# HIV vs. AIDS **URL:** \ **Category:** Factual Questions\ **Created:** [July 9, 2004, 3:07am UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219 "2004-07-09T03:07:21Z")\ **Posts on this page:** 15\ **Page:** 1
**Author:** ![Qwertyasdfg](https://avatars.discourse-cdn.com/v4/letter/q/ecc23a/32.png) [@Qwertyasdfg](https://boards.straightdope.com/u/Qwertyasdfg)\ **Post date:** [July 9, 2004, 3:07am UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/1 "2004-07-09T03:07:21Z")
What are the major differences between the two? Is AIDS technically considered an STD? Does HIV always lead to AIDS? ---
**Author:** ![Triskadecamus](https://avatars.discourse-cdn.com/v4/letter/t/b19c9b/32.png) [@Triskadecamus](https://boards.straightdope.com/u/Triskadecamus)\ **Post date:** [July 9, 2004, 3:22am UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/2 "2004-07-09T03:22:35Z")
AIDS is an acronym for Acquired Immune Deficiency Syndrome, which was described prior to the discovery of HIV, which is the Human Immunodeficiency Virus, which causes it. One is the description of the disease, the other is the name of the virus, or group of viruses that attack the immune system in humans. Tris ---
**Author:** ![CrazyCatLady](https://avatars.discourse-cdn.com/v4/letter/c/dfb087/32.png) [@CrazyCatLady](https://boards.straightdope.com/u/CrazyCatLady)\ **Post date:** [July 9, 2004, 3:42am UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/3 "2004-07-09T03:42:15Z")
HIV is a virus. Being infected with the virus (being HIV+) is not the same thing as having AIDS. AIDS is generally defined as being HIV+ and having one of a certain list of diseases, although I think they also consider it AIDS when an HIV+ patient has CD4 counts under a certain level. Basically, HIV- patient with disease from the list= person with disease from list HIV+ patient with disease from the list=AIDS patient HIV+ patient without disease from the list=HIV+ patient ---
**Author:** ![Mathochist](https://avatars.discourse-cdn.com/v4/letter/m/c89c15/32.png) [@Mathochist](https://boards.straightdope.com/u/Mathochist)\ **Post date:** [July 9, 2004, 5:54am UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/4 "2004-07-09T05:54:37Z")
> [@CrazyCatLady](#): > > HIV- patient with disease from the list= person with disease from list > > HIV+ patient with disease from the list=AIDS patient > > HIV+ patient without disease from the list=HIV+ patient A bit of a hijack, but this trichotomy is the root of a lot of dangerous thinking. Sepcifically, the eminent mathematician and crank Serge Lang has for a long time been on about HIV and AIDS. Specifically, he points out that to say “HIV causes AIDS” is a bit of a logical leap from “everyone with AIDS has HIV”, which is itself trivially true (as you point out). From here he notes that really very few other possible causes have been investigated since everyone decided that HIV was it, which he’s not too sure on since it hasn’t been as thoroughly vetted as he’d like. Then again, he’s a mathematician and his notion of proof goes far beyond what any sane human thinks about. The problem is that in the real world, it’s best not to think of AIDS as existing at all. The simple fact is that there was an unexplained rise in very rare diseases that normal immune systems normally catch. There are many causes of a suppressed immune response and HIV, whether or not it’s “the” cause of the originally noted rise that was labelled “AIDS”, is a major one that deserves study and treatment. From my conversations with him, Lang doesn’t really mean that HIV shouldn’t be studied, but more that there may be other major causes out there that are being ignored. Unfortunately, the sound bite that comes off his presses is “HIV doesn’t cause AIDS”, and a lot of well-meaning people who don’t understand exactly what a rigorous argument says _and doesn’t say_ have been led astray, leading to all sorts of poor public policy. /me gets down from the soapbox. ---
