UPDATE COMING We’re currently working to update this article. Studies have shown that a person living with HIV who is on regular antiretroviral therapy that reduces the virus to undetectable levels in the blood is NOT able to transmit HIV to a partner during sex. This page will be updated soon to reflect the medical consensus that “Undetectable = Untransmittable.”
HIV/AIDS doesn’t make headlines like it did 20 years ago, but it is still a major health concern. Over 35 million people are currently living with HIV infections worldwide, and over half of them aren’t even aware of it.
But while the World Health Organization says that the virus has killed some 39 million people since 1981, HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) continue to be plagued by misinformation.
We reached out to several experts to get their opinions on what the most glaring misconceptions people in the United States have about HIV/AIDS. They treat people, educate medical students, and provide support to patients coping with the disease. Here are the top nine myths and misconceptions that they, and people with HIV or AIDS, continue to combat:
Myth #1: HIV is a death sentence.
“With proper treatment, we now expect people with HIV to live a normal life span,” says Dr. Michael Horberg, national director of HIV/AIDS for Kaiser Permanente.
“Since 1996, with the advent of highly active, antiretroviral therapy, a person with HIV in an industrialized nation can expect to live a normal life span, so long as they take their prescribed medications,” adds Dr. Amesh A. Adalja, a board-certified infectious disease physician with the University of Pittsburgh.
Myth #2: You can tell if someone has HIV/AIDS by looking at them.
Often, there are no visible signs of HIV/AIDS. “Some people develop HIV symptoms shortly after being infected. For others, it can take up to 10 years for symptoms to appear,” says Dr. Gerald Schochetman, senior director of infectious diseases with Abbott Diagnostics. Schochetman worked at the CDC during the height of the AIDS crisis. Further, the first symptoms of HIV, including a fever, fatigue, and muscle aches, may only last for a few weeks.
“Thus, it’s very hard for people to know if they or someone else has HIV without being properly tested,” says Schochetman.
Myth #3: Straight people don’t have to worry about HIV infection.
“We know that the highest risk group is men who have sex with men,” says Dr. Horberg. This group accounts for about 78 percent of new infections, according to the CDC.
“However, heterosexuals accounted for 24 percent of new HIV infections in 2010, and about two-thirds of those were women.”
Myth #4: HIV-positive people can’t safely have children.
It is possible to have a child if you or your partner is HIV-positive. While it’s impossible to guarantee that the infection won’t pass on to the child, the U.S. Department of Health and Human Services says there are ways to greatly reduce the risk. For example, an HIV-positive woman can take antiretroviral therapy (ART) before and during pregnancy.
“As long as a partner takes their medication correctly and has an undetectable viral load, the likelihood of transmitting the infection to their child is pretty slim to none,” explains psychotherapist Keeley Teemsma, who has specialized in the treatment of HIV/AIDS patients.
Myth #5: HIV always leads to AIDS.
HIV is the infection that causes AIDS. But this doesn’t mean all HIV-positive individuals will actually develop AIDS.
“With current therapies, levels of HIV infection can be controlled and kept low, maintaining a healthy immune system for a long time and therefore preventing opportunistic infections and a diagnosis of AIDS,” explains Dr. Richard Jimenez, professor of public health at Walden University.
Myth #6: With all of the modern treatments, HIV is no big deal.
This sort of attitude has led some to practice carefree and reckless sexual behavior.
“The younger generation has lost some fear of HIV because of the success of treatment,” explains Dr. Adalja. “This has caused them to engage in risky behaviors, leading to high rates of infection in young men who have sex with other men.”
Myth #7: If I take PrEP, I don’t need to use a condom.
PrEP (pre-exposure prophylaxis) is a medication that can prevent HIV infection in advance. According to Dr. Horberg, a recent study from Kaiser Permanente followed people using PrEP for two and a half years, and found that it was effective at preventing HIV infections.
However, it doesn’t protect against other sexually transmitted diseases or infections.
“PrEP is recommended to be used in combination with safer sex practices, as our study also showed that half of the patients participating were diagnosed with a sexually transmitted infection after 12 months,” says Dr. Horberg.
Myth #8: If you test negative for HIV, you can have unprotected sex.
If you or your partner was recently infected with HIV, it may not show up on an HIV test until about three months later.
“Traditionally used antibody-only tests work by detecting the presence of antibodies in the body that develop when HIV infects the body,” explains Dr. Schochetman. “But it takes about three weeks for there to be enough antibodies for detection.”
Before you should even consider having unprotected sex, you should take a second HIV test three months after the first, to confirm your negative reading. If you are having regular sex, the San Francisco AIDS Foundation suggests getting tested every three months.
Other tests, known as HIV combo tests, can detect the virus earlier.
Myth #9: If both partners have HIV, there’s no reason for a condom.
Not all strains of HIV are the same, and being infected with more than one can lead to greater complications, or a “superinfection,” according to Dr. Schochetman.
“The new HIV strain may exhibit a different drug resistance profile than the original HIV infection,” he explains. “And the new virus may show resistance to the current treatment, or cause the current treatment option to be ineffective.”
While there is unfortunately no cure for HIV/AIDS, people with HIV can live long, productive lives.
“While the current antiretroviral therapies can be very effective for keeping HIV infection at low levels and preventing it from replicating and destroying the immune system for a long time, there is no cure for AIDS or a vaccine against HIV, the virus that causes AIDS,” explains Dr. Jimenez.
Though the number of new HIV infections has plateaued, according to the CDC, there are still an estimated 50,000 new infections each year in the United States alone.
Troublingly, “new cases of HIV infection have actually increased among certain vulnerable populations including women of color, young men who have sex with men, and hard to reach populations,” according to Dr. Jimenez.
What does this mean? HIV disease and AIDS are still very much top public health concerns. Despite progress in testing and the availability of medications like PrEP, now is no time to let your guard down.