World AIDS Day Takes Place Annually on December 1

What's the Difference Between HIV and AIDS?

Human immunodeficiency virus (HIV) is often confused with AIDS (acquired immunodeficiency syndrome). These are different diseases, though related to each other. HIV can cause AIDS, meaning it can cause acquired immunodeficiency in a person, but not always. Scientists distinguish them simply. HIV is a virus, while AIDS is a human condition that appeared as a consequence of infection and virus progression in the human body.

The immunodeficiency virus belongs to the retrovirus family and lentivirus genus and affects the body's immune cells. Lentiviruses (from lente, slow) develop slowly, heterogeneously, with a long incubation period. The virus gradually breaks through immune cell defenses, affecting receptors on their surface. Thus it makes a person susceptible to various diseases: from infectious to oncological. As a result of virus infection, opportunistic diseases can develop that don't occur in people with healthy immunity. HIV's cytopathic action (cell destruction or changes caused by viral infection) leads to blood cell damage, nervous, cardiovascular, musculoskeletal, endocrine, and other system damage, determining multi-organ failure development characterized by clinical manifestation diversity and steady HIV infection progression.

HIV leads to blood cell damage, nervous, cardiovascular, musculoskeletal, endocrine, and other system damage, which leads to multi-organ failure.

Acquired immunodeficiency syndrome manifests at the third stage of HIV development. Doctors make this diagnosis based on symptom combination: positive HIV infection test, indicators below 200 cells/μl CD4+ lymphocytes, and aggregate of other pathological conditions caused by various disease development. At this stage, the body can no longer resist most diseases; a person can suffer from several diseases simultaneously and die from their symptoms.

However, thanks to medical intervention, antiviral therapy, and prevention, HIV can stop developing and not reach the third stage, thus AIDS disease won't occur.

Note. AIDS is human immunodeficiency syndrome, caused by a virus. Syndrome in turn is a set of symptoms. That is, the virus as an agent destroys immune system cells, essentially making them incubators for producing itself. The body becomes defenseless against infections that in normal situations wouldn't harm it. Symptoms of a whole range of other diseases appear.

How HIV is Transmitted

For a long time, HIV and AIDS were considered among the most terrible threats of the 20th century, which generated many fears and myths around them. People's greatest concern was the possibility of infection through household contact or airborne transmission.

However, scientists proved that the main virus transmission method is blood and other biological fluids (semen, vaginal secretions, breast milk) getting onto mucous membranes or damaged skin. Undamaged skin is an effective barrier against the virus, and outside the body it doesn't survive. This excludes transmission through handshakes or airborne routes. Such biological fluids as saliva or tears also cannot cause HIV transmission. Saliva has too aggressive an environment that destroys virus cells.

Main HIV Infection Methods:

• Sexual route, most common infection type
• Shared needles, syringes, and other injection instruments
• Tattoo equipment if not properly sterilized between uses
• Pregnancy, gestation, and childbirth, from mother to child
• Breastfeeding

Immunodeficiency virus infection is possible under certain conditions: when infection source is a person with high viral load (50,000 to 100,000 viral particles per 1 ml blood); when circumstances favorable for virus transmission exist – damaged skin, mucous membranes of genitals or mouth.

Theoretically, infection can occur through blood transfusion. But since such manipulations in the overwhelming majority of cases involve testing, such precedents are rare.

How HIV Cannot Be Transmitted:

• Airborne route, through coughing and sneezing, talking
• Fecal-oral route, using shared dishes and consuming food contaminated with human immunodeficiency virus
• Contact route, through handshake, ordinary kisses, non-penetrative sexual actions
• At dentist appointments, HIV dies under antiseptic action
• During blood test collection, procedure is performed with disposable instruments and puncture area is necessarily disinfected
• Through insect bite

Note. It's established that HIV was transmitted through zoonosis, a process where viruses and infections transfer from animals to humans. HIV is a relatively "young" virus; evolutionarily HIV is an "offspring" of virus strains affecting monkeys; HIV's evolutionary "cradle" is in Central Africa, where Gabon is today located; starting from the 15th century, black slaves were exported to Caribbean countries, among them were those carrying the virus; globalization processes, emerging mass tourism in the second half of the 20th century became the impetus for virus spread in the USA, then in other Western countries.

What Are the First HIV and AIDS Symptoms?

If infection occurred, the virus can go through three stages.

Can You Recover from HIV and AIDS?

Scientists consider HIV an incurable disease. However, thanks to antiviral therapy, virus cells can be suppressed such that one can remain at the second stage without transformation to AIDS for many years. WHO recommends applying this therapy to all infected people. Highly active antiretroviral therapy (HAART) is conducted with three or more drug types. All of them prevent the virus from multiplying in the body at different levels. Precisely such therapy is recognized as most effective. With treatment using only one drug or incorrectly selected regimen, therapy resistance can arise. Examples of modern drugs: lopinavir, ritonavir, dolutegravir, emtricitabine, tenofovir. Especially important are new long-acting drugs (injections once a month or two), lenacapavir and cabotegravir.

Forecasts are still very cautious, but history knows of 10 patients who completely recovered from this disease. Doctors performed bone marrow transplants from recipients with rare genetic mutation that allowed believing they were virus-resistant. Patients ultimately after some time post-surgery demonstrated complete HIV absence in blood.

Innovative Approaches to HIV Therapy

In recent years, long-acting injectable drugs have been actively developed. The main one is lenacapavir (Lenacapavir) from Gilead, an antiretroviral drug administered once a month or once every two months. This is not a vaccine, but acts similarly: if vaccines teach the immune system to recognize and neutralize the virus, lenacapavir ensures constant presence of active substance in the body blocking HIV at entry.

