Today, December 1st, is World AIDS Day.

A month ago, one of my friends tested positive for HIV. The news hit him like a ton of bricks. When he told me, he thought his life was over.

As I tried to reassure him, I realized that I would also be terrified if I were in his position. And not for any specific reason—just because I knew so little about the disease and had so many doubts. Doubts lead to fear; fear leads to anger… you get the idea.

A month later, I’ve researched everything I can and realized that it’s not such a big deal nowadays. There are far worse things, and people are very misinformed. HIV still carries a heavy social stigma, but it shouldn’t.

That’s why I’ve compiled a list of misconceptions—some I had myself and others I’ve heard recently.

Updated: Nine years later, I’ve updated this article to include discoveries in the fight against HIV.

1. HIV doesn’t exist

False. Here’s proof in the form of a photo:

HIV-budding-Color
Source.

This is an electron microscope image, colorized to highlight the virus (in green) attacking a lymphocyte.

Despite all the existing evidence, some people still deny the existence of the virus, refusing treatment or trying non-scientific alternatives. Patients who believe this only worsens their symptoms die sooner and, worse, risk infecting others.

2. Being HIV-positive means having AIDS

False. HIV is a virus that attacks immune system cells and uses them to reproduce. If untreated, the human body loses its defenses. It’s in this final stage of infection that Acquired Immunodeficiency Syndrome (AIDS) appears.

Hiv-timecourse-en
Source.

At first, the virus reproduces very quickly. The immune system responds and slows the initial infection. However, the virus mutates and eventually overcomes the immune system. This is when the syndrome appears.

That’s why it’s said that there’s no such thing as an AIDS virus; there’s HIV, which can cause AIDS.

3. HIV is a death sentence

False. Today, medication exists to target the virus and prevent it from reproducing. This reduces the viral load and allows the immune system to return to normal.

With medication, the immune system can function properly, preventing opportunistic diseases.

While there’s no vaccine or cure for HIV yet, today’s antiretroviral treatments (like Genvoya or Dovato) involve just one pill a day, are highly effective, and cause very few side effects.

Additionally, injectable treatments have started to roll out, offering even greater convenience. These involve two injections (Cabotegravir Vocabria and Rilpivirine Rekambys) administered once every two months.

These treatments are VERY expensive, costing several thousand dollars per year. Fortunately, they’re covered by public healthcare here in Spain.

With the proper treatment (which depends on the person and the virus mutation), an HIV-positive individual can often eliminate the virus from their blood. At this point, they’re considered undetectable and can live a completely normal life without ever developing AIDS.

4. An undetectable person no longer has HIV

False. Having an undetectable viral load doesn’t mean being cured.

The viral load measures the amount of virus:

  1. At the time of testing.
  2. Per milliliter of blood.

Undetectable means fewer than 20 copies of the virus per milliliter.

However, reservoirs always remain—infected lymphocytes that aren’t currently producing the virus but might in the future. The virus can also exist in other fluids like semen.

That said, when someone is undetectable, there are so few copies of the virus in their blood that it’s impossible to infect anyone else. Undetectable equals untransmittable.

5. It’s impossible to contract HIV through oral sex

False. This is a widespread myth. While it’s difficult, it’s not impossible—in fact, it’s relatively common.

This belief might stem from the fact that the virus isn’t transmitted through saliva, but any wound in the mouth is a potential entry point.

If the person performing oral sex has ulcers, bleeding gums, sores, etc., they can become infected if pre-seminal fluid comes into contact with their wounds. Ejaculation isn’t necessary.

6. A person in the active role can’t contract HIV

False. During penetration, microscopic tears can occur both in the penetrated area and the urethra.

If the receptive partner is HIV-positive (with any viral load), they can transmit the virus through these tears.

While the risk is lower than the reverse scenario—an HIV-positive person penetrating someone without protection—the risk still exists.

7. An HIV-positive person can never have sex again

False. Based on the previous points, it might seem that an HIV-positive person could never have sex again, but that’s not true.

An HIV-positive individual can continue to have sex as long as they’re responsible, meaning USING PROTECTION, such as condoms.

As we’ve discussed, once someone is undetectable, they can lead a completely normal life.

