Introduction As someone who used to review developing news on HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immunodeficiency Syndrome) daily as a profession, there is no disease that probably frightens me more, particularly since there is no known cure. If you randomly ask anyone around the world what the number one health concern is in his/her country, you will probably get the same answer---AIDS! What's incredible, however, is that no one really wants to talk about HIV or AIDS above a whisper, although a survey conducted by the Kaiser Family Foundation (2001) indicated that Americans perceive it to be one of the most urgent health concerns facing the nation, second only to cancer.
On June 5, 1981, the Centers for Disease Control and Prevention (CDC) issued its first public warning about a rare form of pneumonia (Pneumocystis carinii) that was found among a group of gay men living in Los Angeles. Similar cases emerged in New York and San Francisco. This pneumonia was later determined to be AIDS-related, an adverse effect of HIV (Morbidity and Mortality Weekly Report, June 2001). This period in history is now considered the start of the AIDS epidemic in America.
As of December 2004, some twenty-odd years later, over 850-950,000 individuals are currently living with HIV, including the 180-280,000 who do not know they are infected (CDC, 2004). Furthermore, the UNAIDS reported that over 40 million (between 39.4 & 44.3 million) individuals are living with HIV worldwide, and approximately three million people died of AIDS-related complications in 2004 alone (UNAIDS, December 2004).
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What is HIV/AIDS? Most medical professionals today believe that HIV causes AIDS by weakening the body's immune system or its ability to fight infections. When someone is HIV-positive, it means that HIV antibodies are present in their system. Antibodies are proteins produced by the immune system to fight germs or infections. However, the presence of HIV antibodies does not mean that an individual has AIDS. A person can carry the virus for up to 10 years or longer, and although they look healthy, they still have the ability to infect others.
Note: In February 2005, a gay male tested positive for a highly virulent strain of HIV that is resistant to the top HIV/AIDS drug therapies and it developed into AIDS within a two-to-four-month period. Medical experts are unsure whether this is a single incident (Reuters Health, 2005).
You can contract the virus:
Luckily, the virus does not survive long outside the human body and is not contracted casually by touching, hugging, talking to, or sharing common living quarters with a person infected with HIV or AIDS. You cannot contract the virus by using the same eating utensils, swimming pools, hot tubs, drinking fountains, toilet seats, doorknobs, gym equipment, or telephones with infected individuals. No one to date has contracted the disease by having an infected person either spit, sneeze, cough, sweat or shed tears on another individual. Kissing is also an uncommon way to transmit the virus and only one known case has ever been reported involving the intake of blood (from bleeding gums) as a result of kissing (Morbidity and Mortality Weekly Report, 1997).
Furthermore, there is no scientific evidence that verifies the transmission of HIV from mosquito to man. The virus does not infect insects and it has not been detected in insect feces. However, human bite cases from HIV-infected persons, with the presence of blood and severe tissue damage, have been reported to health officials, although biting is also an uncommon method to transmit the virus. As for giving blood, it is considered safer to undergo blood transfusions today since donors are screened for risk factors and donated blood is tested for the presence of HIV antibodies.
The Origin & Types of HIV Depending on whom you talk to, you may get a different version on the origin of HIV. There are those who believe the first strain of the HIV virus and its cousins HIV-2 and simian immunodeficiency viruses (SIVs) evolved as a result of experiments for a genocidal/biological warfare program to thin certain segments of the world population. Notable scholars claim to have credible documentation on the epidemiology of AIDS that corresponds with a section of a government report detailing its "special virus program". Another fact that had these researchers up in arms was the absence of direct scientific evidence to support the natural evolution of HIV-1 from monkeys to humans (Horowitz, 2001).
