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Biology Education – HIV and AIDS

Biology SS 1 Week 8

Topic: HIV and AIDS

Introduction

The human immunodeficiency virus (HIV) is a retrovirus that infects cells of the immune system, destroying or impairing their function. In other words, HIV is a virus that weakens the body’s immune system, which is the body’s defense system. As the infection progresses, the immune system becomes weaker, and the person becomes more susceptible to infections.

The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS). It can take 10-15 years for an HIV-infected person to develop AIDS; however, antiretroviral drugs can slow down the process even further.

HIV is transmitted through unprotected sexual intercourse (anal or vaginal), transfusion of contaminated blood, sharing of contaminated needles, and between a mother and her infant during pregnancy, childbirth and breastfeeding.

Modes of HIV Transmissions

HIV is spread through some of the body’s fluids. HIV is in:
• Blood
• Semen
• Vaginal fluids
• Breast milk
• Some body fluids that may be handled by health care workers (fluids surrounding the brain and spinal cord, bone joints, and around an unborn baby)

HIV may be passed from one person to another by:
1. More common

  • Having sex (vaginal, anal, or oral) with a person who has HIV
  • Sharing needles with someone who has HIV, such as when using drugs
  • Pregnancy, labour, birth, or breastfeeding if a mother has HIV

2. Less common

  • Blood transfusion from an HIV positive blood donor, which is very unlikely today because blood banks test donated blood for HIV
  • Eating food that has been pre-chewed by an HIV-infected person. The blood in a caregiver’s mouth can mix with food while chewing. This is rare and has only been noted among infants whose HIV positive caregiver gave them pre-chewed food.
  • Using a dirty tattooing needle (if it was used before on someone with HIV). Make sure the needle is new.
  • Sharing a toothbrush or razor with someone who has HIV

HIV is not spread through:

• Kissing (there is a small chance of getting HIV from open-mouthed or “French” kissing except there’s contact with blood)
• Touching, hugging, or handshakes
• Sharing food or drinks
• Sharing food utensils, towels and bedding, telephones, or toilet seats
• Donating blood
• Working with or being around someone with HIV
• Biting insects, such as mosquitoes
• Swimming pools or drinking fountains
• Playing sports

The Science behind HIV

HIV attacks and destroys the immune system’s infection-fighting cells, called CD4 cells. They also are called CD4 positive T cells. HIV gets into these cells, makes copies of itself, and kills the healthy cells. As a person loses CD4 cells, the immune system weakens, making it harder for the body to fight infections and cancer. There are many different strains (types) of HIV. Most people have the HIV-1 strain. But, a person can be infected with more than one strain at a time.

HIV turns to AIDS when the immune system gets very weak. One way to know if a person has AIDS is if her CD4 cell count (the number of CD4 cells in a sample of blood) is very low (less than 200). Another way is if she has certain infections or cancers. Moving from HIV to AIDS is different for everyone. Some people live for 10 years or more with HIV without developing AIDS. Others get AIDS faster.

Signs and Symptoms of HIV/AIDS

Many people have no symptoms when they first get HIV. Some have no symptoms for years. It varies from person to person. But some people get a flu-like illness within a month or two after first getting HIV. It’s important to remember that HIV is active inside your body, even when you don’t have symptoms. As HIV spreads in your body, you’ll start to feel sick. For many people, the first symptom they notice is large lymph nodes (swollen glands) that last for more than three months. Symptoms of HIV include:
• Being very tired (fatigue)
• Quick weight loss
• Fevers and night sweats
• Headache
• Diarrhea, vomiting, and nausea
• Mouth, genital, or anal sores
• Dry cough
• Rash or flaky skin
• Short-term memory loss

Test for HIV

You cannot rely on symptoms to know whether you have HIV. If you have symptoms, they may be caused by something else. And many people infected with HIV have no symptoms for many years. The only way to know whether you have HIV is to get a test.

Prevention of Transmission of HIV

HIV prevention refers to practices done to prevent the spread of HIV/AIDS. HIV prevention practices may be done by individuals to protect their own health and the health of those in their community, or may be instituted by governments or other organizations as public health policies.

Anybody can get HIV, but you can take steps to protect yourself from HIV infection.

• Don’t have sex: Abstinence (not having sex of any kind) is the surest way to avoid HIV infection through sexual contact.
• If you must have sex, get tested and know your partner’s HIV status: Talk to your partner about HIV testing and get tested before you have sex.
• Be faithful to your partner: If you and your partner are both HIV negative and have sex only with each other, you are not at risk of HIV infection through sexual contact.
• Use condoms: Use a condom every time you have vaginal, anal, or oral sex.
• Limit your number of sexual partners: If you have more than one sexual partner, get tested for HIV regularly. Get tested and treated for sexually transmitted infections (STIs), and insist that your partners do, too. Having an STI can increase your risk of becoming infected with HIV.
• Don’t inject drugs: But if you do, use only clean needles and equipment and don’t share your equipment with others.

