1. How Can I Help Someone Who Has Been Newly Diagnosed with HIV?

There are many things that you can do to help a friend or loved one who has been recently diagnosed with HIV:

Talk. Be available to have open, honest conversations about HIV. Show them that you see them as the same person and that they are more than their diagnosis.

Listen. Being diagnosed with HIV is life-changing news. Listen to your loved one and offer your support. Reassure them that HIV is a manageable health condition. There are medicines that can treat HIV and help them stay healthy.

Learn. Educate yourself about HIV: what it is, how it is transmitted, how it is treated, and how people can stay healthy while living with HIV.

Encourage treatment. Some people who are recently diagnosed may find it hard to take that first step to HIV treatment. Your support and assistance may be helpful. Encourage your friend or loved one to see a doctor and start HIV treatment as soon as possible.

Support medication adherence. It is important for people living with HIV to take their HIV medication every day, exactly as prescribed. Ask your loved one what you can do to support them in establishing a medication routine and sticking to it. Also ask what other needs they might have and how you can help them stay healthy.

Get support. Take care of yourself and get support if you need it. Turn to others for any questions, concerns, or anxieties you may have, so that the person who is diagnosed can focus on taking care of their own health.

To find support near you, go to: https://locator.hiv.gov/

2. What If a Friend Tells You That They Have HIV?

More than a million people in the United States are living with HIV. You may know someone who has the virus. If your friend, family member, or co-worker has been HIV-positive, here’s how you can be supportive:

Acknowledge. If someone has disclosed their HIV status to you, thank them for trusting you with their private health information.

Ask. If appropriate, ask if there’s anything that you can do to help them. Some people are public with this information and others are not. Ask whether other people know this information, and how private they are about their HIV status.

Reassure. Let the person know, through your words or actions, that their HIV status does not change your relationship and that you will keep this information private if they want you to.

Learn. Educate yourself about HIV.

3. I am a woman with HIV and am considering having children. Should I take HIV medicines?

Yes. In general, all persons with HIV should start antiretroviral therapy (also known as "ART") early, and as soon as possible. If you are a woman who is trying to get pregnant or plans to become pregnant soon, it is even more important to be on ART. These medications will help your body defend itself from HIV-related infections. Taking the medications every day and achieving an undetectable HIV viral load will also protect your partners from getting HIV. And, very importantly, taking ART every day will greatly lower your baby's risk of becoming infected by HIV.

Women with HIV should try to achieve an undetectable viral load before they become pregnant. If a woman with HIV chooses not to take HIV medicines, the chance of the baby being born with HIV is 1 in 4. But with effective treatment and an undetectable viral load, the chance of a baby being born with HIV is only 0.4%, or less!

4. As a pregnant woman with HIV, what HIV medicines should I be taking?

It is very important to see a provider who has experience treating pregnant women with HIV. Most HIV medicines that are used for non-pregnant women can also be used for pregnant women, but some should be avoided or dosed differently.

When you and your provider choose your HIV medicines, the decision will be based on many factors. These include whether your HIV virus has resistance to any of the medications, which ones you've taken in the past, what side-effects you or your baby may experience during pregnancy and after birth, and how easy it will be for you to take the medicines every day.

5. I am already taking HIV medicines and I want to get pregnant. Do I need to switch my medicines?

If your HIV medicines are working and you have an undetectable viral load, you don't usually need to switch when planning for a pregnancy. However, there are a few HIV medications that your provider may want you to avoid because of possible effects on the fetus. Discuss this with your provider before you become pregnant.

A woman's body undergoes many changes during pregnancy. These changes can affect how her body reacts to HIV medications. During pregnancy, a woman's body sometimes becomes more efficient at removing HIV medicines from the bloodstream. Depending on the medicines you are taking, your provider may have to adjust the dosages to ensure that you and the baby are getting a sufficient amount.

6. After my baby is born, will he or she have to take HIV medications?

When a pregnant woman with HIV takes effective ART (HIV medications) during her pregnancy, the chances of her baby getting HIV are extremely low. To reduce the risk even more, it is recommended that all infants who are born to mothers with HIV take medications for a short time. If you took ART during your pregnancy and had an undetectable viral load, your baby will receive liquid zidovudine (AZT, Retrovir®) for 4-6 weeks. If you didn't have an undetectable viral load during pregnancy, your baby may need medicine for a longer period of time.

