HIV is a virus. If it’s not treated, it can weaken and damage your body’s defence (the immune system) so that your body can’t fight off infections. HIV treatment stops the virus from causing damage.

If someone’s immune system is damaged by HIV (usually over many years), they may develop one or more serious infections and illnesses. Historically, this was called acquired immune deficiency syndrome or AIDS. This term isn’t used very often now. ‘Late-stage’, ‘advanced’ or ‘symptomatic’ HIV may be used instead.

Almost all people living with HIV who are diagnosed early enough and have effective treatment won’t go on to develop an AIDS- defining illness. It’s also possible to recover from an AIDS diagnosis with treatment, but diagnosing HIV as early as possible is best.

HIV can be transmitted (passed on) through blood, semen (cum), pre-ejaculate (pre-cum), vaginal and anal fluids, and breast milk.

It can be passed on through sexual contact, and in a few other ways.

Sexual transmission of HIV is not possible when someone living with HIV has an undetectable viral load – also see How do I prevent HIV transmission during sex?

HIV is far more likely to be passed on if someone doesn’t know they have HIV. Increasing the number of people diagnosed and on treatment is essential forto stopping HIV transmission and new HIV diagnoses. This is one reason why regular HIV testing is so important – also see Do I need an HIV test?

• Most people accessing HIV care in England acquired HIV through sex.
• HIV is most commonly passed on through vaginal/frontal or anal sex without a condom.
• There’s a small possibility, in certain situations, of acquiring HIV by giving oral sex (blow job, giving head) to someone with a penis. If you’re worried about this, the advice is to use a condom to cover the penis.
• The chance of acquiring HIV from giving vaginal oral sex (cunnilingus, going down), giving anal oral sex (rimming) or receiving any type of oral sex is likely to be zero or close to zero.
• HIV can also be transmitted by sharing needles and other injecting equipment.
• If you’re pregnant and living with HIV, it’s possible to transmit the virus to the baby before or during birth, or by breastfeeding. This is not common in the UK as transmission can be prevented with HIV treatment. Transmission is more likely if you’re not on treatment or have undiagnosed HIV. HIV testing is part of early pregnancy care – also see What happens if I’m pregnant and find out I’m HIV positive?

You can’t acquire HIV from hugging, saliva, kissing, sneezes, coughs, sharing baths or towels, from swimming pools, toilet seats or sharing cups, plates or cutlery. You can’t acquire HIV from any animals or insects, including mosquitoes.

The following can help prevent HIV transmission during sex.

• Using condoms or internal (female) condoms for vaginal/frontal or anal sex. For anal sex, use water-based or silicone-based lube to reduce the chance of the condom tearing. Condoms also help protect from other sexually transmitted infections (STIs).

• Pre-exposure prophylaxis (PrEP) – also see What is PrEP and can I get it to prevent HIV?

• U=U – when you or a partner are living with HIV and on effective treatment – also see What is U=U?

If you have a higher chance of acquiring HIV (see How common is HIV in the UK?), regular HIV testing can help keep you and your sexual partner(s) healthy.

The amount of HIV in someone’s blood is called their viral load. Effective HIV treatment reduces the viral load so much that HIV cannot be passed on. This is called having an undetectable viral load.

When someone is undetectable, they cannot pass on HIV to sexual partners. The risk is zero. This is known as ‘undetectable equals untransmittable’ or ‘U=U’. It’s sometimes called ‘treatment as sexual prevention’ (TasP).

HIV treatment can reduce viral load to around 20 to 50 copies of the virus in each millilitre of blood. When someone has less than 200 copies of the virus in each millilitre of blood, there is zero risk of passing on HIV through sex.

It may take up to 6 months of effective treatment to become undetectable. To stay undetectable, it’s important to take HIV treatment regularly, according to instructions.

HIV treatment does not help stop other sexually transmitted infections or pregnancy, so you may want to use condoms or other contraception too.

PrEP (pre-exposure prophylaxis) is medicine used by someone who is HIV negative to stop them acquiring HIV. When taken correctly, it’s more than 99% effective at preventing HIV transmission.

PrEP is available free on the NHS across the UK for anyone who would benefit from it. It may be taken regularly or just at certain times, depending on your needs.

It’s usually taken as a tablet but may be offered as a long-acting injection in some areas of the UK.

A healthcare professional at a sexual health clinic can talk to you about whether PrEP is right for you, and the different ways to take it. You’ll need regular HIV tests, STI tests, and a test to check your kidney function at least once a year.

In some areas of England, you may be able to have a free online consultation and assessment to get PrEP by post.

