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What are risk factors for developing AIDS?

Developing AIDS requires that the person acquire HIV infection. Risks for acquiring HIV infection include behaviors that result in contact with infected blood or sexual secretions, which pose the main risk of HIV transmission. These behaviors include sexual intercourse and injection drug use. The presence of sores in the genital area, like those caused by herpes, makes it easier for the virus to pass from person to person during intercourse. HIV also has been spread to health care workers through accidental sticks with needles contaminated with blood from HIV-infected people, or when broken skin has come into contact with infected blood or secretions. Blood products used for transfusions or injections also may spread infection, although this has become extremely rare (less than one in 2 million transfusions in the U.S.) due to testing of blood donors and blood supplies for HIV. Finally, infants may acquire HIV from an infected mother either while they are in the womb, during birth, or by breastfeeding after birth.

The risk that HIV infection will progress to AIDS increases with the number of years since the infection was acquired. If the HIV infection is untreated, 50% of people will develop AIDS within 10 years, but some people progress in the first year or two and others remain completely asymptomatic with normal immune systems for decades after infection. The risk of developing one of the complications that define AIDS is associated with declining CD4 cells, particularly to below 200 cells/ml.

Antiretroviral treatment substantially reduces the risk that HIV will progress to AIDS. In developed countries, use of ART has turned HIV into a chronic disease that may never progress to AIDS. Conversely, if infected people are not able to take their medications or have a virus that has developed resistance to several medications, they are at increased risk for progression to AIDS. If AIDS is not treated, 50% of people will die within nine months of the diagnosis.

Return to Acquired Immunodeficiency Syndrome

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