7. Why can't I breastfeed my baby?

Many mothers look forward to breastfeeding their babies. However, HIV can be passed through breast milk. If you breastfeed your child, you run the risk of your baby getting HIV. It is recommended that mothers with HIV do not breastfeed their babies and that they use formula instead. If you would like more information on the possible risks and benefits of breastfeeding, consult with a pediatrician or obstetrician who is an expert in HIV infection, ideally before delivery.

8. Can you reduce the risk of getting HIV after having unprotected sex with someone who has HIV?

Let's say you had sex with someone who has HIV infection and the condom broke, or you found out only after condomless sex that your partner had HIV. Can you reduce your risk of getting HIV from sex--or from a needlestick--by taking medications afterward?

Yes. This is called postexposure prophylaxis, or PEP.

The medications that are given for PEP are the same types that are used to treat HIV (antiretrovirals, or ARVs), and they usually are given as a combination of 3 medicines for 1 month. To work best, these ARVs should be taken as soon as possible after the exposure, and ideally not later than 72 hours (3 days) after the exposure. To be evaluated for PEP, the exposed individual should contact their clinician or an emergency room promptly after the exposure. If the provider is unsure about whether or how to give PEP, they can call the free 24-hour National Clinicians' Consultation Center (NCCC) PEPline at 888-448-4911. Many emergency rooms and insurance plans will provide the ARVs for PEP.

Exposed persons do not have to know the HIV status of the person with whom they had contact in order to be offered PEP--providers will evaluate the risk level of the exposure and, if possible, offer testing to the source individual. The exposed person should be tested to see if they already (without knowing it) have HIV or other sexually transmitted diseases such as hepatitis B, gonorrhea, chlamydia, and syphilis, but the first dose of PEP should not be delayed in order to complete that testing. The sooner after the exposure PEP medicines are started, the more likely they are to be effective. People on PEP should be monitored for side effects from the PEP medicines and tested again for HIV after the treatment is completed.

If you have a partner who has HIV, or if you have had to take PEP more than once, you might want to consider taking pre-exposure prophylaxis (PrEP). PrEP is an ARV pill that people who are at risk of getting HIV can take every day to prevent HIV infection. See our other FAQs on PrEP or speak with your provider.

9. Why is it important to wear condoms when HIV is treatable?

Latex condoms are highly effective in preventing the sexual transmission of HIV when used consistently and correctly. In addition, the consistent and correct use of latex condoms reduce the risk of other STDs such as gonorrhea and chlamydia, and to a lesser degree, genital ulcer disease such as Herpes. Condom use may also reduce the risk of genial human papillomavirus (HPV) and HPV-associated diseases, e.g. genital warts and cervical cancer.

HIV is treatable but it is a chronic infection and treatment requires taking pills every day so they will continue to work against the virus. If you get HIV, there are also other things to consider like managing medication side effects and risk of infecting other partners. So, consistent and correct use of latex condoms is recommended to prevent HIV transmission.

10. What are the risks of getting HIV if you put on a condom after you've already started having sex?

Delayed condom use during sex with an HIV positive partner may result in HIV transmission. In addition, this may increase your risk in contracting other STDs. Putting on a condom after you already have started having vaginal or anal sex is riskier than using a condom from the start. If it is difficult to talk about condom use with your partner, then it's time to find someone who can talk with both of you. Many cities have STD clinics and HIV counseling and testing sites that can help partners have these discussions. This also may be a great opportunity to consider PrEP if you are not using condoms consistently--discuss this with your VA provider or your local sexual health clinic. If a condom breaks during sex, contact a medical provider or go to an emergency room as soon as possible. There are medications that can help prevent HIV transmission if taken soon after exposure (PEP).

11. What are the chances of a man being infected after condomless sex with a woman who has HIV?

In general, the risk of a man getting HIV from an HIV-positive woman during vaginal intercourse in the United States is low--probably less than 1 of 1,000 exposures will result in actual infection. This risk may be higher depending on certain factors, such as whether the woman is having her period or whether the man is uncircumcised, and it also may be higher in poor countries. It is very low if the woman is taking effective HIV medications and/or if you are taking PrEP (a daily pill to prevent HIV).

