Key takeaways

  • HIV is a virus that weakens the immune system, and if left untreated, can lead to stage 3 HIV. But with proper treatment, people with HIV can live long and productive lives.
  • Early detection and consistent use of HIV treatments are crucial in management, preventing its progression, and reducing the risk of transmission.
  • HIV is transmitted through specific bodily fluids, not through casual contact, and preventive measures like safe sex practices and avoiding shared needles can significantly reduce the risk of transmission.

To develop stage 3 HIV, also known as AIDS, a person has to have contracted HIV. But having HIV doesn’t necessarily mean that someone will develop stage 3 HIV.

Cases of HIV progress through three stages:

  • Stage 1: acute stage, the first few weeks after transmission
  • Stage 2: clinical latency, or chronic stage
  • Stage 3: AIDS

As HIV lowers the CD4 cell count, the immune system weakens. A typical adult’s CD4 count ranges from 500 to 1,500 per cubic millimeter (mm3). A person with a count below 200 is considered to have stage 3 HIV.

How quickly a case of HIV progresses through the chronic stage varies significantly from person to person. Without treatment, it can last up to a decade before advancing to stage 3 HIV. With treatment, it can last indefinitely.

There’s currently no cure for HIV, but it can be managed. People with HIV often have a near-typical life span with early treatment with antiretroviral therapy.

Along those same lines, there’s technically no cure for stage 3 HIV currently. However, treatment can increase a person’s CD4 count to the point where they’re considered to no longer have stage 3 HIV. (This point is a count of 200 or higher.)

Also, treatment can typically help manage opportunistic infections.

HIV and stage 3 HIV are related, but they’re not the same thing.

Learn more about the difference between HIV and AIDS.

HIV is a virus that damages the immune system. Untreated HIV affects and kills CD4 cells, which are a type of immune cell called a T cell.

Over time, as HIV kills more CD4 cells, the body is more likely to get various types of conditions and cancers.

HIV is transmitted through bodily fluids that include:

  • blood
  • semen
  • vaginal and rectal fluids
  • breast milk

The virus isn’t transferred through air, water, or casual contact.

Because HIV inserts itself into the DNA of cells, it’s a lifelong condition, and currently, no drug eliminates HIV from the body, although many scientists are working to find one.

However, with medical care, including treatment called antiretroviral therapy, it’s possible to manage HIV and live with the virus for many years.

Without treatment, a person with HIV is likely to develop stage 3 HIV, also known as acquired immunodeficiency syndrome (AIDS).

At that point, the immune system is too weak to successfully respond against other diseases, infections, and conditions.

Untreated, life expectancy with end stage AIDS is about 3 years. With antiretroviral therapy, HIV can be well-managed, and life expectancy can be nearly the same as that of someone who has not contracted HIV.

It’s estimated that 1.2 million people in the United States are currently living with HIV. Of those people, 1 in 7 don’t know they have the virus.

HIV can cause changes throughout the body.

Stage 3 HIV, also known as AIDS, is a disease that can develop in people with HIV. It’s the most advanced stage of HIV. But just because a person has HIV doesn’t mean stage 3 HIV will develop.

HIV kills CD4 cells. Healthy adults generally have a CD4 count of 500 to 1,500 mm3. A person with HIV whose CD4 count falls below 200 per cubic millimeter will receive a diagnosis of stage 3 HIV.

A person can also receive a stage 3 HIV diagnosis if they have HIV and develop an opportunistic infection or cancer that’s rare in people who don’t have HIV.

An opportunistic infection, such as Pneumocystis jiroveci pneumonia, occurs in a severely immunocompromised person, such as someone with stage 3 HIV.

Untreated, HIV can progress to stage 3 HIV within a decade. There’s currently no cure for stage 3 HIV, and without treatment, life expectancy after diagnosis is about 3 years.

This may be shorter if the person develops a severe opportunistic illness. However, treatment with antiretroviral drugs can prevent stage 3 HIV from developing.

If stage 3 HIV does develop, it means that the immune system is severely compromised. This means it has weakened to the point where it can no longer successfully respond to most diseases and infections.

