The human immunodeficiency virus (HIV) weakens the immune system and causes acquired immune deficiency syndrome (AIDS). When the immune system is weakened, various infections and cancers are able to take hold. In Australia, HIV is most commonly spread by sexual intercourse without a condom. A much smaller percentage is spread through sharing needles, syringes and other injecting equipment.
Someone who has HIV may not have AIDS. For most people who have HIV and are not on treatment, the progression to AIDS can be fairly slow. It can take 10–15 years on average from HIV infection to the development of AIDS. AIDS diagnosis may require a number of special laboratory tests to be performed.
Risk factors for HIV infection
Some of the ways HIV is transmitted include:
- most commonly by anal sex followed by vaginal sex without using a condom, with someone who has HIV and is not on effective treatment
- through sharing needles, syringes and other injecting equipment or having a needle-stick injury
- blood transfusions and treatment with other blood products – if performed in Australia between 1980 and May 1985, or in countries where there are higher rates of HIV
- by anal or vaginal sex without a condom with male or female sex workers in countries with a high rate of HIV infection or who do not work in licensed brothels
- by oral sex without a condom (male and female) – this activity has an extremely low transmission rate and infection is unlikely. Factors that may increase the risk include, high viral load, ejaculation and the presence of gum disease
- from a mother who has HIV to a child – during pregnancy, birth or when breastfeeding.
Low or no risk of HIV infection
There is no evidence to suggest that HIV is spread by ordinary social or family contact such as hugging, kissing, shaking hands, sharing household items such as cups and cutlery or through toilets seats, swimming pools or pets. HIV doesn't live long outside the body. It can be killed by ordinary household bleach, or soap and warm water.
You have a risk of being infected with HIV even if you participate in a high-risk activity only once. The more people you have condomless sex with, or the more times you participate in activities where HIV transmission is possible, the greater your chance of becoming infected.
Practising safer sex reduces the risk of transmission and is recommended if either partner has HIV or if either partner is unsure whether they have HIV. Safer sex means sex where semen, vaginal secretions or blood are not exchanged between sexual partners. Using condoms and water-based lubricants during vaginal or anal sex greatly reduces the risk of infection.
A growing body of evidence is showing that a person with HIV who is on effective treatment has a much lower or minimal chance of passing on HIV. Other studies show that being on Pre Exposure Prophylaxis (PrEP) can prevent people without HIV from becoming infected.
Blood transfusions now have an extremely low risk of causing HIV infection because since May 1985, all blood donations in Australia have been tested for HIV.
It is impossible to get HIV when donating blood in Australia, because equipment such as needles, packs, swabs and finger-pricking lancets are never re-used.
Symptoms of HIV
Many symptoms of HIV are the same as those experienced in a number of other illnesses. If you think you have been exposed to HIV, or if you have any of the signs below (or a combination of them) for a month or longer, you should consult your doctor.
Symptoms can include:
- flu-like symptoms
- extreme and constant tiredness
- fevers, chills and night sweats
- rapid weight loss for no known reason
- swollen lymph glands in the neck, underarm or groin area
- white spots or unusual marks in the mouth
- skin marks or bumps, either raised or flat, usually painless and purplish
- continuous coughing or a dry cough
- decreased appetite.
Diagnosis of HIV
You should get tested for HIV if you are at risk of becoming infected with the virus. Early detection and treatment helps a person with HIV to stay healthy, delays the onset of complications such as AIDS and reduces the spread of infection in the community.
Blood tests for HIV
A blood test can detect HIV antibodies and tell if you are infected with the virus. If a person has HIV, their body will produce antibodies to the virus. There is a short period of time (six to 12 weeks) when the antibodies against HIV can't be detected in the blood. This is often referred to as the 'window period'.
If your blood test shows that antibodies are present, you are infected with HIV (also known as being 'HIV-positive'). If you have no antibodies in your blood (HIV-negative), it is possible you are not infected with HIV. But a negative result might also mean you have been infected in the last six to 12 weeks (in the 'window period') and you might need a follow-up blood test to make sure.
Diagnostic testing for HIV is available on the Medicare Benefits Schedule, which means your doctor can order the test free of charge for you.
In 2013, a new rapid blood test was approved for use in Victoria. The new test gives you a preliminary result at your clinic within 20 to 30 minutes. Results must be confirmed with further laboratory tests. Ask your doctor if it is on the Medicare Benefits Schedule.
Counselling for HIV tests
A positive result can lead to feelings of shock, anger, distress, followed by anxiety and ultimately depression. It is a legal requirement for services that offer testing to also offer counselling both before and after testing.
Before you are tested, talk with your doctor, counsellor or nurse about your level of risk, the likelihood that the test may be positive and about what a positive test may mean for you.
Post-test counselling is also important, regardless of the outcome. If the test is positive, counselling can provide emotional support, further information about the condition and referrals to support services. If the test is negative, counselling can provide education about HIV and how you can avoid getting HIV in the future.
