AIDS – Acquired Immune Deficiency Syndrome

Since the first AIDS cases were reported in 1981, through mid-1994 more than 402,000 AIDS cases and more than 241,000 deaths have been reported in the United States alone. This is only the tip of the iceberg of HIV infection, however. It is estimated that nearly 1 million Americans had been infected with the virus through the mid-1990s but had not yet developed clinical symptoms. In addition, although the vast majority of documented cases have occurred in the United States, AIDS cases have also been reported in almost every country in the world. Sub-Saharan Africa in particular appears to suffer a heavy burden of this illness.

No cure or vaccine now exists for AIDS. Many of those infected with HIV may not even be aware that they carry and can spread the virus. Combating it is a major challenge to biomedical scientists and health-care providers. HIV infection and AIDS represent among the most pressing public-policy and public- health problems worldwide. COSTS I think that the AIDS epidemic is having a profound impact on many aspects of medicine and health care. The U. S. Public Health Service estimates that in 1993, he lifetime cost of treating a person with AIDS from infection to death is approximately $119,000.

Outpatient care, including medication, visits to doctors, home health aids, and long-term care, accounted for approximately 32 percent of the total cost. Persons exposed to HIV may have difficulty in obtaining adequate health-insurance coverage. Yearly AZT expenses can average approximately $6,000, although in 1989 the drug’s maker did offer to distribute AZT freely to HIV- infected children. The yearly expense for DDI is somewhat less at $2,000. Therefore, if the AIDS epidemic is not controlled, its cost to American taxpayers will become overwhelming.

I feel that the effects of the epidemic on society at large are increasingly evident. AIDS tests are now required in the military services. Various proposals have been made for mandatory screening of other groups such as health-care workers. A number of nations, including the United States, have instituted stringent rules for testing long-term foreign visitors or potential immigrants for AIDS, as well as testing returning foreign nationals. In the United States one frequent phenomenon is the effort to keep school-age children with AIDS isolated from their classmates, if not out of school altogether.

Governmental and civil rights organizations have countered restrictive moves with a great deal of success. There is little doubt in my mind that the ultimate physical toll of the AIDS epidemic will be high, as will be its economic costs, however the social issues are resolved. Concerted efforts are under way to address the problem at many levels, and they offer hope for successful strategies to combat HIV-induced disease. In the United States, I feel that AIDS provoked a grass-roots political response, as well as government action.

First evident in urban gay men, AIDS moved an already politically organized gay community to create service, information, and political organizations, such as Gay Men’s Health Crisis (GMHC) and AIDS Coalition to Unleash Power (ACT UP). Those groups have lobbied the federal government for funding and favorable policies. ACT UP was formed in 1987 to urge speed in drug approval and to protest high prices for AIDS drugs. By successfully promoting reforms, ACT UP and other advocates have provided a model or other disease groups, particularly breast cancer advocates.

During the 1980s, AIDS groups accused the government of neglecting its duty in responding to AIDS. Critics cite government reluctance to promote condom use as a prevention method, and the fact that President Ronald Reagan did not mention AIDS publicly until April 1987, six years after the epidemic began. The epidemic’s spread to people of color, often drug users and their intimates, introduced race into the politics of AIDS. Competition for funding and influence arose between gay and minority groups. Disagreements emerged about prevention methods, in particular needle exchange programs.

Many African Americans and Hispanics viewed needle exchange as promoting drug use in their communities, while others cited its role in curbing HIV transmission. The AIDS activists have helped increase federal funding for AIDS from an initial $5. 6 million in 1982, to over $2 billion in 1992. The 1990 Americans with Disabilities Act included protection from discrimination for people with HIV; the Ryan White Comprehensive AIDS Resources Emergency Act was passed to provide funds to cities hard hit by AIDS.

AIDS: The Millenial Bug

At the beginning of the 20th Century it was believed by many, including the United States Patent Office, that there was nothing else to invent. Now, 100 years later at the beginning of the new millenium the ancient Egyptian philosopher is more relevant, “there is nothing new under the Sun”. While HIV/AIDS may be a new disease, there is nothing new about a novel epidemic, which can potentially or actually decimate a population. In the late middle ages, the Black, now known as the Bubonic Plague, swept through Europe killing virtually half the population.

