UPDATE COMING We’re currently working to update this article. Studies have shown that a person living with HIV who is on regular antiretroviral therapy that reduces the virus to undetectable levels in the blood is NOT able to transmit HIV to a partner during sex. This page will be updated soon to reflect the medical consensus that “Undetectable = Untransmittable.”
The outlook for people living with HIV has significantly improved over the past two decades. Many people who are HIV-positive can now live longer, healthier lives when they’re in routine care.
U.S. Kaiser Permanente researchers found that the life expectancy for people living with HIV and receiving treatment has increased significantly since 1996. This is when new antiretroviral drugs were developed and added to the existing antiretroviral therapy. This resulted in a highly effective HIV treatment regimen.
In 1996, the total life expectancy for an infected 20-year-old person was 39 years. In 2011, the total life expectancy bumped up to about 70 years. Someone who is HIV-positive, receiving treatment, and in optimal health — meaning they don’t do drugs and are free of other infections — may live to be in their late 70s.
The survival rate for people living with HIV has also dramatically improved since the first days of the epidemic. Researchers in a 2013 study found that 78 percent of deaths of people with HIV between 1988 and 1995 were due to AIDS. Between 2005 and 2009, that figure dropped to 15 percent.
A person living with HIV who isn’t on treatment is still more likely to develop AIDS and experience an early death.
How many people are affected by HIV?
An estimated 1.2 million Americans are living with HIV, but fewer people are becoming infected each year. This may be because of increased testing and advances in treatment.
Between 2005 and 2014, the annual number of new HIV diagnoses fell by 19 percent.
How has treatment improved?
Antiretroviral medication, also known as anti-HIV drugs, can help to slow damage caused by HIV and prevent it from developing into AIDS.
Your doctor may recommend that you undergo antiretroviral therapy. This treatment requires you to take three or more anti-HIV drugs daily. The combination helps suppress the amount of HIV in your body, or your viral load.
The different classes of anti-HIV drugs include:
- non-nucleoside reverse transcriptase inhibitors
- nucleoside reverse transcriptase inhibitors
- protease inhibitors
- fusion inhibitors
- integrase inhibitors
Viral-load suppression allows people with HIV to live healthy lives and decreases their chances of developing AIDS. The other benefit of an undetectable viral load is that it helps reduce the number of HIV infections.
The 2014 European PARTNER study found that the risk of HIV transmission is very small when a person has an undetectable load. This means that the viral load is below 50 copies per milliliter (mL).
This discovery has led to an HIV prevention strategy called treatment as prevention. It promotes constant and consistent treatment as a way to reduce the spread of the virus.
HIV treatment has evolved tremendously since the onset of the epidemic, and advancements continued to be made. Two recently published studies — one out of the United Kingdom and one from the United States — showed promising results in experimental HIV treatments that could put the virus into remission and boost immunity.
The U.S. study was conducted on monkeys infected with the simian form of HIV, so it’s not clear if people would see the same benefits. As for the U.K. trial, participants showed no signs of HIV in their blood. However, researchers cautioned that there’s potential for the virus to return.
How will HIV affect me in the long term?
Though the outlook has gotten much better for those with HIV, there are still some long-term effects that people living with the virus might experience.
As time passes, people living with HIV may begin to develop certain side effects of treatment.
These may include:
- “accelerated aging”
- cognitive impairment
- inflammation-related complications
- effects on lipid levels
Your body may also undergo a shift in how it processes sugars and fats. This can lead to having more fat in certain areas of your body, which can change your body’s shape and how you look.
If treated poorly or left untreated, HIV infection can develop into AIDS.
A person develops AIDS when their immune system is too weak to defend their body against infections. A doctor will likely diagnose you with AIDS if the number of white blood cells in your immune system, or CD4 count, drops below 200 cells per mL of blood.
Symptoms of AIDS include brain tumors and serious weight loss. The syndrome could also lead to other health issues, including:
Life expectancy is different for every person living with AIDS. Some people may die within months of an AIDS diagnosis, but the majority can live fairly healthy lives.
Are there long-term complications?
Over time, HIV can kill the cells in your immune system. This can make it difficult for your body to fight serious infections. These opportunistic infections (OIs) can be life-threatening, because they can damage your immune system when it’s already weak.
If a person living with HIV develops an opportunistic infection, they will be diagnosed with AIDS.
Some OIs include:
- certain types of cancer, such as lymphoma, Kaposi’s sarcoma, and invasive cervical cancer
- recurring pneumonia
- wasting syndrome
- brain and spinal cord disease
- different types of lung infections
- chronic intestinal infection
- herpes simplex virus
- fungal infections
- HIV-related brain disorder
- cytomegalovirus infection
OIs are the most common cause of death for people living with AIDS. The best way to prevent an opportunistic infection is by remaining in treatment and getting routine checkups. It’s also important to practice safe sex, get vaccinated, and eat properly prepared foods.
Boosting long-term outlook
HIV can quickly cause damage to your immune system and lead to AIDS, so getting timely treatment can help improve your life expectancy. People living with HIV should also visit their doctor regularly and treat other health conditions as they arise. This can help offset the effects of the virus and prevent AIDS from developing.
The bottom line
New tests, treatments, and technological advancements for HIV have greatly improved what was once a grim outlook. Thirty years ago, being diagnosed with HIV was considered death sentence. Today, people with HIV can live long and healthy lives.
That’s why routine HIV screening is vital. Early detection and timely treatment are key to managing the virus, extending life expectancy, and reducing the risk of transmission. Those who remain untreated are more likely to experience complications from HIV that could lead to illness and death.
If you’ve been newly diagnosed, speak with your doctor immediately about starting an HIV regimen that works best for your individual needs.