And most importantly, there’s no obligation to disclose one’s HIV status. This is private information, and it’s up to each individual to decide whom to share it with.

8. Two HIV-positive people can have unprotected sex

False. This is extremely risky.

HIV has multiple mutations, which differ from person to person. Medications target specific aspects of the virus present in certain mutations.

For instance, some people with a common mutation only need one pill daily, while others with a rare mutation might require three or four.

Having unprotected sex can lead to reinfection, causing the virus to mutate further and potentially become resistant to treatment.

9. HIV only affects older people or marginalized groups

False. When it first appeared, HIV was heavily associated with homosexuals and drug users, and part of that stigma still exists. But the reality is very different.

Each year, there are between 2,000 and 3,500 new cases in Spain. In Spain, the virus is often detected late (study in Catalonia), almost 30% of infected people don’t know they have it (study in Aragon), and a quarter of new cases occur among young people (study in Extremadura).

Because of the heavy social stigma, few people publicly disclose their HIV status. Furthermore, with effective treatments, institutional awareness has decreased, and there are fewer informational campaigns. As a society, we’ve let our guard down, leading to more cases of all kinds of STIs. It might seem like a problem of the past, but it’s still very present.

For instance, here’s a news report from October 2024: Sexually transmitted diseases are on the rise: Syphilis and gonorrhea see a 24% and 42% increase.

Today, people of all ages and genders live with HIV—and they do so while leading completely normal lives.

Extra: Cómo se contagia el virus

Todo el mundo puede contagiarse, algunas de las formas más comunes son:

  • Realizar sexo sin protección.
  • Compartir jeringas o intrumentos para esnifar.
  • En el momento del parto.

Algunas de las formas en las que NO se contagia el virus son:

  • A través de insectos.
  • Compartiendo enseres domésticos.
  • En piscinas o gimnasios.
  • A través de animales domésticos.
  • Por contacto.
  • Por besar.

Extra: How the Virus is Transmitted

Anyone can contract the virus. Some of the most common ways include:

  • Having unprotected sex.
  • Sharing needles or instruments for drug use.
  • During childbirth.

Some ways the virus is NOT transmitted include:

  • Through insect bites.
  • Sharing household items.
  • In swimming pools or gyms.
  • Through pets.
  • Through casual contact.
  • Through kissing.

Conclusions

A month after the initial shock, my friend is doing great and living a normal life.

“I barely remember I have this. The hardest part of my day is during lunch when I have to take my medication,” he told me. He mentioned he takes three pills a day at lunch and is waiting on tests to see if he can switch to a single-pill regimen.

I see him as very motivated and eager to move forward. Those who know him have taken the time to educate ourselves to support and help him. 😊

What I’ve noticed over this past month is a significant lack of knowledge among people in general. We treat it like a distant, remote disease and have become complacent. For instance, hardly anyone uses a condom during oral sex. And beyond that, almost no one gets tested to check if they have the virus.

The national health system covers HIV testing in Spain. All you have to do is ask your primary care doctor for a serology test. They draw a blood tube, and a few days later, you get your results. Even if you’re in a relationship, it’s a good practice to get tested once a year (serology also detects other STDs).

Lastly, I’ve encountered a lot of misinformation online. Some websites have false or outdated information or discuss regulations and medications from outside Spain (where the context is entirely different). As with anything you read online, look for reliable sources and approach things skeptically.

Conclusions - December 2024

Over the past nine years, I’ve met many more people living with HIV. When you educate yourself about and discuss the topic openly, people feel safe sharing this private information with you.

I’ll reiterate what I’ve said many times in this article: all these individuals live normal lives and are healthier than me.

Can we please end the stigma already? It’s more harmful than the infection itself. Organizations have launched initiatives like Positive Pride to help normalize living with HIV.

Finally, I’d like to highlight that the new injectable treatments have made a massive difference in mental health. If the daily pill used to be a constant reminder of the condition and required logistical planning for travel, that burden has now disappeared.

Hopeful news keeps coming: vaccines, new treatments, and advancements. We all hope that HIV will soon become a thing of the past. To make that happen, we need to continue investing in research and not let our guard down when it comes to safe sex. 😊

Here are some useful links: