See appendix 2. The Terence Higgins Trust – History.
- It is estimated that there are 50,000 people living with HIV in the UK, the highest number ever; estimated to rise 25% in 2002.
- 12,544 people were reported as having died with AIDS in the UK.
Ref:
But the UK is not alone in Europe in this epidemic; one of the fastest growing HIV/ AIDS epidemics is found in Eastern Europe.
‘HIV incidence is rising faster in the region of Eastern Europe and Central Asia than anywhere else in the world. At the end of 1999 the number of adults and children living with HIV or AIDS in Eastern Europe and the Former Soviet Union was 420,000. Two years later the UNAIDS put the figure at 1 million, the majority [250,000] were drug users.’
Ref: HIV and AIDS in the Russian Federation,
These two early posters are from the UK, and were produced by The Terence Higgins Trust – 1984.
Source: .
How do people get infected with HIV?
You can get infected with HIV from anyone who’s infected, even if they don’t look sick, and even if they haven’t tested HIV+ yet. The blood, vaginal fluid, semen and breast milk of people infected with HIV has enough of the virus in it to infect other people. Most people get the HIV virus by:
- Having unprotected penetrative sex with an infected person.
- Sharing a needle [shooting drugs] with someone who’s infected.
- Being born when their mother is infected, or drinking the breast milk of an infected women.
- Being exposed accidentally to blood or body fluids, like in a hospital environment.
Getting a transfusion of infected blood used to be a way people got HIV, but now the blood supply is screened very carefully and the risk is very low.
There are no documented cases of HIV being transmitted by tears or saliva, but it is possible to be infected with HIV through oral sex or in very rear cases through deep kissing, especially if you have open sores in your mouth or bleeding gums.
Ref:
‘It is not a ‘gay thing’. HIV infections among all teenagers and young adults are increasing. Also, nearly one – fourth of AIDS cases among adolescents and adults age 25 stem from injecting drug use.’
Ref:
See appendix 3. Tips for Teens.
How is HIV Diagnosed?
Early HIV infection often causes no symptoms a doctor or health care provider usually can diagnose it by testing a persons’ blood for the presence of antibodies [disease fighting] to HIV. HIV antibodies generally do not reach detectable levels in the blood for one to three months following infection.
It may take the antibodies as long as six months to be produced in quantities large enough to show up in a standard blood test. Through out this period an infected person has enough viruses in the blood, breast milk and sexual fluids to infect another person – albeit it will not show up on a test.
Where did HIV originate?
Since the discovery of HIV in the early 1980’s, one question has yet to answered: Where did this virus originate? Many theories have been proposed; but the two most likely are:
- HIV originated from a tainted oral polio vaccine in the 1950’s.
- HIV originated by zoonotic transmission from an animal host.
Growing evidence supports the theory that in the recent past HIV – 1 & HIV – 2, jumped the species barrier from primates to humans.
Evolutionary biologists suggest that simian [monkey] immunodeficiency viruses {SIV] have lived in parts of Africa for years – hence the theory an infection jumped from species to species.
It has been suggested that HIV could be traced to the testing of an oral polio vaccine called Chat. The vaccine was grown in chimp kidney cells; and subsequently the vaccine was given to about a million people in the Belgian Congo, Ruanda and Urundi in the late 1950’s.
What is possible is that HIV crossed over into humans on more than one occasion; so therefore it is also possible that HIV emerged in Africa and South America at the same time.
Ref:
See appendix 4. The origins of AIDS and HIV.
‘We will probably never know exactly when and where the virus first emerged; it is clear that sometime in the 20th century HIV developed in humans and then into the epidemic around the world today’.
The HIV Life Cycle
The HIV Virus:
Source:
HIV is a retro virus, a virus that carries its genetic information in RNA rather than DNA. RNA – ribonucleic acid – is a nucleic acid that stores and processes information at the molecular level, inside cells.
Ref: Essentials of Anatomy & Physiology.
