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Human immunodeficiency virus, or HIV, is responsible for more deaths than any other virus in recent history. Over 75 million people have been infected and about 33 million have died since the epidemic was first recognized. The first cases of AIDS (Acquired Immune Deficiency Syndrome) were identified in 1981, and the virus was identified in 1983.

Because of fear of the virus, stigma, denial, and discrimination developed toward those who were infected, thought to be infected, or in high-risk groups. Many have worked to combat these issues.

HIV can weaken the immune system and make us more prone to other infections we would otherwise fight off without ever getting sick. The virus attacks the immune system, and if not treated, it will go on to cause AIDS, where these opportunistic infections that we normally can fight off make us sick. About half of those with HIV develop AIDS in eight to ten years without treatment.

It’s possible to have HIV without symptoms for many years. Some people have initial flu-like symptoms (fever, fatigue, rash, night sweats, muscle aches, sore throat, swollen lymph nodes) about two to four weeks after the initial infection. These symptoms can be overlooked because they seem like many other viruses (commonly mistaken for “mono” or Epstein-Barr virus, or EBV, in particular).

There’s no vaccine against HIV; however, there are many ways to reduce our chance of developing HIV. Safer sex, including using condoms when appropriate, has reduced sexual transmission risks. Using clean needles for any injection, including injection drugs, reduces transmission.

There are also medications, called antiretrovirals, that can reduce transmission. Without treatment, 15 percent to 45 percent of mothers used to pass HIV onto their babies during pregnancy, at birth, or by breastfeeding. Treatment given at birth reduced this risk. Now, treatment for the mother before, during, and after pregnancy greatly reduces the risk of transmission and lets HIV-positive mothers breastfeed.

These same antiretrovirals can help prevent transmission to us. Those who are at high risk for HIV, through sex or injection drug use, can take a daily pill to reduce their risk. This is called PrEP, or pre-exposure prophylaxis. This reduces but does not entirely eliminate the risk of infection.

Another preventive measure is PEP — or post-exposure prophylaxis — which can be taken after a specific exposure, such as through sex, an injection, a needlestick, or other health-worker exposure. This reduces but does not entirely eliminate the risk of infection. These antiretrovirals are best taken within the first 24 hours after exposure but must be taken at least in the first 72 hours. The medications need to be taken daily for four weeks and then stopped.

These same medications that are used to prevent HIV transmission also treat HIV. Treatments developed in the last few decades mean that with treatment, you can live as long with HIV as without it. These medications do not cure HIV. They keep HIV in check, but if these medications are stopped, HIV can bounce back. Medications need to be taken as prescribed, usually daily; otherwise, resistance can develop and the medications may not work anymore for that person. Nearly 20 million people with HIV currently take antiretroviral drugs to manage this disease. Treatment is prevention. Those who take these medications and have the virus fully suppressed won’t transmit the virus to others.