It was introduced by a single or small group of rats that came to Italy abroad a trading ship from what is now Turkey. Small Pox transmitted by trade goods from the Hudson Bay Company wiped out entire Native American tribes. There are other examples of diseases accidentally introduced to a population that had no genetic immunity to them. Not to mention NASA’s fear of an unbeatable super virus from outer space. Now as in previous diseases, one of the dangers of HIV/AIDS is not only in its plague proportions but also in the almost superstitious misunderstanding of the virus itself.

In the treatment of all illness, it is necessary to understand the emotional, economic, psychological and sometimes even political impact that is brought about by the disease. This is particularly true with a disease that is as devastating and heretofore misunderstood as HIV/AIDS. AIDS is the punishment of God on sinners. AIDS is a plot by the CIA and the South African Government to wipe out the population of black Africa. AIDS is the result of medical experimentation during the development of the polio vaccine employing the use of rieces monkeys as guinea pigs. AIDS is this, AIDS is that; AIDS is the end of the world.

There is nothing new under the Sun. As we enter a new millenium, we are still controlled by prejudice, fear and superstition. AIDS is not the end of the world, it is simply the latest challenge the medical community needs to meet. There are new things to invent including an immunization and cure for HIV/AIDS. But before that we must overcome the age-old superstitious fears of the unknown and rise above the prejudices that we harbor of, “those people”. Let us understand HIV/AIDS. AIDS, the acronym for acquired immunodeficiency syndrome, is the end stage disease of the human immunodeficiency virus (HIV).

The result of this disease is the destruction of the patient’s immune system. Since the infected person has no ability to fight off any infection because the virus is replicating in and destroying the cells that normally fight infection, he/she then becomes susceptible to all opportunistic disease. Ultimately death occurs as a result of the body’s inability to fight infection. In the early 1980″sThe Center for Disease Control and Prevention became aware that a new “virus” was effecting certain segments of society. In 1985 researchers isolated a virus believe to be responsible for AIDS.

Since that time the definition of this disease has changed many time. In 1993 the definition was expanded to include conditions more applicable to women and injecting illegal drug users. The new definition includes all HIV infected persons who have a CD4 cell count of 200 cells per microleter of blood. Also added were three clinical conditions. The current definition states that AIDS is an illness characterized by laboratory evidence of HIV infection coexisting with one or more indicator diseases. Most patients are diagnosed by these criteria.

HIV, as its name indicates is a virus and is therefore and obligate parasite. Such parasites can only replicate while inside another living cell, or host. Parenthetically, HIV carries its genetic material in RNA rather than DNA, and while in the host the virus converts RNA to DNA in order to replicate. In seeking hosts, HIV is typically attracted to cells with CD4 + molecules on their surface such as T-helper lymphocytes and similar cells. HIV reproduces at a phenomenal rate, which causes massive destruction to the host cells. Cell destruction grows geometrically as the virus replicates and seeks new host cells.

Immune system breakdown primarily results from the dysregulation and destruction of T-helper cells or CD4+lymphocytes. HIV is particularly sinister in its attack on T-helper cells since one of the functions of those cells is to recognize and alert the immune system to alien infections Initially the body’s immune system, to a certain degree combats the virus. However, since the virus virtually targets CD4+lymphatics or T-helper cells, the immune system begins to loose its ability to even recognize let alone defend the invading virus.

The immune system remains relatively healthy as long as its count of CD4 cells is greater than 500 per microliter of blood. Since CD4 + cells are designed to attack infection, they are ironically drawn to the virus where they are subsequently infected. Ultimately the infection spreads through the lymph system and lymphoid tissue becomes a reservoir for HIV replication. As the disease progresses viral particles begin to enter the blood, this results in the infection of body tissues where the virus begins to replicate in infected macrophages.

Massive reproduction of HIV in these cells causes the macrophage to burst allowing HIV to infect surrounding tissues. The skin, lymph nodes, CNS, lungs and possibly even bone marrow are infected in this manner. The virus at this point is well on its way to infecting every organ and tissue in the body. The symptoms of HIV, while highly identifiable to the patient, are general in nature and are attributable to any number of causes. Early signs are consistent with flu like viruses. They include abdominal pain, chills and fever, coughing, diarrhea, dyspnea, fatigue and headache.

