If you are ‘HIV positive’ this means that you have a virus called HIV in your body. It doesn’t mean that you are ill, or that you have AIDS, or that you are dying.

If you have HIV but don’t take treatment, HIV will slowly attack the immune system, which is your body’s ability to fight other infections.

But there are drug treatments for HIV. They can stop HIV reproducing, and so limit the damage to your immune system and keep you in good health. Because of these drugs, most people living with HIV can expect to have a normal life expectancy (see Life goes on).

‘AIDS’ is different from HIV. AIDS can happen if somebody goes a long time without treatment and the immune system becomes very weak. It means that a person with HIV is at risk of developing serious infections and illnesses that a healthy immune system would be able to fight off.

Thanks to drug treatments, few people in the UK now develop AIDS. If they do, they can usually recover from it.

The initials in HIV stand for Human Immunodeficiency Virus. AIDS stands for Acquired Immune Deficiency Syndrome.

From someone’s physical appearance, you can’t tell if they have HIV or not. And you can’t always know how good their health is.

But blood tests can show how HIV is affecting your health. Whether or not you are taking treatment, it’s important to have some tests done regularly.

One important test is called a CD4 count and is a measure of the strength of your immune system. A low CD4 count means that HIV is damaging your immune system. A higher CD4 count shows that your immune system is stronger.

Another test is called viral load. It’s a measure of the amount of HIV in a sample of blood. If you are taking treatment, the viral load test shows how well your treatment is working – the lower it is, the better.

You’ll probably be asked to have these tests done every few months. They will help you and your doctor make decisions about your health and treatment.

HIV weakens the immune system quite slowly, so you won’t necessarily feel unwell. You may have briefly had something a bit like a flu during the first few weeks after infection – this is known as a ‘seroconversion illness’. After that, most people remain in pretty good health for several years.

But you may have had HIV for several years before you were tested. In this case, HIV may already be making you ill.

Whether you’ve had HIV for a long or a short time, you can benefit from HIV treatment. It will protect your health, both now and in the future.

HIV treatment usually involves taking tablets once or twice a day. The drugs stop the virus from reproducing and reduce the amount of HIV inside your body.

• If there is less HIV, there is less damage to your immune system, and you are less likely to get ill.
• And if there is less HIV in your body fluids, you are less likely to pass on HIV (for example to a sexual partner, or during pregnancy).

The aim of HIV treatment is to have an ‘undetectable’ viral load – this means there is only a tiny amount of HIV in the body. But the drugs are not a cure – they cannot totally wipe out HIV from your body.

Today’s anti-HIV drugs have fewer side-effects than the drugs used in the past.

Most side-effects are caused by the body getting used to a new drug and they go away after a few weeks. Some people feel sick, have diarrhoea or are more tired than usual.

Severe, long-term side-effects are much less common. If a drug does cause you problems, your doctor can usually give you a different drug.

HIV treatment guidelines recommend that all people with HIV should take HIV treatment. The sooner you start to take HIV treatment, the sooner you can benefit from it.

Nonetheless the decision to start treatment rests with the person living with HIV. Before starting treatment, it’s important that you understand how it works and what it involves. You may need a little time before you feel ready to start.

HIV treatment only works well if it is taken exactly as prescribed.

This is often called ‘adherence’, and it means taking the drugs:

• at the right times,
• at the right dose, and
• following any advice about food and drink.

The nurses, pharmacists and doctors at your clinic can help you with this. You may need to develop a routine that helps you remember to take the drugs at the same time each day.

If you sometimes forget to take your pills, the drugs you are taking may stop working properly. If this happens you would need to change your treatment.

As for anyone else, taking care of your health involves more than popping pills.

It will also help if you can:

• Get rest and sleep so that you can wind down and strengthen your immune system.
• Eat a balanced diet to maintain a healthy weight, give you energy and get the nutrients your body needs.
• Get some exercise, which is good for the heart, lungs, circulation and mobility.
• Give up smoking, if you are a smoker.
• Talk to people and seek support (isolation and stress are bad for your health too).

As well as improving your physical health, all these things are good for your feelings and emotional wellbeing. For example, exercise can make you feel more relaxed and energised.

During difficult times, you may find that you use more alcohol or drugs. They may help you to forget, or to stop thinking about things. While they may offer temporary relief, relying on them is likely to make your feelings harder to deal with in the long run. Too much drink or drug use usually brings its own problems.

• HIV and the immune system (Basic leaflet with pictures.)
• Side-effects (One-page factsheet.)
• CD4, viral load & other tests (72-page booklet.)
• Get set for HIV treatment (Online, interactive tool.)