What is AIDS, How is HIV Transmitted, and What Are the Symptoms?

AIDS (Acquired Immunodeficiency Syndrome) is the most advanced stage of HIV (Human Immunodeficiency Virus) infection, which can be life-threatening if left untreated. By targeting the body's immune system—the very defense mechanism that fights off infections—HIV leaves a person vulnerable to diseases that are normally harmless. Thanks to early diagnosis and modern medical treatments, HIV-positive individuals can now keep the virus under control and lead long, healthy lives. In fact, with regular treatment, the transmissibility of the virus can be completely eliminated.

In Brief:

• HIV is the virus that attacks the immune system; AIDS is the final and most severe stage of this infection.
• The virus is primarily transmitted through unprotected sexual intercourse, blood contact, and from mother to child.
• HIV is not transmitted through casual everyday contact, hugging, sharing meals, or mosquito bites.
• With early diagnosis and regular antiretroviral therapy (ART), the disease can be completely controlled.
• Individuals whose viral load is suppressed to undetectable levels in their blood cannot transmit the virus to others (the U=U rule).

What is AIDS and What is the Difference Between HIV and AIDS?

Often used interchangeably in society, HIV and AIDS actually refer to different stages of the same process. The difference between HIV and AIDS essentially comes down to the distinction between the virus itself and the clinical picture it creates. When HIV (Human Immunodeficiency Virus) enters the body, it directly attaches to CD4 T lymphocyte cells—the orchestra conductors of the immune system—and multiplies by destroying them. The AIDS stage does not occur immediately upon the virus entering the body; a person can live as HIV-positive for years without showing any symptoms.

AIDS (Acquired Immunodeficiency Syndrome), on the other hand, is the final stage reached when an HIV infection is left untreated. While a healthy individual has between 500 and 1500 CD4 cells per cubic millimeter of blood, a drop below 200 indicates that the person has progressed to the AIDS stage. At this point, the immune system becomes so severely weakened that the body can no longer fight off even the simplest infections. Opportunistic infections and certain types of cancers emerge during this phase. However, thanks to treatments started early and maintained for life, the vast majority of HIV-positive individuals never progress to the AIDS stage.

How is HIV/AIDS Transmitted?

To stop the spread of the disease, it is essential to clearly understand the answer to the question of how HIV is transmitted. HIV is a highly fragile virus that cannot survive for long outside the body. For transmission to occur, specific virus-carrying bodily fluids must come into direct contact with a healthy person's bloodstream or mucous membranes (such as the vagina, rectum, or inside of the mouth). The most common route of transmission is unprotected (condomless) vaginal, anal, or oral sex. The virus is transmitted through the infected person's blood, semen, pre-seminal fluid, vaginal fluids, or rectal fluids.

Another significant route of transmission is contact with blood and blood products. Sharing needles, unsterilized tattoo or piercing equipment, and contaminated medical devices carry serious risks. Additionally, the virus can be passed from an infected mother to her baby during pregnancy, childbirth, or breastfeeding. However, with medications started during pregnancy and preventive measures taken for the baby, this risk can be reduced to less than one percent.

Contrary to common societal fears, HIV is not transmitted through saliva, sweat, tears, urine, or feces. Being in the same room, shaking hands, hugging, sharing toilets or swimming pools, coughing, sneezing, or insect bites do not cause the virus to spread. Knowing these facts is a critical step in preventing the social stigmatization of patients.

What Are the Symptoms of HIV?

Once the virus enters the body, the disease progresses through certain stages, and HIV symptoms vary according to these phases. The first stage, the acute period, begins 2 to 4 weeks after contracting the virus. During this time, the majority of patients experience flu-like complaints. High fever, severe headache, sore throat, muscle and joint pain, rashes on the torso, and swollen lymph nodes are the most common findings. These symptoms usually resolve on their own within a few weeks. Because the symptoms can easily be confused with a common viral infection, a definitive diagnosis can only be made through testing. Just as with diseases like the flu (influenza), the body's initial reactions can be misleading.

After the acute period passes, the clinical latent period (asymptomatic stage) begins. During this phase, the virus continues to multiply in the body at a very slow rate, but the person feels completely healthy. In individuals who do not receive medical treatment, this silent period can last up to 10 years. However, without treatment, the virus continues to deplete immune cells.

In the final stage, AIDS, the immune system collapses completely. This period is characterized by rapid and unexplained weight loss, diarrhea lasting for weeks, night sweats, persistent white spots in the mouth and on the tongue (thrush), chronic fatigue, memory loss, and neurological issues. When immunity is weakened, much like how some viral infections can trigger dormant cells, the body becomes vulnerable to severe forms of pneumonia, tuberculosis, and rare cancers.

How to Prevent HIV? (PrEP and PEP)

Modern medicine has taken revolutionary steps regarding HIV prevention methods. The most fundamental and accessible way to protect oneself is the correct and consistent use of condoms during all types of sexual intercourse. Condoms provide high protection not only against HIV but also against other sexually transmitted infections. However, current medical approaches have gone beyond condoms to introduce pharmacological prevention methods.

Pre-Exposure Prophylaxis (PrEP) is a regular medication regimen used by HIV-negative individuals who are at high risk to prevent contracting the virus. When used correctly and consistently, PrEP reduces the risk of getting HIV from sex by about ninety-nine percent. This method acts as a powerful shield, especially for those with multiple partners or individuals whose partner's HIV status is unknown.

Post-Exposure Prophylaxis (PEP), on the other hand, is an emergency preventive treatment administered immediately after a suspected exposure (such as unprotected sex, a broken condom, or a needle stick). It is vital to start PEP treatment within the first 72 hours (ideally within the first 24 hours) after the risky contact. The treatment lasts for 28 days and aims to prevent the virus from taking hold and multiplying in the body. In the event of a suspected exposure, one should seek medical attention without delay and request PEP treatment.

How is HIV/AIDS Diagnosed?

Many people rush to a hospital to get tested immediately after a suspected exposure, but the answer to when to take an AIDS test depends on the type of test and a timeframe known as the window period. The virus will not yield a positive test result immediately after entering the body. A certain amount of time must pass for the body to produce antibodies against the virus or for the virus's genetic material to reach a detectable level.

If a test needs to be done within the first few weeks following a suspected exposure, an HIV RNA PCR (Nucleic Acid Test) is preferred. This test looks directly for the genetic material of the virus and can provide reliable results approximately 10 to 33 days after exposure. However, due to its high cost, it is generally not the first choice for routine screenings.

The most commonly used method is the fourth-generation Antigen/Antibody (ELISA) test. These tests simultaneously look for both the p24 antigen of the virus and the antibodies produced by the body. They offer a high degree of accuracy when performed 18 to 45 days after a risky exposure. If an ELISA test returns a positive result, it does not mean the person is definitively HIV-positive; a confirmatory test called the Western Blot must be performed to finalize the diagnosis. If the confirmatory test is also positive, the patient is officially diagnosed, and the treatment process is planned.

HIV/AIDS Treatment and U=U (Undetectable = Untransmittable)

Today, there is no definitive cure that will completely eradicate the HIV virus from the body; however, thanks to Antiretroviral Therapy (ART), the disease has transformed into a chronic, manageable health condition. ART consists of combinations of medications that stop the virus from multiplying in the body. When a patient takes their medication regularly every day, the amount of virus in their blood (viral load) drops to levels so low that they cannot be measured in tests within a few months.

This is where one of the most important discoveries in the medical world comes into play: the Undetectable = Untransmittable (U=U) rule. If an HIV-positive individual takes their treatment regularly and their viral load remains at an undetectable level for at least 6 months, the probability of them transmitting the virus to an HIV-negative partner through sexual intercourse is zero. This scientific fact lifts the psychological burden off patients, allowing them to lead healthy sexual lives and have children naturally.