Later symptoms are more severe and could be consistent with other diagnosis including cancer. Some symptoms include disorders of the lymphatic system, malaise, muscle and joint pain, night sweats, oral lesions, shortness of breath, skin rash, sore throat, weight loss and disorientation. Additionally in the majority of HIV cases there are neurological manifestations as well. In addition to symptoms preliminary diagnosis can be made by deduction in ascertaining whether or not the patient engages in high-risk behaviors. If combinations of symptoms are present and are accompanied by high-risk behaviors, then immediate clinical testing is advised.

The individual’s blood is tested with ELISA or enzyme immunoassay (EIA), antibody tests that detect the presence of HIV antibodies. If this test is positive than the same blood is tested a second time. If a second EIA test is positive a Western blot is performed. This is a more specific confirming test. Blood that tests positive to all three screenings is reported to be positive for HIV. IF the results are inconclusive or indeterminate, the tests are repeated in 4 to 6 weeks. Again, if repeated and the results remain indeterminate a culture is done to determine the viral load, this is done through testing the DNA of the individual.

These tests, whether positive or negative does not confirm nor dismiss the diagnosis of AIDS. That is done according to the 1993 CDC definition of HIV. A negative test is not an assurance that the individual is free of HIV since seroconversion takes up to three months after initial infection. And if the individual continues to engage in risky behaviors, transmission of the disease is likely to occur. At the present time it is believed that the modes of transmission of the HIV virus are clearly identified and understood.

Although generally perceived by the public as a sexually transmitted disease, the method of HIV transmission is far broader than simple sexual contact. As previously stated an obligate virus HIV requires a host organism to survive. Once leaving the human body the virus is extremely fragile and cannot survive outside of a host. Thus, HIV is transferred from person to person through infected body fluids including blood, semen, cervicovaginal secretions, breast milk, pericardial, synovial, cerebrospinal, peritoneal and amniotic fluids.

It has been discovered that not all body fluids, which contain HIV, transmit the virus. These fluids include saliva, urine, tears and feces. Further, the ability for HIV to be transmitted via an infected fluid from one human to another is mitigated by a variety of variables such as duration and frequency of exposure, the amount of the virus inoculated and the virulence of the organism. The efficiency of the immune system is also a factor. Once the virus has been passed to another individual, the newly infected individual then is immediately capable of passing the virus to yet another individual.

However, there are apparently cycles when the probability of transmission is greater than others. The greatest potential for transmission occurs immediately after infected and during their end stages of the disease. Nonetheless, it must be stressed that it is possible for HIV to be transmitted at anytime during the entire disease spectrum. As a practical matter, the most common method of transmission of HIV is through sexual contact. Vaginal and anal intercourse are two of the three most common modes of HIV transmission.

Throughout the world it is believed that 75% of the total AIDS cases were the result of sexual contact. Anal intercourse is the most frequent method of HIV transmission. This being the result of the frequent tearing of the rectal mucosa which allows for direct infusion of the infected semen into the blood stream. In all cases of intercourse the receptive partner is far more susceptible than the insertive partner. This is not only true of anal and vaginal intercourse, but also for oral intercourse as well. HIV can also be transmitted through oral genital sexual contact but such cases are considered rare.

The homosexual community was seriously impacted by HIV in the early days of the epidemic. This was the result of the tendency for unprotected and casual sexual encounters as well as a higher tendency for anal intercourse. The prostitution subculture was and still is seriously impacted by the HIV virus. Causes of this include their numerous and varied sexual encounters, pre-existing sexually transmitted diseases in addition to life style issues such as alcohol, smoking and illegal drug use which weakens the immune system.

Undoubtedly, the most powerful form of transmission from one human to another of the HIV virus is through direct blood transfusions employing infected blood. However, this has resulted in a miniscule number of cases. But the accidental or intentional use of contaminated injecting equipment is the third most common method of HIV transmission. The frequency of transmission being in the deliberate and repeated use of contaminated syringes by infected persons generally occurs in users of illegal drugs. These users typically share syringes and or other improvised injecting paraphernalia.