**Author:** ![Tim\_T-Bonham.net](https://avatars.discourse-cdn.com/v4/letter/t/46a35a/32.png) [@Tim\_T-Bonham.net](https://boards.straightdope.com/u/Tim_T-Bonham.net)\ **Post date:** [July 9, 2004, 11:30am UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/5 "2004-07-09T11:30:36Z")
> [@Qwertyasdfg](#): > > Is AIDS technically considered an STD? To answer this part: Yes, it can be a Sexually Transmitted Disease. But it’s also a Blood Transfusion Transmitted Disease, a Open Wound Exposure Transmitted Disease, a Fetal Placenta Transmission Disease, etc. Saying that it’s “an STD” implies that sex is the only way it’s transmitted, which is not correct. But now that they test blood before transfusing, take precautions when exposed to open wounds, etc., sexual activity is the major mode of transmission for AIDS. ---
**Author:** ![OxyMoron](https://avatars.discourse-cdn.com/v4/letter/o/e9a140/32.png) [@OxyMoron](https://boards.straightdope.com/u/OxyMoron)\ **Post date:** [July 9, 2004, 2:45pm UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/6 "2004-07-09T14:45:25Z")
> [@CrazyCatLady](#): > > HIV is a virus. Being infected with the virus (being HIV+) is not the same thing as having AIDS. AIDS is generally defined as being HIV+ and having one of a certain list of diseases, although I think they also consider it AIDS when an HIV+ patient has CD4 counts under a certain level. > > Basically, > > HIV- patient with disease from the list= person with disease from list > > HIV+ patient with disease from the list=AIDS patient > > HIV+ patient without disease from the list=HIV+ patient Actually, the emphasis should be the other way: Under the CDC’s 1993 AIDS definition, the threshold CD4 level is fewer than 200 cells per microlitre - _or_ HIV infection plus one of 26 clinical conditions. Accordingly, the breakdown you describe in your list is no longer really accurate, because a lot of folks meet the CD4 threshold without having one of the listed conditions. In part, the reform was designed to help people get benefits. In the 1980s and early 1990s, the Social Security Administration and many private insurers used the CDC’s definition to determine who qualified as “disabled.” Under the old infection+condition rule, there were plenty of HIV+ people who were plenty sick and plenty “disabled,” but who couldn’t get benefits because they didn’t have one of the listed conditions. So the 200 CD4 threshold was added, essentially as a shorthand for “probably really weak and shouldn’t be expected to work any more.” (I believe this is no longer an issue because a Supreme Court decision - [_Bragdon v. Abbott_](http://supct.law.cornell.edu/supct/html/97-156.ZO.html) - affirmed that asymptomatic HIV infection itself qualifies as a disability under the Americans with Disabilities Act of 1990.) ---
**Author:** ![Qwertyasdfg](https://avatars.discourse-cdn.com/v4/letter/q/ecc23a/32.png) [@Qwertyasdfg](https://boards.straightdope.com/u/Qwertyasdfg)\ **Post date:** [July 9, 2004, 5:00pm UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/7 "2004-07-09T17:00:41Z")
> [@t-bonham@scc.net](#): > > To answer this part: Yes, it can be a Sexually Transmitted Disease. > > But it’s also a Blood Transfusion Transmitted Disease, a Open Wound Exposure Transmitted Disease, a Fetal Placenta Transmission Disease, etc. > > Saying that it’s “an STD” implies that sex is the only way it’s transmitted, which is not correct. But now that they test blood before transfusing, take precautions when exposed to open wounds, etc., sexual activity is the major mode of transmission for AIDS. I know that HIV can be, and usually is, contracted sexually. My question was could: _AIDS_ be transmitted sexually itself? Or were you referring to AIDS itself in your post? ---
**Author:** ![Otto](https://avatars.discourse-cdn.com/v4/letter/o/bbe5ce/32.png) [@Otto](https://boards.straightdope.com/u/Otto)\ **Post date:** [July 9, 2004, 5:13pm UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/8 "2004-07-09T17:13:07Z")
AIDS is not in and of itself transmitted at all. The acronym AIDS describes a set of circumstances. HIV is transmitted. AIDS is not. I suggest perusing the CDC’s AIDS [FAQ](http://www.cdc.gov/hiv/pubs/faqs.htm#definition), which may better answer your questions and clear up your misconceptions. ---
