What does current HIV research look like?

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Current research says people with HIV who maintain antiretroviral therapy (ART) treatment can have undetectable levels of HIV in their blood, called their viral load.

These treatments can make a person’s viral load so low that tests cannot detect it. Health experts refer to this as an undetectable viral load or viral suppression. Scientists measure viral load in the number of copies of HIV per milliliter (mL) of a person’s blood.

These people are less likely to have HIV symptoms and complications. They also effectively have no risk of transmitting HIV to others. People with an undetectable viral load will not transmit HIV to others, according to the Centers for Disease Control and Prevention (CDC). Healthcare professionals refer to this as “undetectable = untransmittable,” or “U=U.”

In 2023, researchers reviewed over 200 studies into sexual HIV transmission in people on ART with low viral loads. They found that the risk of HIV sexual transmission in those with viral loads of less than 1,000 copies per mL of blood is almost zero.

However, people still have a latent HIV reservoir, which presents a significant challenge to finding a cure. Small amounts of HIV persist in their bodies despite treatment. They must adhere to their treatment plan to suppress the virus, allowing them a typical life expectancy.

Without treatment, most people with HIV will develop AIDS within 10 years. Generally, those with AIDS who do not undergo ART have a life expectancy of 2 years.

Read more about HIV and AIDS.

The CDC provides several statistics for HIV in the United States. The most recent available data is from the end of 2021. According to the CDC:

• An estimated 1.2 million people in the United States had HIV at the end of 2021, and:
  • of these people, about 87% knew they had HIV
  • this is the most individuals with HIV to date
• In 2021, healthcare professionals diagnosed 36,136 people in the United States. and dependent areas with HIV.
• The annual number of new HIV diagnoses decreased by 7% from 2017 to 2021.
• Most cases of HIV occur in metropolitan areas with 500,000 or more people.

Learn about the history of HIV and AIDS.

The current treatment for HIV is ART, where people with HIV take prescription anti-HIV medication. ART treatments reduce the amount of HIV in a person’s body and help them stay healthy. People with HIV must at present take these treatments daily or on a strict schedule as a doctor prescribes.

According to 2023 research, current ART medications have been very effective in managing HIV. However, they have some limitations, including:

• some emerging HIV strains resist medication
• side effects
• long term toxic effects
• limited access in low income regions
• people must take most ART regimens daily

Scientists continue to research different and new kinds of ART medication to overcome these limitations.

One other significant challenge to finding an HIV cure is latent HIV reservoirs. These are small amounts of virus that persist in people with HIV despite treatment. Research into HIV treatments aims to:

• better understand how HIV reservoirs:
  • form
  • persist, or stay in a person’s body
  • reactivate
• develop new treatments that target HIV reservoirs
• better identify HIV reservoirs

Researchers are investigating several ways to eliminate HIV reservoirs. Scientists reviewed new HIV reservoir strategies in 2022.

They concluded it may be necessary to combine different strategies and methods to overcome HIV reservoirs. These strategies could include new antiviral drugs or methods of improving a person’s immune response.

Researchers are investigating new HIV medications and alternative ART medications. They aim to improve care for people with HIV and to develop a cure. For example, those with HIV can have a significantly increased risk for cardiovascular disease.

In 2023 research, scientists found that a class of cholesterol-lowering medications called statins can lower this risk.

Scientists are currently developing experimental HIV treatments. These treatments aim to achieve sustained viral remission without ART. This is where a person with HIV can go for a long time without ART treatment. These treatments currently include

• HIV vaccines
• genetically engineered cells that resist HIV
• drugs that make the virus visible to a person’s immune system
• immunotherapies

Scientists have recently achieved encouraging results in HIV vaccine research. Research from 2022 showed that an experimental HIV vaccine is safe in people.

Although the experimental vaccine alone will not offer HIV protection, the researchers found that it caused a strong HIV immune response in volunteers. Scientists intend such a vaccine to provide eventual HIV protection as part of a multistep process.

The following are answers to common questions about HIV.

What is the life expectancy of a person with HIV?

According to 2023 research, people with HIV can have an almost typical life expectancy. However, they found that without early diagnosis and sustained HIV treatment, a person’s life expectancy could be significantly lower.

Can you have HIV for 20 years and not know?

A person may have no HIV symptoms during stage 1 or stage 2 HIV — the latter can last 10 years or more. Testing is the only way for a person to know if they have HIV.

Current antiretroviral therapy treatments allow someone with HIV to live long and healthy lives. People with HIV can achieve undetectable viral loads with effective treatment. However, they usually need to take these treatments daily.

Scientists are researching treatments that would allow viral suppression without taking these medications regularly. These are known as functional cures. Some HIV research aims to improve care for people with this infection.

Scientists are also researching methods to eliminate HIV.