Of course, there is no risk of getting HIV from a woman unless she has HIV, so it's good to talk about this with any potential sex partner. After all, she may have the same thoughts or concerns about whether YOU have HIV, but also might not bring up the subject. And since it's often hard to be sure, especially if you don't know someone very well, remember that using a condom can greatly reduce the risk of spreading or getting HIV and other diseases, can prevent unintended pregnancy and can be a good way to show that you care about your partner.

12. Can you get HIV through oral sex?

The risk of getting HIV through receiving oral sex (that is, a partner's mouth on your genitals) is very, very low.

We can't say that there's zero risk, because there are a few cases of HIV infection in people who have no other known risk factors for HIV.

Also, we can imagine a scenario where an HIV-infected person's mouth is bleeding when he or she is giving oral sex. This could increase the risk of infecting the partner. But, in general, becoming infected with HIV by receiving oral sex is probably a very rare occurrence.

The risk of getting HIV through giving oral sex (that is, your mouth on a partner's genitals) is low compared with unprotected vaginal or anal sex, but there is some risk. The risk appears to be higher if you have cuts or sores in your mouth. Risk also appears to increase with the amount of your partner's fluids that contact your mouth and throat. If there is blood in these fluids, that probably increases the risk as well.

Of course, if your partner is not HIV infected, there is no risk of getting HIV. But if your partner is HIV positive, or you are not sure, it makes sense to use a condom or other barrier (a latex sheet, for example) for oral sex, or to take PrEP (pre-exposure prophylaxis). (See tips for using condoms and dental dams and FAQs on PrEP for more information.)

13. Is it safe for an HIV-positive person to have unprotected sex with another HIV-positive person?

We assume you are referring whether you can be "re-infected" or "superinfected" with another strain of HIV. While the research on this question is not 100% clear, there are only rare reports of someone who already has HIV getting another HIV infection that damages their health.

It is true that a person who's been infected with one strain can become infected with a second strain when exposed to it (such as through unprotected sex), but this appears to be quite uncommon. A person whose first HIV infection is relatively recent may be more susceptible to infection with a second strain. Someone may become sicker once the second strain of the virus enters the system. This happens because the new strain may be more difficult for the immune system to control, or because the new strain is resistant to the HIV medications the person is taking. (See resistance testing for an explanation of what it means for the virus to be resistant.)

For a person with HIV who is taking antiretroviral medicine and has an undetectable viral load, the risk of infecting someone else (or becoming re-infected) through sex is extremely low. If you have (or your partner has) a viral load that is not fully suppressed with HIV meds and a virus that has resistance mutations, it would be a good idea to use condoms to prevent transmission of a difficult-to-treat HIV infection.

There are more reasons for two HIV-positive people to use condoms. Correct condom use can prevent the transmission of other STDs, such as gonorrhea, chlamydia, syphilis, hepatitis B, and hepatitis C. And, condom use can prevent unintended pregnancy.

14. Will cleaning IV-drug needles and syringes with bleach before using them prevent you from getting HIV?

You can be infected with HIV if you use needles and syringes contaminated with blood from a person who has HIV. One way to avoid getting HIV from IV drug use is to stop injecting drugs. Talk to your provider if you need help stopping. Another effective way is to always use new, sterile syringes and needles and also to be sure not to use any shared injecting equipment (cookers, spoons, cottons, etc.). Ask your provider if you need assistance locating a Syringe Services Program (SSP) locally to obtain clean needles or dispose of used ones.

But what if you can't get into a drug treatment program, it hasn't worked for you, or you can't get your hands-on sterile equipment? There is some evidence that cleaning your needles and syringes with laundry bleach can lower your risk of getting HIV. In laboratory studies, HIV in syringes was killed after contact with undiluted bleach for at least 30 seconds. Watered-down bleach did not work, and neither did contact with bleach for less than 30 seconds.

Does this process work outside the lab? It's hard to know, because this is very difficult to study. But it's probably a lot better than not doing anything at all to kill HIV in drug-injecting equipment.

Note: It is important to rinse the syringes and needles with water after cleaning them with bleach, so that you won't inject the bleach into your body. And how do you know when 30 seconds are up? Use a watch or a clock, or hum the song "Happy Birthday to You," all the way through, three times over.

15. I was just diagnosed with HIV and my clinician wants me to start treatment right away. Does that sound like the right thing to do?

