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HIV
Explained:

Symptoms, Risks, & Prevention

What is HIV?

What is HIV?

HIV (human immunodeficiency virus) is a virus that attacks the immune system and lowers the body’s natural defence against illness and disease.

HIV is a lifelong condition. It can be managed with effective treatment, but right now there isn't a cure.

How is HIV transmitted?

There is a risk of HIV being transmitted only when one of the following fluids enters the bloodstream of somebody else. This can be through broken skin (e.g. injecting drugs, cuts or sores) or a mucous membrane (in the rectum, vagina, and penis):

Blood
Anal fluids
Vaginal fluids
Breastmilk/ Chestmilk
Semen/ Pre-cum
Blood
Anal fluids
Vaginal fluids
Breastmilk/ Chestmilk
Semen/ Pre-cum
Transmission can occur through: broken skin, penis opening, vagina, rectum, and foreskin.

Very Common:

Condomless Anal Sex
Sharing Injections

Common:

  • Condomless Vaginal Sex

Not Common:

  • Oral Sex With No Barriers

*There is no risk of HIV from receiving any kind of oral sex. There is almost no risk from fellatio (giving head) if your partner doesn't cum in your mouth or from performing cunnilingus (eating someone out). HIV transmission could be a risk if your partner cums in your mouth and you have cuts or sores there.

Possible in Theory:

Fingering
Handjobs
Anilingus

*There is no evidence that HIV transmission occurs these ways, but in theory it is possible if broken skin or a mucous membrane makes contact with infectious bodily fluids.

Not Possible:

Kissing
Sharing Toilets
Food/Drinks
Hugging
Shaking Hands
Bug Bites
Petting Animals
Fingering  Handjobs   Anilingus (Eating Ass)   Kissing  Sharing Toilets   Food/Drinks   Hugging   Shaking Hands   Bug Bites   Petting Animals

Take an
HIV Risk Assessment

This 1-minute, 100% confidential questionnaire will help you understand your risk of HIV.

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People on effective HIV treatment can’t transmit HIV

This is known as Undetectable = Untransmittable (U=U).

With today's medical advancements, HIV+ individuals can:

  • Live long, healthy lives.
  • Reach a point where they can't transmit HIV to others. By taking medication, those living with HIV can achieve a suppressed or undetectable viral load, a state where there is not enough HIV in your bodily fluids to pass HIV on during sex.

Tips to protect yourself from HIV

  • Use condoms (including on shared toys)
  • Understand your partner’s capability to transmit HIV (HIV+ people on effective treatment with an undetectable viral load can’t transmit)
  • Taking PrEP (a pill that can help prevent HIV when taken as prescribed)

Take an
HIV Risk Assessment

By answering some questions about your sexual behaviour, our 1-minute questionnaire can help you better understand your HIV risk. It’s 100% confidential.

GET STARTED

Symptoms & signs of HIV

Not everyone that has HIV will show symptoms. The only way to be sure of one’s HIV status is by testing.

Stage 1: Acute HIV

This is when the body will recognize the new infection, as the virus has had time to multiply. Due to the body’s fight against the new HIV infection, its immune system can cause the symptoms listed below. However, it is also common to have no symptoms at all.

Symptoms:

  • Swollen lymph nodes (usually found around the neck, armpits, groin)
  • Flu-like symptoms (fever, chills, sore throat, body aches, headaches, coughing and nausea)
  • Skin rash (typically looks like a series of red bumps on a flat, red patch of skin)

Since these symptoms usually happen before HIV is detected, they are hard to prevent.

The acute HIV stage is also when the body begins producing antibodies to recognize HIV.

For most people, an HIV test will turn positive just after this period. This testing is possible because there will now be enough of the virus and subsequent antibodies to detect the presence of HIV.

Can it be treated at this stage?
Yes, you can start HIV treatment at any point after diagnosis and international guidelines support starting treatment as soon as possible.

Stage 2: Chronic HIV

Chronic HIV is often referred to as the asymptomatic stage. During this stage, many people with HIV do not have any symptoms. This asymptomatic period can range from just a few years to over 20 years.

However, as time passes and HIV slowly compromises the immune system, some symptoms listed below can start to develop.

Symptoms:

  • Sores
  • Weight loss
  • Fatigue
  • Diarrhea

Can it be treated at this stage?
Yes, treatment can resolve symptoms experienced in the chronic HIV stage. All people living with HIV must maintain this treatment for the rest of their life for it to keep working.

Stage 3: AIDS

While HIV is a virus, AIDS is a syndrome. This means AIDS is a condition characterized by a set of associated symptoms that consistently occur together.

A person who is living with HIV is classified as having AIDS when one of the following conditions is met:

  1. Their T-cell count (a kind of white blood cell) drops below 200 per cubic millimetre of blood.

 2. They have an opportunistic infection or a type of cancer that’s rare for HIV-negative people.

Symptoms:

  • Chills and night sweats
  • Genital or anal sores
  • Rashes (brown, red, purple, pink)
  • Random bruises or bleeding
  • Memory problems
  • Diarrhea
  • Pneumonia

This list isn’t exhaustive as AIDS can include a number of opportunistic infections.

