What Everyone Should Know
HIV and AIDS are a global pandemic. HIV has infected people in every country on earth and devastated entire nations. The numbers are enormous, but these numbers represent people. There are mothers, fathers, brothers, sisters, children, grandparents, and babies who have been infected with HIV and have died from AIDS.
Education is the first step in preventing, treating, and stopping the spread of HIV and the progression to AIDS. You will find information here and in the related Web site links that will help you become more educated.
- HIV is mostly a disease of homosexual men. Primarily spread by heterosexual sex, HIV now infects as many women as men worldwide.
- HIV and AIDS are mostly an African problem. Found in every country in the world, HIV infections are growing most rapidly in countries outside of Africa, including India and Russia.
- HIV spreads mostly because of poor moral choices. Women are often infected by their husbands, and children most often contract HIV by being born to HIV-positive mothers.
- Plenty of money is being spent on fighting HIV and AIDS. While a great deal of money is being spent by governments, private organizations, and individuals to fight HIV and AIDS, much more is needed.
- HIV and AIDS are no longer a problem in the United States. Because antiretroviral drugs (ARVs) are widely available in the United States, the death rate has decreased. But the number of people living with HIV or AIDS in the United States has not decreased, and the rate of new infections is not going down.
- ARVs are widely available. While antiretrovirals are becoming more available, they are still difficult to find and afford in many rural areas and in some countries. Both the drugs and the health care workers to administer them are needed in many poor countries.
- A cure exists for AIDS. While there are treatments to prolong life, there is no cure.
- There is no hope for those with HIV and AIDS. Great progress is being made in treatments, and the rate of infant infection is dropping rapidly. There is also a dropping rate of new infections in many countries with strong prevention programs.
- If I'm not HIV-positive, the disease doesn't affect me. The high rate of HIV and AIDS infections is causing instability in many countries and reversing the progress made in development. It is also causing a worldwide tuberculosis pandemic. Everyone is affected by the pandemic.
- There's nothing I can do. Everyone can do something. First, become educated. Then help teach others in your church, school, or community. Help support an organization working to stop the spread of HIV, or help support groups that care for AIDS orphans.
What are HIV and AIDS? HIV stands for human immunodeficiency virus. Human means that it affects men, women, and children. Immunodeficiency refers to a decline in the body's natural ability to fight infection. Virus means that it is a small, infectious organism that reproduces inside a person.
AIDS stands for acquired immunodeficiency syndrome. Acquired means that it is not genetic. Immunodeficiency, as with HIV, means that the immune system has become very weak or ineffective. Syndrome refers to a group of symptoms that occur together and characterize a disease.
If a person has HIV, do they also have AIDS?
AIDS and HIV are not the same thing. A person may be infected with HIV for many years before developing AIDS, which is considered to be the last stage of the illness resulting from the HIV virus.
A person with HIV may not show any major symptoms of infection. Or, there may be flu-like symptoms in the first month or two, such as fever, headaches, or swollen glands. During this period, the person may not test positive for HIV but is able to transmit the disease.
After this initial phase, the person may be free of symptoms for many years. During this time, the virus is invading and attacking a person's CD4 cells, often known as T cells. T cells are the body's primary defense against viruses and bacteria.
How are HIV and AIDS diagnosed?
A blood test is required to accurately confirm the diagnosis of HIV, although it may not show up until six months after infection. New testing methods, such as scraping the inside of your cheek, are simple, painless, and quick, making it possible to test anyone easily and rapidly.
AIDS can be diagnosed either through measuring the T-cell count or when a number of opportunistic infections or cancers become present in a person with HIV. A person with AIDS may live for a few years or succumb quickly to another disease.
How are HIV and AIDS treated?
Antiretroviral drugs may be used with a person who has HIV or AIDS, and these have been effective in treating both.
Just how bad is the international AIDS crisis? AIDS is the biggest public health problem the world has ever faced. It has already surpassed the bubonic plague, which wiped out 25 million people-one-quarter of Europe's population at the time. An estimated three million people die each year from AIDS, a death toll that has been compared to 20 fully loaded 747s crashing every single day for a year.
AIDS typically infects people in the prime of life, depriving children of their parents and communities of their most productive workers. In some countries, more than one-third of the population is infected, effectively wiping out an entire generation.
Since many people are HIV-positive for years without showing symptoms, no one really knows the magnitude of the problem. Most people in poorer countries are never tested, and many who die of AIDS-related infections are officially listed as succumbing to tuberculosis, malaria, or other illnesses in order to keep their families from being stigmatized.
Most estimates show the rate of infection and death growing at a high rate at least until 2010, even with aggressive worldwide interventions. Experts from various disciplines agree that the problems associated with AIDS will dominate the entire twenty-first century.
Isn't AIDS primarily a disease of homosexuals?
