April 16, 2021

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The Meaning of a Positive HIV Test

Being HIV-positive means someone has signs of the human immunodeficiency virus (HIV) in their bodies, usually discovered through an HIV test. There are approximately 1.2 million people living with HIV in the United States today, and 14% of them (one in seven) don’t know it and need testing.

An initial HIV-positive test result is preliminary. The person tested positive usually needs a follow-up test to confirm the result. Some individuals who initially tested negative for HIV could be tested positive in the follow-up test because it takes time for the body to produce a detectable amount of antibodies. There is currently no cure for HIV, but the infection can be controlled with medical treatment.

HIV is a virus that attacks cells in the immune system, killing them and leaving the body defenseless against infection. It is transmitted through contact with infected blood, semen, or vaginal fluids.

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HIV Positive Meaning

If someone tests positive for HIV, it’s considered a preliminary positive result. A second confirmation test is needed to confirm an initial HIV-positive diagnosis.

The only way to know if someone has HIV is through testing. An HIV-positive diagnosis is made after HIV antibodies and/or antigens are detected in the body. Once HIV enters the body, the immune system produces antibodies (proteins that help fight off infection) in response to the virus. An HIV antigen called p24 is produced even before antibodies develop. The presence of antibodies or antigens in a blood, saliva, or urine sample detected through an HIV test indicates that HIV has entered the bloodstream and that someone is HIV-positive.

The CDC primarily recommends antibody and antigen combination tests since they can check for HIV antibodies as well as the p24 protein. Everyone between the ages of 13 to 64 should get tested for HIV at least once.

Stages of HIV

Stage 1: Acute HIV Infection

There are three stages of HIV. In stage 1 of the HIV infection, acute HIV infection, the immune system attempts to attack the virus by producing HIV antibodies, a process called seroconversion. It usually takes place within a few weeks of infection. These antibodies will stick around and remain detectable for many years. As a result, someone who is living with HIV will continue to test positive on HIV tests even if their viral load (the amount of HIV in the blood) is undetectable.

Within two to four weeks of being infected, those with HIV may experience:

  • Fever
  • Night sweats
  • Joint pain
  • Headache
  • Sore throat
  • Muscle aches
  • Fatigue
  • Swollen lymph nodes
  • Mouth ulcers

Symptoms may be absent in some people, however. 

Stage 2: Clinical Latency

When the body enters stage 2, clinical latency, where the virus still multiplies but at very low levels, infected individuals begin to feel better with little to no symptoms. HIV can still be transmitted to other people, however, during this stage.

Stage 3: AIDS

If an HIV infection is left untreated, it will progress to stage 3, acquired immunodeficiency syndrome (AIDS), where the body’s immune system is badly damaged and becomes vulnerable to other infections as well. A doctor will diagnose whether someone has AIDS through CD4 cell testing.

At this stage, someone with HIV may experience recurrent fever, extreme fatigue, chronic diarrhea, depression, and memory loss. Other symptoms of stage 3 include: 

HIV Testing

If someone suspects exposure to HIV, they can get tested at a clinic or purchase an at-home test online or from a pharmacy. If they ask for a test at a medical office, they will be offered pre-test and post-test counseling about their positive result and transmission risk reduction. Some seek at-home testing for privacy and rapid results.

The HIV Services Locator, run by the U.S. Department of Health and Human Services, can help someone find an HIV testing site near them.

Besides testing for HIV antibodies and antigens, health care providers will also look at how a person’s immune system is functioning and examine the level of HIV in the body. One measure they look at is the CD4 test counts, which is the number of CD4 immune cells in the blood. CD4 cells are vital to proper functioning of the immune system. Normal CD4 count is between 500 and 1,5000 cells per cubic millimeter. The more CD4 cells a person has, the healthier they are. A low CD4 count, defined as 200 or fewer cells per cubic millimeter, indicates AIDS and a high risk of life-threatening opportunistic infections, infections that occur more frequently and are more severe in people with weakened immune systems like those with HIV.

HIV is spread through sexual contact or sharing drug equipment with someone who is infected with the virus. It can also be transmitted from mother to child through breast milk.

The following can put someone at higher risk of HIV:

  • Unprotected sex
  • Anal sex
  • Sharing drug needles and syringes
  • Another sexually transmitted disease like syphilis, chlamydia, and gonorrhea
  • Unsafe injections for blood transfusions
  • Accidental needle stick injuries (more common among health care workers)

Antiretroviral Therapy

Antiretroviral therapy, or ART, is not a care, but can control HIV by stopping the virus from making copies of itself. Antiretroviral therapy can reduce the viral load of a person with HIV and result in viral suppression, which is when a person has less than 200 copies of HIV per milliliter of blood. This can help protect the immune system, which the virus attacks, and make it less likely for the infected individual to become sick.

There are seven classes of antiretrovirals and within those classes, there are 39 different antiretroviral drugs.

ART can also reduce the risk of HIV transmission by keeping the viral load low and help someone achieve something called an undetectable viral load, which means the amount of HIV in their blood is so low that it can’t be passed on through sex. A study found that serodiscordant couples (where one person is HIV-positive and the other is HIV-negative) who were on ART were 96 percent less likely to infect their partners.

Doctors recommend that patients start ART immediately once an HIV-positive diagnosis is confirmed. Starting treatment early can stop the progression of HIV and keep the infected individual health for many years. People who have undetectable viral loads within a year of therapy are more likely to have a normal life expectancy compared with those who failed to achieve viral suppression.

Other lifestyle changes to consider after an HIV-positive result include: 

  • Staying up-to-date on vaccines
  • Quitting smoking
  • Lowering alcohol intake
  • Taking over-the-counter pain relievers

Having HIV means on-going therapy and regular doctor’s visits to properly monitor the progression of the infection. Diagnosis may bring feelings of distress and anxiety. It’s important to surround have a support system and cope in a healthy way with a new HIV-positive diagnosis.

HIV v. AIDS

HIV and AIDs are often incorrectly described as the same disease. In fact, HIV is a virus, and AIDS is a condition. AIDS is the late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus. Most people with HIV do not develop AIDS because taking HIV medicine as prescribed stops the progression of the disease. HIV is a virus and AIDS is a condition. 

Without HIV medicine, people with AIDS typically survive about three years. Once someone has an opportunistic infection, life expectancy without treatment falls to about one year. HIV medicine can still help people at this stage, but those who start ART soon after they get HIV experience more benefits.

A Word From Verywell

Getting an HIV-positive diagnosis can be overwhelming, but finding out now can help treatment get started and prevent the infection from getting worse. Many people living with HIV manage to keep their infection under control with the latest treatment options.

If you’ve been diagnosed with HIV, locate your HIV care service, your state’s HIV hotline, an HIV health provider, and an HIV specialist. The CDC offers a large list of resources for housing, mental health care, traveling, and combating the stigma surrounding HIV. 

For those feeling alienated or confused, join an HIV support group, stay up-to-date on HIV therapy, and focus on your well-being. An HIV-positive diagnosis isn’t the end of your future. Maintaining a positive mindset and taking proactive steps toward controlling the infection can help you keep living a healthy life.