Myths and Truths About HIV and AIDS

HIV and AIDS are sexually transmitted infections (STIs) that affect an estimated 1.2 million people in the United States, according to HIV.gov. About 13 percent of them don’t know it and need testing.

Human immunodeficiency virus (HIV) is a virus that weakens the immune system and targets CD4 cells, a type of white blood cell that’s crucial for your body to fight infections. Acquired immunodeficiency syndrome (AIDS) is the most advanced stage of HIV.

It’s a common misconception that HIV and AIDS can immediately lead to death. Fortunately, if you have HIV, there are treatments to prevent you from developing AIDS and help you live a close to normal life.

Eric Rosenberg, MD, a Mass General Brigham infectious diseases doctor who cares for patients at Massachusetts General Hospital, addresses myths and truths about HIV and AIDS. 

Myth: HIV and AIDS are pretty much the same thing.

HIV and AIDS aren’t the same. Being HIV infected just means that the human immunodeficiency virus is living in your body. However, having AIDS is what happens to someone after years of having HIV inside their body. 

Myth: If you have HIV, it's only a matter of time before you have AIDS.

There are now over 30 drugs that can effectively treat HIV infection. These medications prevent the virus from replicating or reproducing. 

The right treatment can stop and even reverse HIV progression. Though it may take years for HIV to develop into AIDS, it’s crucial for someone infected with HIV to start treatment early to make sure the virus in their blood does not increase. 

“Medicines will stop the virus from replicating and therefore will lower the viral load in the blood,” says Dr. Rosenberg. “The development of AIDS is like a train speeding down the track toward a cliff. When you take medication, it’s analogous to stepping on the brakes of the train and stopping it from speeding down the track. It will actually start to reverse the process and pull the train back from the cliff.” 

Some myth, some truth: There are no symptoms of HIV until I have AIDS.

“This is a tricky question because many people are unaware of early symptoms of HIV until they develop AIDS,” says Dr. Rosenberg. “However, many people have flu-like symptoms, several weeks after being infected with HIV. This flu-like illness, also called the acute retroviral syndrome, can make you feel sick for a few days or weeks and then goes away.”

Most people with the acute retroviral syndrome are unaware that they are HIV infected, and because they get better over time, often don't seek medical attention. However, if you become sick and had a possible recent exposure to someone with HIV, you should reach out to your doctor as soon as possible.

Fact: HIV lasts forever, but AIDS does not

While infection with HIV is forever because the virus will always be within your body, the development of AIDS is not. AIDS can be prevented with effective treatment, particularly with early prevention medication.

Most infections occur when the CD4 T lymphocyte count, the white blood cells that are important to your immune system, falls below 200. “That level is when we consider people as having AIDS,” says Dr. Rosenberg. “However, with effective therapy, we can build CD4 cells back up, almost to near normal levels. So once the CD4 lymphocyte count goes above 200, that person is not considered to have AIDS anymore, even though they're still HIV infected.”

Myth: You need to take lots of pills every day if you have HIV or AIDS.

This used to be true many years ago, but now therapy is easier for patients. Many patients may only have to take as little as one pill once a day, and there's even a once per month injection that also works well. 

“So long gone are the days in which HIV infected patients have to take lots and lots of pills,” says Dr. Rosenberg. 

Some myth, some truth: Is it true that if I get treatment, I'll have lots of side effects from HIV medication? 

While there are common side effects from HIV medications, they are manageable. Some people initially get side effects like headache or gastrointestinal upset, but these side effects tend to be short-lived and will likely get better after several days or weeks of treatment.

However, some people do get intolerable side effects. If that's the case, medications may need to be switched around until your doctor finds the best treatment plan for you.

Fact: People with AIDS can have a close to normal life expectancy.

“The key to having a long and healthy life while living with HIV/AIDS is to seek out medical care and take HIV medications,” says Dr. Rosenberg.

While medication will not cure HIV, these medicines are so effective that they can restore your immune system to near normal levels. Therefore, you should live a near normal life. 

How to prevent HIV and AIDs

There are many options available to prevent HIV, or to prevent spreading HIV to others if you already have HIV. 

To prevent the spread of HIV and AIDS:

• Use condoms during sex to also prevent other STIs like herpes or syphilis.
• Don’t share needles or syringes with anyone. Sharing needles also can spread hepatitis C.
• Use pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), which are medications used to prevent HIV infection before or after an exposure.

When should you call your doctor about HIV and AIDS?

You should contact your health care provider if you:

• Had sex with someone who has HIV
• Are a sexually active gay or bisexual man, or assigned male at birth. In which case you should get tested every 3 to 6 months.
• Had sex with someone and don’t know their sexual history
• Develop symptoms related to HIV or AIDS

If you think you may have been exposed to HIV, call your PCP as soon as possible to request an HIV test.