HIV Resource Center HIV & PrEP Resource Center Find a PrEP Provider preplocator.org Get Tested gettested.cdc.gov HIV: What We Know HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome). There is currently no effective cure. Once people get HIV, they have it for life. But with proper medical care, HIV can be controlled. People with HIV who get effective HIV treatment can live long, healthy lives and protect their partners. What is HIV stigma? HIV stigma is negative attitudes and beliefs about people with HIV. It is the prejudice that comes with labeling an individual as part of a group that is believed to be socially unacceptable. Here are a few examples: Believing that only certain groups of people can get HIV Making moral judgments about people who take steps to prevent HIV transmission Feeling that people deserve to get HIV because of their choices What is discrimination? While stigma refers to an attitude or belief, discrimination is the behaviors that result from those attitudes or beliefs. HIV discrimination is the act of treating people living with HIV differently than those without HIV. Here are a few examples: Refusing casual contact with someone living with HIV Socially isolating a member of a community because they are HIV positive Referring to people as HIVers or Positives What are the effects of HIV stigma and discrimination? HIV stigma and discrimination affect the emotional well-being and mental health of people living with HIV. People living with HIV often internalize the stigma they experience and begin to develop a negative self-image. They may fear they will be discriminated against or judged negatively if their HIV status is revealed. “Internalized stigma” or “self-stigma” happens when a person takes in the negative ideas and stereotypes about people living with HIV and start to apply them to themselves. HIV internalized stigma can lead to feelings of shame, fear of disclosure, isolation, and despair. These feelings can keep people from getting tested and treated for HIV. What causes HIV stigma & discrimination? HIV stigma is rooted in a fear of HIV. Many of our ideas about HIV come from the HIV images that first appeared in the early 1980s. There are still misconceptions about how HIV is transmitted and what it means to live with HIV today. The lack of information and awareness combined with outdated beliefs lead people to fear getting HIV. Additionally, many people think of HIV as a disease that only certain groups get. This leads to negative value judgments about people who are living with HIV. How is HIV transmitted? Can I get HIV from anal sex? You can get HIV if you have anal sex with someone who has HIV without using protection (like condoms or medicine to treat or prevent HIV). Anal sex is the riskiest type of sex for getting or transmitting HIV. Being the receptive partner (bottom) is riskier than being the insertive partner (top). The bottom’s risk is higher because the rectum’s lining is thin and may allow HIV to enter the body during anal sex. The top is also at risk. HIV can enter the body through the opening at the tip of the penis (urethra); the foreskin if the penis isn’t circumcised; or small cuts, scratches, or open sores anywhere on the penis. Can I get HIV from vaginal sex? You can get HIV if you have vaginal sex with someone who has HIV without using protection (like condoms or medicine to treat or prevent HIV). Vaginal sex is less risky for getting HIV than receptive anal sex. Either partner can get HIV during vaginal sex. HIV can enter a person’s body during vaginal sex through the delicate tissue that lines the vagina and cervix. Vaginal fluid and blood can carry HIV, which can pass through the opening at the tip of the penis (urethra); the foreskin if the penis isn’t circumcised; or small cuts, scratches, or open sores anywhere on the penis. Can HIV be transmitted from a mother to her baby? HIV can be transmitted from a mother to her baby during pregnancy, birth, or breastfeeding. However, it is less common because of advances in HIV prevention and treatment. This is called perinatal transmission or mother-to-child transmission. Mother-to-child transmission is the most common way that children get HIV. Recommendations to test all pregnant women for HIV and start HIV treatment immediately have lowered the number of babies who are born with HIV. If a woman with HIV takes HIV medicine as prescribed throughout pregnancy and childbirth, and gives HIV medicine to her baby for 4 to 6 weeks after birth, the risk of transmission can be less than 1%. Can I get HIV from sharing needles, syringes, or other drug injection equipment? You are at high risk for getting HIV if you share needles, syringes, or other drug injection equipment (for example, cookers) with someone who has HIV. Never share needles or other equipment to inject drugs, hormones, steroids, or silicone. Used needles, syringes, and other injection equipment may have someone else’s blood on them, and blood can carry HIV. People who inject drugs are also at risk for getting HIV (and other sexually transmitted diseases) if they engage in risky sexual behaviors like having sex without protection (such as condoms or medicine to prevent or treat HIV). Sharing