Both the HIV-1 and HIV-2 strains share a common ancestor---the SIV from the African green monkey was allegedly transformed (mutated) in laboratory experiments by replacing the DNA in the SIV with cat leukemia or chicken sarcoma---thus creating a very deadly virus. Then in 1999, a group of researchers from the University of Alabama-Birmingham studied frozen tissue from a chimpanzee and discovered that the simian virus it carried was almost identical to HIV-1. It is now widely claimed that West-African chimps were the source of HIV-1 and the virus did indeed cross from chimps to mankind via human consumption or genetic experimentation (Kanabus, Allen, 2003).
We may never know the true origin of HIV, but we do know that the earliest known cases of HIV are documented as follows:
Differences between HIV-1 and HIV-2 Today, there are two types of HIV---HIV-1 and HIV-2. Although the predominant virus is HIV-1, both types are transmitted sexually, through blood, or from mother-to-child, and they both share similar symptoms as they progress to AIDS. However, HIV-2 is not easily transmitted and the time between the initial infection of HIV and the illness (AIDS) is much longer.
Consequently, HIV-1 is a highly changeable form of the virus with various subtypes that fall within two groups, group M and group O. At least 10 genetic subtypes (A-J) of HIV-1 exist within group M alone. Group O, on the other hand, contains another group of heterogeneous viruses. The differences between subtypes primarily rest in their genetic composition (live or vitro), and their mode of transmission. For example, subtype B is common among the disease contracted via blood versus subtypes E and C, which are more easily transmitted via mucous membranes (Kanabus, 2002). All subtypes are found in various places around the world. For example, individuals living in America, Japan, Australia, Europe and the Caribbean mainly have subtype B. Whereas subtype A and D are mainly found in sub-Sahara Africa, while subtype C exists mainly among individuals living in South Africa and India (Kanabus, 2002).
It is obvious that more research is needed, particularly since subtypes are known to take on different characteristics. Therefore, you can imagine how complicated it is for scientists to find a cure. It is likely the first HIV vaccines, as with any vaccine, will not be 100 percent effective. But progress will continue until a cure is found.
Status of Global Epidemic Chances are far greater today that you have met someone who is HIV-positive, or have heard of someone who has died as a result of AIDS. More than 20 million people have died of AIDS globally and more than 40 million people in the world are estimated to be currently living with HIV/AIDS, including at least 5.3 million people who were newly infected in the year 2000 alone. The highest concentration of HIV/AIDS is in Africa, where 70 percent of the adults and 80 percent of the children are infected.
In December 2004, UNAIDS provided the following breakdown of the number of adults and children currently living with HIV worldwide:
Oceania
The transmission of the virus is higher in densely populated areas where the infrastructure does not permit effective treatment or response such as in Asia, Africa, and rural America. As one can imagine, the pandemic is causing global emergencies as it destroys the lives of individuals and communities, and delays economic, political and social progress. As Swaziland's King Mswati III once stated during a United Nations conference, "My people are dying. They are dying before their time, leaving behind children as orphans, and a nation in a continuous state of mourning."
Secretary-General of the United Nations Kofi Annan continues to be a leading figure in the fight against HIV/AIDS. Secretary-General Annan met with global media executives in January 2004 to encourage them to launch media campaigns about HIV/AIDS. During the forum he stated, "If there is one thing that we have learned in the two decades of this epidemic, it is that in the world of AIDS, silence is death. As broadcasters, you can bring the disease out of the shadows and get people talking about it in an open and informed way." (UN News, 2004)
Conference participants included the British Broadcasting Company, Black Entertainment Television, Broadcasting Organisations of Nigeria, the Motion Picture Association of America, Time Warner, Inc., Viacom, and the Corporation for Public Broadcasting. The Secretary-General considers partnering with these organizations and other global entities an opportunity they should not miss, particularly in relating to young people who are viewed as the catalyst that may very well turn this epidemic around.
