HIV (human immunodeficiency virus) is a virus that attacks and weakens the immune system. It can be transmitted through body fluids such as blood, semen, vaginal fluid, breast milk and anal mucous of a person with HIV who has a detectable viral load.
HIV transmission most commonly happens through sex without the use of a barrier method like a condom. This includes anal, vaginal and oral sex with people of all genders. (In fact, ‘heterosexual’ sex accounts for nearly 30% of HIV transmission in Australia). HIV transmission can also occur by sharing injecting or tattooing equipment, and during pregnancy, birth or breastfeeding.
If left untreated for some time, the HIV virus can severely damage a person’s immune system and lead to AIDS (acquired immunodeficiency syndrome).
AIDS is not a single disease. It is a diagnosis that can result from a range of conditions that can occur when a person’s immune system has been damaged by untreated HIV.
HIV and AIDS are not the same thing, and it is important to remember that a person living with HIV does not necessarily have AIDS. As a result of effective treatment, very few people in the ACT are currently living with AIDS.
Meridian (then the ACT AIDS Action Committee) was established in 1983 as a response to the HIV and AIDS epidemic in the ACT. Today, Meridian continues to lead the ACT community response by providing prevention, education, treatment and support services for people living with and impacted by HIV (PLHIV).
If you have HIV, we can help you find support and get information on and access to treatment options.
Frequently asked questions about HIV
How is HIV transmitted?
HIV can be transmitted through the blood, semen, vaginal fluid, anal fluid or breast milk of a person living with HIV who has a detectable viral load. The main ways this can occur are through:
- sexual intercourse (anal or vaginal) without the use of an HIV prevention strategy (such as barrier methods, PrEP, PEP or U=U)
- sharing injecting or tattooing equipment
- pregnancy, birth or breastfeeding (from the birthing parent to the child).
HIV cannot live outside of the body for very long and it is not air-borne like the flu or COVID-19.
HIV cannot be transmitted by hugging, holding hands, coughing, sneezing, sweat, saliva, mosquitos or sharing utensils, plates or cups.
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If you think you have been exposed to HIV in the last 72 hours (3 days), start PEP (post-exposure prophylaxis) now. PEP is a month-long course of medication that helps prevent HIV infection after a possible exposure. In Canberra, you can access PEP from the emergency departments of Canberra Hospital and North Canberra Hospital, and during business hours at the Canberra Sexual Health Centre. |
What prevents HIV transmission?
There are several ways to prevent HIV transmission. Many people use more than one strategy to increase effectiveness. Options include:
Condoms and lube
Condoms prevent HIV by stopping the exchange of body fluids during anal or vaginal sex. They also prevent the transmission of other STIs and unplanned pregnancy.
Using water-based or silicone-based lube helps condoms work effectively and reduces the risk of breakage.
PrEP
PrEP (pre-exposure prophylaxis) is a HIV prevention medication for HIV-negative people. It can be taken daily or on-demand (for some people).
When taken as prescribed, PrEP reduces the likelihood of HIV transmission by almost 100%.
PEP
PEP (post-exposure prophylaxis) is a short course of HIV medication taken after a potential exposure. It must be started as soon as possible: ideally within 24 hours and no later than 72 hours to be effective.
If you think you have been exposed to HIV in the last 72 hours (3 days), start PEP now.
PEP is a month-long course of medication that helps prevent HIV infection after a possible exposure. In Canberra, you can access PEP from the emergency departments of Canberra Hospital and North Canberra Hospital, and during business hours at the Canberra Sexual Health Centre.
HIV treatment as prevention (U=U)
HIV treatment lowers the amount of virus in the body to undetectable levels. When someone has an undetectable viral load, HIV cannot be passed on through sex. This is known as U=U: undetectable equals untransmittable.
Maintain your own or rely on someone’s undetectable viral load to prevent HIV transmission.
Using new injecting equipment
Using new needles and injecting equipment (including filters, spoons, mixing water and tourniquets) when injecting drugs prevents transmission of HIV and other blood-borne viruses (such as hepatitis B and hepatitis C).
New injecting equipment is available for free from needle and syringe programs (NSPs).
Used needles and syringes can be returned to an NSP, put into a sharps bin, or thrown away in something hard like a bottle with a lid.