PrEP does not help to stop other sexually transmitted infections or pregnancy, so you may want to use condoms or other contraception too.

• England: PrEP is available on the NHS from sexual health clinics and some online sexual health services

• Northern Ireland: PrEP is accessed for free through genitourinary medicine (GUM) clinics

• Scotland: PrEP is available on the NHS from sexual health clinics

• Wales: PrEP is available on the NHS from sexual health clinics

Some people choose to buy PrEP online or from private clinics. If you’re thinking about buying PrEP, you can still talk with a sexual health clinic about whether PrEP is right for you and what to do before you start taking it. See Prepster.info or iwantprepnow.co.uk for more information.

Post-Exposure Prophylaxis (PEP) is an emergency course of treatment to prevent transmission of HIV after sex.

PEP is a combination of tablets taken every day for 4 weeks. It works best if it’s started as soon as possible within 24 hours of sex where HIV transmission could have happened. It can also be started up to 3 days (72 hours) after sex.

PEP is usually only given or considered if you’ve had sex without a condom (or a condom failed) and you’re not taking PrEP or haven’t taken enough PrEP and you had:

• anal sex (where you were the receiving partner) or vaginal sex with someone living with HIV with a detectable viral load or their viral load is unknown

• anal sex (especially if you were the receiving partner) with someone who has a higher chance of having HIV but an unknown HIV status

PEP may be given in other situations, for example, if there’s a high chance you’ve been exposed to HIV at work, you’ve shared drug injecting equipment with someone who has a detectable viral load, or after a sexual assault.

You can get PEP for free at sexual health clinics, genitourinary medicine (GUM) clinics or an emergency (A&E) department. A healthcare professional will ask you some questions to find out if PEP is suitable for you.

PEP is only suitable for people who are HIV negative. Before getting PEP you’ll usually be offered a rapid HIV test to check your HIV status.

After finishing the course of PEP, wait at least 4 weeks before taking an HIV test to check if the PEP has worked.

All health professionals in the UK – such as dentists, doctors, midwives and nurses – must follow infection control procedures to prevent transmission of HIV and other blood-borne viruses.

In the UK, organ donors and blood from blood donors are tested to reduce the chance of HIV transmission through blood, blood products or donated organs. There have been no new cases of HIV due to blood donation in the UK since 2002.

Some countries don’t have the same standards of medical and dental care as the UK. If you receive healthcare in another country, there may be a chance of HIV transmission from blood products or equipment not effectively sterilised.

Overall, fewer than 2 in 1,000 people in the UK are living with HIV. It’s estimated that in 2023, around 113,500 people in the UK were living with HIV. Of these, about 95% have been diagnosed.

Anyone can acquire HIV. You don’t need to have lots of sexual partners. People from some groups may have a higher risk, including:

• gay, bisexual and other men who have sex with men, and their female sexual partners
• Black African people
• people who inject drugs
• sex workers
• people in prison
• trans and non-binary people
• people from countries with high rates of HIV and their sexual partners

If any of these apply to you, and you’re sexually active, you may have a higher chance of acquiring HIV than the overall population. You may want to consider if PrEP is a good choice for you – also see What is PrEP and can I get it to prevent HIV?

It’s also a good idea for everyone sexually active to test for HIV at least once a year, and sometimes more often, especially if:

• you have sex with a new partner without using a condom or PrEP
• you or a partner have sex with other partners without using a condom or PrEP

Many people living with HIV have no obvious signs and symptoms.

Most, but not all, people who acquire HIV will have some symptoms within a few weeks of getting the virus.

This is known as seroconversion illness. It can include fever, a rash over the body, sore throat, headache, feeling generally unwell, aches and pains, night sweats, weight loss, tiredness, swollen glands, and illnesses like meningitis. But not everyone has these symptoms and they’re easily mistaken for flu or other common illnesses.

After the first few weeks, most people living with HIV will live for years without any signs or symptoms.

If it’s not treated, HIV can weaken and damage a person’s immune system. Eventually they can start to develop serious illnesses or infections.

In the UK, about 2 in 5 newly diagnosed people are diagnosed late. This means they’ve been living with undiagnosed HIV for a number of years.

An HIV test checks to see if the virus is in your body.

Anyone can have a free HIV test. You don’t need to have signs or symptoms. You can get tested no matter what your immigration or asylum status is.

You can go to a healthcare setting, like a sexual health service, or do a test at home.

Blood tests sent to a lab

This type of test checks your blood for HIV antibodies and antigens. Antibodies are made by your immune system to try and fight the virus. Antigens are a part of the virus.

