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He doesn't have AIDS, he's HIV-positive.
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I understand the difference between those statements, but confess that I'm not clear on the important distinction. Are there situations where untreated HIV doesn't progress to AIDS? Is the virus more transmissible in someone with AIDS than someone who's still at the HIV-positive stage?

Asking here because I don't know, and I think an answer might help others know, too.

(And to clarify, I genuinely don't know, and I'm asking from a supportive POV.)

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We are unaware of any situations where HIV+ doesn’t turn into AIDS without treatment.

But being HIV+ is simply having a virus, not actively dying. HIV+ status also never clears - later tests that are “negative” mean your viral load is undetectable, at which point you can no longer transmit HIV to others. Undetectable = Untransmissable.

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FTA, it seems that a (very) small number of people develop effective antibodies againt HIV.

"These antibodies are very, very rare, but they can be found in blood samples from a small number of people living with HIV.

The vaccine causes the immune system to produce more of these "broadly neutralizing" antibodies.

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That all makes sense. A couple things I’m still not clear on:

* If someone has a negative test after treatment, but that’s not counted as “cured”, does that imply it could (or maybe will) come back if treatment is stopped?

* What’s the importance of the distinction between HIV+ vs AIDS, from a public health or human perspective? We don’t talk about influenza+ vs “has the flu”, at least as far as I know. Does HIV+ carry less stigma than AIDS?

Thanks for your earlier answer. I know this specific infection has lots of difficult history. It’s hard to formulate my questions without sounding suspiciously close to a sea lion or something, but I sincerely want to know. And yes, I could google it but then it wouldn’t be an interesting conversation, or one others could read and learn from.

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* If someone has a negative test after treatment, but that’s not counted as “cured”, does that imply it could (or maybe will) come back if treatment is stopped?

Yes. HIV+ patients require antiretroviral treatment for the remainder of their lives. Most are able to manage with a pill regimen. This is not to say it is cheap or side effect free, but most HIV+ people are able to live normal lives with outpatient support.

(To link it back, PrEP is the same drug used to treat; ex, emtricitabine + tenofovir. Dosage, schedule differs. Other antiretrovirals may be chosen.)

* What’s the importance of the distinction between HIV+ vs AIDS, from a public health or human perspective? We don’t talk about influenza+ vs “has the flu”, at least as far as I know. Does HIV+ carry less stigma than AIDS?

Public health does talk about Inflenza (and other viral positive) individuals. Public messaging is usually with the term “carrier” - but in jargon, this implies that the individual will likely mot develop the disease themself, and will remain asymptomatic, which is untrue for HIV. NCoV-19, recently in the public eye more than any other virus, has a lot of literature around positive tests vs disease.

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1. What a freaking miracle. Growing up in the 80's, the notion was terrifying. I was straight and it was something my friends and I discussed. I can't imagine how awful it must've been for gay communities. Again, what a miracle.

2. OK, fair point.

Thanks for the info! I know HIV isn't exactly "no big deal" today, but seeing it go from "you're certain to die" to "it's annoying to have to take medicine forever" is still a wonder of modern science.

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