1. Is it possible I got a false positive on my HIV test?
When your initial test comes back positive (unless you’ve done the at-home test) you should be offered a confirmatory test, basically a second test to make sure you’re HIV-positive. The likelihood of two false positives is extremely rare. If you took the at-home test, it’s a good idea to go to a doctor or clinic to do the second test. Sadly, false-negative test results can happen too, so if you come up positive and your partner comes up negative, be cautious and have your partner retest. According to AIDS.gov, the likelihood of a false negative depends on when you might have been exposed to HIV and when you took the test: “It takes time for seroconversion to occur. This is when your body begins to produce the antibodies an HIV test is looking for—anywhere from two weeks to six months after infection. So if you have an HIV test with a negative result within three months of your last possible exposure to HIV, the CDC recommends that you be retested three months after that first screening test. A negative result is only accurate if you haven’t had any risks for HIV infection in the last six months—and a negative result is only good for past exposure.”
2. How did I get HIV?
This is a question you’ll get asked exhaustively, but right now you’re probably just asking yourself. The bottom line is that the main risk is having unprotected anal sex or (for women) vaginal sex or sharing needles with an infected person. It’s possible but quite a bit less likely that you got it from oral sex. The CDC says it’s also possible to acquire HIV through exposure to infected blood, transfusions of infected blood, blood products, or organ transplantation, “though this risk is extremely remote due to rigorous testing of the U.S. blood supply and donated organs.”
3. Can “tops” get HIV?
Actually, there’s some truth to the assumption that male “tops” (insertive partners in anal sex) get HIV less. The insertive partner in both anal and vaginal sex is less likely to contract HIV—in the case of anal sex, tops have 86 percent reduction in transmission, according to a 2012 study—but that still means tops can get HIV from sex.
4. Does being HIV-positive mean I also have AIDS?
Absolutely not. In the U.S., the majority of people living with HIV will never develop AIDS, the most advanced stage of HIV disease. HIV is the virus that causes AIDS, but for most people, proper treatment and regular medical care to keep your immune system strong will prevent you from ever developing AIDS. Remember, an HIV-positive test result means only that: You have HIV.
5. Am I going to die?
No, probably not anytime soon. There can always be complications, just as there are with any chronic condition (like diabetes, for example), but generally, with current medications, people with HIV are living near-normal lifespans. You will be susceptible to the same medical conditions that affect all people as they age, and some experts say that people with HIV will experience some of these conditions associated with aging (like osteoporosis) sooner because of the lifesaving antiretroviral drugs you need to take.
6. What do I tell people about how HIV is transmitted?
Let’s start with how it is not transmitted. Since the virus cannot survive outside the body, you cannot get it from toilet seats or shared cups or utensils. You can’t get it from kissing or from spit, since it’s not transmitted in your saliva. It is also not transmitted in sweat or urine. You can’t get it from a swimming pool, hot tub, sauna, mosquito or rodent bites, tattoos, or ear/body piercings. Only four bodily fluids are known to carry HIV in quantities concentrated enough to infect another person: blood, semen, vaginal fluids, and breast milk. According to the Centers for Disease Control and Prevention, it is one of these fluids from an HIV-positive person that has to come in contact with a mucous membrane or damaged tissue, or be directly injected into the bloodstream (from a needle or syringe) for HIV transmission to possibly occur.
7. Who is at higher risk of HIV infection?
Across all ethnicities, in the U.S. the group most affected by HIV infection is gay and bisexual men and other men who have anal sex with men (but for some reason don’t identify as gay or bi, dubbed MSM). Transgender women, especially women of color, are at a significantly higher risk as well, though exact numbers aren’t known because in many studies they are included, erroneously, in the MSM category. Black and Latino men and women and injection drug users have higher risk rates, but of course anyone (straight, gay, black, white, whatever) who has unprotected anal or vaginal sex is at risk.