Some HIV medicines used to prevent HIV infection

In some situations HIV medicines are used to reduce the risk of HIV infection

Pre-exposure prophylaxis (PrEP) – PrEP is an HIV prevention method that involves taking an HIV medicine every day. PrEP is intended for people who don’t have HIV but who are at high risk of sexually transmitted HIV infection. PrEP should always be combined with other prevention methods, including condom use.

Post-exposure prophylaxis (PEP) – PEP involves taking HIV medicines as soon as possible after exposure to HIV to reduce the risk of HIV infection. For example, a health care worker exposed to HIV in the workplace may require PEP.

Prevention of mother-to-child transmission of HIV – HIV-infected women take HIV medicines during pregnancy and childbirth to reduce the risk of mother-to-child transmission of HIV. To further reduce the risk, their newborn babies also receive HIV medicine for six weeks after birth. In the United States, women with HIV are counseled not to breastfeed their babies to prevent mother-to-child transmission of HIV in breast milk.

Management of HIV (Use of Anti-Retro Viral Drugs)

Once HIV infection is diagnosed, a person has a life-long condition which will go through several stages and has many consequences. The disease needs to be managed by people with HIV themselves as well as their healthcare providers.

An overview of the needs of a person with HIV infection (not necessarily in order of priority) is as follows:
1. Education / information – learning how to best take care of yourself, staying informed about new treatments or approaches
2. Maintaining general health – self care, nutrition
3. Financial planning – medical aid, future provision for self and dependents
4. Monitoring HIV disease – regular medical check-ups, monitoring tests
5. Preventing opportunistic disease – avoiding exposure, alertness to early signs of disease, prophylactic medication
6. Psychological health – informing others, dealing with stigma, spiritual support, managing anxiety and depression
7. Sexual and reproductive – safer sex for partners and self, whether to have a baby, avoiding infection of the baby
8. Antiretroviral treatment: Standard antiretroviral therapy (ART) consists of the combination of at least three antiretroviral (ARV) drugs to maximally suppress the HIV virus and stop the progression of HIV disease. Huge reductions have been seen in rates of death and suffering when use is made of a potent ARV regimen, particularly in early stages of the disease.
9. Terminal care – care and treatment during the final stages of the disease.

Agencies/Organisation for HIV/AIDS Control

The non-governmental organisations listed below help in the control of HIV/AIDS around the world.

1. IAS (International AIDS Society)

2. UNAIDS (Joint United Nations Programme on HIV/AIDS)

3. WHO (World Health Organization)

Others include:

4. National Agency for the Control of AIDS (NACA)
5. Society for Family Health (SFH)

Myths about HIV/AIDS

1. I can get HIV by being around people who are HIV-positive: The evidence shows that HIV is not spread through touch, tears, sweat, or saliva.

You cannot catch HIV by:
• Breathing the same air as someone who is HIV-positive
• Touching a toilet seat or doorknob handle after an HIV-positive person
• Drinking from a water fountain
• Hugging, kissing, or shaking hands with someone who is HIV-positive
• Sharing eating utensils with an HIV-positive person
• Using exercise equipment at a gym

2. I don’t need to worry about becoming HIV positive, new drugs will keep me well: Yes, antiretroviral drugs are improving and extending the lives of many people who are HIV-positive. However, many of these drugs have serious side effects. None yet provides a cure. Also, drug-resistant strains of HIV make treatment an increasing challenge.

3. I can get HIV from mosquitoes: Because HIV is spread through blood, people have worried that biting or bloodsucking insects might spread HIV. Several studies, however, show no evidence to support this even in areas with lots of mosquitoes and cases of HIV. When insects bite, they do not inject the blood of the person or animal they have last bitten. Also, HIV lives for only a short time inside an insect.

4. I’m HIV-positive, my life is over: In the early years of the disease epidemic, the death rate from AIDS was extremely high. But today, antiretroviral drugs allow HIV-positive people — and even those with AIDS — to live much longer, normal, and productive lives.

5. I’m straight and don’t use HIV drugs, I won’t become HIV-positive: Most men do become HIV-positive through sexual contact with other men or through injection drug use. However, about 16% of men and 78% of women become HIV-positive through heterosexual contact.

6. If I’m receiving treatment, I can’t spread the HIV virus: When HIV treatments work well, they can reduce the amount of virus in your blood to a level so low that it doesn’t show up in blood tests. Research shows, however, that the virus is still “hiding” in other areas of the body. It is still essential to practice safe sex so you won’t make someone else become HIV-positive.

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