**Author:** ![CrazyCatLady](https://avatars.discourse-cdn.com/v4/letter/c/dfb087/32.png) [@CrazyCatLady](https://boards.straightdope.com/u/CrazyCatLady)\ **Post date:** [July 9, 2004, 5:29pm UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/9 "2004-07-09T17:29:19Z")
I don’t think you’re quite following us here. AIDS is not a disease in and of itself, but rather the area where two conditions overlap–being infected with HIV (which is sometimes sexually transmitted) and either having a low CD4 count or having one of a certain group of diseases. The virus is sexually transmissable, yes, but CD4 counts and diseases like pneumocystis pneumonia and Kaposi’s sarcoma aren’t. You can’t say someone gave you AIDS in the same sense that you can talk about them giving you herpes, because they can’t affect your cell counts and disease status. The most you can really say is that they gave you HIV. That, of course, doesn’t stop people from talking about catching AIDS, because the two terms are pretty equivalent in their minds. HIV causes AIDS, and the last time a lot of people learned anything about the disease was back when having HIV tended to develop into AIDS in very short order, so they treat the terms interchangeably. HIV is considered a sexually transmissable disease, but AIDS isn’t really, because only half the equation is transmissable. I suppose you could make a case that since AIDS is caused by HIV, then it’s technically transmissable, too. You’d be reaching, though. ---
**Author:** ![scotandrsn](https://avatars.discourse-cdn.com/v4/letter/s/a4c791/32.png) [@scotandrsn](https://boards.straightdope.com/u/scotandrsn)\ **Post date:** [July 9, 2004, 5:45pm UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/10 "2004-07-09T17:45:47Z")
> [@Qwertyasdfg](#): > > I know that HIV can be, and usually is, contracted sexually. My question was could: _AIDS_ be transmitted sexually itself? Or were you referring to AIDS itself in your post? Think of AIDS as a set of symptoms. That’s pretty much a what doctors think of as a “syndrome”. Rapid wieght loss, dry cough, recurring fever or profuse night sweats, profound and unexplained fatigue, swollen lymph glands, extended bouts of diarrhea, white spots in the mouth, purple blotches under the skin, neurological disorders are all symptoms associated with AIDS Any one or a set of these symptoms could be present in a variety of diseases, but it was the frequent appearance of groups of them (particularly the purple blotches, or Kaposi’s sarcoma, appearing in relatively young people, as it’s mostly a disease the elderly get when their immune system wears out) that led to the idea that there was a particular syndrome afoot. Another thing that the patients displayed was a crippled immune system, which explained a lot of the symptoms of the syndrome. And it was clear from the patterns of infection that this was not a genetically transmitted disease, but one that the victim picked up from their environment somehow. Hence the name Acquired Immune Defiency Syndrome. Once you know it’s an acquired syndrome, you look for the infectious agent and try to figure out how it spreads. In this case, it turned out that victims of the syndrome all had a certain, newly seen virus in their blood. Further study of this virus showed the specific mechanisms by which the virus used certain immune system cells to reproduce, which destroyed those cells in the process, leading to the loss of immune fucntion, which leads to the syndrome. The virus can be transmitted through the exchange of blood or seminal fluids. If you become infected with the virus, it is likely that you will eventually suffer from AIDS and probably die from it, although the likelihood of this after infection, while high, is not a full 100%. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [July 9, 2004, 6:13pm UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/11 "2004-07-09T18:13:49Z")
Another point about AIDS is that under the current definition, if you ever have it, you have it for life. A friend of mine got HIV from a bad transfusion as a child, and at one point his white blood cell count was in the cellar (I’m not sure exactly how low, but low enough to qualify for the AIDS diagnosis). I don’t think that he ever had Kaposi’s sarcoma or the like, thankfully. Now, thanks to a cocktail of various medications, his white cell levels are back to normal, and his virus load is undetectable. But he’s still considered to have AIDS. ---
