron to prevent anemia, and calcium to prevent bone loss. Never eat raw eggs, unpasteurized foods, undercooked meat, or anything else that could cause food poisoning.
  
  
• Stay active. Most people with HIV can safely exercise for at least 20 minutes, 3 times a week. Regular exercise can strengthen your heart and help prevent depression. Ask your healthcare provider about the best exercise plan for you.
  
  
• Do not smoke. If you currently smoke, ask for information on how to stop. HIV and medicines to treat HIV can increase your risk for heart disease. Nicotine increases the risk even higher. Do not use e-cigarettes or smokeless tobacco products instead of cigarettes. They still contain nicotine.
  
  
• Find support in your community. Ask your healthcare provider to help you find counseling and other mental health services. You may want to join a support group for people with HIV.

How can I prevent the spread of HIV through body fluid?

• Tell healthcare providers you are HIV-positive. Include all healthcare providers, such as your doctor, dentist, and anyone taking a blood sample.
  
  
• Be careful with body fluids. Do not let your body fluids get near the mouth, eyes, anus, or open skin cuts of others. Do not let anyone who is not wearing gloves touch your sores, cuts, blood, or body fluids.
  
  
• Do not donate blood or tissue. Do not donate blood or blood products. Do not donate sperm, organs, or body tissues.
  
  
• Do not share needles or other injectable drug equipment. Use a needle exchange program to get clean needles. Also do not share syringes, rinse water, or anything else used to prepare drugs for injection. Ask your healthcare provider for information if you need help to stop using illegal drugs.
  
  
• Do not share objects or tools. Examples include razors, toothbrushes, or tweezers. They may cut or scrape the skin and cause others to come into contact with blood.
  
  
• Do not pierce your ears, navel, or any other place on your body. Piercing can cause bleeding. This may spread HIV.

What else can I do to prevent the spread of HIV?

• Take every dose of HAART medicines exactly as directed. This will prevent the virus from mutating and becoming much harder to treat. Consistent use of HAART medicines may help prevent the spread of HIV to a sex partner or an unborn baby.
  
  
• Have safe sex. Tell your sex partners that you are HIV-positive. Use a latex condom correctly each time you have vaginal, anal, or oral sex. Women may use latex female condoms when a male condom cannot be used. Do not share sex toys.
  
  
• Join a risk reduction program. Ask your healthcare provider or local health department to help you find a risk reduction program. This program will teach you how to tell others that you have HIV and ask sexual partners to use condoms.
  
  
• Treat STIs right away. If you are sexually active, get tested for STIs at least once a year. If you become infected with an STI, treat it right away. This may help reduce the risk that you will give HIV to a sex partner.

What do women with HIV need to know?

• HIV increases the risk for cancer of the cervix, anus, vulva, and vagina. Follow up with your healthcare provider and get a Pap smear as directed. Pap smears check for signs of cervical cancer.
  
  
• Ask your healthcare provider which birth control method is best for you. Condoms are the best way to prevent passing HIV to a sexual partner. In addition to condoms, use a second form of birth control to prevent pregnancy. Do not use vaginal spermicides, because they may increase the risk that you will spread HIV.
  
  
• Tell your healthcare provider if you are pregnant or want to become pregnant. Treatment can lower the risk that you will give HIV to your baby. Attend all prenatal visits. Follow your healthcare provider's advice to improve your chances of a healthy outcome for you and your baby. Do not breastfeed, because your breast milk can infect your baby with HIV.

Call 911 for any of the following:

• You have trouble breathing.
  
  
• You have a seizure.

When should I seek immediate care?

• You have a fever and night sweats.
  
  
• You cough up blood.
  
  
• You have a headache and a stiff neck.
  
  
• You are confused and notice changes in the way you think.

When should I contact my healthcare provider?

• You are having side effects from your medicines that make you want to stop taking them.
  
  
• You are more tired than usual or you have lost weight without trying.
  
  
• You have ongoing nausea, vomiting, and diarrhea.
  
  
• You have white vaginal discharge and vaginal pain or swelling.
  
  
• You see white spots or hairy patches inside your mouth.
  
  
• You have a rash, blisters, bruises, or other skin changes.
  
  
• You have a cough that will not go away.
  
  
• You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.