What is HIV/AIDS?
HIV, or Human Immunodeficiency Virus, is the virus that leads to AIDS, or Acquired Immunodeficiency Syndrome. HIV is a virus, or a tiny, microscopic particle that can infect biological organisms, such as humans. Viruses spread by first infecting a host cell of a biological organism and then making copies of themselves in other cells. Viruses are incapable of reproducing on their own. Viruses are known to cause serious diseases in humans, including of course HIV, as well as rabies and influenza. It is difficult to cure viruses, because antibiotics, such as penicillin, are ineffective at stopping viruses. Vaccines prevent viruses by creating immunity in the human body. However, there is currently no known vaccine for the HIV virus. There are many obstacles to creating an HIV vaccine, including the fact that there are so many strains of HIV. Creating a vaccine would prevent the transmission of HIV and hence for AIDS. Since there is no known cure, HIV/AIDS education targets the prevention of the spread or transmission of the virus.
Since HIV is a virus, it is important to discuss the life cycle of a virus in order to be able to better understand the HIV/AIDS pandemic. Viruses cannot reproduce by themselves. Conversely, they reproduce by getting into cells, which do in fact have the ability to reproduce. The challenge for the virus then is to take advantage of a cell by entering it. Fortunately for the virus, and unfortunately for us, the body is made up of many cells. Each cell in the body has what are known as receptors that line along the outside of its surface. Receptors are proteins that are used to detect what is going on outside of the cell. Receptors are very important because there is a special kind of molecule that can bind to them, known as ligands. Viruses take advantage of the fact that cells have receptors. They do so by binding their ligands to the appropriate receptors on various cells, which then allow them into the cells. In order for a virus to enter a cell, this ligand-receptor action is requisite. Once the ligands on a virus bind to the receptors on a cell, the viral life cycle has begun. The virus thus enters the cell, and disassembles. The genetic material and proteins that make up the virus can now be duplicated. The RNA or DNA that make up the virus is replicated. The proteins that make up the virus are then produced. New viruses are then assembled from these replicated materials. Finally, the new viruses are released, a step in the viral life cycle that is often deadly to the host cell.
HIV is spread from human to human through several methods. It can be transmitted through blood-to-blood contact, as well as sexual contact. In addition, mothers can pass it to their children during birth. It is passed through bodily fluids, including of course blood, vaginal fluid, semen and pre-ejaculate fluid, as well as breast milk. HIV is a latent virus, meaning that when it is transmitted, it can take some time before it starts to replicate. Therefore, it can take up to several years for the virus to show signs.
HIV causes major damage to the immune system, the system which protects our body by fighting off infections. HIV hurts our immune system by attacking certain cells which help the immune system to protect our body, including special cells of the immune system called CD4 T cells or CD4 cells. As HIV replicates itself in the human body over time, it destroys a large amount of these cells, so many that the body becomes unable to defend itself against simple diseases, including other viruses, parasites, bacteria, and certain cancers (5). The fact that HIV infects T cells is extremely detrimental to those infected, because T cells are the cells that recognize cells in our body infected with viruses, and kill them. Leaving HIV untreated can produce AIDS and even death.
Since there is no known vaccine for HIV, the only way to prevent contraction of the virus is through preventing contact with the virus. There are many methods to preventing the transmission of HIV. As previously stated, there are three main ways of transmission: sexual transmission, transmission through blood, and mother-to-child transmission. There are prevention methods for each of these types of transmission. First and foremost, education on the virus is a must for prevention of all three kinds of HIV transmission. In terms of sexual transmission, three ways to prevent contraction of the virus include abstinence, using a condom, and being faithful to one¥s sexual partner or having few sexual partners. There are many ways of preventing transmission of HIV through blood. Using sterile medical equipment is essential, as well as screening blood for diseases. Using sterile needles and not sharing needles is another preventative measure. Finally, refraining from direct contact with blood and other bodily fluids can prevent the transmission of HIV. In terms of mother-to-child transmission, there are certain antiretroviral treatments that can reduce the risk of the mother¥s passing HIV on to the infant. A caesarean section also reduces the risk of transmitting HIV because it reduces the infant¥s contact with the mother¥s bodily fluids. Finally, the World Health Organization recommends against breast-feeding when the mother is infected with HIV and when replacements are available, feasible, and safe (3).
Since HIV is a virus and antibiotics are not effective against viruses, today¥s treatment for HIV infection is comprised of highly active retroviral therapy (HAART). This treatment was introduced in 1996. HAART has achieved far better results than previous treatments. On the other hand, HAART does not always achieve the most favorable results. Research has shown that it is only effective in only about 50% of patients. There are many causes to this low number, including side effects to the medication, as well as intolerance to the medication. Other causes include infection with a strain of HIV that is drug-resistant, as well as a prior antiretroviral treatment that was ineffective. However, the largest reason for the failure of HAART is both a lack of adherence and persistence to the antiretroviral therapy (2). There are many causes to these two reasons, and many of these causes are related and overlap. For example, a major cause which we will look at in depth in the course of this unit is a lack of access to medical care, in addition to inadequate medical care. Other causes include a lack of adequate social supports, drug abuse, and mental illness.
As previously stated, about 40 million people in the world today are currently living with HIV/AIDS. Sadly, a large majority of these 40 million people do not know they are HIV positive (15). Ninety five percent of those infected with HIV/AIDS live in poor, developing countries (15). This adds to the cause of non-adherence and non-persistence in HAART treatment. HAART treatment, involving anti-retroviral drugs, is also very expensive. Since 95% of those infected with HIV live in developing countries, many of these people do not have proper access to the necessary treatments and medications.