needles, syringes, or other injection equipment increases your risk for getting hepatitis B and hepatitis C, and other infections. What are some rare ways that HIV has been transmitted? Little to No Risk There is little to no risk of getting HIV from the activities below. For transmission to occur, something very unusual would have to happen. Oral Sex Oral sex involves putting the mouth on the penis (fellatio), vagina or vulva (cunnilingus), or anus (rimming). Factors that may affect the risk of getting HIV include: Ejaculation in the mouth with oral ulcers, bleeding gums, or genital sores. The presence of other sexually transmitted diseases (STDs). You can get other STDs from oral sex. If you get feces in your mouth during anilingus, you can get hepatitis A and hepatitis B, parasites like Giardia, and bacteria like Shigella, Salmonella, Campylobacter, and E. coli. Workplace The most likely cause is injury with a contaminated needle or another sharp object. Careful practice of standard precautions protects patients and health care personnel from possible occupational HIV transmission. Medical Care The US blood supply and donated organs and tissues are thoroughly tested. It is very unlikely that you would get HIV from blood transfusions, blood products, or organ and tissue transplants. You cannot get HIV from donating blood. Blood collection procedures are highly regulated and safe. Food Contamination The only known cases are among infants. Contamination occurs when blood from a caregiver’s mouth mixes with pre-chewed food and an infant eats it. You can’t get HIV from consuming food handled by someone with HIV. Biting and Spitting The small number of documented cases have involved severe trauma with extensive tissue damage and the presence of blood. This rare transmission can occur through contact between broken skin, wounds, or mucous membranes and blood or body fluids from a person who has HIV. There is no risk of transmission through unbroken skin. There are no documented cases of HIV being transmitted through spitting as HIV is not transmitted through saliva. Deep, Open-Mouth Kissing Very rarely, transmission has occurred if both partners have sores or bleeding gums. You can’t transmit HIV through closed-mouth or “social” kissing with someone who has HIV. You can’t transmit HIV through saliva. Touching Touching involves putting your hands, other body parts, or sex toys on your partner’s vagina, penis, or anus. The only possible risk would be if body fluids from a person with HIV touch the mucous membranes or damaged tissue of someone without HIV. Mucous membranes are found inside the rectum, vagina, opening of the penis, and mouth. Damaged tissue could include cuts, sores, or open wounds. You can get or transmit some other STDs (like human papillomavirus or HPV, genital herpes, and syphilis) through skin-to-skin contact. Tattoos and Body Piercings There are no known cases in the United States of anyone getting HIV this way. It is possible to get HIV from tattooing or body piercing if the equipment or ink has someone else’s blood in it. This is more likely to happen when the person doing the procedure is unlicensed because they may use unsterilized needles or ink. If you get a tattoo or a body piercing, be sure that the person doing the procedure is properly licensed and uses only new or sterilized equipment. Symptoms & Stages For many, yes. Most people have flu-like symptoms within 2 to 4 weeks after infection. Symptoms may last for a few days or several weeks. Having these symptoms alone doesn’t mean you have HIV. Other illnesses can cause similar symptoms. Some people have no symptoms at all. The only way to know if you have HIV is to get tested. What are the stages of HIV? When people with HIV don’t get treatment, they typically progress through three stages. But HIV treatment can slow or prevent progression of the disease. With advances in HIV treatment, progression to Stage 3 (AIDS) is less common today than in the early years of HIV. Stage 1: Acute HIV Infection People have a large amount of HIV in their blood and are very contagious. Many people have flu-like symptoms. If you have flu-like symptoms and think you may have been exposed to HIV, get tested. Stage 2: Chronic Infection This stage is also called asymptomatic HIV infection or clinical latency. HIV is still active and continues to reproduce in the body. People may not have any symptoms or get sick during this phase but can transmit HIV. People who take HIV treatment as prescribed may never move into Stage 3 (AIDS). Without HIV treatment, this stage may last a decade or longer, or may progress faster. At the end of this stage, the amount of HIV in the blood (viral load) goes up and the person may move into Stage 3 (AIDS). Stage 3: Acquired Immunodeficiency Syndrome (AIDS) The most severe stage of HIV infection. People with AIDS can have a high viral load and may easily transmit HIV to others. People with AIDS have badly damaged immune systems. They can get an increasing number of opportunistic infections or other serious illnesses. Without HIV treatment, people with AIDS typically survive about three years. Prep & PEP: What You Need To Know PrEP (pre-exposure prophylaxis) is medicine that reduces your chances of getting HIV from sex or injection drug use. When taken as prescribed, PrEP is highly effective for preventing HIV. When used correctly, studies have shown that PrEP reduces the risk of getting HIV from sex by up to 99%. In 2020, 30,635 people received an HIV diagnosis in the United States and dependent areas. The annual number of new diagnoses decreased 8% from 2016 to 2019. Sadly, most of these cases are among gay and bisexual men of color. Male-to-male sexual contact accounted for 68% of all new HIV diagnoses in the United States and dependent areas. In the same year, heterosexual contact accounted for 22% of all HIV diagnoses. That’s why now, more than ever, we need to increase awareness and uptake for Pre-Exposure Prophylaxis (PrEP), a new, highly effective tool to prevent the transmission of HIV. If you decide that PrEP is right for you, you can speak with your primary care physician. Californians can receive PrEP and PEP directly from a pharmacist and without a physician’s prescription. PrEP is for HIV negative patients only, and routine HIV screening and blood work is required to remain on the medication. To determine if you can get PrEP for free or low cost, check out NASTAD’s PrEP cost calculator, here: PrEPcost.org. Different types of PrEP PrEP can be pills or shots. There are two pills approved for use as PrEP: Truvada® and Descovy®. Truvada® is for people at risk through sex or injection drug use. Descovy® is for people at risk through sex. Descovy is not for people assigned female at birth who are at risk for HIV through receptive vaginal sex. Apretude is the only shot approved for use as PrEP. Apretude is for people at risk through sex who weigh at least 77 pounds (35 kg). Can I switch from pills to shots? Talk to your health care provider about switching from PrEP pills to shots. PrEP shots may be right for you if you do not have HIV and have no known allergy to the medicines in the shot. If you decide to switch from PrEP pills to shots, you’ll need to visit your health care provider regularly to receive your shot. You’ll also need to be tested for HIV prior to each PrEP shot. The CDC has determined that 1 in 4 gay and bisexual men should be on PrEP. Who else should be on PrEP? Does PrEP have side effects? The majority of PrEP users report zero side effects. However, some people experience nausea, dizziness, and weightloss, with these minor side effects usually resolving within the first few weeks of starting PrEP. A very small number of individuals experience modest declines in kidney function1 or bone mineral density2, both of which returned to normal once PrEP was discontinued. Your provider will do tests while you are taking PrEP to determine if you are experiencing any of these problems. Importantly, this study has shown PrEP to be as safe as aspirin. What is PEP? PEP (post-exposure prophylaxis) means taking medicine to prevent HIV after a possible exposure. PEP Must Be Started Within 72 Hours of Possible Exposure to HIV Talk right away (within 72 hours) to your health care provider, an emergency room doctor, or an urgent care provider about PEP if you think you’ve recently been exposed to HIV: during sex (for example, if the condom broke), through sharing needles, syringes, or other equipment to inject drugs (for example, cookers), or if you’ve been sexually assaulted. The sooner you start PEP, the better. Every hour counts. If you’re prescribed PEP, you’ll need to take it daily for 28 days. PEP is for Emergency Situations PEP is given after a possible exposure to HIV. PEP is not a substitute for regular use of other HIV prevention. PEP is not the right choice for people who may be exposed to HIV frequently. If you are at ongoing risk for HIV, such as through repeated exposures to HIV, talk to your health care provider about PrEP (pre-exposure prophylaxis). Talking to your doctor: Patients interested in PrEP or PEP should also check out LA County Department of Public Health’s Patient PrEP Self-Assessment Card to see if PreP is right for you! Be honest. If you rarely or never use condoms, then tell your doctor. Inconsistent condom-use is a great reason to be on PrEP, and you shouldn’t be ashamed to tell that to your doctor. Remember, while PrEP helps prevent HIV, it does not protect against other sexually transmitted infections (STI). Condoms remain the most effective tool to protect against all STIs. All PrEP & PEP educational content and information on this website has been compiled from information consistent with current CDC guidelines for use of PrEP, Risk Evaluation and Mitigation Strategy (REMS) guidelines, and clinical trials of oral daily PrEP. More Information CDC (Monkeypox and HIV) Elizabeth Taylor AIDS Foundation Resources HIV Is Not A Crime website CDC HIV Information Center AIDS Healthcare Foundation Provider Search VIH en Español HIV 101 Fact Sheet HIV Timeline HIV and COVID-19 Basics Criminalization Reform FAQs Lipodystrophy & HIV #TAKEIT: I’M PREP’D Prep for Women Prep Resources Endhivnevada.org The information provided on this website is intended for your general knowledge only and is not a substitute for professional medical advice or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your health.