Yes, today HIV is a manageable disease. HIV medications have significantly changed the course of HIV infection since the early days of the epidemic and with the proper care and treatment, you can live a healthy life.
The sooner you take steps to protect your health, the better. Early treatment with antiretroviral drugs and a healthy lifestyle can help you stay well. Prompt medical care prevents the onset of AIDS and some life-threatening AIDS-related conditions.
To view the personal stories of others who have been diagnosed with HIV and learn how they managed their infection and got the virus under control with medication, visit AIDS.gov’s Positive Spin.
The most significant change that has taken place in HIV prevention and in the thinking and strategies of many public health workers and prevention advocates since the last edition of Preventing HIV is a much greater emphasis on the role of HIV treatment as a method of HIV prevention. A few advocates feel that we may not even need new treatments (like vaccines) and new approaches (like pre-exposure prophylaxis) to significantly reduce HIV transmission, but may simply need to step up what we are already doing, namely treating people who have HIV. This is a minority view, but, encouraged by new evidence of the efficacy of HIV treatment as prevention, many experts and advocates now believe that the provision of ARVs may be one of the most important elements of any strategy to end the HIV epidemic. At the very least it provides another powerful reason to expand access to treatment.
While AIDS remains incurable, patients are living much longer – even decades after infection – because of the development of many effective medications to suppress the virus. The most effective type are known as antiretroviral drugs, which are often taken in combination to prevent the patient from becoming resistant to any one drug.
According to the National Institutes of Health, the most common antiretroviral drugs fall into three categories:
Reverse transcriptase inhibitors, which keep the virus from reproducing
Protease inhibitors, which interfere with an HIV protein that produces infectious particles
Fusion inhibitors, which prevent the virus from entering healthy cells
Doctors verify if medications are working through blood tests, which measure levels of various infection-fighting blood cells as well as the level of HIV in the blood. Even when the virus is undetectable, AIDS is not cured and can still be transmitted to others.
Other HIV/AIDS treatment focuses around living a healthy lifestyle with optimum nutrition, sleep and exercise. Regular doctor’s visits are also scheduled, with frequency depending on viral levels in the blood and what symptoms are present, according to the American Academy of Family Physicians.
Prevention
More than 56,000 Americans become infected with HIV each year, according to the U.S. Department of Health and Human Services. While some AIDS patients have been infected through blood transfusions during medical procedures, preventing infection usually depends on avoiding risky habits or behaviors that lead to exposure to the virus, which can be transmitted through blood, bodily fluids such as semen and infected needles.
Prevention measures include:
Knowing yours and your partners’ HIV status
Using latex condoms correctly during every sexual encounter, whether gay or straight
Limiting the number of sexual partners
Abstaining from injectable drug use
Seeking medical treatment immediately after suspected HIV exposure, since medications can sometimes prevent infection if started early
It’s just as important to know the ways HIV cannot be spread, such as by:
Saliva, tears or sweat
Water or air
Casual contact such as closed-mouth kissing or shaking hands
Insects, including mosquitoes
The advent in 1996 of potent combination antiretroviral therapy (ART), sometimes called HAART (highly active antiretroviral therapy) or ART (effective combination antiretroviral therapy), changed the course of the HIV epidemic.1 These “cocktails” of three or more antiretroviral drugs used in combination gave patients and scientists new hope for fighting the epidemic,2 and have significantly improved life expectancy—to decades rather than months.1,3
For many years, scientists believed that treating HIV-infected persons also significantly reduced their risk of transmitting the infection to sexual and drug-using partners who did not have the virus. The circumstantial evidence was substantial, but no one had conducted a randomized clinical trial— the gold standard for proving an intervention works. That changed in 2011 with the publication of findings from the HIV Prevention Trials Network (HPTN) 052 study, a randomized clinical trial designed in part to evaluate whether the early initiation of ART can prevent the sexual transmission of HIV among heterosexual couples in which one partner is HIV-infected and the other is not. This landmark study validated that early HIV treatment has a profound prevention benefit: results showed that the risk of transmitting HIV to an uninfected partner was reduced by 96%.4
As a concept and a strategy, treating HIV-infected persons to improve their health and to reduce the risk of onward transmission—sometimes called treatment as prevention— refers to the personal and public health benefits of using ART to continuously suppress HIV viral load in the blood and genital fluids, which decreases the risk of transmitting the virus to others. The practice has been used since the mid- 1990s to prevent mother-to-child, or perinatal, transmission of the virus. Research published in 1994 showed that zidovudine, more commonly known as AZT, when given to HIV-infected pregnant women and to their newborns reduced the risk of perinatal transmission from about 25% to 8%.5 Since then, routinely testing pregnant women and treating infected mothers with ART during pregnancy, delivery, and while breastfeeding, when practiced according to recommendations, has reduced the mother’s risk of transmitting HIV to her child by 90%.6 In one study, women who received at least 14 days of ART reduced the risk of transmitting HIV to their babies to less than 1%.
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