HIV is a long term health condition which is now very easy to manage. HIV stands for human immunodeficiency virus. The virus targets the immune system and if untreated, weakens your ability to fight infections and disease.

Nowadays, HIV treatment can stop the virus spreading and if used early enough, can reverse damage to the immune system.

HIV is most commonly transmitted through having unprotected sex with someone with HIV who isn’t taking HIV treatment. Unprotected sex means having sex without taking HIV PrEP or using condoms.

HIV can also be transmitted by:

• sharing infected needles and other injecting equipment
• an HIV-positive mother to her child during pregnancy, birth and breastfeeding

All pregnant women are offered an HIV test and if the virus is found, they can be offered treatment which virtually eliminates risk to their child during pregnancy and birth.

People who take HIV treatment and whose virus level is undetectable can’t pass HIV on to others. Although there is no cure for HIV yet, people living with HIV who take their treatment should have normal lifespans and live in good health.

Without treatment, people with HIV will eventually become unwell. HIV can be fatal if it’s not detected and treated in time to allow the immune system to repair. It’s extremely important to test for HIV if you think you’ve been exposed.

How do you get HIV?

HIV is found in body fluids of a person with the virus, whose levels of virus are detectable.

The body fluids most likely to contain enough virus to pass on HIV to another person are:

• semen (including pre-cum)
• vaginal fluid
• anal mucus
• blood
• breast milk

HIV is a fragile virus and does not survive outside the body for long.

HIV is most commonly passed on through unprotected anal or vaginal sex. There is a very low risk of getting HIV through oral sex and there can be a small risk through sharing sex toys, which can be eliminated by using fresh condoms for each person using the toy.

Read more about what causes HIV

How do I know if I have HIV?

Seek healthcare advice as soon as possible if you think you might have been exposed to HIV.

The only way to find out if you have HIV is to have an HIV test. This involves testing a sample of your blood or occasionally saliva for signs of the infection. In NHS services this usually involves a blood test with results available within a few days.

Some services, including HIV or sexual health charities, may provide saliva tests. Saliva tests that indicate a person may have HIV will need to be confirmed through a blood test.

It’s important to be aware that:

• HIV tests may need to be repeated four weeks after potential exposure to HIV, this is known as the “window period”, but you shouldn’t wait this long to seek help
• you can get tested in a number of places, including your GP surgery, sexual health clinics and clinics run by charities
• clinic tests can sometimes give you a result in minutes, although it may take a few days to get the result of a more detailed blood test
• home-testing or home-sampling kits are available to buy or order online or from pharmacies – depending on the type of test you use, your result will be available in a few minutes or a few days

If the test shows you have HIV, you’ll be referred to a specialist HIV clinic for some more tests and a discussion about your treatment options.

Read more about diagnosing HIV

Treating and living with HIV

Treatments for HIV are now very effective, enabling people with HIV to live long and healthy lives.

Medication, known as antiretrovirals, work by stopping the virus replicating in the body, allowing the immune system to repair itself and preventing further damage. These medicines usually come in the form of tablets, which need to be taken every day.

HIV is able to develop resistance to a single HIV drug very easily, but taking a combination of different drugs makes this much less likely. Most people with HIV take a combination of 3 antiretrovirals (although some people take 1 or 2) and it’s vital that the medications are taken every day as recommended by your doctor.

Taking a number of different drugs doesn’t always mean taking many tablets though as some drugs are combined together into one tablet.

For people living with HIV, taking effective antiretroviral therapy (where the HIV virus is “undetectable” in blood tests) will prevent you passing on HIV to sexual partners.

It’s extremely rare for a pregnant woman living with HIV to transmit it to their babies, provided they receive timely and effective antiretroviral therapy (ART) and medical care. An HIV test is routinely offered to all women in Scotland as part of antenatal screening.

Read more about living with HIV

Preventing HIV

It has never been easier to prevent the transmission of HIV.

Someone living with HIV who takes their HIV treatment and who has had an undetectable level of virus for six months, cannot transmit HIV to anyone else. Over 90% of all people diagnosed with HIV in Scotland have undetectable virus. It’s therefore extremely rare for someone to get HIV from a person that knows they have the virus.

HIV Pre Exposure Prophylaxis (PrEP)

PrEP is a form of HIV medication taken by someone who does not have HIV which will help to prevent them from getting HIV. In Scotland PrEP is available on the NHS through sexual health clinics for people who are at risk of getting HIV. PrEP only provides protection from HIV and not from any other sexually transmitted infections.

Read further information about HIV PrEP

Condoms (and lubricant)

Properly used condoms (and lubricant for anal sex) are effective at preventing transmission of HIV as well as other sexually transmitted infections and pregnancy.

HIV Post Exposure Prophylaxis (PEP)

HIV Post exposure prophylaxis (PEP) is a form of emergency HIV medication taken by someone who does not have HIV but who has or may have been very recently exposed to HIV.

PEP should be taken as soon as possible, but it can be taken up to 72 hours after exposure. The earlier it is taken the more effective it is.

Clean Injecting Equipment

Using fresh injecting equipment, including any needles, syringes, swabs and spoons and avoiding sharing will eliminate any risk of HIV.

How common is HIV?

At the end of December 2019, there were 326 reports of HIV diagnoses in Scotland. Of these, 167 were first-ever HIV diagnoses and 158 had been previously diagnosed outwith Scotland, but were newly reported in Scotland during 2019. It’s estimated that there are 6,122 individuals living with HIV in Scotland and of these 92% have been diagnosed. A total of 5,074 are attending specialist HIV treatment and care services. Of these, 98% are receiving antiretroviral therapy with 95% achieving an undetectable viral load.

The three groups with highest rates of HIV are:

• gay and bisexual men or other men who have sex with men
• people from countries with high HIV prevalence, especially sub Saharan African countries
• people who share injecting equipment (including needles, syringes, spoons and swabs) or who have sex with people who inject drugs

The World Health Organisation estimates that around 36.9 million people in the world are living with HIV.