HIV/AIDS in Teens

Human immunodeficiency virus, or HIV, is a virus that weakens and can ultimately destroy the body's ability to fight infection. Acquired immunodeficiency syndrome, or AIDS, is the most advanced stage of HIV infection when the immune system of the body becomes very weak, and the body has a hard time coping with HIV and other infections.

HIV attacks the immune system, specifically white blood cells called CD4 cells, also known as T-cells. People living with HIV may not look or feel sick for a long time after acquiring the virus. They might not know they are living with HIV. HIV cannot be cured yet, but it can be prevented and treated effectively with as little as one pill a day. If you are living with HIV and are not diagnosed and treated, you are at risk of developing infections and other diseases and certain forms of cancer.

HIV can be passed from person to person, most often through sexual activity or sharing needles. People living with HIV should take medicine to treat HIV as soon as possible. Taking HIV medicine will help people with HIV to have very low (or "undetectable") virus. People cannot pass HIV through sex when they have undetectable levels of HIV. You might have heard people referring to this as "U = U," which means "Undetectable = Untransmittable."

The Difference Between HIV and AIDS

HIV stands for Human Immunodeficiency Virus, the virus that causes Acquired Immunodeficiency Syndrome, also known as AIDS. HIV and AIDS are not the same thing. HIV is a virus that can lead to AIDS, if you don't treat it and/or your body gets too weak to fight the virus.

AIDS frequently presents with weight loss, skin rashes, weakness, mental health problems and serious infections. You can live with HIV and never develop AIDS. In fact, with modern HIV treatment, people on treatment never develop AIDS.

• About 1.2 million people in the United States had HIV at the end of 2018; of those, one in seven did not know that they were infected.
• Someone in the United States is infected with HIV every 9 1/2 minutes.
• There were nearly 38,000 new cases of HIV reported in the United States in 2018; 21% of these new infections were in people 13-24 years old.
• Washington, D.C., has a higher rate of people living with HIV/AIDS than any state in the United States. About 12,300 people were living with HIV in Washington, D.C., as of 2019.

You can have HIV and not know it, since it can be months or even years before you notice any symptoms.

While some people might not have any early symptoms, others get an illness within six weeks of being infected and have flu-like symptoms that can include:

• Fever
• Headache
• Swollen glands
• Feeling very tired
• Aching joints or muscles
• Sore throat
• Rapid weight loss
• Diarrhea
• Night sweats

When HIV becomes AIDS, symptoms can include:

• Fever that lasts longer than one month
• Weight loss
• Feeling extremely tired
• Diarrhea that lasts longer than one month
• Swollen lymph glands
• Not being able to think clearly
• Losing sense of balance
• Skin rashes
• Difficulties swallowing
• Feeling sick

Not all people with HIV get AIDS. If your T-cell numbers drop and the amount of virus in your blood stream rises (this is called your viral load), your immune system can get too weak to fight off infections and you are considered to have AIDS.

If HIV becomes AIDS, you can get sick with diseases that don't usually affect other people, including:

• Kaposi Sarcoma (KS) – a rare type of skin cancer
• Pneumocystis Carinii Pneumonia (PCP) – a type of pneumonia

You can treat these diseases and your T-cells and viral load can get back to healthier levels with the right type of medicine.

• Anyone who has unprotected or under-protected sex and/or shares needles and syringes with an infected person is at risk for getting HIV.
  
  • Unprotected or under-protected sex means having sex without condoms or using a condom, but the condom breaks, slips off, or you don't use it the entire time.
• Many people used to think that only men who have sex with men get HIV, but that is not true. About half of all new infections occur in heterosexual people.

The virus is found in and can be spread through four bodily fluids:

• Semen
• Vaginal fluids
• Blood
• Breast milk

You can get HIV from an infected person by:

• ANY type of sex; vaginal, anal and oral, that is unprotected or under-protected.
• Sharing needles and/or syringes
• Through open sores and irritations from other STIs
• Through the urethra,the tube than urine passes through
• Through small tears in the vagina and/or anus from vaginal or anal sex

HIV can be passed from mother to baby before or during birth or during breastfeeding.

You cannot get it from:

• Touching
• Hugging
• Shaking hands
• Coughing
• Sneezing
• Sharing glasses or dishes
• Toilets
• Doorknobs
• Pets
• Insects
• Donating blood (A new needle is used for each donor)
• Blood transfusions (In the past, people did become infected from blood transfusions, but now donated blood is tested for the virus first.)