While AIDS in the United States and many developed countries has had its highest incidence in the gay community, internationally HIV is primarily transmitted through heterosexual sex, intravenous drug use, transmission from infected mothers to their babies, and infection through the blood supply. The virus does not exist for long outside of the body, so early fears about contracting the virus through casual contact have been laid to rest. Worldwide, it is not primarily a disease of homosexuals. More women than men are infected in Africa, and many are infected by their husbands.
How do you contract HIV?
HIV is transmitted through contact with blood, semen, vaginal secretions, or amniotic fluid and to a lesser degree through breast milk. Although the virus is found in saliva, tears, and perspiration, the concentration is generally too low for transmission. Unless a person has a cut or tear in the skin, they cannot be infected by dealing with human waste of those infected. Neither can a person be infected by sharing utensils with an infected person, swimming or bathing in the same water, being bitten by an insect, or being coughed or sneezed on, according to the Center for Disease Control (CDC).
Although HIV is, itself, often a sexually transmitted disease (STD), the risk of transmitting or contracting the disease is increased by the presence of another STD in either partner.
Do infected mothers always pass the virus to their babies?
No. Women may pass the virus to their babies in three different ways: during pregnancy through the placenta; during childbirth; and through breast milk. Without treatment, between 15 to 30 percent of babies born to HIV-positive mothers are infected. Caesarian deliveries reduce this to some degree. There are ongoing discussions and studies regarding breast-feeding versus the challenges of providing infant formula requiring a regular and affordable supply of safe water, clean bottles, and infant formula.
Why do groups oppose the use of condoms?
Some organizations do not promote the use of condoms at all, while some groups simply promote certain types of prevention more than condom usage.
Religious organizations opposing use of condoms sometimes believe that their use encourages promiscuity or early sexual activity. Others oppose all methods of birth control, including condoms. Some feel that condoms are unreliable and should not be encouraged over abstinence. Others point out that the cost of condoms is too great of a burden on the poor, and it is not realistic to believe that they will be used regularly.
Do condoms really stop the transmission of sexually transmitted diseases?
There have been some groups who have asserted that condoms do not stop STDs. It's true that condoms made of natural materials as opposed to latex or polyurethane have pores that may allow transmission of such microbes. But according to the CDC, latex or polyurethane condoms, when used correctly and consistently with every sexual act, are a very effective means of preventing the transmission of HIV and other STDs.
However, these studies have been done in laboratories. Condoms are used in real life, where they are susceptible to being reduced in efficacy by heat, sunlight, ozone, lubricants, tears, and improper usage. Most men prefer not to use condoms because they believe that condoms reduce pleasure. Some women don't like condoms because they block their ability to become pregnant. Condoms can be expensive for poor people and must be resupplied, another challenge for those living outside major cities. Condoms should never be washed and reused.
Is homosexuality a factor worldwide, or is it mostly in Western countries?
Homosexuality does exist in other parts of the world, but probably not to the extent that it does in more wealthy, developed countries. The practice is highly stigmatized in Africa, Asia, and Latin America and is illegal in 84 countries. Worldwide, UNAIDS estimates that HIV infections from men to men account for five to 10 percent of all infections. Because relationships between men are far more hidden in developing countries, it is particularly difficult to find effective ways to teach HIV prevention to men in this group.
Although HIV primarily infects women and men in the prime of life, the disease affects children more than any other group. Today, 12 million children are orphaned in sub-Saharan Africa alone because of HIV and AIDS.
These orphans are often growing up without any adult supervision and are malnourished, illiterate and lack even basic medical care. Those who are cared for by relatives or others are straining the structure of families and often receive meager rations and no schooling.
Women who are HIV positive give birth to babies with HIV as much as 30 percent of the time. They may also pass the virus to their baby through breast feeding, although sometimes it is still safer to use a mother's milk than infant formula. Administering even a single dose of anti-retrovirals before a woman gives birth can greatly reduce the rate of transmission to the child.
According to UNICEF, every minute a children under 15 dies of an AIDS-related illness and every minute, another child becomes HIV-positive.
Because the disease has had such a negative impact on societies, young people are also becoming sexually active at a young age, often because of rape or the need to survive on the street. The rate of infection in the age group of 15-24 is growing greatly, with estimates as high as four new infections in this group alone every minute.
Even when the rate of new infections declines, the number of orphans continues to grow for many years.
Most experts believe that the next century will be influenced by the impact of millions of children who have grown up without families, education and basic social structures.
Taking A Test
I sat in line at the clinic, waiting for my turn. When I told the nurse that I wanted to have an HIV test, she gave me information about the test and a form with a number on it. From that point on, I would be identified only by a confidential number. No one would know my name unless I told them.
When it was my turn, I went to a private enclosure, where a nurse gave me a swab and asked me to open my mouth and brush it against my gums. She asked me to press hard enough so that the swab would contain cells shed from my skin, not just saliva. Then she had me place the swab into a container, which she marked with my number. The test was painless, and I did not have to have blood taken.