HIV enters the blood stream and begins to take up residence in the cells. HIV begins to attack the immune system – which is vital for our ability to resist or overcome infection and disease.
People with HIV are considered to be infectious immediately after infection with the virus.
HIV’s main target is an immune cell called a lymphocyte, more specifically a CD4 helper cell, and a type of T-cell. T-cells are an important part of the immune system because they help and assist the body’s responses to many common, but potentially fatal infections.
Ref: Immunology
Knowing how the virus functions and reproduces itself is a process called its life cycle.
Source:
HIV has to complete many steps in its life cycle to produce thousands of copies of itself. Below is a [very] simplified version of events:
- HIV comes into contact with a T-cell; it fuses and injects its genetic material [blueprint for making more HIV].
- Binding between proteins on surface of virus and proteins that serve as receptors on surface of the T-cell.
- HIV uses a receptor on the surface of the T-cell called CD4 to latch onto the cell.
- After attachment is completed the virus penetrates the cell.
- HIV releases it’s genetic information [RNA] and is then incorporated into the T-cells genetic core.
- The T-cell is now infected with the HIV – the subunits produced from the RNA & DNA produce a new viron.
- The new HIV leaves the now deformed T-cell and enters the circulation, ready to start the whole process again.
Ref:
‘Consequently there is one less T-cell in the body, and with this happening on a monumental scale, T-cells begin to decline. Over time there are not enough T-cells to defend the body = AIDS’.
Source:
The Stages of HIV Infection
Primary Infection [or Acute Infection]:
Primary infection is the first stage of HIV disease, when the virus first establishes itself in the body. This stage is the period when a person starts to produce antibodies against the infection [usually 6 – 12 weeks].
Some people have a flu-like illness within a month or two; other illness may include:
- Fever
- Headache
- Tiredness
- Enlarged lymph nodes [glands of the immune system]
70% of people newly infected will experience some flu-like symptoms; which might include fevers, chills, night sweats and rashes.
During acute infection, the virus makes its way to the lymph nodes [takes 3 to 5 days]. Then HIV actively reproduces and new viruses enter the bloodstream. This burst of rapid replication lasts about two months; at this stage a person is said to have a very high HIV ‘viral load’.
Seroconversion:
This is when the body begins to produce antibodies to the virus. 95% of people will develop antibodies within three months; nearly all people within six months. People who get tested need to wait three months for the test; if first result is negative, they need to be retested three months later.
‘ A person with HIV is infectious all the time. A person does not need to have symptoms or look sick to have HIV’.
‘ More persistent or severe symptoms may not appear for 10 years or more after HIV first enters the body in adults – or within two years in children born with HIV infection. This period of ‘asymtomatic’ infection is highly individual’.
Immune System Decline:
The virus appears to slowly damage the immune system for a number of years. The term AIDS applies to the most advanced stages of the infection.
CDC’s definition of AIDS including all HIV+ infected people who have fewer than 200 CD4+ T-cells per cubic millimetre of blood: Healthy adults usually have a CD4+ T-cell count of 1,000 or more.
In addition, the definition includes 26 clinical conditions that are opportunistic infections that do not affect healthy people. To people with AIDS, these infections are severe and sometimes fatal; as the immune system is so ravaged by HIV; therefore the body cannot fight of certain bacteria, viruses, fungi and parasites.
The most common opportunistic infections are:
- PCP [Pneumocystis carinii pneumonia] a lung infection.
- KS [kaposi’s sarcoma] a skin cancer.
- CMV [cytomegalovirus] an infection that usually affects the eyes.
- Candida a fungal infection that can cause thrush or infections in your throat or vagina.
Ref:
See appendix 5: What are opportunistic infections?
‘Many people are so debilitated by the symptoms of AIDS that they cannot hold steady employment or do household chores. Others experience phases of intense illness followed by phases in which they function normally’.
How do you prevent HIV from infecting you?
Since there is no cure, so the best things to do is prevent it from being transmitted or passed, to you are:
- Not have sex.
- Not shoot drugs – not share injecting needles.
- Use latex condoms the right way every time you have sex.
- Limit your number of sex partners.
- Learn to clean your works the right way if you shoot drugs.
- The important thing to remember is that as long as you keep someone else’s blood, seminal fluid, semen and vaginal from getting inside your body, you are safe.
- If you are sexually active, use latex condoms every time you have sex- condoms can break if not used right – they can also break if you use oil, lotion or petroleum jelly as a lubricant.
‘ Using latex condoms every time you have sex also reduces the risks of getting other STD’s besides HIV’.
‘ Having a STD, such as syphilis, genital herpes and chlamydial infection [too name a few] appears to make people more susceptible to getting HIV during sex with infected partners’.
How is HIV infection treated?
During the past ten years, researchers have developed drugs to HIV infection and its associated infections and cancers.
The first group used to treat HIV, called RT inhibitors interrupt an early stage of the virus making copies of itself. This class of drugs called nucleouside analogs, one of which is AZT; which is given to pregnant women so she can reduce significantly the chances that her baby will be infected with HIV. These drugs may slow down the spread of HIV in the body and delay the start of opportunistic infection.
Other drugs called protease inhibitors, interrupt virus replication at a later stage in its life cycle. They include:
- Ritonavir
- Saquinivir
- Indinavir
- Amprenivir
- Nelfinavir
- Lopinavir
Because HIV can become resistant to any of these drugs [it mutates] there must be a combination treatment to effectively suppress the virus: It is referred to as highly active antiretroviral therapy, or HAART.
‘ While HAART is not a cure for HIV/ AIDS; it has greatly improved the health of many people’.
Ref:
Socio – Economical factors & HIV/ AIDS
The socio- economical factors that are related to the spread of HIV/ AIDS include increased drug abuse, rises in sex outside marriage, world travel and the most importantly poverty.
Malnutrition & Sanitation:
‘These two factors worsen the spread of the disease, and also hamper recovery’.
Orphans:
‘South Africa faces an increase in mortality among the people it could least afford to lose, the young people in society’.
Ethics:
‘HIV / AIDS patients should be given drugs to assist them in recovery – regardless of which laboratory they come from’.
Human Rights:
‘South African issues related to non- discriminatory social environments, including issues related to social conditions, the status of women, inequality, the elevation of poverty and human rights’.
Stigmatisation:
‘People living with HIV /AIDS, their families and ‘at risk’ groups such as sex workers and migrants are often subject to social alienation’.
Ref:
See appendix 6: Socio- economic factors in the context of HIV/ AIDS.
The role of Research, Education and Health Promotion
After 20 years of HIV, research is crucial and a key important factor in the spread of HIV. Investigators are researching all areas of HIV infection, from testing preventative HIV vaccines, new treatments, to exactly how HIV damages the immune system. Hopefully this could produce more efficient targets for drugs and vaccines.
Educating people must be in the forefront of preventative research ; it’s no good saying ‘HIV can never happen to us’.
Quote from + ve: ‘ A study shows that nine out of 10 doctors and nurses in China know very little about HIV and are worried about treating patients’.
See appendix 7: Globe trotting- News from around the world. [Check out news from Botswana & Kenya]
In many societies people living with HIV and AIDA are often seen as shameful. Culture, tradition and religion probably have most influence over opportunities to prevent and respond to the HIV epidemic.
See appendix 8: Stigma & Discrimination.
Conclusion:
HIV and AIDS is a threat to ALL nations. The only way forward is research and fundamentally, good available education. The HIV virus is slow moving in the destruction of the human body; it’s time span is not a few weeks like that of a flu epidemic but five, ten, fifteen or possibly 20 years. This is disturbing intimation of what is to come in the next two decades.
Even if we do begin to make necessary changes in our behaviour, the sad fact is these changes will come too late for the great number of people who are already known and unknowingly infected.