HIV & AIDS

HIV (Human Immunodeficiency Virus) attacks the CD4+ T-cells that coordinate the immune system. Without treatment, sustained damage to the immune system leads to AIDS (Acquired Immunodeficiency Syndrome) — a state of severe immune suppression that leaves the body vulnerable to opportunistic infections.

HIV is not a death sentence. With modern antiretroviral therapy (ART), people living with HIV can expect a near-normal life expectancy. When viral load is reduced to undetectable levels, HIV cannot be transmitted sexually — a principle known as U=U (Undetectable = Untransmittable), endorsed by the WHO and UNAIDS.

Acute HIV infection (2–4 weeks after exposure) — sometimes called 'seroconversion illness' — often produces flu-like symptoms that are easily mistaken for a common viral illness:

• Fever (very common)
• Swollen lymph nodes in the neck, armpits, or groin
• Sore throat
• Skin rash — flat or slightly raised red patches, often on the trunk
• Fatigue and muscle aches
• Headache
• Ulcers in the mouth or on the genitals

These symptoms usually resolve within two to four weeks. HIV then enters a chronic phase that can last 10+ years with few or no symptoms. Late-stage HIV or AIDS produces more serious symptoms: unexplained weight loss, chronic diarrhoea, night sweats, persistent fever, recurring respiratory infections, and neurological effects.

• Unprotected anal or vaginal sex (anal sex carries the highest risk for the receptive partner)
• Sharing needles, syringes, or other injection equipment
• Mother-to-child transmission during pregnancy, childbirth, or breastfeeding
• Blood transfusions (rare in India due to mandatory blood screening since 1989)

HIV is NOT transmitted through: casual contact, hugging, kissing (with no mouth sores), sharing food or utensils, mosquitoes or other insects, air, water, or toilet seats.

• 4th-generation antigen/antibody combined test — detects both p24 antigen and HIV antibodies. Window period: 18–45 days. The standard in most clinics and ICTC centres.
• Rapid antibody test — results in 20–30 minutes. Window period: 3–12 weeks.
• NAT/NAAT (Nucleic Acid Test) — detects HIV RNA directly. Window period: 10–33 days. Used after high-risk exposures.
• Self-test kits are now available over the counter in India — collect a blood drop or oral fluid sample at home.

Free HIV testing and counselling is available at ICTC (Integrated Counselling and Testing Centres) in every district across India, operated by NACO under the National AIDS Control Programme. All testing is confidential.

Antiretroviral therapy (ART) — a combination of HIV medicines taken daily — suppresses the virus to undetectable levels in the blood. ART does not cure HIV but controls it so effectively that people on treatment live long, healthy lives and cannot transmit the virus sexually.

• ART is available free of charge at government ART centres under NACP across India.
• PrEP (Pre-Exposure Prophylaxis) — a daily pill that prevents HIV in HIV-negative people with ongoing high-risk exposure. Available in India through selected clinics.
• PEP (Post-Exposure Prophylaxis) — a 28-day ART course started within 72 hours of a potential exposure. Contact a healthcare provider immediately if you think you've been exposed.

• Every 3–6 months if you are sexually active with multiple partners
• Immediately after unprotected sex with a partner of unknown status
• Before starting a new relationship (both partners)
• During pregnancy — all pregnant women in India are recommended HIV testing as part of antenatal care
• If you share injection equipment
• If you have a diagnosed STI (STIs increase HIV risk)