I went outside to wait, and a half hour later, my number was called. I went in to meet with another nurse in a private enclosure. She showed me the results from my test and asked if I had any questions. I asked her if she was sure, and she said that the test was 99 percent accurate.
My test was negative, but the nurse told me that I should be tested again if I engaged in any risky behavior, such as unsafe sex or sharing of needles. She also said that if I had been involved in those types of things in the past month or two, I should be tested again because the results might not have shown up. Had I tested positive, the nurse would have given me another test, just to be sure.
Having an HIV test is easy, fast, and confidential. It isn't painful. Everyone should be tested, even if they don't feel sick. Knowing your HIV status is the first step toward prevention and treatment.
Suggested website resources and links
- UK website for those living with HIV/AIDS.
- News and information about Africa.
- UN Foundation website about AIDS response.
- British Broadcasting Company's website.
- The Centers for Disease Control website.
- The National Institutes of Health home page.
- Statistics and other resources on the global pandemic.
- Information on children and their global struggle.
- Website of the US Agency for International Development.
- The World Health Organization's website.
- Organization dedicated to fighting global poverty.
What To Do When...
HIV infections cannot occur through casual contact. Primarily, HIV is contracted through sexual relations with an infected person, sharing needles, receiving tainted blood or when an open wound comes in contact with infected fluids.
If you have engaged in unprotected sex with a person who may be infected, or used a non-sterile syringe or needle, you should contact your doctor or local clinic and request an HIV test.
HIV tests are simple and quick. At some clinics they are free, or available for minimal cost. Rapid testing involves a simple swab of the gums, with results usually available in less than 30 minutes. If you test negative and believe your contact was recent, you should be tested again in six months, since infections do not always show up on tests when they have occurred very recently.
If the test is positive, a blood test is then required to verify the results.
All testing is confidential and voluntary. The information from the test cannot be shared or used against you in any way. But if you are HIV infected, you many begin treatments as soon as your doctor believes the use of drugs will help manage your symptoms or stop the progress of the disease.
Being diagnosed as HIV positive is not a death sentence. Hundreds of thousands of people with HIV live normal lives as long as they take regular medication.
Everyone should know their HIV status and be tested again if they have engaged in risky behaviors or believe they may have been infected. Early detection of HIV means that treatment can occur when it is most helpful and infections of others can be avoided.
Being diagnosed as HIV positive is not a death sentence. HIV is now considered treatable like diabetes or asthma. As long as a person is under regular care by a doctor and takes the properly prescribed medications, she or he can live a long and productive life.
Depending on the level of HIV in your system, a doctor may prescribe various regimens of drug treatment. If your infection is very low, a doctor may wait to prescribe anti-retrovirals(ARVs) and instead encourage good nutrition to build up your natural immune system.
Being well-nourished and having a healthy lifestyle are important factors in fighting HIV. If your doctor has prescribed ARVs, be sure he or she knows if you are taking any other drugs or any herbal supplements or vitamins, since they may interact with the ARVs.
If you are taking ARVs, be sure to take them consistently. Missing a dosage can increase your body's tendency to develop immunities to the drug. If this happens, you will have to change to a different drug.
While taking any prescription, you should let your doctor know immediately if you develop a rash, have nausea, vomiting or diarrhea, headaches, or any other unusual symptoms. ARVs are very strong drugs and your doctor may need to adjust your dosage.
Most insurance plans cover ARVs and there are programs available to assist those who are not covered by insurance. The cost of ARVs should never stop anyone from seeking and receiving treatments.
Remember, if you are HIV positive you are able to infect others through unprotected sex or sharing of needles.
A person's HIV status is very personal and is legally protected. If someone tells you that they are HIV positive, you should consider it confidential and never share it with anyone else.
While millions of people are HIV positive, many prefer not to share their status with others for fear of discrimination or prejudice. A person who is HIV positive is often referred to as a person who is living with HIV or AIDS or a PLWHA.
HIV is now considered a chronic disease rather than a fatal disease, and infected people can live long and productive lives as long as they receive regular medical treatment and take prescribed medications.
A person who has HIV or AIDS is not contagious. The infection cannot be spread through casual contact and the virus does not survive outside of the body. Sharing glasses or utensils, kissing or coming in contact with a person's saliva or perspiration, or any other casual contact will not expose another person to HIV.
But if a person is HIV positive, he or she is always potentially infectious, no matter what the medications or how low the infection rate. An infected person should never engage in unprotected sex (including oral), share needles, or fail to disclose their status when receiving health care.
If you believe someone who works for you is HIV positive, it is not legal to ask their status or to treat them in any discriminatory manner. People living with HIV or AIDS are protected under the Americans with Disabilities Act.