You may know that we currently recommend HIV treatment (called antiretroviral therapy, or ART) for everyone with HIV. That's because research studies show that effective ART improves the health of people with HIV no matter the stage of their infection, and it enormously reduces the chance of HIV passing to an HIV-negative sex partner. HIV providers almost always offer ART during one of the first clinic visits.

Some clinics and some local health departments go further and recommend that people with a new diagnosis of HIV start treatment immediately, either that same day or within the next few days. This approach sometimes is called "Treatment on Diagnosis" or "Rapid ART." There are several reasons for starting treatment at the time of HIV diagnosis, but the basic reason is that if early treatment is beneficial, starting treatment at the earliest possible time may be even better, and patients may get the benefits of ART sooner. This may be especially true for people who are diagnosed very soon after they are infected (during the acute HIV infection period). Also, we know that delays or barriers to getting clinic appointments are common, and it may take a while to get a prescription for ART, which can result in worse health outcomes. Strategies that get newly diagnosed people straight into care and onto treatment may bypass these barriers.

For individuals with new diagnoses of HIV who are starting ART immediately, clinicians must choose the treatment regimens carefully, and offer extra support and guidance. Please discuss this with your health care provider and decide whether you are ready to start treatment. Remember that this is your decision and you should be comfortable with it.

16. I have hepatitis C and hope to start treatment soon. Can I take hep C medications along with my HIV medications?

It's great that you are about to start hepatitis C treatment--good luck with it.

Yes, you can and should continue HIV medications while you take medications for hepatitis C but discuss this with your provider. Some HIV medications interact with some of the hepatitis C medicines (the so-called direct acting antivirals, or DAAs). This could cause unwanted increases or decreases of drug levels in your body (depending on the specific interaction) and thus increase the risk of side effects (if a drug level rises) or of treatment failure (if a drug level drops).

It is very important for your providers to be sure that the two sets of medications are compatible. In some cases, it may be necessary to change your HIV medications in order to allow treatment with certain DAAs. Please discuss this with your HIV and hepatitis providers before you start hepatitis C treatment.

17. How do I tell my someone I’m HIV positive?

Choosing if and when to tell someone that you have HIV is a personal decision.

Having trusted friends and/or family who know your HIV status may help you manage your diagnosis.

Having this conversation may bring up a range of emotions. Some things you may want to consider when sharing this information:

• What kind of relationship do you have with this person?
• What are the possible consequences of telling them that you have HIV?
• Will telling them be a safe experience?
• What is that person’s attitude and knowledge about HIV?
• Is there information about HIV you can share that may be helpful?
• Are there particular issues this person might have that will affect the support they can offer?

It is best to share your status with your partner before becoming intimate. In some states, it is a legal requirement.

While many people living with HIV have loving intimate relationships, for some, disclosure can lead to violence. To minimize risk, consider telling them in a public space with others around but private enough to talk. Or, have them talk with a health care provider to answer any questions they may have.

Don’t let HIV stand in the way of love. People with different HIV statuses can have healthy and safe intimate relationships. There are more options than ever to prevent the spread of HIV and keep both of you healthy.

18. What do I do when a loved one tells me they have HIV?

When a friend or family member shares that they have HIV, it shows they trust you.

One of the best things you can do is listen without judgment and offer your love and support.

Allow them to guide the conversation and share the level of detail that is comfortable for them. Let them know you are here to provide whatever help they may need. Support them in getting into care and on treatment.

Some things to keep in mind if someone tells you they have HIV:

• HIV is not a death sentence. With ongoing treatment, you can live a normal, healthy lifespan.
• In addition to keeping an individual healthy, treatment also prevents the spread of the virus.
• HIV is not spread through casual contact.
• It is possible to have healthy intimate relationships. There are more options than ever to prevent the spread of HIV and keep you both healthy.
• Keep it confidential. It is not your information to share and the consequences of doing so can be serious.
• Your support will help them be healthier.
• Getting into and staying in care is critical to living well with HIV. Given the clear benefits, it’s recommended that people diagnosed with HIV start treatment as soon as possible.

You can show your support by offering to go with loved ones with HIV to appointments or to pick up their prescriptions. Keeping up with care and treatment is very important. If someone with HIV stops taking their medications, they can get very sick.