Jean Q. Davis
AIDS (Acquired Immune Deficiency Syndrome) is caused by a virus (Human Immunodeficiency Virus).
A cquired—something you get or develop
I mmune—system in the body to fight foreign material such as bacteria or transplanted tissue
D eficiency—a lack of something
S yndome—a set of symptoms, signs and other findings that frequently accompany each other
AIDS results from the damage done to the immune system by the HIV infection. The virus makes the immune system less able to fight off infection. Because the system fails, a person with AIDS develops a variety of life-threatening illnesses. This process may take many years (up to ten or more).
Terms are important in the preventive education of this disease because adolescents believe that you look sick and feel sick when you have an illness. The focus is changing from the term AIDS to HIV infection so that teens understand the full range of the disease—beginning with infection by the virus and concluding with AIDS.
AIDS—is the result of a long process that begins with HIV
HIV—the virus is a germ that causes the illness
HIV infection—when the virus enters the blood stream and begins to damage the immune system
HIV+—one has a positive blood test showing that they have antibodies to the virus while one is not sick, one can still pass the infection on to others
What is the difference between HIV and AIDS? One is the cause, the other the effect: a person will not develop AIDS unless he or she has been infected with HIV. If we prevent HIV infection, we prevent future cases of AIDS.
How does someone get AIDS? When the virus, HIV, is spread through blood-to-blood or sexual contact with someone who has the virus, the end result of the HIV infection is AIDS. The most common ways that people become infected with HIV are:
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through sharing needles or syringes with someone who has the virus: some blood containing the virus is passed from one person to another
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through having sex vaginal, oral, or anal with someone who has the virus
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through exposure of a baby to an infected mother’s blood during pregnancy or delivery, or rarely, through breast feeding
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through receiving blood transfusion, or certain blood products infected with the virus. (This is rare, since 1985 the American blood supply has been tested for HIV.) (CDC, 1990)
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How do you get HIV through sex? It is spread through sexual intercourse from male to female, female to male, or male to male. HIV can be in an infected person’s semen, blood, or vaginal secretions. It can enter the bloodstream through normal cells or unseen cuts or sores.
How do you get HIV from sharing needles? Blood from an infected person can stay in a needle or syringe and then be transmitted to the next person who uses it. It can happen regardless of what it is that’s being injected.
Who can get AIDS: Anyone who does risky behaviors. It’s not who you are, but what you do.
Who are the adolescents with HIV infection at present? Many of the teens who are infected now are hemophiliacs. It is a rare, inherited bleeding disorder of males in which blood clotting is abnormal. It is treated with either a product made from human blood from donors, or a product made through recombinant genetics, both of which allow normal clotting to occur. These young men acquired the illness from blood products they received prior to 1985. Ryan White is the best known example of a teen with hemophilia who died of AIDS. Some children who acquired HIV infection from their mothers are beginning to reach the early teen years. The third group acquired HIV infection from their own risky behaviors, sex with someone who was infected or sharing needles with someone who was infected. If teens are conscious of these behaviors they can protect themselves.
The ways by which one cannot get HIV infection are also important to know. AIDS/HIV are not casually transmitted. One will not contract HIV infection in the normal course of daily contact with friends, at school or at work. HIV doesn’t live in the air or on things that people touch. HIV is not spread by:
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coughs or sneezes, sweat or tears
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holding or shaking hands, hugging, touching someone with the HIV infection
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swimming pools, hot tubs, showers, locker rooms, bathtubs, or toilet seats
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mosquito bites the virus does not live in a mosquito and is not transmitted through a mosquito’s salivary gland not from bed bugs, lice flies, or other insects
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eating in a restaurant or using a public phone
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The virus does not survive outside the human body, one doesn’t get HIV infection through “casual contact.”
Currently, the issue of the dentist in Florida who is believed to have transmitted the virus to several of his patients is getting lots of attention. As I write this, the United States Senate has passed two proposals pertaining to health care workers and HIV infection. One would mandate prison terms of at least ten years and fines of up to $10,000 for health care workers who knew they had AIDS but failed to inform patients on whom they had performed invasive procedures. Another proposal that passed would direct states to require health professionals engaged in invasive procedures to be tested for AIDS infection. It would bar those infected from performing invasive procedures unless they received permission from a panel of experts and informed their patients. States that didn’t comply would risk loss of federal health financing. Neither of these proposals have passed in the House of Representatives.
This issue would certainly stimulate discussion in a classroom. It would bring up the question of testing. How often would health care workers have to be tested. Adolescents like the concept of testing because it seems concrete. But what does testing actually mean? A positive test means that you have the HIV antibodies in your blood. A negative test isn’t so clear. It means you do not have antibodies in your blood but you may still have the virus in your blood. It can take up to eight month for your body to make the antibodies after you get the virus. A negative HIV test means that you do not have the virus only if you have not been exposed to the virus over that time span.
Another issue that caused consternation in the classroom was the news item about allergy to latex. One student’s mother walked into class and announced that she was never using condom again. It behooves teachers to be up on the current news about AIDS and I have included a lesson for students to bring in current articles.
The definition of AIDS is also under debate. Since HIV infection attacks the immune system, opportunistic infections take many forms. The standard definition of AIDS is being rethought, because the characteristics of the illness that are required for inclusion often are not those that women get when they are infected with HIV. The definition was developed years ago when most of the cases were men, and it’s meant that it has been harder for women to be declared eligible for various benefits when they have the illness. The issues include: when an HIV infection becomes AIDS and when AIDS becomes disabling. Women rarely get Kaposi’s sarcoma, but they do get cervical cancer which is not included in the standard AIDS definition.
Recently, an international conference on AIDS in Florence, Italy, produced a staggering forecast of a world AIDS epidemic.
The New York Times
outlined several of the AIDS mysteries under investigation: (Altman, 6/25/91 )
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Geography—why does the HIV infection spread faster in some countries than others
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Survival—why do some infected people live years while others get sick quickly and die
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Infection—where does the virus enter the body and how does the infection begin
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Defenses—why is the immune system ineffective against HIV
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Drugs and Vaccines—why does drug resistance develop and how can the vaccines be tested
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Kaposi’s sarcoma—why mostly in gay men
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viral strains—how many strains must researchers study
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Is there a cure for AIDS? No. There are medicines that help people with HIV infection live longer but there is no cure. There is cautious optimism about the development of an AIDS vaccine. There are several being tested now but only for safety, not for effectiveness.
