Stage 2: Clinical latency (HIV inactivity or dormancy) This period is sometimes called asymptomatic HIV infection or chronic HIV infection. During this phase, HIV is still active but reproduces at very low levels. People may not have any symptoms or get sick during this time. For people who aren’t taking medicine to treat HIV, this period can last a decade or longer, but some progress through this phase much faster. People who are taking medicine to treat HIV (ART) the right way, every day may be in this stage for several decades or throughout their life span. It’s important to remember that people can still transmit HIV to others during this phase, although people who are on ART and
stay virally suppressed (with a very low level of virus in their blood) are much less likely to transmit HIV than those who are not virally suppressed. The CDC estimates that roughly 1.2 million people in the United States are living with HIV (CDC, 2023c). There are 39 million people living with HIV globally. At the end of this phase, a person’s viral load starts to go up, and the CD4 cell count begins to go down. As this happens, the person may begin to have symptoms as the virus levels increase in the body and the person moves into Stage 3. People are diagnosed with AIDS when their CD4 cell count drops below 200 cells/mm3 or if they develop certain opportunistic illnesses. People with AIDS can have a high viral load and be very infectious. More than 700,000 people in the United States with an AIDS diagnosis have died since its discovery, with 1,744 deaths in 2020, despite advances in treatment (KFF, 2023).
Stage 3: Acquired Immunodeficiency Syndrome (AIDS) AIDS is the most severe phase of HIV infection. People with AIDS have badly damaged immune systems, leading to an increasing number of severe illnesses called opportunistic illnesses. Without treatment, people with AIDS typically survive about three years. Common symptoms of AIDS include chills, fever, sweats, swollen lymph glands, weakness, skin lesions, and weight loss.
RISK FACTORS
The following are risk factors that can affect anyone at any age, regardless of status: ● Having sex with someone without being 100% sure of their HIV status. Remember, 13% of people are unaware of their infection. ● Injecting drugs or sharing needles. This can include steroids, hormones, and insulin. ● Acquiring any sexually transmitted disease, hepatitis, or tuberculosis. HIV often travels with other infectious diseases, so if you have contracted another virus, there is a heightened chance that you could have also contracted HIV. ● Having sex with someone who has any of the above risk factors. Don’t forget, when you put yourself at risk, you put all of your future partners at risk as well. ● By race/ethnicity : In 2021, according to the CDC, Black/ African American persons made up approximately 12% of the population of the U.S. and accounted for 40% (13,000) of the estimated 32,100 new HIV infections. White persons made up 61% of the population of the U.S. and accounted for 26% (8,200) of new HIV infections, and Hispanic/Latino persons made up 18% of the population of the U.S. and accounted for 29% (9,300) of HIV infections. By rate, the highest rates of new HIV infections in 2021 were among Black/African American persons (37.3%), Hispanic/Latino persons (18.9%), and persons of multiple races (17.0%) (HIV.gov, 2023b). ● By sex at birth : People assigned male at birth accounted for 81% (25,900) of the estimated 32,100 new HIV infections in 2021, and people assigned female at birth accounted for 24% (6,200) of new HIV infections. According to the CDC, the annual number of new HIV infections in 2021, as compared to 2017, decreased among people assigned male at birth but remained stable among people assigned female at birth. In 2021, the rate for people assigned male at birth (18.8%) was four times the rate for people assigned female at birth (4.4%) (HIV.gov, 2023b).
Anyone who engages in behaviors that place them in contact with blood, semen, rectal fluids, vaginal fluids, and breast milk may be at risk for getting HIV. Even if you are in a long-term, monogamous (one-partner) relationship, it is important to confirm your HIV status to be sure that you and your partner remain healthy and HIV negative. According to the CDC, everyone ages 13 to 64 should include HIV testing at least once as part of their healthcare routine, even if they do not feel they are at risk.
High risk groups In the United States, HIV is most commonly spread through sexual intercourse, be it anal or vaginal, and by sharing drug-use equipment (or works) with someone who is carrying the virus. HIV continues to devastate some risk groups more than others. Certain populations are at greater risk because there are higher rates of HIV infection within their communities or population groups. This means that with each sexual or drug use encounter, they are placing themselves at heightened risk of contracting the virus. Furthermore, the different demographic, social, and economic factors of each distinct community can further contribute to the level of risk. These factors can include income, education, geographic region, or even the prevalence of stigma and discrimination. Key points: HIV incidence ● The estimated number of new HIV infections in 2021 was 36,136, showing a decline of 7% from 2017 to 2021 (CDC, 2024). ● By age group : People ages 13 to 34 accounted for 58% (18,700) of the estimated 32,100 new HIV infections in 2021. In 2021, as compared with 2017, the annual number of HIV infections among persons ages 13 to 34 decreased 18%. According to the CDC, no change was detected in persons ages 25-34, 35-44, 45-54, and ≥55 years (HIV.gov, 2023b).
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