HIV: symptoms, treatment and prevention

Author: Jessica Lloyd
Senior Vulvovaginal Specialist Naturopath | BHSc(N) | ISSVD, ISSWSH, BSSM, ATMS

Last reviewed: July 4, 2026

HIV (human immunodeficiency virus) is no longer the death sentence it was in the 1980s. Today it’s a manageable long-term condition: with early diagnosis and modern treatment, people with HIV live long, healthy lives, and someone on effective treatment cannot pass the virus on through sex.^1–2

That’s a huge shift from the 1980s. What hasn’t changed is that HIV is still around, the old public-health campaigns have faded, and a lot of people carrying the virus don’t know it. So testing and prevention still matter for everyone who’s sexually active.

HIV is passed on through blood and sexual fluids, including semen and vaginal fluids. It attacks the immune system, and if it’s left untreated for years the immune system can weaken to the point where the body struggles to fight off other infections. That late stage used to be called AIDS (acquired immunodeficiency syndrome), and is now usually called late-stage or advanced HIV.¹

How HIV affects the body

HIV is a retrovirus that targets CD4 T cells, the white blood cells that help coordinate your immune response.³ It gets inside these cells, uses them to make copies of itself, and destroys them in the process. Because it hides and replicates inside the very cells meant to fight it, and constantly changes its outer coat, the immune system can’t clear it on its own.

Left untreated over years, CD4 numbers slowly fall and immunity weakens, which is when someone becomes vulnerable to infections that a healthy immune system would shrug off.³ Antiretroviral treatment (ART) stops this process, which is why starting treatment early matters so much. Having HIV today does not mean you will develop AIDS; treated in good time, that late stage is prevented.

Symptoms of HIV

Soon after infection, many people get a short flu-like illness called seroconversion illness, though not everyone notices it. The most common signs are a fever, sore throat and a blotchy rash, sometimes with tiredness, aching, headache, swollen glands or diarrhoea, and it can last a week or two.

After that, HIV often causes no symptoms at all for years, which is exactly why so many people don’t realise they have it. You cannot tell from how you feel, so testing is the only way to know.

How HIV is passed on

HIV is carried in blood, semen, vaginal and rectal fluids, and breast milk. It’s passed on mainly through unprotected vaginal or anal sex, by sharing needles, and from parent to baby during pregnancy, birth or breastfeeding. The virus enters through the delicate mucous membranes of the vagina, rectum, penis or mouth.¹

Oral sex carries a much lower risk, higher if there are mouth ulcers or bleeding gums. Everyday contact does not pass HIV on: you can’t catch it from kissing, hugging, sharing cups, sneezing or toilet seats.

One important modern fact runs through all of this: someone with HIV who is on effective treatment with an undetectable viral load cannot transmit the virus sexually. This is known as U=U, undetectable equals untransmittable, and it’s backed by large studies following thousands of couples with zero transmissions.⁴

There’s a vaginal-health angle worth mentioning honestly. Research links a lactobacillus-dominant vaginal microbiome with a lower risk of acquiring HIV, while a disrupted, low-lactobacillus microbiome is linked with higher risk.^5–6 That’s an association, not protection: a healthy microbiome is no substitute for condoms, PrEP or the other prevention below, but it’s one more reason to look after your protective bacteria.

Who gets HIV

Anyone who is sexually active or shares needles can get HIV. It became widely known in the 1980s among gay and bisexual men, who were hit hard and early, and gay and bisexual men still carry a significant share of new diagnoses in many countries.

But HIV was never confined to one group, and today a large proportion of new infections worldwide are in heterosexual women and men. HIV tracks exposure and opportunity, not identity or orientation, so the useful question isn’t who you are, it’s whether you or a partner may have been exposed and tested.

Thanks to treatment and prevention, new diagnoses in many high-income countries have fallen a long way from their peak, but they haven’t disappeared, and rates are rising in some settings.²

Preventing HIV

There are now several highly effective ways to prevent HIV, and used together they’re powerful.

Condoms remain a simple, effective barrier against HIV and other sexually transmitted infections.
PrEP (pre-exposure prophylaxis) is HIV medication taken by someone who is HIV-negative to stop them acquiring it. Taken as prescribed, as a daily pill or a long-acting injection, it reduces the risk of getting HIV from sex by around 99 per cent.⁷
PEP (post-exposure prophylaxis) is emergency medication that can prevent infection after a possible exposure. It must be started as soon as possible, within 72 hours, and taken for 28 days.⁷
Treatment as prevention: because U=U, getting people diagnosed and onto effective treatment also stops onward transmission.^2,4
Never sharing needles, and needle and syringe programmes, have hugely reduced transmission among people who inject drugs.¹
Screening donated blood has all but ended transfusion transmission in countries that test their blood supply.

HIV and pregnancy

HIV testing is a routine part of antenatal care, and for good reason: when a pregnant person with HIV is on effective treatment, the risk of passing the virus to the baby drops to well under one per cent.^8–9

With an undetectable viral load, a vaginal birth is usually safe, and the decision about delivery is guided by viral load rather than being an automatic caesarean. Feeding advice varies by setting, so it’s worked out with the maternity and HIV team. The headline is simple and hopeful: with treatment, the overwhelming majority of babies born to parents with HIV are born HIV-free.⁹

Getting tested for HIV

Testing is quick, and modern tests can pick up HIV around a month after exposure, far sooner than the old three-month wait. Sexual-health clinics often give results the same day, and home self-test kits are available too.¹⁰

Regular testing is worth it for anyone having sex without condoms, with new or multiple partners, or after another STI diagnosis, and at least yearly for those at higher ongoing risk.¹¹ Testing is the gateway to everything else, since it’s what connects people to treatment and prevention.

Treatment with ART

HIV is treated with antiretroviral therapy (ART), a combination of medicines that stops the virus replicating.¹² Current guidelines are clear: everyone diagnosed with HIV should start treatment straight away, whatever their CD4 count, because starting early protects health and prevents onward transmission.¹³ This is a real change from the old approach of waiting until CD4 counts fell.

Treatment is far simpler than it used to be, often a single daily pill combining several medicines, with long-acting injectable options now available too. Side effects such as nausea or headaches are usually mild and manageable, and modern regimens are much better tolerated than the early drugs.¹²

Living well with HIV

Started early and taken consistently, ART keeps HIV in check, prevents AIDS, and lets people expect a lifespan close to anyone else’s.¹² Being diagnosed late, when the immune system is already damaged, has a harder outlook, which is the whole argument for testing and starting treatment early.

Living well with HIV is also about the ordinary things: staying on top of general health, since people with HIV can face other conditions a bit earlier, and looking after the basics of sleep, food, movement and mental health.^14–15 A diagnosis is life-changing, but it is not the catastrophe it once was, and support makes a real difference.

If you’d like to be tested, your local sexual-health clinic or doctor can help, and they can also advise on PrEP, PEP and support services if you need them.

This is general information, not a substitute for personalised medical advice.