**Author:** ![Qwertyasdfg](https://avatars.discourse-cdn.com/v4/letter/q/ecc23a/32.png) [@Qwertyasdfg](https://boards.straightdope.com/u/Qwertyasdfg)\ **Post date:** [July 9, 2004, 9:05pm UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/12 "2004-07-09T21:05:40Z")
**Chronos** is that really a definitional issue or a factual one? If your friend stopped taking the cocktail, would he revert to a very low count and the other symptoms of HIV/AIDS? ---
**Author:** ![barbitu8](https://avatars.discourse-cdn.com/v4/letter/b/839c29/32.png) [@barbitu8](https://boards.straightdope.com/u/barbitu8)\ **Post date:** [July 9, 2004, 11:07pm UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/13 "2004-07-09T23:07:32Z")
> [@OxyMoron](#): > > In part, the reform was designed to help people get benefits. In the 1980s and early 1990s, the Social Security Administration and many private insurers used the CDC’s definition to determine who qualified as “disabled.” Under the old infection+condition rule, there were plenty of HIV+ people who were plenty sick and plenty “disabled,” but who couldn’t get benefits because they didn’t have one of the listed conditions. So the 200 CD4 threshold was added, essentially as a shorthand for “probably really weak and shouldn’t be expected to work any more.” > > (I believe this is no longer an issue because a Supreme Court decision - [_Bragdon v. Abbott_](http://supct.law.cornell.edu/supct/html/97-156.ZO.html) - affirmed that asymptomatic HIV infection itself qualifies as a disability under the Americans with Disabilities Act of 1990.) It might have been easier if a person meets a “listed condition,” but one does not have to meet a “listed condition” to get benefits. Getting SS benefits is complicated, involves a 5-step sequential evaluation, and I’m not going to get into it here. Further, AIDS was not a listed condition until very recently, somewhere around the turn of the century, when the SSA amended its Listings to include Listing 14.00 et seq. [http://www.ssa.gov/OP\_Home/cfr20/404/404-ap09.htm](http://www.ssa.gov/OP_Home/cfr20/404/404-ap09.htm) > [@](#): > > 14.08 Human immunodeficiency virus (HIV) infection. With documentation as described in 14.00D3 and one of the following: > > A. Bacterial infections: > > 1. Mycobacterial infection (e.g., caused by M. avium-intracellulare, M. kansasii, or M. tuberculosis) at a site other than the lungs, skin, or cervical or hilar lymph nodes; or pulmonary tuberculosis resistant to treatment; or > > 2. Nocardiosis; or > > 3. Salmonella bacteremia, recurrent non-typhoid; or > > 4. Syphilis or neurosyphilis—evaluate sequelae under the criteria for the affected body system (e.g., 2.00 Special Senses and Speech, 4.00 Cardiovascular System, 11.00 Neurological); or > > 5. Multiple or recurrent bacterial infection(s), including pelvic inflammatory disease, requiring hospitalization or intravenous antibiotic treatment 3 or more times in 1 year. > > or > > B. Fungal infections: The List goes on, and you can check all the opportunistic infections noted yourself. In addition, reference should be had to the child’s AIDS Listing noted _infra_ and explanatory info noted _supra_ to the above Listing. As you can see, one who is asymptomatic will never get SS benefits. SS benefits is predicated upon the functional capacity of one to work. There is no correlation between the Americans with Disability Act and the Social Security Act. ---
**Author:** ![OxyMoron](https://avatars.discourse-cdn.com/v4/letter/o/e9a140/32.png) [@OxyMoron](https://boards.straightdope.com/u/OxyMoron)\ **Post date:** [July 11, 2004, 10:22pm UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/14 "2004-07-11T22:22:18Z")
> [@barbitu8](#): > > It might have been easier if a person meets a “listed condition,” but one does not have to meet a “listed condition” to get benefits. Getting SS benefits is complicated, involves a 5-step sequential evaluation, and I’m not going to get into it here. Further, AIDS was not a listed condition until very recently, somewhere around the turn of the century, when the SSA amended its Listings to include Listing 14.00 et seq. > > [http://www.ssa.gov/OP\_Home/cfr20/404/404-ap09.htm](http://www.ssa.gov/OP_Home/cfr20/404/404-ap09.htm) The List goes on, and you can check all the opportunistic infections noted yourself. In addition, reference should be had to the child’s AIDS Listing noted _infra_ and explanatory info noted _supra_ to the above Listing. > > As