• You can use a postal self-sampling test to take a small sample of blood yourself, by pricking your finger. You send the blood to a lab to be tested. You’ll usually get the result within 1 week.

• A healthcare professional can take a small amount of blood from your arm and send it to a lab to be tested. You’ll usually get the result in 1 to 7 days.

Point of care and instant home tests

These tests can give you a result in around 15 to 30 minutes. They’re sometimes called rapid tests. They usually look for HIV antibodies but not antigens.

If you have a positive result from one of these tests, you’ll need a blood test at a sexual health service to confirm the result.

• Some services and community settings offer point of care testing. Trained staff will take a small sample of blood from a finger-prick or will take a sample from your mouth by swabbing your gums. This is tested straight away.

• You can use a home self-test to take a small sample of blood or take a swab from your mouth to test yourself straight away.

Cervical screening (smear) tests, routine blood tests and swabs won’t detect HIV. If you’re not sure whether you’ve been tested for HIV, just ask.

You can only be sure of your HIV status if you have an HIV test.

HIV can affect anyone. If you’re sexually active, it’s a good idea to test for STIs, including HIV, once a year even if you don’t think you’ve been exposed. You can go to a clinic or order a free postal testing kit online. Some people may be advised to test more often.

An HIV test is also advised in the following situations, even if you don’t have symptoms:

• you or a partner have another sexually transmitted infection
• you’ve recently had vaginal/frontal or anal sex with a new partner without using a condom or PrEP
• a sexual partner tells you they’re living with HIV and they’re not on treatment or have a detectable viral load
• you’ve shared needles or injecting equipment
• you’re pregnant or planning a pregnancy

If you or a partner think you might have been exposed to HIV, it’s important not to delay seeking advice and getting a test.

If there’s a high chance you’ve been exposed to HIV in the last 3 days (72 hours) you may be able to get an emergency treatment called PEP to help lower your chance of acquiring HIV – see What is PEP and how soon do I need to use it to prevent HIV? PEP is more effective the earlier you start it.

You can test for HIV at any time. But if you’ve recently acquired HIV, it can take time before a test can detect it.

The time from acquiring HIV to the time a test can accurately detect it in your body is called the ‘window period’. The length of the window period depends on the type of test.

• For tests where blood from your arm or finger is sent to a lab, HIV can usually be detected about 21 days after exposure in most people. Tests done 45 days or more after exposure will reliably detect HIV in almost all cases.

• For point of care tests and self-tests which give rapid results, the recommended window period is usually 90 days (3 months). The service or test kit you use should clearly explain the window period for that test.

You can still get tested during the window period. So don’t delay getting a test if you’ve had sex without a condom with someone living with HIV and not on effective treatment, or someone whose HIV status you don’t know. A test can often detect HIV after just 3 to 4 weeks.

But sometimes your test result may be negative even though you do have HIV. If your result is negative but you may have been exposed to HIV in the last 6 to 13 weeks, you may be advised to have another test later.

There are different services you can go to. You can also use a postal testing kit or a self-test. Choose what you feel most comfortable with.

For information on how to find a testing service or order a test see Where can I get more information and advice?

An HIV test can be done by a healthcare professional at:

• a sexual health clinic or genitourinary medicine (GUM) clinic
• an HIV testing centre run by a charity
• some contraception clinics and young people’s services
• many GP surgeries
• a private clinic (for a fee)

People who inject drugs may be able to get a test through a local drugs service.

Antenatal (pregnancy care) services and some gynaecology services will offer a test.

In some areas, testing is done by trained staff in places such as nightclubs, community events and churches.

In some Emergency (A&E) Departments, if you have blood taken it will be tested for HIV unless you choose not to have this test (‘opt-out’ testing).

If you’re worried that you may have been exposed to HIV, don’t wait to be offered a test. Go to a clinic and ask for a test or order a postal kit or self- test kit (see below).

Postal (self-sampling) tests

Postal tests are available for free in almost all areas – also see Where can I get more information and advice? You can also buy them online and at some high-street pharmacies.

You prick your finger to take your own blood sample (self-sampling) and post it to a lab to be tested.

Buying an HIV Self-sampling Test from the FPA:

• an HIV Self-Sampling Test Kit is available here
• an STI Four Screen Self-Sampling Test Kit is available here – this test covers HIV, syphilis, chlamydia and gonorrhoea

Before buying any type of test it’s worth checking if there are free tests available in your area first.

Self-tests (home tests)

You can buy an HIV self-test online (also known as a home testing kit) which can give you your result in around 15 to 30 minutes.

