HIV is transmitted through contact with HIV-infected body fluids, including blood, semen, pre-seminal fluids, vaginal fluids, rectal fluids, and breast milk. HIV is mainly spread by:

• Anal or vaginal sex with an HIV infected person without using a condom or taking medications to prevent or treat HIV
• Sharing injection drug equipment, such as needles, with an HIV infected person
• Mother-to-child transmission can occur from a woman with HIV to her child during pregnancy, childbirth, or breastfeeding

• Shaking hands or hugging a person who has HIV
• Sharing objects such as dishes, toilet seats, or doorknobs used by a person with HIV
• HIV is not spread through the air or in water or by mosquitoes, ticks, or other blood-sucking insects

Pre-exposure prophylaxis (PrEP) is also an option for people who are at high risk of becoming infected. PrEP entails taking a medication daily to prevent HIV infection and requires your health care provider to determine if you are a candidate.

What are the symptoms of HIV infection?

At about 2-4 weeks after infection with HIV, the virus multiplies rapidly and some people develop flu-like symptoms, such as fever, headache, and rash. After this stage, the virus continues to multiple, but at very low levels. People may not have any symptoms at this point. It can take several years before signs of severe infection and opportunistic infections* develop. Without treatment, HIV advances to AIDS in about 10 years (can be more or less in some people). At this point, the immune system is typically severely damaged. HIV transmission can occur at any stage after infection, even if the person has no symptoms.

*Opportunistic infections are infections that occur more frequently and are more severe in people with weakened immune systems, including people with HIV.