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     Volume 4 Issue 73 | December 2, 2005 |

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Basic Facts About HIV/AIDS

What is HIV?
HIV is the human immunodeficiency virus that causes AIDS. A member of a group of viruses called retroviruses, HIV infects human cells and uses the energy and nutrients provided by those cells to grow and reproduce.

What is AIDS?
AIDS (acquired immunodeficiency syndrome) is a disease in which the body's immune system breaks down and is unable to fight off certain infections, known as "opportunistic infections," and other illnesses that take advantage of a weakened immune system.

When a person is infected with HIV, the virus enters the body and lives and multiplies primarily in the white blood cells. These are the immune cells that normally protect us from disease. The hallmark of HIV infection is the progressive loss of a specific type of immune cell called T-helper or CD4 cells.

As the virus grows, it damages or kills these and other cells, weakening the immune system and leaving the individual vulnerable to various opportunistic infections and other illnesses, ranging from pneumonia to cancer.

How quickly do people infected with HIV develop AIDS?
In some people, the T-cell decline and opportunistic infections that signal AIDS develop soon after infection with HIV. Most people remain asymptomatic for 10 to 12 years, and a few for much longer. As with most diseases, early medical care can help prolong a person's life.

How many people are affected by HIV/AIDS?
The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that there are now over 40 million people living with HIV or AIDS worldwide. Most of them do not know they carry HIV and may be spreading the virus to others.

Since the beginning of the epidemic, AIDS has killed more than 30 million people worldwide, including more than 500,000 Americans. AIDS has replaced malaria and tuberculosis as the world's deadliest infectious disease among adults and is the fourth leading cause of death worldwide. Over 13 million children have been orphaned by the epidemic.

How is HIV transmitted?
A person who is HIV-infected carries the virus in certain body fluids, including blood, semen, vaginal secretions, and breast milk. The virus can be transmitted only if such HIV-infected fluids enter the bloodstream of another person. This kind of direct entry can occur (1) through the linings of the vagina, rectum, mouth, and the opening at the tip of the penis; (2) through intravenous injection with a syringe; or (3) through a break in the skin, such as a cut or sore. Usually, HIV is transmitted through:

  • Unprotected sexual intercourse (either vaginal or anal) with someone who is HIV infected.
  • Unprotected oral sex with someone who is HIV infected.
  • Sharing needles or syringes with someone who is HIV infected.
  • Infection during pregnancy, childbirth, or breast-feeding (mother-to-infant transmission).

How is HIV not transmitted?
HIV is not an easy virus to pass from one person to another. It is not transmitted through food or air (for instance, by coughing or sneezing). There has never been a case where a person was infected by a household member, relative, co-worker, or friend through casual or everyday contact such as sharing eating utensils and bathroom facilities, or hugging and kissing. (Most scientists agree that while HIV transmission through deep or prolonged "French" kissing may be possible, it would be extremely unlikely).

Here in the U.S., screening the blood supply for HIV has virtually eliminated the risk of infection through blood transfusions. (And you cannot get HIV from giving blood at a blood bank or other established blood collection center.) Sweat, tears, vomit, feces, and urine do contain HIV, but have not been reported to transmit the disease (apart from two cases involving transmission from feces via cut skin). Mosquitos, fleas, and other insects do not transmit HIV.

Is there a link between HIV and other STIs?
Having a sexually transmitted infection can increase your risk of acquiring and transmitting HIV. This is true whether you have open sores or breaks in the skin (as with syphilis, herpes, chancroid) or not (as with chlamydia and gonorrhea). Where there are breaks in the skin, HIV can enter and exit the body more easily. Even when there are no breaks in the skin, STIs can cause biological changes that may make HIV transmission more likely. Studies show that HIV-infected individuals who are infected with another STI are three to five times more likely to contract or transmit the virus through sexual contact.

Are some people at greater risk of HIV infection than others?
HIV does not discriminate. It is not who you are, but what you do that determines whether you can become infected with HIV.

Are women especially vulnerable to HIV?
In western countries, women are four times more likely to contract HIV through vaginal sex with infected males than vice versa. This biological vulnerability is worsened by social and cultural factors that often undermine women's ability to avoid sex with partners who are HIV infected or to insist on condom use.

Are there treatments for HIV/AIDS?
For many years, there were no effective treatments for AIDS. Today, people in the United States and other developed countries can use a number of drugs to treat HIV infection and AIDS. Some of these are designed to treat the opportunistic infections and illnesses that affect people with HIV/AIDS. In addition, several types of drugs seek to prevent HIV from reproducing and destroying the body's immune system.

Is there a cure for AIDS?
There is still no cure for AIDS. And while new drugs are helping many people with HIV/AIDS live longer, healthier lives, there are many problems associated with them:

Anti-HIV drugs are highly toxic and can cause serious side effects, including heart damage, kidney failure, and osteoporosis. Many (perhaps even most) patients cannot tolerate long-term treatment with HAART.

HIV mutates quickly. In as many as 50% of people on HAART, HIV mutates into new viral strains that have become highly resistant to current drugs.

Because treatment regimens are unpleasant and complex, many patients miss doses of their medication. Failure to take anti-HIV drugs on schedule and in the prescribed dosage encourages the development of new viral strains that are resistant to current HIV drugs.

Even among those who do respond well to treatment, HAART does not eradicate HIV. The virus continues to replicate at low levels and often remains hidden in "reservoirs" in the body, such as the lymph nodes and brain.

Is there a vaccine to prevent HIV infection?
Despite continued intensive research, experts believe it will be at least a decade before we have a safe, effective, and affordable AIDS vaccine. And even after a vaccine is developed, it will take many years before the millions of people at risk of HIV infection worldwide can be immunized. Until then, other HIV prevention methods, such as using condoms and avoiding needle-sharing, will remain essential.

How do I know if I'm infected?
Immediately after infection, some people may develop mild, temporary flu-like symptoms or persistently swollen glands. Even if you look and feel healthy, you may be infected. The only way to know your HIV status for sure is to be tested for HIV antibodies, that is, proteins the body produces in an effort to fight off infection. This usually requires a blood sample. If your blood has HIV antibodies, that means you are infected.

Should I get tested?
If you think you might have been exposed to HIV, you should get tested as soon as possible. Here's why:

Even in the early stages of infection, you can take concrete steps to protect your long-term health. Many physicians still recommend a "hit early and hit hard" approach to anti-HIV therapy.

But even if you don't begin taking medications right away, regular check-ups with a doctor who has experience with HIV/AIDS will enable you (and your family members or loved ones) to make the best decisions about how and when to begin treatment, without waiting until you get sick.

Taking an active approach to managing HIV may give you many more years of healthy life than you would otherwise have.

If you are HIV positive, you will be able to take the precautions necessary to protect others from becoming infected.

If you are HIV positive and pregnant, you can take medications and other precautions to significantly reduce the risk of infecting your infant, including refraining from breast-feeding.

How can I help fight HIV/AIDS?
Everyone can play a role in dealing with this epidemic. Here are just a few suggestions for how you can make a difference in the fight against HIV/AIDS:

Volunteer with your local AIDS service organization.

Talk with the young people you know about HIV/AIDS.

Sponsor an HIV/AIDS education event or fund-raiser with your local school, community group, or religious organization.

Urge government officials to provide adequate funding for AIDS research, prevention education, medical care, and support services.

Speak out against AIDS-related discrimination.

Support continued research to develop better treatments and a safe and effective AIDS vaccine by making donations to organisations working for AIDS awareness, prevention and treatment.

Source: MedicineNet.com, FamilyDoctor.org and netdoctor.co.uk

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