Diagnosis
The human immunodeficiency virus (HIV) can be found in the body with blood tests or tests on fluid from your mouth. Blood may be collected from a vein or from a finger stick. Testing can be done in a clinic or healthcare professional's office. You also may be able to order an at-home test for HIV.
Screening at least once for HIV is recommended for all people age 13 to 65. Getting tested for HIV more often may be recommended if you have risk factors.
One HIV test looks for genetic material from the virus in the blood. This test measures the amount of virus present, called the viral load. The test will identify an infection around 10 to 33 days after exposure.
Other tests look for a part of the virus called an antigen or for the immune system's response to HIV infection, called an antibody. A test that looks for both antigens and antibodies can identify HIV infection around 18 to 90 days after exposure. A test that looks only for antibodies will identify infection around 23 to 120 days after exposure.
If done too early, these tests may not catch an infection. So a test with a negative result may need to be repeated. If there is a detectable amount of genetic material from HIV in the blood but the antibody or antigen tests are negative, this result suggests an early HIV infection. The test may be repeated to rule out a false positive result.
If your results are positive and you live in the United States, a state health department staff member may contact you.
People diagnosed with HIV may be able to work with a specialist. HIV specialists help you decide on baseline tests and follow-up testing. The specialist also can help guide your treatment, including selecting HIV antiretroviral therapy (ART). In general, the specialist helps you manage your health.
Testing may include:
- CD4 T cell counts. This helps determine the stage of an HIV infection. AIDS is diagnosed if CD4 counts fall below 200 cells in the blood sample.
- Viral load measurements. This also is called HIV RNA. The goal of treatment is to lower viral load to a level that can't be detected.
- Medicine resistance. Some HIV strains are not affected by medicines any longer. Testing to see what strain of HIV is present helps identify the best treatment.
You also may get tests and screening for other infections or complications. These may include:
- Tuberculosis.
- Hepatitis B or hepatitis C virus infection.
- Sexually transmitted infections.
- Liver or kidney damage.
- Cervical and anal cancer.
- Cytomegalovirus.
- Toxoplasmosis.
Treatment
Once you have an HIV infection, your body can't get rid of it. Medicines are used to control HIV and to prevent complications. Medicine to treat HIV is called antiretroviral therapy (ART). It is a mix of two or more medicines that work together to lower the amount of HIV in the blood. This also helps prevent HIV from becoming resistant to the medicine.
Treatment should lower your viral load so that it can't be found in the blood. Regular blood tests are used to check viral load and CD4 T cell counts. Even if HIV cannot be found in the blood, that doesn't mean your HIV is gone. HIV is still in your body, but ART prevents it from making viral particles.
There are many ART options that mix more than one type of HIV medicine into a single pill taken once a day. Different types of HIV medicine include:
- Integrase inhibitors. These medicines stop an enzyme called integrase. That keeps HIV from putting viral genetic material into a cell.
- Nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs). These medicines stop HIV from copying its RNA into DNA. That means that HIV can't make viral copies easily.
- Protease inhibitors. These medicines block an enzyme called protease. That damages HIV's ability to make new virus particles.
ART is a part of treatment for everyone with HIV, no matter your CD4 T cell count or symptoms. For the best results, take ART medicines as prescribed. Don't miss or skip doses.
Talk with your healthcare professional about possible side effects or trouble you may have taking medicines. Treatment side effects depend on the type, also called class, of ART medicine you take.
Possible side effects of some ART medicines can include:
- Nausea, vomiting or diarrhea.
- Heart disease.
- Kidney and liver damage.
- Weakened bones or bone loss.
ART medicines can make cholesterol levels harder to manage. Mental health conditions or substance use issues can make it hard to stay on ART. Talk with a healthcare professional about ways these issues can be managed.
Regular follow-ups let your healthcare team check your response to treatment and respond to any concerns you have about ART. To see how you're responding, viral load of HIV is checked 4 to 6 weeks after starting ART. After that, viral load is checked every three months for at least the first two years of treatment.
Some health issues that are a part of aging may be harder to manage if you have HIV. Some medicines that are common for age-related heart, bone or metabolic conditions, for example, may not mix well with anti-HIV medicines. Talk with your healthcare professional about your other health conditions and the medicines you take for them.
If another health professional prescribes a medicine for another condition, be sure to mention your HIV therapy. Then the health professional can make sure there are no issues with taking the medicines together.
Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and home remedies
Taking antiretroviral therapy medicine on schedule and working with your healthcare team are vital for HIV management. There also are things you can do every day to support your health.
Get all recommended vaccinations. Common vaccines prevent illnesses such as pneumonia, influenza, COVID-19 and mpox. Other vaccines that may be recommended include HPV, hepatitis A and hepatitis B. Some vaccines that use weakened but infectious viruses may only be safe if your CD4 T cell counts are high enough. Other types of vaccines may be offered regardless of your CD4 count.
Avoid foods that are high risk of foodborne illness. People with HIV can become seriously ill from foodborne illness. Thoroughly cook food to a safe temperature. Avoid eating raw eggs, meat or seafood. Wash all raw vegetables and fruit thoroughly. Don't leave food out for too long. Avoid dairy and juices that haven't been heated to kill bacteria, called pasteurized. Don't drink water that isn't treated to remove germs.
Focus on hand hygiene if you have a pet. Caring for a pet can raise your risk of some infections. Wash hands thoroughly after handling pets or emptying litter boxes.
Alternative medicine
Nothing replaces the benefit of antiretroviral therapy for HIV treatment. Also important is the need to avoid risky behavior or habits that aren't healthy, such as smoking.
If you're interested in dietary supplements, talk with your healthcare professional before taking any supplements to make sure they won't affect the way your medicines work.
Supplements that are known to interfere with HIV medicines include St. John's wort and garlic.
Coping and support
People living with HIV can find it overwhelming. Negative reactions are common. These feelings may go away over time. HIV infection can be treated, and people with HIV often live long and healthy lives.
But if you or someone you're caring for is considering suicide, get help now. You can call a local emergency number or a suicide hotline.
- In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, every day. Or use the Lifeline Chat. Services are free and confidential.
- If you're a U.S. veteran or service member in crisis, call 988 and then press 1, or text 838255. Or chat online. The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454.
If it's safe to do so, talk about your diagnosis with people who can support you. Ask for help if you need it, and talk with them about how you're feeling. Also, seeing a therapist can help you manage the feelings this diagnosis can cause.
Joining a support group for people with HIV also may help you connect with other people going through the same diagnosis.
Preparing for your appointment
If you think you might have an HIV infection, you're likely to start by seeing your family healthcare professional. You may see an infectious disease specialist who focuses on treating HIV/AIDS.
What you can do
Before your appointment, think about the answers to these questions and be prepared to talk about them at your appointment:
- How do you think you were exposed to HIV?
- What are your symptoms?
- Do you have risk factors, such as having sex without protection or shooting illicit drugs?
- What medicines or supplements do you take?
What to expect from your doctor
Your healthcare professional asks you questions about your health and lifestyle and does a physical exam, checking you for:
- Swollen lymph nodes.
- Sores on your skin or in your mouth.
- Issues with your nervous system.
- Unusual sounds in your lungs.
- Swollen organs in your belly.
What you can do in the meantime
If you think you might have an HIV infection, protect yourself and others before your appointment. Don't have sex without using protection. If you shoot illicit drugs, always use a fresh, clean needle. Don't share needles with others.