That makes the person living with stage 3 HIV vulnerable to a wide range of illnesses, including:

The shortened life expectancy linked with untreated stage 3 HIV isn’t a direct result of the syndrome itself. Rather, it’s a result of the diseases and complications that arise from having an immune system weakened by stage 3 HIV.

After the first month or so, HIV enters stage 2, also known as clinical latency. Without treatment, stage 2 may last 10 years or longer, but may advance more quickly.

Some people don’t have any symptoms during this time, while others may have minimal or nonspecific symptoms. A nonspecific symptom is one that doesn’t belong to one specific disease or condition.

These nonspecific symptoms may include:

  • headaches and other aches and pains
  • swollen lymph nodes
  • recurrent fevers
  • night sweats
  • fatigue
  • nausea
  • vomiting
  • diarrhea
  • weight loss
  • skin rashes
  • recurrent oral or vaginal yeast infections
  • pneumonia
  • shingles

Symptoms of HIV vary from person to person, but they’re similar across all sexes. These symptoms can come and go or get progressively worse.

If a person has been exposed to HIV, they may also have been exposed to other sexually transmitted infections (STIs). These include:

Even when men notice STI symptoms, like sores or discharge, many don’t get checked right away. A 2019 study found that more than a quarter waited over a week before seeking care for an STI. Women, on the other hand, generally use healthcare services more often than men, which can create more opportunities to get tested and treated.

In addition, women with HIV are at increased risk for:

While not related to HIV symptoms, another risk for women with HIV is that the virus can be transmitted to a fetus during pregnancy. However, antiretroviral therapy is considered safe during pregnancy.

Women who are treated with antiretroviral therapy are at very low risk for transmitting HIV to their baby during pregnancy and delivery.

Breastfeeding or chestfeeding is an important consideration for people living with HIV. Current U.S. guidelines encourage shared decision making between a person and their healthcare team when deciding whether to breastfeed. Consistently taking HIV medication and maintaining an undetectable viral load reduces the risk of transmitting HIV through breastfeeding to less than 1%. However, infant formula or are safe, risk-free alternatives.

As with the early stage, the clinical latency stage of HIV is still transferable during this time, even without symptoms, and can pass to another person.

However, a person won’t know they have HIV unless they get tested. If someone has these symptoms and thinks they may have been exposed to HIV, it’s important that they get tested.

HIV symptoms at this stage may come and go, or they may progress rapidly. This progression can be slowed substantially with treatment.

With the consistent use of this antiretroviral therapy, chronic HIV can last for decades and will likely not develop into stage 3 HIV if treatment begins early enough.

Early symptoms of HIV

The first few weeks after someone contracts HIV are called the acute infection stage.

During this time, the virus reproduces rapidly. The person’s immune system responds by producing HIV antibodies, which are proteins that take measures to respond against infection.

During this stage, some people have no symptoms at first. However, many people experience symptoms in the first month or so after contracting the virus, but they often don’t realize HIV causes those symptoms.

This is because symptoms of the acute stage can be very similar to those of the flu or other seasonal viruses, such as:

  • they may be mild to severe
  • they may come and go
  • they may last anywhere from a few days to several weeks

Early symptoms of HIV can include:

  • fever
  • chills
  • swollen lymph nodes
  • general aches and pains
  • skin rash
  • sore throat
  • headaches
  • nausea
  • upset stomach

Because these symptoms are similar to common illnesses like the flu, the person who has them might not think they need to seek medical attention.

And even if they do, their healthcare professional might suspect the flu or mononucleosis and might not even consider HIV.

Whether a person has symptoms or not, their viral load is very high during this period. The viral load is the amount of HIV found in the bloodstream.

A high viral load means that HIV can be easily transmitted to someone else during this time.

Initial HIV symptoms usually resolve within a few months as the person enters the chronic, or clinical latency, stage of HIV. This stage can last many years or even decades with treatment.

Learn more about the early symptoms of HIV.

Many people with HIV experience changes to their skin. Rash is often one of the first symptoms of an HIV infection. Generally, an HIV rash appears as multiple small lesions that are flat and raised.

Rash related to HIV

HIV makes someone more susceptible to skin problems because the virus destroys immune system cells that take measures against infection. Co-infections that can cause rash include:

The cause of the rash determines:

  • how it looks
  • how long it lasts
  • how it can be treated

Rash related to medication

While rash can be caused by HIV co-infections, it can also be due to medication. Some drugs used to treat HIV or other conditions can cause a rash.

This type of rash usually appears within 1 or 2 weeks of starting a new medication. Sometimes, the rash will clear up on its own. If not, a change in medications may be necessary.

Rash due to an allergic reaction to medication can be serious.

Other symptoms of an allergic reaction include:

  • trouble breathing or swallowing
  • dizziness
  • fever

Stevens-Johnson syndrome (SJS) is a rare allergic reaction to HIV medication. Symptoms include fever and swelling of the face and tongue. A blistering rash, which can involve the skin and mucous membranes, appears and spreads quickly.

When 30% of the skin is affected, it’s called toxic epidermal necrolysis, which is a life threatening condition. If this develops, emergency medical care is needed.

While rash can be linked with HIV or HIV medications, it’s important to keep in mind that rashes are common and can have many other causes.

Learn more about HIV rash.

Stage 3 HIV, or AIDS is the point where the immune system is weakened due to HIV that’s typically gone untreated for many years.

If HIV is found and treated early with antiretroviral therapy, a person will usually not develop stage 3 HIV.

People with HIV may develop stage 3 HIV if they received a later diagnosis or if they know they have HIV but don’t consistently take their antiretroviral therapy.

They may also develop stage 3 HIV if they have a type of HIV that’s resistant to (doesn’t respond to) the antiretroviral treatment.

Without proper and consistent treatment, people living with HIV can develop stage 3 HIV sooner. By that time, the immune system is quite damaged and has a harder time generating a response to infection and disease.

With the use of antiretroviral therapy, a person can maintain a chronic HIV diagnosis without developing stage 3 HIV for decades.

Symptoms of stage 3 HIV can include:

  • recurrent fever
  • chronic swollen lymph glands, especially of the armpits, neck, and groin
  • chronic fatigue
  • night sweats
  • dark splotches under the skin or inside the mouth, nose, or eyelids
  • sores, spots, or lesions of the mouth and tongue, genitals, or anus
  • bumps, lesions, or rashes of the skin
  • recurrent or chronic diarrhea
  • rapid weight loss
  • neurologic problems such as trouble concentrating, memory loss, and confusion
  • anxiety and depression

Antiretroviral therapy controls the virus and usually prevents progression to stage 3 HIV. Other infections and complications of stage 3 HIV can also be treated. That treatment must be tailored to the person’s individual needs.

Anyone can contract HIV. The virus is transmitted in bodily fluids that include:

  • blood
  • semen
  • vaginal and rectal fluids
  • breast milk

Some of the ways HIV is transferred from person to person include:

  • through vaginal or anal sex — the most common route of transmission
  • by sharing needles, syringes, and other items for injection drug use
  • by sharing tattoo equipment without sterilizing it between uses
  • during pregnancy, labor, or delivery from a pregnant person to their baby
  • during breastfeeding or chestfeeding
  • through “premastication,” or chewing a baby’s food before feeding it to them
  • through exposure to the blood, semen, vaginal and rectal fluids, and breast milk of someone living with HIV, such as through a needle stick

The virus can also be transmitted through a blood transfusion or an organ and tissue transplant. However, rigorous testing for HIV among blood, organ, and tissue donors ensures that this is very rare in the United States.

It’s theoretically possible, but considered extremely rare, for HIV to be transmitted through:

  • oral sex (only if there are bleeding gums or open sores in the person’s mouth)
  • being bitten by a person with HIV (only if the saliva is bloody or there are open sores in the person’s mouth)
  • contact between broken skin, wounds, or mucous membranes and the blood of someone living with HIV

HIV does not transfer through:

  • skin-to-skin contact
  • hugging, shaking hands, or kissing
  • air or water
  • sharing food or drinks, including drinking fountains
  • saliva, tears, or sweat (unless mixed with the blood of a person with HIV)
  • sharing a toilet, towels, or bedding
  • mosquitoes or other insects

It’s important to note that if a person living with HIV is being treated and has a persistently undetectable viral load, it’s virtually impossible to transmit the virus to another person.

Learn more about HIV transmission.

HIV is a variation of the simian immunodeficiency virus (SIV), which is typically found in chimpanzees in Central and West Africa. Scientists suspect SIV jumped from chimpanzees to humans when cross-contamination occurred, likely during hunting or as a result of human encroachment into forest areas where the chimpanzees live.

Once inside the human population, the virus mutated into what we now know as HIV. This likely occurred as long ago as the 1920s.

Eventually, the virus migrated to other parts of the world. Scientists first discovered HIV in a stored human blood sample in 1959.

It’s thought that HIV has existed in the United States since the 1970s, but transmission and widespread reporting didn’t happen until the 1980s.

Treatment should begin as soon as possible after a diagnosis of HIV, regardless of viral load.

The main treatment for HIV is antiretroviral therapy, a combination of daily medications that stop the virus from reproducing. This helps protect CD4 cells, keeping the immune system strong enough to take measures against disease.

Antiretroviral therapy helps keep HIV from progressing to stage 3 HIV. It also helps reduce the risk of transmitting HIV to others.

When treatment is effective, the viral load will be “undetectable.” The person still has HIV, but the virus is not visible in test results.

However, the virus is still in the body. And if that person stops taking antiretroviral therapy, the viral load will increase again, and the HIV can again start attacking CD4 cells.

Learn more about how HIV treatments work.

Many antiretroviral therapy medications are approved to treat HIV. They work to prevent HIV from reproducing and destroying CD4 cells, which help the immune system generate a response to infection.

This helps reduce the risk of developing complications related to HIV, as well as transmitting the virus to others.

These antiretroviral medications are grouped into different classes:

Combination medications already contain two or more medications from different classes.

Treatment regimens

Generally, a starting treatment regimen for HIV will include three HIV medications from at least two of these drug classes.

This combination helps prevent HIV from forming resistance to medications. (Resistance means the drug no longer works to treat the virus.)

Many of the antiretroviral medications are combined with others so that a person with HIV typically takes only one or two pills a day.

A healthcare professional will help a person with HIV choose a regimen based on their overall health and personal circumstances.

These medications must be taken every day, exactly as prescribed. If they’re not taken appropriately, viral resistance can develop, and a new regimen may be needed.

Blood testing will help determine if the regimen is working to keep the viral load down and the CD4 count up. If an antiretroviral therapy regimen isn’t working, the person’s healthcare professional will switch them to a more effective regimen.

Side effects and costs

Side effects of antiretroviral therapy vary and may include nausea, headaches, and dizziness. These symptoms are often temporary and disappear with time.

Serious side effects can include swelling of the mouth and tongue and liver or kidney damage. If side effects are severe, a doctor can adjust the medications.

The costs of antiretroviral therapy vary depending on geographic location and type of insurance coverage. Some pharmaceutical companies have assistance programs to help lower the cost.

Learn more about the drugs used to treat HIV.

Stage 3 HIV is caused by HIV. A person can’t get stage 3 HIV if they haven’t contracted HIV.

Healthy individuals have a CD4 count of 500 to 1,500 per mm3. Without treatment, HIV continues to multiply and destroy CD4 cells. If a person’s CD4 count falls below 200, they have stage 3 HIV.

Also, if someone with HIV develops an opportunistic infection associated with HIV, they can still receive a diagnosis of stage 3 HIV, even if their CD4 count is above 200.

Today, it’s easier than ever to get tested for HIV, and several different tests can be used. Healthcare professionals determine which test is best for each person.

Antibody/antigen tests

Antibody/antigen tests are the most commonly used tests.

These tests check the blood for antibodies and antigens. An antibody is a type of protein that the body makes to respond to an infection. An antigen, on the other hand, is the part of the virus that activates the immune system.

Antibody tests

These tests check the blood solely for antibodies. About 23 to 90 days after transmission, most people will develop detectable HIV antibodies, which can be found in the blood or saliva.

These tests are done using blood tests or mouth swabs, and no preparation is necessary. Some tests provide results in 30 minutes or less and can be performed in a healthcare professional’s office or clinic.

Other antibody tests can be done at home:

  • OraQuick HIV Test: An oral swab provides results in as little as 20 minutes.
  • Home Access HIV-1 Test System: After the person pricks their finger, they send a blood sample to a licensed laboratory. They can remain anonymous and call for results the next business day.

If someone suspects they’ve been exposed to HIV but tested negative in a home test, they should repeat the test in 3 months. If they have a positive result, they should follow up with their healthcare professional to confirm.

Nucleic acid test (NAT)

This expensive test isn’t used for general screening. It’s for people who have early symptoms of HIV or have a known risk factor. This test doesn’t look for antibodies; it looks for the virus itself.

This test can usually identify HIV as soon as 10 to 33 days after exposure. It’s usually accompanied or confirmed by an antibody test.

Learn more about HIV home testing options.

As soon as someone contracts HIV, the virus starts reproducing in their body. The person’s immune system reacts to the antigens (parts of the virus) by producing antibodies (cells that take countermeasures against the virus).

Timing is important when testing for HIV.

The time between exposure to HIV and when it becomes detectable in the blood is called the HIV window period. Most people develop detectable HIV antibodies within 23 to 90 days after transmission.

If a person takes an HIV test during the window period, it’s likely they’ll receive a negative result. However, they can still transmit the virus to others during this time.

If someone thinks they may have been exposed to HIV but tested negative during this time, they should repeat the test in a few months to confirm (the timing depends on the test used). And during that time, they need to use condoms or other barrier methods to prevent the spread of HIV.

Someone who tests negative during the window might benefit from postexposure prophylaxis (PEP). This is medication taken after an exposure to prevent getting HIV.

PEP needs to be taken as soon as possible after the exposure; it should be taken no later than 72 hours after exposure, but ideally before.

Another way to prevent getting HIV is preexposure prophylaxis (PrEP). A combination of HIV drugs taken before potential exposure to HIV, PrEP can lower the risk of contracting or transmitting HIV when taken consistently.

And though many researchers are working to develop one, there’s currently no vaccine available to prevent the transmission of HIV. However, taking certain steps can help prevent the transmission of HIV.

Safer sex

The most common way for HIV to be transferred is through anal or vaginal sex without a condom or other barrier method. This risk can’t be completely eliminated unless sex is avoided entirely, but people can considerably lower their risk by taking a few precautions:

To reduce risk, it’s important to:

  • Get tested for HIV: Everyone should know their status and that of their partner.
  • Get tested for other STIs: Having an STI increases the risk of contracting HIV. If you have a positive STI result, take the steps to get treated.
  • Use condoms: Learn the correct way to use condoms and use them every time you have sex, whether it’s through vaginal or anal intercourse. It’s important to keep in mind that pre-seminal fluids (which come out before male ejaculation) can also contain HIV.
  • Take medications as directed if they have HIV: This lowers the risk of transmitting the virus to a sexual partner.

Other prevention methods

Other steps to help prevent the spread of HIV include:

  • Avoiding sharing needles or other paraphernalia: HIV is also transmitted through blood, and can be contracted by using materials that have come in contact with the blood of someone who has HIV.
  • Considering PEP: A person who has been exposed to HIV should contact their healthcare team about obtaining PEP. PEP can reduce the risk of contracting HIV. It consists of three antiretroviral medications given for 28 days. PEP should begin as soon as possible after exposure, but no later than 36 to 72 hours.
  • Considering PrEP: A person who has a higher chance of contracting HIV should talk with their healthcare professional about PrEP. If taken consistently, it can lower the risk of acquiring HIV.

Healthcare professionals can offer more information on these and other ways to prevent the spread of HIV.

Learn more about STI prevention.

About 1.2 million people in the United States are living with HIV. With treatment, many can expect to live a long, productive life.

The most important thing is to start antiretroviral treatment as soon as possible. By taking medications exactly as prescribed, people living with HIV can keep their viral load low and their immune system strong.

It’s also important to follow up with a healthcare professional regularly.

Other ways people living with HIV can improve their health include:

  • Make their health their top priority: Steps to help people living with HIV feel their best include:
    • fueling their body with a well-balanced diet
    • exercising regularly
    • getting plenty of rest
    • avoiding tobacco and other drugs
    • reporting any new symptoms to their healthcare professional right away
  • Focus on their mental health: They could consider seeing a licensed therapist who is experienced in treating people with HIV.
  • Use safer sex practices: Talk with their sexual partner(s). Get tested for other STIs. And use condoms and other barrier methods every time they have vaginal or anal sex.
  • Talk with their healthcare professional about PrEP and PEP: When used consistently by a person without HIV, these medications can lower the chances of transmission. PrEP is most often recommended for people without HIV in relationships with people with HIV, but it can also be used in other situations. Online sources for finding a PrEP provider include PrEP Locator and PleasePrEPMe.
  • Surround themselves with loved ones: When first telling people about their diagnosis, they can start slow by telling someone who can maintain their confidence. They may want to choose someone who won’t judge them and who will support them in caring for their health.
  • Get support: They can join an HIV support group, either in person or online, to meet with others who face the same concerns they have. Their healthcare professional can also steer them toward a variety of resources in their area.

There are many ways to get the most out of life when living with HIV.

In the 1990s, a 20-year-old person with HIV had a 19-year life expectancy. By 2011, a 20-year-old person with HIV could expect to live another 53 years.

It’s a dramatic improvement, due in large part to antiretroviral therapy. With proper treatment, many people with HIV can expect a “normal” or near-normal life span.

Of course, many things affect life expectancy for a person with HIV. Among them are:

  • CD4 cell count
  • viral load
  • serious HIV-related illnesses, including hepatitis
  • misusing drugs
  • smoking
  • access, adherence, and response to treatment
  • other health conditions
  • age

Where a person lives also matters. People in the United States and other developed countries may be more likely to have access to antiretroviral therapy.

Consistent use of these drugs helps prevent HIV from progressing to stage 3 HIV. When HIV advances to stage 3 HIV, life expectancy without treatment is about 3 years.

Life expectancy statistics are just general guidelines. People living with HIV should talk with their healthcare professional to learn more about what they can expect.

Currently, there are no vaccines to prevent or treat HIV. Research and testing on experimental vaccines are ongoing, but none are currently close to being approved for general use.

HIV is a complicated virus. It mutates (changes) rapidly and is often able to fend off immune system responses. Only a small number of people who have HIV develop broadly neutralizing antibodies, the kind of antibodies that can respond to a range of HIV strains.

An HIV vaccine efficacy study started in South Africa in 2016. The experimental vaccine was an updated version of one used in a 2009 trial in Thailand. The study involved 5,400 men and women.

In 2020, vaccinations for the study were suspended. Based on the study’s findings, the researchers concluded that the vaccines hadn’t shown any efficacy and that there was no significant evidence of reduced or increased infection rates.

Research into an HIV vaccine is ongoing, and other vaccine clinical trials are also currently underway.

While there’s still no vaccine to prevent HIV, people with HIV can benefit from other vaccines to prevent HIV-related illnesses. Here are the recommendations:

  • Pneumonia: Recommended for all children younger than 5 years and all adults ages 65 years and older.
  • Influenza: Recommended for all people over 6 months old annually, with rare exceptions.
  • Hepatitis A and B: People can ask their doctor about getting vaccinated for hepatitis A and B, especially if they’re in a higher-risk group.
  • Meningitis: Meningococcal vaccination is recommended for all preteens and teens, as well as children ages 2 months to 10 years who are at increased risk, and adults ages 19 years or older who are at increased risk.
  • Shingles: Recommended for those ages 50 or older, and people ages 19 or older with weakened immune systems.

Learn more about HIV vaccine development.

HIV is a virus that weakens the immune system, but it doesn’t have to define a person’s future.

With early detection and consistent treatment, HIV can be managed as a chronic condition, and most people with HIV can expect to live long, productive lives. Understanding how HIV is transmitted, the difference between HIV and stage 3 HIV, and the range of available treatment options is key to staying healthy and preventing transmission.

Preventive steps, like practicing safe sex, using clean needles, and getting tested regularly, not only protect an individual but also their loved ones and community. While there’s no vaccine yet, ongoing research continues to bring hope for the future.