HIV/AIDS

Acquired Immune Deficiency Syndrome (AIDS) is an infectious disease which causes degeneration of the body's immune system. It is caused by the Human Immunodeficiency Virus (HIV), a virus transmitted through bodily fluids such as blood and semen. The most common ways to contract HIV include unprotected sexual activity and the use of unsterilized needles by users of intravenous recreational drugs. In the past (and in some countries even today) transfusions of contaminated blood as well as blood products to treat hemophilia have also been major routes of infection.

Not everyone who is infected with the HIV virus is considered to have AIDS. The AIDS diagnosis is usually made when a certain level of damage has been done to the immune system. The usual standard is that the person's T-cell count has fallen below 200. Up until that point, the person is considered simply HIV-positive.

History of the AIDS problem

HIV is closely related to viruses causing AIDS-like diseases in many primates, and it is generally believed to have been transferred from animals to humans at some time during the early twentieth century, though some evidence suggests it may have been transfered earlier in several isolated cases. The exact animal source, time, and location of the transfer (or indeed, how many transfers there were) is not known. A virus virtually identical to human HIV has been found in chimpanzees, but it is not certain that the transfer was from chimps to humans or whether both chimps and humans were infected from a third source. Scientific studies have suggested the virus spread initially in West Africa, but it is possible that there were several separate "initial sources", including somewhere in South America. The earliest sample known to contain HIV was taken in 1959 in what is now the Democractic Republic of the Congo. Other early samples include one from an American male who died in 1969, and a Norwegian sailor in 1976.

AIDS in America

In the early 1980s, doctors in large urban American centers began seeing young gay male patients having bizarre diseases. One was Kaposi's Sarcoma, a cancer usually associated with elderly men of Mediterranean ethnicity. Another was pneumocystis carinii pneumonia, or PCP, a rare form of pneumonia caused by protozoa. Eventually the men wasted away and died.

The syndrome became known as "GRID", or Gay Related Immune Deficiency. Later on the name became AIDS, for Acquired Immune Deficiency Syndrome, as it became clear that the disease had nothing to do with being gay. That the initial cases were found in sexually active gay men has been explained as due to the disease being first introduced to that population in the United States of America, paired with the relatively promiscuous behavior of gay male populations in urban centers.

At first it was believed that the disease was introduced by a gay male flight attendant, referred to as "Patient Zero". However, subsequent research has revealed that there were cases of AIDS much earlier than initially known. It has also been theorized that a series of inoculations against hepatitis that were performed in the gay community of San Francisco were tainted with the HIV virus. There is a high correlation between recipients of that vaccination and initial cases of AIDS.

One of the best works on the history of HIV is "And the Band Played On", by Randy Shilts. Shilts contends that Ronald Reagan's administration dragged its feet in dealing with the crisis due to homophobia, thus allowing the disease to spread and hundreds of thousands of people to needlessly die. This resulted in the formation of ACT-UP, or "AIDS Coalition To Unleash Power" by Larry Kramer.

He also details the fact that the Red Cross refused to ban homosexuals from giving blood at the request of the Centers for Disease Control early in the discovery of the epidemic in order to not stigmatize homosexuals. Thus, tens of thousands of hemophiliacs and transfusion receivers were infected needlessly, and died. Some might say that this is bias on Shilts' part, but Shilts himself was a non-self-hating gay.

Another preventable impediment to the attack on the disease was the academic elitism of Robert Gallo, an American scientist who was one of many to try to attempt to figure out if there was some kind of new virus in the people who were affected with the disease. He became embroiled in a legal battle with French scientists trying to do the same thing, because he wanted glory and fame. This held up progress on research and more people needlessly died.

Publicity campaigns were started in attempts to counter the often vitriolic and homophobic perception of AIDS as a "gay plague" and replace it with actual medical knowledge that would save lives. In particular this included the Ryan White case, the red ribbon campaigns, the celebrity dinners, the film of "And the Band Played On", sex education programs in schools, TV adverts, and etc.

AIDS in Africa

to be written

AIDS elsewhere in the world

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Effects of AIDS

Fill this in. Everybody knows it somehow kills T-cells, which are part of the immune system, but what are the details? AIDS remains largely dormant in many people for some years after infection (even without treatment). How long? What secondary infections occur?

AIDS Prevention

HIV infection is entirely preventable by following simple, basic precautions. The only known cause of transmission is the exchange of bodily fluids.

• Wear a condom during all sexual activity. Anal sex is a particularly high-risk behavior. A few people have been infected with HIV from giving oral sex to an infected partner, but it is considered very low risk. If you want to be absolutely certain you're safe, use a condom even during oral sex.
• Do not share needles. If you use drugs intravenously, such as heroin, do not share your needle with someone else, and do not use a needle that has been used by others. In many places you can find a local needle exchange program where you can trade a used needle for a clean one, without any legal hassles.
• Medical workers who follow universal precautions or body substance isolation can prevent the spread of HIV from patients to workers, and from patient to patient. The risk of being infected with HIV from a single needlestick is less than 1 in 200. Post-exposure prophylaxis with anti-HIV drugs can further reduce that small risk.

AIDS Treatment

There is still no known cure for AIDS, and many people still die every year, particularly in Third World countries where treatments are either not available or prohibitively expensive. Current and experimental treatments for AIDS are covered in the HIV section. Work on a vaccine continues, but progress has been slow.

AIDS denialism

Some people and organizations (particularly in Africa) refuse to believe in AIDS, claiming that it is a Western plot to weaken the developing world. This denial of the nature of the AIDS problem has itself compounded the AIDS crisis, by preventing discussion and adoption of preventive measures. This view was until recently prominent within the African National Congress government of South Africa. The ANC has recently shown signs of rejecting AIDS denialism.

A small minority of scientists continue to question the connection between HIV and AIDS, or even the very existence of HIV. See Duesberg hypothesis.

Current Status

As of the year 2002 AIDS is a global pandemic, and it shows no signs of slowing down. It is estimated that over 40 million people worldwide are HIV-positive and about 13 million have already died from AIDS-related disease, mainly tuberculosis. It is likely that the global death toll for AIDS will be comparable to other plagues such as the Black Death.

In Western countries, the infection rate of HIV has slowed somewhat, due to education of safe sex practices. In some populations, however, such as young urban gay men, infection rates show signs of rising again. This is of major concern to public health workers. AIDS continues to be a problem with illegal sex workers and injection drug users. The death rate has also fallen considerably, as combinations of AIDS treatment drugs (often called "cocktails") have proven to be an effective (if expensive) means of supressing HIV.

However in Third World countries (especially Sub-Saharan Africa), economic conditions and lack of sex education means continued high infection rates. Some countries in Africa now have up to 25% of the working adult population who are HIV-positive. As these people begin to develop full-blown AIDS, they will be unable to work, and require significant medical care. This is likely to cause a collapse of societies and governments in the region, further increasing the suffering and hardship faced. Many governments in the region continued to deny that there was a problem for years, and are only now starting to work towards solutions. Lack of adequate health-care, ignorance towards the disease and its causes, as well as the money to educate and treat are the main reasons that most AIDS deaths occur in Third World countries.