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You do not have AIDS as soon as you acquire HIV. You can live with HIV (be HIV+) for many years with no signs of disease, or only mild-to-moderate symptoms. People living with HIV and taking HIV drugs as prescribed have a very low risk of progressing to AIDS. But without treatment, HIV will eventually wear down the immune system in most people to the point that they have low numbers of CD4 cells and develop opportunistic infections. Without treatment, this usually happens in five to ten years.

The definition of AIDS was established before there was effective treatment for HIV. It indicated that a person was at higher risk for illness or death. In countries where HIV treatment is readily available, AIDS is no longer as relevant as it once was. This is because having access to effective treatment means people can stay healthier even with low CD4 counts. Also, someone could have received the AIDS diagnosis years ago, which means they still have that diagnosis--even though they no longer have a low CD4 count.

The US Centers for Disease Control and Prevention (CDC) identifies someone as having AIDS if she or he is living with HIV and has one or both of these conditions:

At least one AIDS-defining condition (see our list of AIDS-Defining Conditions)

A CD4 cell count of 200 cells or less (a normal CD4 count is about 500 to 1,500)

People with AIDS can rebuild their immune system with the help of HIV drugs and live a long healthy life. Even if your CD4 cell count goes back above 200 or an OI is successfully treated, you will still have a diagnosis of AIDS. This does not necessarily mean you are sick or will get sick in the future. It is just the way the public health system counts the number of people who have had advanced HIV disease.