In the US and the industrialized world it's manageable, expensive but manageable. Medication can reduce the viral load to almost nothing, this makes it possible for patients to lead normal lives, even having children without passing the virus on. They still have to take precautions as does anyone with a compromised immune system. (yet another reason why anti vaxxers are dangerous)
In less developed countries it is a death sentence. It's been awhile since I've read up on it but it was particularly bad in Africa. Uganda, like 20 years ago, was able to stem transmission by taking a proactive stance on safe sex, much like the US in the 90s.
It used to be that Infectious Disease (as a specialty) was '*travel medicine*'. Then came HIV/AIDS, and it changed the landscape of medicine forever.
AIDS, or acquired immunodeficiency syndrome, is the end result of infection with HIV, the human immunodeficiency virus. AIDS can be diagnosed when certain [criteria](https://www.cdc.gov/hiv/statistics/surveillance/terms.html
) are met or a person suffers any [AIDS defining illness](https://en.wikipedia.org/wiki/AIDS-defining_clinical_condition
). These opportunistic organisms are ubiquitous, so the only defense we have from them is a constant battle fought by our immune system. Patients who meet certain CD4 count criteria (a measure of a type of cell of the immune system) are given prophylactic antibiotics until their CD4 counts respond to therapy.
HIV positive people now have essentially a normal life expectancy. The caveat to that is that they need to be appropriately treated. Uncontrolled HIV will lead to AIDS and can cause premature death from opportunistic infections.
There are methods of reducing risk of transmission. Post-exposure prophylaxis and even pre-exposure prophylaxis exist for couples where one partner is positive and the other one is not. Maternal-to-fetal transmission is still possible, and HIV infection is one of the [contraindications to breastfeeding](http://pediatrics.aappublications.org/content/115/2/496
). However, suitable alternatives to breastfeeding are not always available in developing countries, which has led to increased transmission rates in some areas of the world.
Additionally, HIV positive people are also often co-infected with Hepatitis C or B, so looking at overall mortality introduces confounders.
The consequences of contracting HIV are still life-altering. But modern medicine has allowed us to manage it. It is by no means as bad as it was even 10 or 20 years ago.