Can it be treated at this stage?
AIDS can be reversed, meaning the diagnosis is removed, with effective treatment of HIV and treatment of the opportunistic infection or illness. This possibility of reversal is because AIDS is a syndrome, not the infection itself.

If you start on HIV medications and follow the advice of your doctor, it is possible for your health to improve.

Stage 1: Acute HIV


This is when the body will recognize the new infection, as the virus has had time to multiply. Due to the body’s fight against the new HIV infection, its immune system can cause the symptoms listed below. However, it is also common to have no symptoms at all.

Symptoms:

  • Swollen lymph nodes (usually found around the neck, armpits, groin)
  • Flu-like symptoms (fever, chills, sore throat, body aches, headaches, coughing and nausea)
  • Skin rash (typically looks like a series of red bumps on a flat, red patch of skin)

Since these symptoms usually happen before HIV is detected, they are hard to prevent.

The acute HIV stage is also when the body begins producing antibodies to recognize HIV.

For most people, an HIV test will turn positive just after this period. This testing is possible because there will now be enough of the virus and subsequent antibodies to detect the presence of HIV.

Can it be treated at this stage?
Yes, you can start HIV treatment at any point after diagnosis and international guidelines support starting treatment as soon as possible.

Stage 2: Chronic HIV


Chronic HIV is often referred to as the asymptomatic stage. During this stage, many people with HIV do not have any symptoms. This asymptomatic period can range from just a few years to over 20 years.

However, as time passes and HIV slowly compromises the immune system, some symptoms listed below can start to develop.

Symptoms:

  • Sores
  • Weight loss
  • Fatigue
  • Diarrhea

Can it be treated at this stage?
Yes, treatment can resolve symptoms experienced in the chronic HIV stage. All people living with HIV must maintain this treatment for the rest of their life for it to keep working.

Stage 3: AIDS


While HIV is a virus, AIDS is a syndrome. This means AIDS is a condition characterized by a set of associated symptoms that consistently occur together.

A person who is living with HIV is classified as having AIDS when one of the following conditions is met:

  • Their T-cell count (a kind of white blood cells) drops below 200 per cubic millimeter of blood.
  • They have an opportunistic infection or a type of cancer that’s rare for HIV-negative people.

Symptoms:   

  • Chills and night sweats
  • Genital or anal sores
  • Rashes (brown, red, purple, pink)
  • Random bruises or bleeding
  • Memory problems
  • Diarrhea
  • Pneumonia

This list isn’t exhaustive as AIDS can include a number of opportunistic infections.

Can it be treated at this stage?
AIDS can be reversed, meaning the diagnosis is removed, with effective treatment of HIV and treatment of the opportunistic infection or illness. This possibility of reversal is because AIDS is a syndrome, not the infection itself.

If you start on HIV medications and follow the advice of your doctor, it is possible for your health to improve.

PEP

Post-exposure prophylaxis

If you have had a potential HIV exposure within the last 72 hours, it’s recommended you head to your nearest emergency room to get PEP.

  • PEP is only meant to be used in emergency situations after an event where HIV could have been transmitted.
  • For PEP to be effective, treatment must begin within 72 hours from the initial HIV exposure and ideally as close to that exposure as possible. This involves a 4-week course of medication that is usually used to treat HIV.

PEP

Post-exposure prophylaxis

If you have had a potential HIV exposure within the last 72 hours, it’s recommended you head to your nearest emergency room to get PEP.

  • PEP is only meant to be used in emergency situations after an event where HIV could have been transmitted.
  • For PEP to be effective, treatment must begin within 72 hours from the initial HIV exposure and ideally as close to that exposure as possible. This involves a 4-week course of medication that is usually used to treat HIV.

Testing for HIV

Testing
for HIV

When to get tested
It can take anywhere between 2 weeks and 3 months after exposure for HIV to show up through testing. This time frame is known as the HIV window period. The time varies based on the person and the type of test used.

Regardless of where you access it, HIV testing should be provided free of charge.

Types of tests
The type of HIV test can vary with three main characteristics:

1. Timeliness: How quickly you can receive a result.
2. Accuracy: How reliable the result is.
3. Accessibility: How easy it is to get the test performed.

Laboratory Tests

Laboratory testing is the most common type of testing method for HIV. During this test, blood is drawn from the patient’s vein and sent to a laboratory for review.

All labs in Canada use a 4th-generation test to screen blood samples.

It can take up to 1-2 weeks to receive the results from a laboratory HIV test.

Accuracy after initial HIV exposure:
- 50% by 18 days after exposure
- 99% by 44 days after exposure

Accessibility:
Laboratory testing may be challenging as it must be ordered by a prescribing healthcare provider and it can be difficult to find inclusive providers in more remote locations. It is generally recommended to find the appropriate healthcare provider at STI clinics, a family doctor's office, or a walk-in clinic.