HIV testing and your rights
Testing should be voluntary and only carried out with informed consent, except in exceptional circumstances. Information should be provided about what is involved in the test, and information and discussion should take place about what it means to get tested. All people who request an HIV test must receive pre-test and post-test counselling.
Under Victorian law, it is unlawful to discriminate against anyone who has HIV. Test results, as well as the fact that you have been tested at all, are kept strictly confidential. It is illegal for any information about a person being tested or a person with HIV being disclosed without their strict permission.
Let your partners know if you have HIV
If you have just been given a diagnosis of HIV infection, this may be a difficult time for you and you might still be struggling to come to terms with this diagnosis. However, it is important to let your partner(s) know as soon as possible that they have been at risk of HIV infection. Your health professional or Partner Notification Officers can help you through this process and ensure your identity is not revealed.
The Letting your partner know booklet contains more information for people newly diagnosed with HIV.
Treatment of HIV
Medications for HIV offer many people the chance to control the virus and stay healthy for much longer. Treatment options have had a huge impact on the lives of people with HIV and those who care for them. They can reduce AIDS-related illnesses, admissions to hospital and death rates. Treatment has also enabled some people with HIV to go back to or continue working and plan for the future. Treatment has also been shown to greatly reduce the risk of transmission.
While treatments have advanced greatly, medications for HIV do not work equally as well for everyone and they can have side effects.
Types of HIV treatment
There are five main groups of medications used to treat HIV. These medications target different stages of the lifecycle of the virus and are known as antiretroviral medications.
Usually, three different medications from at least two groups are combined into one tablet and taken once or twice a day.
Over time, and if the treatments are not taken properly, the virus can become resistant to a medication, which means that it will not work as well. The treatment may then have to be changed to a different combination of medications.
People taking medication for HIV will probably need to take it for the rest of their lives. Stopping your treatment, even for short periods of time, can cause the virus to become resistant to medication. It is not recommended that anyone interrupt treatment without medical advice.
New medications for HIV
New medications and types of medications are being developed all the time. Trials of these treatments are being conducted in specialist HIV and AIDS treatment and research centres.
Side effects of HIV treatment
Some of the most common side effects of HIV treatment are:
- nausea (feeling sick)
- difficulty sleeping
- peripheral neuropathy (problems with the nerves in the legs, such as pain)
- skin rashes.
People taking HIV treatment have to go to their doctor at least every three to six months. They need to have regular blood tests to make sure that the treatment is working and that it is not having serious side effects.
Complementary and alternative medicine for HIV
Some people with HIV use other types of therapy, either alone or with their medications. It is important to tell your HIV specialist doctor if you are seeking out alternative therapies, as some medications and treatments may have unwanted side effects or might not be able to be used in certain situations.
Some of the most popular complementary therapies are:
- vitamin and mineral supplements
- herbal remedies
- traditional Chinese medicine
Where to get help
- Your doctor
- Your community health clinic
- BBV/STI Resource Centre Bendigo Tel. (03) 5430 0500
- CBD Action Centre (Family Planning Victoria, for people under 25) Tel. (03) 9660 4700 or 1800 013 952
- Family Planning Victoria Tel. (03) 9257 0100 or 1800 013 952
- Gateway Health Sexual Health Clinic Wangaratta Tel. (03) 5723 2000
- Gateway Health Sexual Health Clinic Wodonga Tel. (02) 6022 8888 or 1800 657 573
- Kardinia Health – Reproductive and Sexual Health Clinic Tel. (03) 5202 9333
- Living Positive Victoria Tel. (03) 9863 8733
- Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 (toll free from outside Melbourne only) or National Relay Service (for people who are deaf, hearing impaired, and speech impaired) (03) 9347 8619
- Multicultural Health and Support Service, Centre for Culture, Ethnicity and Health Tel. (03) 9418 9929
- Positive Women Victoria Tel. (03) 9863 8747
- Sexual Health Clinic Ballarat Tel. (03) 5338 4500
- The Centre Clinic, St Kilda Tel. (03) 9525 5866
- Victorian AIDS Council (VAC) Tel. (03) 9865 6700 or 1800 134 840
- Victorian HIV/AIDS Service, Alfred Health Tel. (03) 9076 6076
Things to remember
- In Australia, HIV is most commonly spread by sexual intercourse without a condom. It can also be spread through sharing needles, syringes and other injecting equipment.
- Someone who has HIV may not have any symptoms, but they carry the virus and could pass it on through blood or body fluids.
- Early testing for HIV helps people to stay healthy and reduces the spread of infection in the community.
- Medications are available that can postpone and prevent HIV-related illnesses developing.
- HIV treatment can cause side effects and may be less effective for some people.
- Treatment prevents the virus from being passed to other people.
- It is illegal to discriminate against people with HIV as well as disclose any information about them without their strict permission.
This page has been produced in consultation with and approved by:
Department of Health and Human Services - RHP&R - Health Protection - Communicable Disease Prevention and Control Unit
Page content currently being reviewed.
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