you can see, one who is asymptomatic will never get SS benefits. SS benefits is predicated upon the functional capacity of one to work. There is no correlation between the Americans with Disability Act and the Social Security Act. Undoubtedly you’re correct in this last conclusion as a matter of law, but what you’re describing prior to that conclusion doesn’t seem to jibe with the policy history - although it may be entirely correct based on current practice. I based my post partly on my own memory, and partly on a history noted at [The Body](http://www.thebody.com/encyclo/aids.html), which is usually pretty authoritative. > [@](#): > > Further, the [list-only] CDC definition was adopted as an eligibility criterion by U.S. government public assistance programs including the Social Security Administration. This was a problematic and inappropriate usage of the case definition, because the definition was intended for purposes of epidemiological surveillance and not to measure the disabling effects of HIV-related disease. The use of the CDC definition to measure disability thus became the subject of a 1990 class action lawsuit brought by individuals who were severely ill with HIV-related disease but who did not meet the CDC definition of AIDS. Physicians, activists, and, in particular, HIV-positive women began a movement to force the CDC to expand the surveillance definition of AIDS. > > By the spring of 1992, the CDC began to consider expanding the surveillance definition to address a widely noted undercounting of certain populations, namely women, injecting drug users, and communities of color. The initial proposal by the CDC was to include all HIV-positive individuals with certain evidence of advanced CD4+ cell depletion. The CDC argued that this change would enable it to capture all those who were severely immunocompromised but were not suffering from one of the 23 opportunistic infections in the 1987 surveillance definition. Many HIV-positive individuals, activists, and health care providers, however, made the counterargument that abandoning a disease-based approach in favor of a surveillance system that was reliant upon the accuracy and availability of CD4+ cell count testing might lead to continued underdiagnosing and undercounting. In particular, advocates for women were concerned that this would perpetuate the medical community’s historical failure to diagnose HIV-related illnesses in women. > > Using the medical evidence collected for the Social Security litigation, a campaign was developed to lobby the CDC to add three additional conditions to the definition of AIDS. These were the three conditions for which there was the most medical evidence of recurrence and a more rapid advancement in the presence of HIV infection: invasive cervical cancer, recurrent bacterial pneumonia, and pulmonary TB. In November 1994, the CDC announced that it was expanding the surveillance definition, effective January 1, 1993, to include the three conditions from the community proposal and any HIV-positive individual with a CD4+ cell count of 200 or less or whose CD4+ cells represented less than 14 percent of all lymphocytes. ---
**Author:** ![barbitu8](https://avatars.discourse-cdn.com/v4/letter/b/839c29/32.png) [@barbitu8](https://boards.straightdope.com/u/barbitu8)\ **Post date:** [July 11, 2004, 10:47pm UTC](https://boards.straightdope.com/t/hiv-vs-aids/254219/15 "2004-07-11T22:47:46Z")
The CDC definition of AIDS was expanded to include any HIV+ person with a CD4 count of 200 or less. However, merely because one has been diagnosed as having AIDS does not _ipso facto_ entitle him or her to SS benefits. Entitlement under the Listings is noted in my above link. One of those conditions must be present to meet a Listing. If one does not meet a Listing, attention is directed as to whether he can perform his vocationally relevant past work or any other work which exists in significant numbers in the national economy. Virtually anyone who has a CD4 count of under 200 will have one of the additional required concomitant conditions, but if not, he or she will have little chance of getting benefits, even with the diagnosis of AIDS, unless the person can demonstrate such weakness as not to be able to perform even sedentary work or has developed depression.