• The only 100% effective way to not get HIV is to not have sex.
• If you have sex, use a condom every time you have any type of sex and get tested regularly.
• Ask your partner(s) to get tested before you start having sex.
• Only have sex with a partner who has tested negative for HIV and is not having sex with anyone else.
• Using condoms every time you have sex greatly reduces your risk of getting HIV, but you also need to make sure you are putting the condom on the right way and using it the entire time you have sex. Also, check the expiration date on the package and only use condoms that are not expired.
• Use dental dams during oral sex. A dental dam is like a condom but is used specifically for oral sex.
• Don't share needles or syringes.
• Only use sterile needles, and make sure that anything that pierces your skin has been fully sterilized first. This includes needles and equipment used for getting a tattoo, body piercing or using IV drugs.
• Don't share razors or toothbrushes, since these items could have blood on them that may carry the virus (if the blood is from someone who is infected with HIV).

Use Post-Exposure Prophylaxis (PEP) if you had unprotected sex with a person living with HIV who is not virally suppressed or shared needles for intravenous drugs or tattoos. PEP is HIV medicine started within 72 hours after possible HIV exposure, to reduce the risk of acquiring HIV. 

Use Pre-Exposure Prophylaxis (PrEP) if you are at high risk for acquiring HIV. PrEP is HIV medicine taken once daily by HIV negative persons to reduce the risk of acquiring HIV. 

See our PEP/PrEP page to learn more or contact your child's healthcare team for more information about ways to prevent the spread of HIV. 

• If you think you might have been exposed to HIV or AIDS, make an appointment to get tested as soon as possible.
• Get tested regularly.
• Use a condom EVERY TIME you have vaginal, anal or oral sex.
• Don't share needles, razors, toothbrushes or anything that breaks the skin or could have your blood on it.
• If you test positive for HIV, tell all of your past and current partners or anyone you may have shared needles with about your positive test. It's important to let them know because they could have it too, and need to begin a treatment plan as soon as possible. This can be a scary thing to do, but:
  • Your doctor or the health department can help you notify these people confidentially, without identifying who you are.
  • There are online resources, like inSPOT or National HIV and STD.
  • Testing Resources, which can help you contact these people anonymously or give you tips on how to talk about it, if you choose to speak to them yourself.
  • Remember, untreated HIV can cause dangerous health problems, so anyone who might be infected should get tested and begin a treatment plan.

You cannot get rid of HIV. Once you become infected, you will always have the virus in your body.

There are some medicines that can slow down the progress of HIV in your body for a long time, but you still have the virus and can pass it to other people.

If you test positive for HIV, your doctor will make a special treatment plan for you that may include:

• Taking medicine
• Eating healthy food
• Exercising
• Lowering stress in your life
• Treating substance abuse when indicated
• Getting mental health screening and support
• Offering peer and adherence support

Following the doctor's treatment plan is extremely important. If you are prescribed medicine, you must take it at specific times and not miss doses.

Over time, HIV and AIDS keep your body from being able to fight off diseases. Medicines can slow this process down, but without them, the process happens faster and you can have more serious or life-threatening health problems.

You can lose a dangerous amount of weight, experience mental problems, get cancers and even die.

If you think you have been exposed, are infected, or have symptoms, see a doctor and get tested right away. The earlier you get tested, the sooner you can start medicine to control the virus, if you have been infected. Getting treated early can improve your chance at living a healthy life. It can slow down the infection and may prevent you from getting AIDS.

Testing is available at Children's National Emergency Departments, Adolescent and Young Adult Medicine, Children's Health Center Anacostia and Children's Health Center at THEARC. 

There are a few different ways to test for HIV:

• Blood test
• Collecting some saliva from your cheek on a cotton swab

There are three different types of tests for HIV that are done in a doctor's office:

• Standard blood test, also known as EIA or ELISA tests
  • A sample of blood is taken from your arm
  • You get the results in about two weeks
• Rapid tests
  • Two types:
    • Finger stick – some blood is taken from the tip of you finger
    • Oral – some saliva is taken from your mouth with a cotton swab
  • You get the results in about 20 minutes
• Western Blot test
  • If the Standard blood test or a rapid test comes back positive, a Western blot test is automatically done.
  • If this test comes back positive, you will be diagnosed with HIV

There is another type of test that you can buy at most pharmacies without a prescription – the home access kit. This is also a finger stick test – you prick your finger, place a drop of blood on the card that comes with the kit and send the card to a lab. You can get the results over the phone in one to three days. If this test comes back positive, you should see a doctor to make sure the test is correct.

BE AWARE: HIV doesn't show up in test results right away. It can take up to three months or longer for a test to come back positive after someone is infected. Your doctor may recommend that you retake the test in three months, to be sure you are not infected.

Many doctor's offices, hospitals and clinics offer HIV testing at a low cost or for free. Find a place to get tested from our list of testing locations.

The American Academy of Pediatrics recommends that all teenagers should have at least one HIV test by the time they are 16 to 18 years old.

If you are sexually active, get tested at least ONCE A YEAR. You should get tested more often if you change sex partners or have shared needles with someone. Talk to a doctor to figure out how often you should get tested.

If you think you may have been exposed to HIV or have shared needles or another object that pierces the skin with someone else, talk to a doctor about when you should get tested.