Pregnant parent to child prevention
HIV transmission from a pregnant parent to their child (also known as vertical transmission of HIV) is very rare in Australia. Minimising HIV transmission during pregnancy, birth and breastfeeding/chestfeeding includes:
- the use of HIV medications to reduce the pregnant parent’s viral load.
- elective caesarean delivery of the baby
- considering formula feeding, donor milk or maintaining an undetectable viral load while breastfeeding/chestfeeding.
Find out more information about preventing parent-to-child transmission.
Other strategies to prevent HIV transmission
Some people also use strategies that may reduce risk but are less reliable when used on their own. These include:
- Negotiated safety and relationship agreements: People agree on how to prevent HIV transmission within their relationship and with any outside sexual partners. This relies on regular HIV testing, trust and open communication.
- Serosorting: Choosing sexual partners who share the same HIV status. This relies on people knowing their HIV status through regular and recent HIV testing, trust and open communication.
- Pulling out: Also known as withdrawal, involves removing the penis before ejaculation during anal or vaginal sex. This is a high-risk strategy as HIV can still be transmitted through pre-cum and anal and vaginal fluids, and it relies on timing.
- Strategic positioning: Choosing sexual positions or acts that carry lower likelihood of HIV transmission, such as being in the insertive position (the top) during anal or vaginal sex, or other sexual acts carrying very low to no risk, such as oral sex, using sex toys, hand play or mutual masturbation. While lower likelihood than receptive positioning, HIV can still be passed on to people in the insertive position during sex.
It’s important to note that condoms are the only HIV prevention strategy that also reduce the transmission of other STI.
How is HIV detected?
HIV is detected through a blood test. This test detects the antibodies that are produced by the body when an HIV infection occurs.
You can be tested for HIV during a sexual health check (while getting tested for other STIs) or use a self-testing kit if you'd prefer to do the test at home.
You can get a free HIV self-test kit from our reception (during business hours) or 24/7 using the CONNECT vending machine outside our office, thanks to the federally funded CONNECT project by Thorne Harbour Health. To get a kit through the vending machine, you just need to head to the CONNECT website, answer a few questions and provide a mobile phone number. You'll then get an SMS with a code you can use at the machine to get your free test. Using the kit is straightforward and there’s a detailed instructional video on the CONNECT website, along with plenty of other information. If you are not near Meridian or a HIV self-test kit vending machine, and you live in Australia, you can get a HIV self-test delivered to you from HIV Self-Testing Australia.
If you get a positive result, you can follow up with a doctor or nurse who will do a blood test to confirm. You can call the Meridian office for support on (02) 6257 2855 during business hours.
HIV antibodies can take up to 12 weeks (3 months) to be detected in your blood with a test. This period of time between exposure to HIV and when it shows up in a test is called a 'window period'. Because of this window period, it is best practice to get an HIV test every 3 months if you are at risk of HIV, or 3 months after a potential exposure to HIV.
Read more about sexual health testing.
How is HIV treated?
HIV treatment involves antiretroviral therapy (ART) which can be taken orally or by injection with the goal of reducing the viral load in the body and keep you living well with HIV, reducing the risk of disease advancement associated with HIV.
Decisions about starting treatment and what treatments to take should always be done in consultation with a doctor with expertise in HIV management.
Read more about HIV treatment.
What is a 'viral load'?
Viral load refers to the amount of HIV virus that is in an HIV-positive person’s body. This is determined by testing a blood sample in a lab.
In the results, the viral load is shown as a number. The figure is the number of viral copies per millilitre of blood (copies/ml). This can range from less than 20 copies/ml to more than one million copies/ml.
What is an 'undetectable' viral load or 'U=U'?
When a person living with HIV is taking HIV medication as prescribed, the viral load of HIV in their blood often reduces to a point where there is not enough for a test to measure. This is called an 'undetectable viral load' (UVL).
Having a UVL does not mean the person is cured of HIV, but they will experience greatly improved health outcomes and, after 6 months or more of a UVL, they cannot transmit HIV to a partner who is HIV-negative. This is referred to as 'undetectable equals untransmissible' or 'U=U'. It is also called 'treatment as prevention'.
Read more about U=U.
Where can I find more information?
Find more information about HIV in Australia at Health Equity Matters and The Kirby Institute.
Find more information about HIV around the world at UNAIDS.