United States & Alabama HIV/AIDS Statistics Based on 1981-2003 statistics compiled by the CDC, approximately 929,985 cases of AIDS have been reported in the United States (US) and at least 524,060 of these Americans have died as a result of the disease. At the end of December 2004, at least 850-950,000 people are reported to be living with HIV/AIDS in the United States. On average, more than 40,000 new HIV infections are reported annually.
In the early 1980s, AIDS was more prominent among whites; however, there has been a steady increase in the number of cases among racial/ethnic populations. Men who have sex with men is still the most common method of exposure (46 percent), followed by injection drug users (25 percent), and heterosexual sex (11 percent). Exposure to the disease is declining among MSM and injection drug users, than those who are exposed to the virus through heterosexual contact.
Southern Region/Alabama According to the CDC, the South has the greatest number of people living with HIV/AIDS---up from approximately 17,224 reported cases in 1999 to 337,409 by the end of 2003. (For purposes of this article, the South includes the states of Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia.)
Unfortunately, in the rural parts of the South, it is not uncommon to find a high concentration of new HIV cases. The virus is globally prominent among cultures/communities with high joblessness, substance abuse, teenage pregnancy, sexually transmitted diseases, poverty, and limited access to healthcare.
As of May 2005, approximately 13,800 cases of HIV/AIDS have been reported in Alabama since 1982 according to the Alabama Department of Public Health. Nearly 70 percent of new infections in Alabama have been reported among African-Americans, although they comprise 26 percent of the state's population.
Finding a Cure Finding a cure may seem impossible. HIV protects itself with a ring of sugars that expose potential antibody binding sites briefly while it infects cells. This diminishes the amount of time a perfect antibody would have to seize or capture the virus. Simultaneously, the virus mutates rapidly and further reduces the likelihood of an antibody match. In addition, the various strains found around the world vary greatly. Therefore, a vaccine that might work in North American strains for instance, may prove to be useless in Africa (Vastag, 2001).
On the other hand, even if a vaccine fails to prevent individuals from becoming infected, cell-mediated responses could still ease the course of the disease, and perhaps keep viral loads down and reduce the risk of transmission. In other words, it could slow the spread of HIV.
Currently, there are medical treatments that can slow down the rate at which HIV weakens the immune system and other treatments that have been identified to prevent or cure some of the illnesses associated with AIDS. However, there is no cure for AIDS. As with most diseases, early detection does offer more options for treatment and preventive health care. For instance, HIV-positive mothers can reduce the risk of transmitting the virus to a fetus by two-thirds if they take the drug AZT (zidovudine) during pregnancy, birth and delivery, and if the infant receives AZT during the first six weeks following birth.
Note: The Food and Drug Administration has approved close to 30 drugs for the treatment of complications due to HIV/AIDS and other experimental therapies are in the pipeline. However, patient resistance to these drugs still poses a problem.
Prevention Methods Today, antiviral therapies have improved the length and the quality of life for individuals infected with HIV. However, these individuals need to be reminded that they can still infect others and should avoid engaging in risky behavior.
In order to respond to the HIV/AIDS epidemic, it is necessary for the media and educational, government, medical, health, and religious organizations to work together to inform the public about HIV/AIDS. According to the CDC, there is greater need to develop new strategies and increase progress in HIV/AIDS prevention in order to reach populations that have been hard hit by the epidemic such as African Americans between the ages of 25 and 44, young gay men, and heterosexual women.
According to data compiled by the CDC, prevention efforts work! New infections in the US have declined annually from over 150,000 as first reported in the 1980s to 40,000 cases a year.
Safe Health Practices The only way to tell if you have HIV is by being tested. A person living with HIV is diagnosed by a physician as having AIDS when they have one or more "opportunistic infections" associated with an impaired immune system, or when there is evidence that their immune system is "depressed" by a diminished supply of CD4 cells in their blood. A person who is diagnosed as being HIV-positive, on the other hand, has undergone an antibody test to confirm that they are infected with the virus. To avoid being infected, it's important to make smart decisions about sex and drugs. Get tested regularly for HIV---this includes youth, singles, married couples, and adults over the age of 50 since HIV/AIDS does not discriminate across gender, age, or racial lines.
