The most pernicious of sexually-acquired infections is HIV/AIDS. Though there are different mechanisms for contracting this infection (see below) it is extremely important for women to understand that this is not a disease limited to gay men or I.V. drug users. Women now constitute the most rapidly growing segment of the HIV-infected population in the U.S.
HIV infections were first reported in 1981, although the disease was probably around for 20 years prior to that. According to the World Health Organization (WHO) the human immunodeficiency virus (HIV) has claimed more than 25 million people worldwide making it one of the worst pandemics in history. In 2005 alone AIDS claimed almost 3 million lives of which more than half a million were children. Only the Black Death or bubonic plague (1347-1351) and the Great Influenza Pandemic (1918-1919) claimed more lives. But unlike those terrible disasters the final chapter on HIV/AIDS has yet to be written. In 2006 over 39.5 million people were living with HIV/AIDS—an increase of 2.6 million since 2004. As of May 2007 over 40.3 Million people worldwide are living with HIV/AIDS. To see the “AIDS Clock” visit http://www.unfpa.org/aids_clock/index.html.
According to the Center for Disease Control (CDC) there are 1.185 million people with HIV/AIDS in the U.S.—25% of them unaware of their infection. About 42,000 new cases appear each year. At any one time 25 out of every 100,000 New Yorkers have the HIV virus.
America’s African American and Hispanic communities have been disproportionately affected by HIV/AIDS. Currently 50% of new HIV and 50% of new AIDS diagnoses are in African Americans. Of newly infected women, 64% are black, 18% are white and 18% are Hispanic.
What is HIV?
HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immune deficiency syndrome). HIV weakens a person’s immune system. Specifically HIV attacks and destroys a type of white blood cell called a CD4 cell. This cell’s main function is to fight disease. When a person’s CD4 cell count gets low they become more susceptible to disease. Your immune system plays two important roles: first, it protects you against infection and second, it protects you against developing cancer. People with HIV generally go on to develop full blown AIDS, though treatment can forestall this progress for many years. Those with AIDS most often die of infections or cancers.
What is AIDS?
People with HIV are said to develop AIDS when:
- They develop certain infections called opportunistic infections. These are infections resulting from common everyday bacteria and spores that most healthy people can normally resist. Examples include certain pneumonia, thrush or recurrent childhood infections.
- They develop certain cancers such as Kaposi’s sarcoma and non-Hodgkin’s lymphoma
- When their CD4 count is less than 200.
What is a CD4 cell?
The CD4 cells are a certain type of white blood cell also called T-cells. HIV attacks these types of cells and uses them to make more copies of HIV. In doing so, the CD4 cell becomes unable to do its job of protecting the body. At first, the body can make more of these T-cells but eventually the body can’t keep up and the number of working T-cells decreases. This weakens the immune system and leaves the body at risk for different types of infections.
If left untreated, 90% of HIV-infected individuals develop AIDS and die—about 10% will remain healthy for many years without noticeable symptoms. The development of new medications, called anti-retrovirals, increases life expectancy and improves quality of life so that HIV-infected individuals can lead normal productive lives with near normal life expectancy.
A person gets HIV when an infected person’s body fluids (blood, semen, fluids from the vagina or breast) enter his or her blood stream. The virus can enter the blood through linings of the mouth, anus or sex organs (penis and vagina), or through broken skin. Both men and women can spread HIV. Moreover, someone with HIV can feel fine and still give the virus to others.
There are 3 major routes of transmission of HIV. They are:
- Unprotected sexual intercourse (vaginal, oral or anal)
- Contaminated needles
- Transmission from an infected mother to her baby at birth or through breast milk.
- Fortunately, in the United States, HIV transmission through blood transfusions has been virtually eliminated though this remains a problem in underdeveloped countries.
The years that followed the discovery of HIV/AIDS were years of hysteria during which those infected with HIV were marginalized. The disease itself was the subject of unfounded rumors. Just to be clear, you cannot get HIV from:
- Touching or hugging someone who has HIV/AIDS
- Coming into contact with someone’s saliva who has HIV/AIDS
- Public bathrooms or swimming pools
- Sharing cups and utensils with someone who has HIV/AIDS.
Can HIV/AIDS be cured?
No. The past decade has seen tremendous strides in helping those affected with HIV manage their disease and lead longer and healthier lives. But there is no known cure at this time for the disease.
The best way to be certain if you have HIV is to take a blood test. Your blood test results are kept absolutely confidential. In fact they are not sent to the lab with your name, but instead a number is assigned to your blood specimen (anonymous testing). A negative test means that no signs of HIV were found in your blood.
Why should I get HIV testing?
There are many reasons to get an HIV test. Here are just a few:
- If your test it negative it will put your mind at ease.
- If your test is positive
- Your doctor will want you to start antiretroviral medications (see “HAART” below) to help slow the progression of the infection
- A health care provider can monitor your health.
- If you do fall ill, knowing your HIV status in advance will help your health care provider interpret any signs or symptoms you may develop.
- If you know you are HIV positive you can protect other people.
- If you know you are HIV positive it may affect your future decisions.
- How can I tell if I have the virus that causes AIDS?
People with HIV may look and feel healthy. Many do not even know they have the virus, but they can still infect others through blood-to-blood or sexual contact. Typically, a blood test will show whether you have antibodies to HIV (the virus that causes AIDS). If you have HIV antibodies, it is assumed that you have the HIV infection. It can take up to two weeks to get these results. But now there is a faster test with results in as little as 20 minutes.
Who should be tested?
Our current recommendations are that people who engage in risky behaviors be tested. This includes:
- Unprotected intercourse in multiple short term relationships
- Unprotected intercourse with a partner who is suspected of having other sexual partners
- I.V. drug users
- People who share needles
- Additionally, all pregnant women should be tested for HIV infection.
If I have HIV will I get AIDS?
People with HIV are said to be “infected” with HIV. As of 1992 scientists estimated that about half of people who become infected with HIV will develop AIDS within 10 years. However, with newer treatments the pace of the disease can be slowed down dramatically in many individuals.
How is HIV Treated? How can I prevent HIV from progressing to AIDS?
There was a time when HIV was considered a death sentence. Today, however, there are a variety of treatments which can retard the progression of the disease and in some cases stop altogether the progression of HIV infection.
After HIV infection is confirmed your doctor will start you on a drug regimen consisting of several drugs: combination of different types of anti-HIV drugs sometimes called HAART (highly-active-retroviral therapy). These drugs must be taken at exactly the right time each day.
You can help prolong your own life by taking good care of yourself and insisting on good medical care from providers who are experienced in treating HIV infection. It is absolutely essential to be consistent about taking your HIV medications as prescribed.
What is the outlook for someone with HIV or AIDS?
The majority of people with HIV who take care of themselves and adhere to their drug regimens can expect to live long and healthy lives. No one can give you a precise answer to the question of “how long do I have?” That said, however, our ever increasing knowledge and treatments offer tremendous hope to those who test positive. HIV is no longer a death sentence.
How can I get more information?
Our best local resource is the
AIDS Community Health Center
At 87 North Clinton Avenue Suite #4
Rochester, NY 14604
You can also get information at the CDC National AIDS Hotline: 1-8000-CDC-INFO (232-4636)