By Julia Rosebush, DO, FAAP & Andrés Camacho-González, MD, FAAP
Human immunodeficiency virus (HIV) can affect anyone, including infants, children and teens. HIV causes damage to the body's immune system. The immune system is the body's way of fighting infections. When the immune system does not work well, the body cannot fight off many serious illnesses.
Since HIV first became an epidemic in the 1980s, there have been major advances in treatment and survival rates. Today, children and teens with HIV can live long, fulfilling lives. Currently, though, there is no cure. Untreated HIV infection can lead to severe illnesses and death.
Learn how HIV spreads, common HIV symptoms, how doctors test for and treat HIV, and how families can help prevent HIV infection.
Why HIV prevention & early treatment is key
Early testing, diagnosis and treatment remain important because HIV infection may not cause symptoms for years. During this time, many people do not realize they have HIV and can unknowingly spread the virus to others. Most people with HIV appear healthy. You cannot tell just by looking at people whether they have HIV. A blood test is the only way to be sure.
How does HIV spread from person to person?
Most often, HIV is passed on during sexual intercourse through bodily fluids such as semen and vaginal fluid. It can also be passed on through injectable drug use. Blood products, needles or other sharp instruments contaminated with infected bodily fluids or blood itself can also spread HIV. However, this is very rare today because donated blood and blood products are routinely tested for HIV.
Infants and children most often get HIV infection from a birthing parent with HIV who is untreated during pregnancy, labor, and/or delivery. Breast milk from nursing parents with untreated HIV can also transmit the virus.
The HIV virus cannot be spread through:
Hugging or sitting next to someone living with HIV
Shaking the hand of someone living with HIV
Eating food prepared by someone living with HIV
Sharing glasses, utensils or plates with someone living with HIV
Sharing bathrooms with someone living with HIV
Breathing the same air as someone living with HIV
Signs & symptoms of HIV
Symptoms of HIV may not appear for many months or years after becoming infected with the virus. This means that people may not be aware that they have HIV and can unknowingly transmit the virus to others. Once symptoms develop, they may include:
Persistent fevers
Swollen lymph nodes or neck glands
Persistent diarrhea
Minor skin infections
Fungal infections of the mouth (thrush)
Failure to gain weight or grow in height at a typical rate
An enlarged liver and spleen
Recurrent or unusual infections
As the immune system continues to weaken, infections and
cancers can develop.
How is HIV diagnosed?
Routine testing is indicated to detect HIV infection as early as possible. Typically, blood or saliva are used to
diagnose HIV infection.
There are three types of tests available:
- Nucleic acid test (NAT): This test uses blood to check how much of the virus is in the body.
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Antigen/antibody test: Antigens are foreign substances (such as viruses, bacteria, or pollen) that cause your immune system to react. When you're exposed to a virus like HIV, your immune system makes antibodies to fight it. In HIV, the specific antigen is called p24. It shows up even before antibodies do. This blood test looks for both HIV antibodies and p24.
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Antibody test: This test uses either saliva or blood to look for HIV antibodies. Self-tests and some rapid result tests for HIV are antibody tests.
What if the test is positive?
If the test is positive for HIV, prompt linkage to care and sexual partners notification should be considered. Local or state public health departments should have confidential
Partner Notification Services programs that can notify past and present partners without disclosing your identity. Your medical provider can help you with this.
Keep in mind that in some states, the law requires informing sexual or injection partners that you have HIV. You can check your state's HIV-related laws with
The Center for HIV Law and Policy.
How is HIV treated?
Doctors use a combination of several medications to treat people with HIV, including infants, children and teens. Because of advances in treatment, many people can now take a single pill once daily to treat HIV.
Others may choose to receive two injections every two months instead of a daily pill. These medicines lower the levels of HIV in the blood to undetectable levels and prevent transmission of the virus to others through sexual contact while promoting good health.
It's important that people with HIV take their medication exactly as it is prescribed, whether it is a pill or injections. This prevents the development of HIV resistance and associated infections and helps the immune system stay strong and healthy.
If sticking with a treatment plan is difficult, be sure to talk with your medical provider. They can help you pinpoint the problem and come up with a plan to help make it easier.
People may be exposed to HIV after sexual activity, sharing needles or sexual violence. In these cases, a medical provider may recommend post-exposure prophylaxis (PEP), or medicine that is used to prevent HIV infection. If PEP is started within 72 hours after exposure, it is extremely effective.
