What is HIV, and should I be tested?

A:  HIV stands for human immunodeficiency virus.  This is the virus that can lead to AIDS (acquired immunodeficiency syndrome).  Unlike other viruses, like a cold or the flu, your body cannot “get over” HIV.  Currently, there is no effective cure so once you contract HIV, you have it for the rest of your life.

The CDC recommends that everyone between the ages of 13 and 64 get tested at least once as part of their routine health care.  If you have a higher risk factor, such as more than one sex partner, have unprotected sex, other sexually transmitted diseases (STD), are a gay or bisexual man or are an intravenous  drug user, you should be tested at least once a year.


How long after a possible exposure should I be tested for HIV?

A:  The time it takes for a person who has been infected with HIV to seroconvert (test positive) for HIV antibodies is commonly called the “Window Period.”  Generally, when a person is infected with the HIV virus, the window period for 95-97% of those individuals is within 12 weeks  (3 months).  The CDC has said that in some rare cases it may take up to six months for someone to seroconvert (test positive).  At this point in time, the results would be 99.9% accurate.

What does this mean for you?

The three-month window period after the last possible exposure is normal for approximately 95% of the population. If you feel any anxiety about relying on the 3-month test result, by all means you should have another HIV test at 6 months just to be sure.


Are HIV and AIDS the same thing?

A:  No. HIV and AIDS are not interchangeable terms, although the media often uses them that way.  HIV is a tiny microscopic organism.  AIDS is a specific collection of illnesses or diseases caused by having the HIV virus in your body.


How many people have HIV?

A:  In 2015, 39,513 people were diagnosed with HIV in the United States.  Gay and bisexual men are the population most affected by HIV: in 2015, gay/bisexual men accounted for 82% of HIV diagnoses among males and 67% of all diagnoses.  African American gay/bisexual men had the largest number of HIV diagnosis, followed by white gay/bisexual men.  Among all gay and bisexual men, HIV trends have varied by race and over time.

According to the CDC, from 2005 to 2014:

  • Among white gay and bisexual men, diagnoses dropped steadily, declining 18% overall.
  • Among Hispanic/Latinoe gay and bisexual men, diagnoses rose by 24%.
  • Although diagnoses among African American gay/bisexual men increased 22%, they have leveled off in the past 5 years, increasing less than 1% since 2010.
  • Young African American gay and bisexual men (aged 13 to 24) experienced an 87% increase in diagnoses. But since 2010, diagnoses have declined 2%.

Persons diagnosed with HIV in 2015, 4%  were aged 13-19, 37%  were aged 20-29, 24%  were aged 30-39, 17%  were aged 40-49, 12%  were aged 50-59, and 5%  were aged 60 and over.

The CDC also reports that HIV and AIDS infection is not evenly distributed geographically.  The population rates of persons diagnosed with HIV in 2015 were highest in the South  (16.8), followed by the Northeast (11.6), the West (9.8), and the Midwest (7.6). The South generally is behind other regions in some key HIV prevention and care indicators.

Currently, an estimated 1,242,000 adults and adolescents are living with HIV.  An estimated 161,200 (13%) have not been diagnosed.  Young people are the most likely to be unaware of their infection, and among people aged 13-24, an estimated 51% of those living with HIV don’t know they have the virus.


How do I know if I am at risk for HIV?

A:  Knowing your risk can help you make important decisions to prevent exposure to HIV.  The CDC has developed the HIV Risk Reduction Tool  which can help you determine your risk and better understand the different prevention methods like using condoms or taking PrEP to reduce your risk.  Overall, you have a 1 in 99 chance of being diagnosed with HIV at some point in your lifetime.  Plus, the lifetime risk is much greater among some populations. For example the risk is:

  • 1 in 6 for gay and bisexual men
  • 1 in 2 for African American gay and bisexual men
  • 1 in 4 for Hispanic gay and bisexual men
  • 1 in 11 for white gay and bisexual men
  • 1 in 20 for African American men (gay and straight)
  • 1 in 48 for African American women overall.  Currently, heterosexual  African American women account for 9 out of 10 new HIV infections.
  • 1 in 23 for women who inject drugs
  • 1 in 36 for men who inject drugs


How can I tell if I have HIV?

A:  You can’t rely on signs or symptoms to indicate HIV status.  The symptoms associated with HIV/AIDS are similar to the symptoms of many common illnesses such as the flu, plus many people who are infected with HIV don’t have any symptoms at all for many years!

If you are feeling sick or having illness symptoms, you should see your doctor.  If you think you might be at risk of getting, or may have HIV, ask your doctor to test for HIV or visit your health department for a free, confidential test.  An HIV test is the only way to determine whether or not you have the virus.


How is HIV transmitted?

A:  HIV can be transmitted through semen, blood (including menstrual blood), vaginal secretions, and breast milk.  Blood contains the highest concentration of the virus, followed by semen, then vaginal fluids and lastly via breast milk.

Activities that allow transmission of HIV include unprotected sexual contact (vaginal, anal or oral), direct blood contact such as drug injection needles and in some cases, blood transfusions.  Body fluids that are NOT infectious include saliva, sweat, tears, urine and feces.


Can I get HIV from kissing?

A:  Because of the potential for contact with blood during “French” or open-mouth, wet kissing, the CDC recommends against this level of kissing with a person known to be infected.  However, the risk of acquiring HIV during open-mouth kissing is believed to be very low. Deep kissing may transmit other sexually transmitted diseases, but not HIV.  Casual contact through closed mouth or “social” kissing is not a risk for transmission of HIV.


Can I get HIV from oral sex?

A:  There is some risk associated with performing oral sex without protection.

You can reduce your risk when performing oral sex on a man (fellatio) by using latex condoms, and also by withdrawal before ejaculation without a condom (avoiding semen in the mouth) although the presence of pre-ejaculatory fluid (pre-cum) will increase risk.  You should not engage in oral sex when cuts or sores are present in your mouth.

When performing oral sex on a woman (cunnilingus), moisture barriers such as a dam (sheet of latex), a cut-open and flattened condom, or household plastic wrap can reduce the risk of exposure to vaginal secretions and/or blood.  While HIV is not believed to be easily transmitted through anal-oral contact (anilingus or rimming) on either a man or woman,  safe sex practices include the use of a barrier such as a dam or cut open & flattened condom and avoiding unprotected sex that involves fellatio or cunnilingus after anal contact.


Would performing oral sex on a man/woman be as risky as anal sex, vaginal sex, or sharing drug needles?

A:  No. Performing oral sex on a man or woman is lower risk than vaginal and anal sex or sharing needles. However, low risk does not mean no risk.  In a man with HIV, both semen and pre-ejaculatory fluid (pre-cum) containing the virus could be introduced into the mouth, so merely stopping before ejaculation may not eliminate the risk.  In a woman, HIV is present in vaginal and cervical secretions that could be introduced into the mouth, increasing the risk of transmission.

The correct and consistent use of a latex condom, dam or cut open and flattened condom for oral sex on a man/woman reduces the risk of getting HIV.  Also, the risk of a man (or woman) getting HIV by receiving oral sex is very low.   However, other sexually transmitted diseases (STDs) such as chlamydia, gonorrhea, syphilis, herpes and human papillomavirus (HPV) may be transmitted through unprotected oral sex.


Are all condoms the same?

A:  No. While there are many options available in brands, styles, colors, flavors and lubrication, latex condoms are highly effective in preventing HIV transmission when used correctly and consistently each time you have sex.  Natural skin or animal membrane condoms do not prevent HIV transmission.

Picking out condoms can be a fun experience for you and your partner, but an important thing to consider is whether you plan to use the condom as HIV/STD protection, or if you just want to use it for sex play.  You should be aware that many condoms such as french ticklers, flavored, glow in the dark, etc. are considered novelty condoms and are generally intended for play, not to prevent infection of any disease.  However, some novelty condoms, like flavored, are a good option for lowering the risk of disease transmission during oral sex, but should never be used for any type of vaginal or anal sex.


How do you use a condom?

A:  First, always store your condoms in a cool, dry place away from sunlight.  It’s never a good idea to keep condoms in your pocket, wallet or car for days or weeks on end.  Instead, grab a few and put them in your car or wallet before you hit the town!  Also, make sure to check the expiration date on the condom.  Most importantly – be sure to always use a new condom for every act of vaginal, anal and oral sex throughout the entire sex act (from start to finish). Never, ever reuse a condom!

The right way to use a condom (español):

  • Before any genital contact, put the condom on the tip of the erect penis with the rolled side out.
  • If the condom does not have a reservoir tip, pinch the tip enough to leave a half-inch space for semen to collect.
  • Holding the tip, unroll the condom all the way to the base of the erect penis while checking for holes and removing air bubbles. If the penis is uncircumcised (uncut), pull back the foreskin before rolling the condom down. 
  • It’s a good idea to always have a spare condom available, just in case!
  • After ejaculation and before the penis gets soft, grip the rim of the condom and carefully withdraw. Then gently pull the condom off the penis, making sure that semen doesn’t spill out.
  • Wrap the condom in a tissue and throw it in the trash where others won’t handle it.
  • If you feel the condom break at any point during sexual activity, stop immediately, withdraw you penis, remove the broken condom and put on a new condom. 
  • Ensure that adequate lubrication to the outside of the condom, vagina or anus is used during vaginal and anal sex, which might require using water-based lubricants. Oil-based lubricants (e.g., petroleum jelly, shortening, mineral oil, massage oils, body lotions and cooking oil) should never be used because they can weaken latex, causing breakage.


For more information about HIV/AIDS, how to protect yourself and your partner and how to stay healthy: