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Sexual Health

What is HIV?

  • 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.

Where did HIV come from?

  • HIV infection in humans came from a type of chimpanzee in Central Africa.

  • The chimpanzee version of the virus (called simian immunodeficiency virus, or SIV) was probably passed to humans when humans hunted these chimpanzees for meat and came in contact with their infected blood.

  • Studies show that HIV may have jumped from chimpanzees to humans as far back as the late 1800s.

  • Over decades, HIV slowly spread across Africa and later into other parts of the world. We know that the virus has existed in the United States since at least the mid to late 1970s.

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How to get tested for HIV?

​Although there is currently no cure for HIV/AIDS, Ontario offers a number of testing and treatment programs. These programs help people with HIV/AIDS live for many years after contracting the disease.

All doctors, nurse practitioners and midwives in Ontario can order HIV tests. There are three types of tests:

  • standard HIV testing: a sample of your blood is taken and sent to a public health laboratory

  • anonymous testing: the test is ordered for you and your results are provided using a code known only to you. Anonymous HIV testing is offered at 50 locations in communities across Ontario

  • point of care testing: your blood is tested while you wait. If you test negative for HIV/AIDS, you will learn your results immediately. If you test reactive, your blood sample will be sent for standard testing

How soon after exposure to HIV can a test detect if I have the virus?


  • No HIV test can detect HIV immediately after infection. If you think you’ve been exposed to HIV in the last 72 hours, talk to your health care provider about post-exposure prophylaxis (PEP), right away.

  • The time between when a person may have been exposed to HIV and when a test can tell for sure whether they have the virus is called the window period. The window period varies from person to person and depends on the type of test used to detect HIV.

  • A nucleic acid test (NAT)can usually tell you if you have HIV infection 10 to 33 days after an exposure.

  • An antigen/antibody test performed by a laboratory on blood from a vein can usually detect HIV infection 18 to 45 days after an exposure. Antigen/ antibody tests done with blood from a finger prick can take longer to detect HIV (18 to 90 days after an exposure).

  • Antibody tests can take 23 to 90 days to detect HIV infection after an exposure. Most rapid tests and self-tests are antibody tests. In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid.

Are HIV and AIDS the same thing?


  • HIV is a virus that can lead to immune system deterioration. The term “HIV” stands for human immunodeficiency virus. The name describes the virus: Only humans can contract it, and it attacks the immune system. As a result, the immune system is unable to work as effectively as it should.

  • Our immune systems can completely clear many viruses our bodies, but that’s not the case with HIV. Medications can control HIV very successfully by interrupting its viral life cycle.

  • While HIV is a virus that may cause an infection, AIDS (which is short for acquired immunodeficiency syndrome) is a condition. Contracting HIV can lead to the development of AIDS.

  • AIDS, or stage 3 HIV, develops when HIV has caused serious damage to the immune system. It is a complex condition with symptoms that vary from person to person. Symptoms of stage 3 HIV are related to the infections a person may develop as a result of having a damaged immune system that can’t fight them as well. Known collectively as opportunistic infections, they include tuberculosis, pneumonia, and others.

  • Certain types of cancer become more likely when an immune system works less effectively as well.

  • Adherence to antiretroviral therapy can prevent stage 3 HIV from developing.

How is HIV spread?

The spread of HIV from person to person is called HIV transmission. HIV is spread only through certain body fluids from a person who has HIV. These body fluids include:


  • Blood

  • Semen

  • Pre-seminal fluid

  • Vaginal fluids

  • Rectal fluids

  • Breast milk

HIV is spread mainly by:


  • Having anal or vaginal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV

  • Sharing injection drug equipment (works), such as needles or syringes, with someone who has HIV

  • The spread of HIV from a woman with HIV to her child during pregnancy, childbirth, or breastfeeding is called perinatal transmission of HIV. 

  • Perinatal transmission of HIV is when HIV is passed from a woman with HIV to her child during pregnancy, childbirth (also called labor and delivery), or breastfeeding (through breast milk). Perinatal transmission of HIV is also called mother-to-child transmission of HIV.

  • Women should get tested for HIV before they become pregnant or as early as possible during each pregnancy. The earlier HIV is detected, the sooner HIV medicines can be started.

  • The use of HIV medicines and other strategies have helped lower the rate of perinatal transmission of HIV to 1% or less in the United States and Europe. (HIV medicines are called antiretrovirals.)

  • Pregnant women with HIV should take HIV medicines throughout pregnancy and childbirth to prevent perinatal transmission of HIV. A scheduled caesarean delivery (sometimes called a C-section) can reduce the risk of perinatal transmission of HIV in women who have a high viral load (more than 1,000 copies/mL) or an unknown viral load near the time of delivery.

  • After birth, babies born to women with HIV should receive HIV medicines to reduce the risk of perinatal transmission of HIV. Several factors determine what HIV medicines babies receive and how long they receive the medicines.

  • Despite ongoing maternal use of HIV medicines after childbirth, a woman with HIV can still pass HIV to her baby while breastfeeding. In the United States and Canada, infant formula is a safe and readily available alternative to breast milk. For these reasons, women with HIV who live in the United States should not breastfeed their babies.

You cannot get HIV by shaking hands or hugging a person who has HIV. You also cannot get HIV from contact with objects, such as dishes, toilet seats, or doorknobs, used by a person with HIV. HIV is not spread through the air or water or by mosquitoes, ticks, or other blood-sucking insects. 

How do I know if I have HIV?

  • The only way to know for sure whether you have HIV is to get tested. 

  • A drop in CD4 count to less than 200 cells/mm3. A CD4 count measures the number of CD4 cells in a sample of blood. 

    • A CD4 count is a blood test to check the amount of CD4 cells in the body. CD4 cells are a type of white blood cell. They play a key role in the immune system. They alert other immune cells to the presence of infections such as bacteria and other viruses in the body. CD4 cells are also a subset of immune cells called T cells.

    • When a person is living with HIV, the virus attacks the CD4 cells in their blood. This process damages CD4 cells and causes a drop in the number of them in the body, making it difficult to fight infections. Monitoring CD4 cells is important for people who are receiving treatment for HIV.

    • An HIV viral load test measures the number of HIV particles in a milliliter (mL) of blood. These particles are also known as “copies.” The test assesses the progression of HIV in the body. It’s also useful in seeing how well a person’s HIV therapy is managing the virus in their body.

    • A person may have a high viral load soon after contracting HIV or if treatment is not proving effective. When a person first contracts the virus, levels will rise significantly, but in the next 3 to 8 weeks, the body starts to produce antibodies. This can reduce the virus levels. A viral load can include over a million copies per mL of blood, especially after recent exposure.

    • Effective treatment will result in viral suppression. This is when there are fewer than 200  copies/mL. At this stage, the risk of HIV progressing is low, but the virus is still present A person can still pass on the virus.

    • As treatment progresses, the viral load can become so low that it is undetectable in a test. An undetectable viral load will be under 40 to 75 copies in a blood sample. This means there are relatively few copies of HIV in the blood.

  • Knowing your HIV status helps you make healthy decisions to prevent getting or transmitting HIV as well as accessing immediate treatment.

Are there symptoms?

Some people have flu-like symptoms within 2 to 4 weeks after infection (called acute HIV infection). These symptoms may last for a few days or several weeks. Possible symptoms include:

  • Fever

  • Chills

  • Rash

  • Night sweats

  • Muscle aches

  • Sore throat

  • Fatigue

  • Swollen lymph nodes

  • Mouth ulcers


But some people may not feel sick during acute HIV infection. These symptoms don’t mean you have HIV. Other illnesses can cause these same symptoms.

See a health care provider if you have these symptoms and think you may have been exposed to HIV. Getting tested for HIV is the only way to know for sure.


What are the stages of HIV?


When people with HIV don’t get treatment, they typically progress through three stages. But HIV medicine can slow or prevent the progression of the disease. With the advancements in treatment, progression to Stage 3 is less common today than in the early days of HIV.


Stage 1: Acute HIV Infection

  • People have a large amount of HIV in their blood. They are very contagious and can easily transfer the virus.

  • Some people have flu-like symptoms. This is the body’s natural response to infection.

  • But some people may not feel sick right away or at all.

  • If you have flu-like symptoms and think you may have been exposed to HIV, seek medical care and ask for a test to diagnose acute infection.

Stage 2: Chronic HIV Infection

  • This stage is also called asymptomatic HIV infection or clinical latency.

  • HIV is still active but reproduces at very low levels.

  • People may not have any symptoms or get sick during this phase.

  • Without taking HIV medicine, this period may last a decade or longer, but some may progress faster.

  • People can transmit HIV in this phase.

  • At the end of this phase, the amount of HIV in the blood (called viral load) goes up and the CD4 cell count goes down. The person may have symptoms as the virus levels increase in the body, and the person moves into Stage 3.

  • People who take HIV medicine as prescribed may never move into Stage 3.


Stage 3: Acquired Immunodeficiency Syndrome (AIDS)

  • The most severe phase of HIV infection.

  • People with AIDS have such badly damaged immune systems that they get an increasing number of severe illnesses, called opportunistic infections.

  • People receive an AIDS diagnosis when their CD4 cell count drops below 200 cells/mm, or if they develop certain opportunistic infections.

  • People with AIDS can have a high viral load and be very infectious.

  • Without treatment, people with AIDS typically survive about three years.

What is the treatment for HIV?


  • Antiretroviral therapy (ART) is the use of HIV medicines to treat HIV infection. 

  • People on ART take a combination of HIV medicines (called an HIV treatment regimen) every day.

  • ART is recommended for everyone who has HIV. 

  • ART prevents HIV from multiplying, which reduces the amount of HIV in the body (called the viral load).


  • Having less HIV in the body protects the immune system and prevents HIV infection from advancing to AIDS. 

  • ART cannot cure HIV, but HIV medicines help people with HIV live longer, healthier lives.

  • ART also reduces the risk of HIV transmission. 

  • A main goal of ART is to reduce a person’s viral load to an undetectable level. 

  • An undetectable viral load means that the level of HIV in the blood is too low to be detected by a viral load test. 

  • People with HIV who maintain an undetectable viral load have effectively no risk of transmitting HIV to their HIV-negative partner through sex.


What is U=U?


  • U=U means “undetectable equals untransmittable.” 

  • More specifically, it means that people living with HIV who have an undetectable level of virus in their blood due to treatment are unable to transmit the virus to others. 

  • The U=U campaign hopes to spread awareness that medications for HIV are extremely effective and fight the stigma affecting HIV-positive folk.

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