Besides lenacapavir, scientists are developing other drugs that can seriously change the HIV treatment approach. Among the most promising research are two new-generation antiretroviral drugs from ViiV Healthcare, which should help those already infected. These are VH-184, a third-generation integrase inhibitor, meaning a drug that blocks HIV virus enzyme and protects against strains that other drugs don't handle. And VH-499, a promising capsid inhibitor that destroys the virus "shell" (capsid, "shell"). Both plan to release as injections potentially needed once every six months. VH-499 may repeat lenacapavir's path: become a long-acting drug but with excellent resistance profile.

A group of scientists in 2025 presented results of "functional cure" research. They tested a method that allows maintaining the virus at very low level without constant medication. An experiment was conducted with 28 adult patients who had long taken regular HIV medications and had sustainably low virus levels in blood. They were given a mixture of special antibodies that can neutralize the virus, and N‑803 drug, which strengthens immunity, helping "awaken" hidden virus and strengthen body's defensive reactions. After six months, more than half of participants didn't need therapy resumption, and about a third were without medication for over a year.

Post-Exposure HIV Prophylaxis

Post-exposure prophylaxis (PEP) is taking antiretroviral drugs for 28 days after possible virus contact (e.g., unprotected sex with HIV-positive or unknown status partner, using non-sterile needles, etc.). It must be started as early as possible, optimally within first 2 hours, but no later than 72 hours after contact.

In Russia, PEP standard exists predominantly for medical workers who are prescribed drugs after occupational risks. For other people, such protocol isn't as widely accessible due to lack of official standards and financial limitations: antiretroviral drugs are expensive (about 7–9 thousand rubles per course), and obtaining them without prescription and physician recommendations is difficult.

For PEP prescription, consultation with infectious disease physician is conducted, who assesses risk and selects treatment regimen. Early PEP intake significantly reduces infection probability.

Is There an HIV Vaccine?

For over 40 years after HIV discovery, scientists haven't managed to create a full vaccine. As of 2025, a fully ready HIV vaccine doesn't yet exist, but several promising vaccines on mRNA platforms and other innovative technologies are actively being developed and tested.

In Russia, for example, at the Gamaleya Center an mRNA vaccine against HIV is being developed, its task is to elicit strong and broad immune response against various virus variants. According to forecasts, trials may take about two years.

Also international studies show successes in creating vaccines eliciting production of powerful antibodies capable of neutralizing most HIV strains. Some companies are already conducting clinical trials of such drugs.

Is It True That an HIV Epidemic Is Raging Worldwide?

The HIV epidemic remains one of the largest pandemics in human history. From epidemic start to 2023, about 88 million people were infected, and the number who died from AIDS-related diseases exceeded 42 million. According to WHO, by end of 2024, 40.8 million people with HIV lived worldwide. In 2023, new infection cases numbered approximately 1.3 million people. Antiretroviral therapy in 2023 covered about 30.7 million people, higher than previously but still insufficient for full epidemic combat.

According to 2024-2025 data, Russia observes declining HIV incidence. In 2024, about 52,800 new cases were recorded (incidence about 36 per 100,000 population), 9.9% below 2023 indicators. As of end 2024, approximately 1.2 million people with HIV lived in Russia (about 831 per 100,000 population). In 2024, virus was suppressed in 76.8% of patients receiving antiretroviral therapy.

Thus, although the global situation is gradually improving thanks to expanded treatment and prevention access, the HIV epidemic still remains a serious population health threat and requires further efforts.

HIV Test: When and How to Test

An HIV test is the only reliable way to know if the virus is in the body. The main method is laboratory blood analysis detecting antibodies the body produces in response to HIV. In Russia, saliva express tests are also available, which can be bought in pharmacies and used independently at home. They're simple to use, give results in 10–15 minutes, though sensitivity and accuracy are slightly lower than blood tests.

After possible infection, it's recommended to wait at least 3 months (window period) to avoid false negative results. During this time, observing precautions is important. Before submitting material for analysis, the patient signs informed consent; results are confidential information, meaning they cannot be transferred to third parties. Moreover, there's the possibility of anonymous testing, when results won't be tied to patient data but assigned code and number.

How Russia Fights HIV

In Russia, HIV combat is built on the State Strategy for Countering HIV Infection Spread until 2030. This task entered the list of measures to increase life expectancy, approved in the unified plan for achieving Russian Federation national development goals until 2030 and prospectively until 2036. Main measures include an approach aimed at preventing infection spread, diagnosis, treatment, and social support for people with HIV.

Key Directions:

- Raising awareness and reducing stigma toward HIV-positive people.

- Free testing of maximally broad population segments (in 2023, over 49 million people were tested). There's no universal screening in Russia, as in other countries. Ministry of Health orders regulate only groups of persons subject to examination: blood and organ donors, workers of certain professions, and since 2021, also foreigners arriving in the country for over 90 days.

- Ensuring quality antiretroviral therapy (ART), which reduces viral load and virus transmission risk. In 2024-2025, the government allocated record budgets for drug procurement, about 41.9 billion rubles. All specialized antiretroviral therapy is provided by the government free of charge; ARVT drugs prescribed by infectious disease physician are issued to patients at AIDS centers at registration location. Government and society are interested in such treatment no less than patients themselves. If virus load in HIV-positive person's body can be reduced to sustainably undetectable level, they fully retain work capacity, can have healthy children, and also minimize infection transmission risk to sexual partner.

- Prevention programs including condom distribution and harm reduction for drug users.

- Social and psychological support for HIV-infected people and their families.

- Development of specialized medical organizations and regulatory improvement to enhance care quality.

- Reducing mother-to-child transmission risk to minimum indicators.

The HIV epidemic in Russia remains a serious problem, but thanks to government programs and NGO work, declining new cases and mortality are observed.