Some tests ask you to prick your finger to take a blood sample. Other tests ask you to take a sample from your mouth by swabbing your gums. You test the sample and read the result yourself. If you buy a kit, check it has a CE mark and is licensed for sale in the UK.

Before doing a self-test, think about how you might feel and what support you may need if the test shows that you may have HIV.

If you think you’ve been exposed to HIV in the last 3 months, a self-test may not be able to detect the virus yet – also see How soon after sex can I have an HIV test?

Ask for a test at a sexual health or GUM clinic or order a free self-sampling test.

If blood was taken from your arm by a healthcare professional your test result will be either:

• Negative – no HIV antibodies or antigens were detected. If the test was done 45 days or more since you could have been exposed to HIV, you can be confident you did not have HIV at the time of the test.

• Reactive – the test has reacted to something in your body. This is sometimes called a positive result. In most cases this result is due to the presence of HIV, but not everyone with a reactive result will have HIV. You’ll have another test to confirm if you’re living with HIV.

If you had a test using blood from your finger or a mouth swab, your test result will be either:

• Negative – no HIV antibodies or antigens were detected. You’ll be advised if you need another test later to confirm the result.

• Reactive – the test has reacted to something in your body. This is sometimes called a positive result. In many cases this result is due to the presence of HIV, but not everyone with a reactive result will have HIV. You’ll need a test at a clinic (where they’ll take blood from your arm) to confirm whether you’re living with HIV.

• Indeterminate or invalid – the test did not work or the result was unclear.

No tests for any virus are 100% accurate, but an HIV test should pick up almost all instances of HIV if done after the window period – also see How soon after sex can I have an HIV test?

All reactive or positive HIV tests are repeated to confirm the result.

If your result is negative and you haven’t been exposed to HIV in the 3 months before the test, you can be confident you didn’t have HIV at the time of the test.

Information about your HIV test should only be given to someone else with your permission. Talk to the healthcare professional or service you get your test from if you’re concerned about your results being kept confidential.

If your tests confirm you are living with HIV then it’s important that your current sexual partner(s) and any other recent partners are advised to get tested for HIV. This can be done without sharing your name or any other details so your confidentiality will still be protected.

Staff at your HIV clinic can help with this – see below – Should I tell my partner(s) about my diagnosis?

HIV testing is available on the NHS free of charge to anyone, no matter what your immigration or asylum status is.

In most areas, free postal self-sampling tests can be ordered online – also see Where can I get an HIV test? You can also buy postal and self-test kits.

Anyone living in the UK is entitled to free NHS HIV treatment.

If your tests show you have HIV, try not to worry. Help is available.

You’ll be referred to a specialist HIV clinic. The clinic will do blood tests to monitor the stage of infection and you’ll be offered treatment straight away.

Treatment will be given as a pill or pills which you take every day.

At first, you’ll attend the clinic every few weeks or months. Once you’re settled on treatment, you may only need to go twice a year. Once your viral load is undetectable, it may be possible to have injections every 8 weeks instead of taking tablets. You can discuss your treatment preference with your HIV clinic.

The aim of treatment is to keep the level of HIV in your blood as low as possible, so it can’t harm your immune system. When the level is close to zero, this is known as an undetectable viral load and is the best result you can get from treatment. This helps keep you healthy and means you can’t pass on the virus to sexual partner(s).

The earlier that HIV is diagnosed, and treatment started, the more successful it’s likely to be at keeping you healthy.

Your HIV clinic can give you full information about the best treatment options for you, possible side effects and long-term effects of treatment.

HIV support organisations and charities offer advice, information and peer support to help you understand and adjust to an HIV diagnosis, consider treatment options, and think through sharing your status with family, friends, and partners. They often work together with clinics.

It’s important that HIV is treated and monitored by specialist healthcare professionals.

Untreated HIV will cause long-term damage to your health. Eventually it can develop into late- stage HIV infection, which can lead to death.

This may happen more quickly in some people than others. So if there’s any chance you could have been exposed to HIV, it’s important to get tested so you can begin treatment if needed.

An HIV test can’t tell you how long you’ve been living with HIV.

After you’re diagnosed, blood tests will look at the level of damage to your immune system. The results may give an idea of whether you’ve been living with the virus for a longer or shorter time but can’t confirm this.

If you feel upset or angry about having HIV and find it difficult to talk to a partner, family or friends, don’t be afraid to discuss how you feel with the clinic staff or a support organisation – also see Where can I get more information and advice?

