If someone gets HIV and doesn’t get treatment, it can slowly damage their immune system over time. HIV mainly attacks CD4 T cells — these are white blood cells that help fight infection. Without enough of these cells, the body can have a harder time staying healthy.

Getting tested and starting treatment early helps people live long, healthy lives.

Stage 1: Acute HIV

This is the first stage, usually within 2 to 4 weeks after HIV enters the body. 

During this time:

• The virus makes lots of copies of itself quickly resulting in a high viral load (the amount of HIV in the blood).
• Most HIV tests can’t detect the virus this early
• A person is very contagious. During this time, the risk of passing HIV to partners are higher than other stages of HIV.
• Flu-like symptoms and other symptoms may occur during this time, though some people will be asymptomatic (not showing symptoms). 

Seroconversion Illness:

In some cases, early symptoms of HIV include:

• Fever and flu-like symptoms
• Swollen glands in the armpits, groin and neck
• Feeling tired all of the time
• Sore muscles and joints
• Sore throat
• Diarrhea
• Headache
• Rashes on torso
• Night sweats
• Mouth ulcers

Many of these symptoms can be caused by other diseases or illnesses, so having them doesn’t necessarily mean it is HIV. 

Stage 2: Asymptomatic Infection 

After the first few weeks, HIV levels go down but the virus is still in the body. This stage can last for years without symptoms. Without treatment, HIV continues to slowly weaken the immune system.

Stage 3: AIDS (Acquired Immunodeficiency Syndrome)

Sometimes it takes years to notice the effects of HIV. After the early stages, HIV is still active, but copies itself at lower rates. This period is called asymptomatic infection.

For people who aren’t on treatment for HIV, the virus can weaken the body’s immune system even further and progress to AIDS . A person living with AIDS’ immune system can get so weak that they might get all kinds of different serious illnesses and infections. Because of modern testing, awareness campaigns, and treatment options, HIV rarely develops into AIDS, especially in Canada where most people have access to treatment.

If you think you’re HIV-negative but you haven’t been tested in a while, remember that it’s important to get tested for HIV frequently if you’re having sex or using shared injection or drug equipment, whether or not you have symptoms. Being diagnosed early is one of the best ways to access treatment quicker, avoid passing the virus on to someone, and better support your overall health in the long run.

You may be wondering, am I at risk of getting HIV? Let’s start by talking about what risk really means.

Risk, in this context, is about your chance of getting HIV.

Everyone’s risk is different. Taking part in something considered “high-risk” doesn’t mean you’ll definitely get HIV, and doing something considered “low-risk” doesn’t guarantee you won’t. You might hear things like “being gay puts you at risk” which is not inherently true but we’ll talk more about this in the section below. Reducing risk down to people’s identities alone does not actually provide the information needed to make a risk assessment. 

A more helpful way to conceptualize risk is not by how you identify but things like:

• The kinds of sex you have
• Whether you use condoms or other forms of protection
• If you use substances, especially if you use substances during sex
• If you share needles or drug equipment
• Your access to basic needs
• Your partners’ risk and their HIV status is
• Access to HIV testing and treatment
• If you have sex with multiple partners, especially strangers

HIV exposures are most commonly from condomless penetrative sex with genitals and sharing injection equipment and needles. We understand that all kinds of circumstances can lead to these activities and that for many it simply can be pleasurable and important to our lives. By learning how HIV works and the ways we can reduce the risks of getting or passing it along, we can find ways to still have fun doing the things we like to do.

HIV can affect anyone but some groups are more affected than others. According to Nova Scotia Health, most new HIV diagnoses in the province in recent years are amongst men who have sex with men and people who use drugs. HIV has often been thought of as only a gay men’s issue in North America. While it does disproportionately impact Two-Spirit, gay, bisexual, and queer (2S/GBQ) men who have sex with men than some other populations, being a queer man does not mean you will get HIV, and not being a queer man does not mean you won’t. It’s worth noting that the language used in public health data is limiting and does not represent the complex web of identities/genders/sexualities of those impacted by HIV, including trans and non-binary people. We see certain populations (2S/GBQ+ men, Indigenous people, people who use drugs, African/Caribbean//Black people) overrepresented in rates of HIV because of health inequities as a result of systemic issues. These social and structural determinants of health include:

• access to basic needs like healthcare and housing
• income
• education
• social stigma and discrimination; and
• traumatic histories both individual and communal, to name a few.

We talk about priority and high-risk populations because these communities frequently face gaps in care and intersecting social and systemic barriers which can lead to disproportionate HIV rates. Not because belonging to them is inherently a risk.