Pregnant people with HIV & their infants
Medicines help a pregnant person with HIV to prevent transmitting the virus to the baby. These medicines keep the pregnant person healthy too. If you have HIV and are pregnant, your newborn will be treated for two to six weeks with medicines after birth to prevent HIV infection.
Breast milk can transmit HIV to babies; however, the risk is very low if the birth parent is receiving medical treatment and has no detectable HIV virus in the blood. Parents with HIV should speak with their healthcare providers as soon as they are determined to be pregnant to help them decide how to best feed their baby.
Teens and HIV
An estimated 19% of all new HIV infections in the United States occur in
teens and
young adults. Yet most sexually active 13- to 24-year-olds often don't realize that they're at risk for HIV, so they don't get tested.
In fact, this age group is more likely than any other to have undiagnosed HIV.
Even when they are diagnosed, teens and young adults are less likely than other people to follow through with treatment. This age group also has lower rates of
viral suppression (when treatment gets the virus to an undetectable level) and therefore they're less likely to stay healthy. All these factors not only increase the risk of HIV related health problems, but also of transmitting HIV to others.
HIV screening for all teens
All teens ages 13 years and older are recommended to get at least one routine HIV screening test.
After the first screening, teens who are sexually active should be screened for HIV at least yearly. Some providers may opt to test teens every 3 to 6 months for HIV if they identify as males having male sexual contact; people who inject drugs; transgender youth; youth of both genders having sexual partners with HIV or who inject drugs; youth who exchange sex for drugs or money; or teens who have had a diagnosis of or request testing for other sexually transmitted infections (STIs) .
How to prevent HIV transmission in teens
Based on the most recent national data, 40% of high school students reported that they had ever engaged in sexual activity with 29% reporting sexual activity within the last 3 months. Only 54% of sexually active high school students said they used condoms during their last sexual encounter.
Condom use
If teenagers are sexually active, they should be encouraged to practice safe sex. This means using a
condom during EVERY sexual experience. Even when people with HIV don't have symptoms, they can still transmit the virus to others if they are not on treatment and with an undetectable viral load. Other sexually transmitted infections (STIs) can also be transmitted if condoms are not used.
Pre-exposure prophylaxis or "PrEP" can also be prescribed by a medical provider to prevent HIV in teens and young adults. PrEP is a pill taken once daily, a shot given every 8 weeks, or 2 shots given every 6 months. When taken as prescribed, PrEP lowers the risk of HIV by about 99%.
It is also important to be routinely screened and treated for STIs like gonorrhea, chlamydia and syphilis. Being diagnosed with certain STIs can increase the chance of HIV infection. Prompt diagnosis and treatment of STIs also decreases the likelihood of transmitting infection to sexual partners.
Remember
Your medical provider is a trusted source and can provide you with information on HIV testing, prevention and staying healthy with HIV.
More information
About Dr. Rosebush
 Julia Rosebush, DO, FAAP, is an Associate Professor in the Section of Pediatric Infectious Diseases at the University of Chicago and serves as Assistant Dean for Admissions at the Pritzker School of Medicine. Since joining the University of Chicago faculty in 2014, Dr. Rosebush has led initiatives that center health equity in both clinical care and research. As Medical Director of Care2Prevent, the University’s Pediatric and Adolescent HIV Program, she oversees comprehensive, multidisciplinary services designed to reduce barriers to care and improve outcomes for youth on Chicago’s South Side, a community disproportionately impacted by HIV. She is an active member of the American Academy of Pediatrics Committee on Pediatric and Adolescent HIV and contributes to national policy through the Department of Health and Human Services Panel on Treatment of HIV in Pregnancy and Prevention of Perinatal Transmission. In 2025, she was elected to the Board of Directors of the HIV Medicine Association, where she advocates for policies that promote equitable access to HIV prevention and treatment across the United States.
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About Dr. Camacho-González
 Andrés Camacho-González, MD, FAAP, is an Associate Professor of Pediatrics at Emory University School of Medicine and Children's Healthcare of Atlanta. In addition to his position as the Director of the Pediatric HIV Clinical Trials Unit, Dr. Camacho-Gonzalez serves as the Pediatric Infectious Disease Fellowship Director and Associate Program Director for the Pediatric Residency Program. His expertise extends to his role as the Associate Director of the Clinical Core of Emory Center for AIDS Research and he is an elected member of the U.S. Department of Health and Human Services Panel on Pediatric HIV Opportunistic Infections Guidelines.
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