Here are some other helpful preventive measures.
Of course the surest way to avoid HIV infection is to practice sexual abstinence and avoid sharing blood tainted needles during drug injections or when getting tattoos or a body piercing.
Where to Go for Help in Alabama
Alabama Department of Public Health HIV/AIDS Service Regions & Regional Offices
Public Health Area 1: Northwest Alabama HIV Prevention Community Planning Group - Tuscumbia, AL Phone: 256-383-1231 Public Health Area 2: North Alabama Community Planning Group - Huntsville, AL Phone: 256-539-3711 Public Health Area 3: West Alabama HIV Prevention Planning Council - Tuscaloosa, AL Phone: 205-554-4500 Public Health Area 4: Jefferson County HIV/AIDS Prevention Planning Group - Birmingham, AL Phone: 205-918-0978 Public Health Area 5: HIV/AIDS Ongoing Prevention Education (HOPE) Community Planning Group - Gadsden, AL Phone: 256-547-6311 Public Health Area 6: Cheaha-Coosa Valley Community Planning Group - Anniston, AL Phone: 256-236-3274 Public Health Area 7: Black Belt HIV Prevention Community Planning Group - Selma, AL Phone: 334-874-2550 Public Health Area 8: East Central Alabama Community Planning Group - Phenix City, AL Phone: 334-298-5581 Public Health Area 9: Southwest Alabama Community Planning Group - Brewton, AL Phone: 334-867-5765 Public Health Area 10: Southeast Alabama Community Planning Group - Dothan, AL Phone: 334-678-2800 or 2805 Public Health Area 11: Mobile County HIV Prevention Planning Group - Mobile, AL Phone: 334-690-8167
Public Health Area 1: Northwest Alabama HIV Prevention Community Planning Group - Tuscumbia, AL Phone: 256-383-1231
Public Health Area 2: North Alabama Community Planning Group - Huntsville, AL Phone: 256-539-3711
Public Health Area 3: West Alabama HIV Prevention Planning Council - Tuscaloosa, AL Phone: 205-554-4500
Public Health Area 4: Jefferson County HIV/AIDS Prevention Planning Group - Birmingham, AL Phone: 205-918-0978
Public Health Area 5: HIV/AIDS Ongoing Prevention Education (HOPE) Community Planning Group - Gadsden, AL Phone: 256-547-6311
Public Health Area 6: Cheaha-Coosa Valley Community Planning Group - Anniston, AL Phone: 256-236-3274
Public Health Area 7: Black Belt HIV Prevention Community Planning Group - Selma, AL Phone: 334-874-2550
Public Health Area 8: East Central Alabama Community Planning Group - Phenix City, AL Phone: 334-298-5581
Public Health Area 9: Southwest Alabama Community Planning Group - Brewton, AL Phone: 334-867-5765
Public Health Area 10: Southeast Alabama Community Planning Group - Dothan, AL Phone: 334-678-2800 or 2805
Public Health Area 11: Mobile County HIV Prevention Planning Group - Mobile, AL Phone: 334-690-8167
American Red Cross Facilities Near Urban Centers (Provides Administrative, Technical, Educational & Referral Information)
Alabama residents, visit this site to find a Red Cross Chapter near you: Red Cross: Alabama & Central Gulf Coast Region. For other states, visit the Red Cross website.
Conclusion It is my sincere hope that this article is useful to families and individuals in particular who desire to understand the basics of HIV and AIDS. In an increasingly connected global society, we can no longer afford to make unwise or cavalier decisions regarding sex, drug use, or the sharing of dirty needles. Remember, regardless of your ethnic or socioeconomic background, you could become infected with HIV. NO ONE is exempt from this deadly virus. So, do yourself a favor--GET TESTED!
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