You don’t have to share your HIV status if you don’t want to. It may take some time to adjust to living with HIV.

Staff at your HIV clinic can support you to tell your partner(s) when you’re ready, including support with talking to a current or long-term partner about your diagnosis.

They’ll advise you on ways to prevent passing on HIV, including treatment, condom use, and your partner(s) using PrEP until you have an undetectable viral load.

If your current sexual partner(s) knows you’re living with HIV they can decide whether PrEP is right for them – also see What is PrEP and can I get it to prevent HIV?

It’s important that your current sexual partner(s) and any other recent partners are tested for HIV.

The staff at the clinic can discuss with you which recent partners may need to be tested and help you contact them. This is called partner notification. They’ll be sent a message to say they may have been exposed to a sexually transmitted infection (STI) and suggest they go for a check-up. It may or may not say what the STI is. The message won’t have your name on it, so your confidentiality is protected.

If you live in England, Wales or Scotland and are living with HIV, you have rights protected by The Equality Act 2010.

It’s against the law to discriminate against you, harass you or treat you unfavourably compared to people who are not living with HIV.

At work

• In most jobs, you only have to share your HIV status if you want to.
• If you do share your HIV status, your employer must not discriminate against you or treat you less favourably than other employees because you have HIV.
• If your employer knows your HIV status, you have the right to ask for any reasonable adjustments that you need.

When accessing healthcare

• Your HIV status can usually only be shared with your consent, although there are some exceptions to this.
• You should not be refused care or given worse care because of your HIV status.

When accessing other services

• You cannot be denied a service, or treated in a discriminatory way, because of your HIV status. For example, you should not be refused a tattoo, cosmetic surgery, or a piercing because of your status.

In Northern Ireland, The Equality Act 2010 does not apply. This can make it harder to challenge discrimination and harassment, but support is available.

Wherever you live in the UK, get information and support at www.nat.org.uk/about-hiv/hiv-information-and-advice.

Yes. It’s possible for someone living with HIV and on effective treatment to conceive a child with an HIV negative partner without HIV being passed on to their partner or child. It’s also possible for 2 people living with HIV and both on effective treatment to conceive a child together. Your HIV clinic can give you advice on this.

If you’re living with HIV and could get pregnant, your clinic will support you with your reproductive health choices and with pregnancy and birth if you decide to have children.

You can take treatment during pregnancy that will stop HIV from being passed on to your baby in pregnancy and birth. In the UK, fewer than 1 in 200 babies born to people living with HIV during their pregnancy acquire the virus.

If you’re on effective treatment and have an undetectable viral load, you can donate sperm, eggs or embryos to someone you know or to be used as part of a surrogacy arrangement.

You’ll be offered an HIV test as part of the routine screening early in your antenatal (pregnancy) care.

If the test shows you have HIV, you’ll be referred to a specialist HIV clinic. The staff will help you understand the diagnosis and talk to you about starting treatment immediately.

HIV treatment is safe to take during pregnancy and helps prevent the baby acquiring HIV. Staff will support you through your pregnancy, birth and beyond.

In the UK, you’ll be advised to bottle feed with formula milk. This is because there is a zero chance of passing on HIV through formula feeding.

If you have an undetectable viral load and want to breastfeed, you can discuss this with your HIV clinic. They’ll talk through the risks and benefits with you. They can support you to breastfeed as safely as possible but there could still be a chance of passing on HIV to the baby. Your HIV team will monitor you and your baby closely and you’ll both need to have regular blood tests.

The following will help protect you from getting and passing on HIV and most other sexually transmitted infections (STIs).

And:

• If you think you may have a higher chance of acquiring HIV, consider whether PrEP is right for you. See What is PrEP and can I get it to prevent HIV? PrEP will not help protect you from any other STIs.

Information HIV

• It Starts With Me – www.startswithme.org.uk
• NAT – www.nat.org.uk
• Positive Life NI – www.positivelifeni.com
• Positively UK – www.positivelyuk.org
• Terrence Higgins Trust (THT) – www.tht.org.uk or call 0808 802 1221 (10am to 6pm, Monday to Friday)
• Waverly Care (Scotland) – www.waverleycare.org

Free postal HIV testing services

• England: freetesting.hiv
• Northern Ireland: sh24.org.uk/orders/sti-test-kit/intro-sti
• Scotland: nhsinform.scot/STIselfsample
• Wales: shwales.online/wales-sti-testing-kit-test-and-post.html

Find local HIV and STI testing services

• Terrence Higgins Trust online test finder for HIV and other STIs
• NHS service finder

Other places to get help