Please refer to the clinic list on this page for potential clinic options.

Rapid Tests (Point-of-Care)

Rapid HIV testing requires a drop of blood from a finger prick to perform the test. Similar to a laboratory test, point-of-care rapid tests are performed by a healthcare provider.

There is currently only one Rapid HIV test approved for use in Canada: The INSTI HIV-1/HIV-2 Antibody Test.

Results can be provided within minutes.

Accuracy after initial HIV exposure:
-
50% by 22 days after exposure
- 99% by 84 days after exposure

Accessibility:
Rapid tests (point-of-care) are harder to come by, and can sometimes be accessed through specialized STI clinics and other LGBTQ2S+ organizations.

Please refer to the clinic list on this page for potential clinic options.

Rapid Tests (Self-Test)

Rapid HIV testing requires a drop of blood from a finger prick to perform the test. Unlike laboratory tests and point-of-care rapid tests, self-tests are performed by the patient themselves.

There is only one Rapid HIV test approved for use in Canada: The INSTI HIV Self Test.

Results can be provided within minutes.  

Accuracy after initial HIV exposure:
-
50% by 22 days after exposure
- 99% by 84 days after exposure

Accessibility:
There are two ways to get HIV rapid self-tests in Canada.

You can order them online from the test manufacturer, BioLytical - these cost $34.95 for one or $54.95 for a pack of two.

Alternatively, you can get up to three free tests from I’m Ready to Know. This is a method run by Canadian researchers who are studying HIV self-testing. You’ll need to sign up for their study to receive the kits - visit their website or download their app to learn more.

Mail-In HIV Test

A mail-in self-test for HIV collects a small amount of blood by pricking the tip of your finger. Once the sample is collected, it’s mailed to a lab for verification. Unlike a rapid self-test, mail-in HIV tests are able to detect HIV shortly after exposure.

Accuracy after initial HIV exposure:
- 50% by 22 days after exposure
- 99% by 84 days after exposure

Accessibility
A mail-in HIV test is included as part of Freddie’s at-home testing kit. To get your own at-home test kit – and learn more about how you can get PrEP for $0 – book a free consultation with a Freddie clinician.

Rapid Self-Test

Rapid HIV self-testing requires using an oral swab to collect a sample. The result will be visible on the test device itself, similar to a COVID-19 test, roughly 20 minutes after the sample is collected.

Accuracy
Rapid self-tests report results with roughly 92% accuracy. If the result is invalid, you will have to use another test kit.

Accessibility
The only rapid self-test approved for use in the U.S. is OraQuick. You can order OraQuick online or have a healthcare provider order it for you.

Rapid Tests (Point-of-Care)

Rapid HIV testing requires a drop of blood from a finger prick to perform the test. Similar to a laboratory test, point-of-care rapid tests are performed by a healthcare provider. Results can be provided within minutes.

Accuracy after initial HIV exposure:
-
50% by 22 days after exposure
- 99% by 84 days after exposure

Accessibility:
Rapid tests (point-of-care) are harder to come by, and can sometimes be accessed through specialized STI clinics and other LGBTQ2S+ organizations.

Please refer to the clinic list on this page for potential clinic options.

Laboratory Tests

Laboratory testing is the most common type of testing method for HIV. During this test, blood is drawn from the patient’s vein and sent to a laboratory for review.

It can take up to 1-2 weeks to receive the results from a laboratory HIV test. 

Accuracy after initial HIV exposure:
-
50% by 18 days after exposure
- 99% by 44 days after exposure

Accessibility:
Laboratory testing may be challenging as it must be ordered by a prescribing healthcare provider and it can be difficult to find inclusive providers in more remote locations. It’s also typically more expensive than self-tests or rapid tests delivered at the point-of-care.

Find a clinic near you
Looking to get tested for HIV or other STIs? Check out our resources on clinics for the following cities:

HIV prevention today is easier than ever

There are multiple ways to prevent HIV. We’ve listed 3 of the most common ones below.

Condoms - Help prevent HIV & STIs

Condoms, when used consistently and correctly, prevent the transmission of HIV and other STIs by up to 98%.

When using condoms, make sure to use only water or silicone-based lubricants. Oil-based lubricants can cause condoms to break, which raises the risk of HIV and STI transmission.

U=U - HIV+ individuals can’t transmit

By taking the right medications, persons living with HIV can achieve a state where they cannot transmit HIV to their sexual partners.

PrEP - A daily pill to prevent HIV

PrEP is a daily pill that can help prevent HIV when taken as prescribed. If you are inconsistent with condom use, have multiple sexual partners, or just want an additional layer of protection, PrEP is an accessible option for many Americans.

PrEP CAN HELP PROTECT YOU AGAINST HIV

Most Freddie patients pay $0 for it.

Learn More

Know your chances of getting or passing on other STIs with different kinds of sex on the BCCDC website. Learn more