That being said, the HIV infection itself and some ART medications can affect the body's metabolic balance. Patients may experience insulin resistance, high cholesterol, osteoporosis, and changes in body fat distribution (lipodystrophy). Therefore, patients should be monitored not only by infectious disease specialists but also by endocrinologists. Early detection of metabolic issues is a critical step in preserving the patient's quality of life.

When to See a Doctor?

If you have experienced a suspected sexual encounter or an incident that carries the risk of bloodborne transmission, you should consult a physician as soon as possible without waiting for any symptoms. Seeking help within the first 72 hours is especially valuable so that you can receive preventive PEP treatment. Aside from this, you should request a medical evaluation without delay if you experience one or more of the following symptoms:

• Unexplained high fever lasting for weeks.
• Excessive and rapid weight loss occurring without diet or exercise.
• Long-lasting swelling in the lymph nodes of the neck, armpits, or groin.
• Severe diarrhea lasting more than a month that does not respond to treatment.
• Painful white lesions in the mouth, on the tongue, or in the throat (thrush).

If emergency situations develop, such as severe difficulty breathing, intense chest pain, sudden confusion, seizures, unilateral paralysis, or a feeling of fainting due to excessive fluid loss, you should immediately call the 112 Emergency Call Center or go to the nearest emergency room.

The Process at BHT CLINIC İstanbul Tema Hospital

At BHT CLINIC İstanbul Tema Hospital, the diagnosis, treatment, and follow-up of HIV/AIDS are carried out with the utmost respect for patient privacy. For our patients presenting after a suspected exposure, all necessary modern laboratory tests (PCR, Antigen/Antibody ELISA) are performed rapidly and reliably in accordance with international standards. The antiretroviral therapy (ART) processes for our newly diagnosed patients are meticulously planned by our infectious disease specialists.

Furthermore, for conditions such as insulin resistance, diabetes, lipid metabolism disorders, and thyroid problems that may be caused by the HIV infection or the medications used, our Endocrinology and Metabolism department steps in. Thanks to our multidisciplinary approach, both the viral load of our patients is suppressed and their overall metabolic health is safeguarded. Our hospital is always by your side with its fully equipped emergency room, providing 24/7 service against unexpected health issues in Küçükçekmece, Istanbul. Do not delay getting tested to secure your own health and the health of your loved ones.

To schedule your regular check-ups and consult with our expert physicians, you can visit our appointment page: Book an Appointment at BHT CLINIC.

Frequently Asked Questions

Do I need to fast for an HIV test?

No, whether you are fasting or full does not affect the results for HIV tests (ELISA, PCR, or p24 antigen tests). You can have these tests done by giving blood at any time of the day. However, for the test to provide an accurate result, you must wait for the required window period to pass after the suspected exposure.

Can an HIV-positive person get married or have children?

Yes, HIV-positive individuals can get married and have healthy children. A person who receives regular treatment (ART) and has an undetectable viral load will not transmit the virus to their spouse (the U=U rule). Additionally, with medical precautions taken during pregnancy, the risk of transmitting the virus to the baby is reduced to almost zero.

Is HIV transmitted through saliva or kissing?

Although the HIV virus can be found in saliva, the amount is not sufficient to cause an infection. Therefore, HIV is not transmitted simply by kissing, sharing the same glass, or through saliva contact. For there to be a risk of transmission, there must be severe bleeding wounds inside the mouth, and this blood must come into direct contact.

Can AIDS be completely cured?

With current medical capabilities, there is no treatment that will completely eradicate the HIV virus from the body (provide a cure). However, thanks to modern medications, the multiplication of the virus is stopped, and the immune system is protected. Patients who take their medication regularly live normal, healthy lives without progressing to the AIDS stage.

What should I do immediately after a suspected exposure?

If you have experienced a risky situation such as unprotected sex or blood contact, you should visit a healthcare facility within the first 72 hours (preferably within the first 24 hours). Following a physician's evaluation, a 28-day preventive medication regimen called PEP (Post-Exposure Prophylaxis) may be started to prevent the virus from establishing itself in the body.

This article is for informational purposes only; please be sure to consult your physician for diagnosis and treatment.