While any illegal drug can be injected, heroine and cocaine are the most widely used injectable illegal drug. Less frequent forms of HIV transmission are vertical transmission and occupational exposure. Vertical transmission occurs when a mother, either during pregnancy, at time of delivery, or after birth (through breast-feeding) infects an infant. Occupational exposure is considered to be rare but does occur. Studies ending in 1996 found 52 documented cases and another 111 cases of possible occupational transmission.

These cases, by enlarge, involved health care workers who acquired the disease after percutaneous injury, mucocutaneous exposure and exposure through open wounds. Most of these cases involve puncture wounds from needle stick type injuries. In addition to health care workers, at risk personal include police officers, fire fighters, military personal and prison employees. Since often the infectious contact is the result of elective human behavior, there are strategies for preventing the continued spread of HIV virus.

At the center of these strategies is education which must be world wide, multileveled, intercultural and, of course, non-judgmental. Modifying behavior through education would include teaching safe sex practices, including stressing the proper and consistent use of effective condoms. Similarly for the person who continues to use injected drugs, the use sterile needles must be taught. Deactivation of HIV requires only a 30-second exposure to 100% bleach. Instruction in the cleaning methods used to deactivate HIV should be done. Education without resources can only achieve marginal results.

Therefor, although problematic and controversial it is necessary after education to provide easy and in most cases free access to condoms, sterile needles, early HIV testing and follow up medical treatment. As discussed, while most but not all HIV transmission is the result of risky behavior, there are other causes of transmission as well. Prevention then must entail education, discipline and procedures to minimize infection through transfusion and safety procedures to prevent accidental transmission to people engaged in certain occupations such as health care workers.

On this last point herein lies another controversy which is beyond the scope of this paper. That subject deals with what level should a person who is living with the HIV infection have his/her medical and or other records reflect that fact. At what point is the individual’s right to privacy negated, if ever, in regards to the individuals who are charged with caring for the infected person. The public at large uses interchangeably the terms HIV and AIDS. This sloppy inaccuracy is one of the basis for the gross misunderstanding of the disease.

The history of AIDS

“Somewhere among the million children who go to New York’s publicly financed schools is a seven-year-old child suffering from AIDS. A special health and education panel had decided, on the strength of the guidelines issued by the federal Centers for Disease Control, that the child would be no danger to his classmates. Yet, when the school year started on September 9th, several thousand parents in two school districts in the borough of Queens kept their children at home. Fear of plague can be as pernicious, and contagious, as the plague itself(Fear of dying 1). ” This article was written in 1985.

Since then much has been found out about AIDS. Not enough for a cure though. There probably will be no cure found in the near future because the technology needed is not available. AIDS cases were first identified in 1981,in the United States. Researchers have traced cases back to 1959. There are millions of diagnosed cases worldwide, but there is no cure(Drotman 163). There are about a million people in the United States who are currently infected with HIV(HIV/AIDS 1). It infects the population heavily in some areas of the country and very lightly in other areas.

No race, sex, social class, or age is immune(AIDS Understanding 10). AIDS has killed more americans than the Vietnam War, which killed 58,000(AIDS Understanding 10). AIDS stands for Acquired Immune Deficiency Syndrome. Acquired means that it is not hereditary or introduced by medication. Immune indicates that it is related to the body’s system that fights off disease. Deficiency represents the lack of certain kinds of cells that are normally found in the body. Syndrome is a group of symptoms and signs of disordered function that signal the diagnoses(Hyde 1). You don’t catch AIDS, you catch HIV.

HIV is the virus that leads to AIDS. HIV stands for Human Immunodeficiency virus. HIV severely damages a person’s disease fighting immune system. There are two viruses that cause AIDS. They belong to a group called retroviruses. The first virus is HIV-1. It was isolated by researchers in France in 1983, and in the U. S. in 1984. In 1985, the second one was identified by scientists in France. It is closely related to HIV-1. It is called HIV-2. HIV-2 mainly occurs in Africa but HIV-1 occurs throughout the world(Drotman 163). There are three stages of the infection.

The first stage is acute retroviral syndrome and asymptomatic period. This is the flulike or mononucleosislike illness that most people get within 6-12 weeks after becoming infected. It usually goes away without treatment. From this point on the person’s blood tests positively for HIV. The second stage is symptomatic HIV infection. This is when the infected person’s symptoms show up. It can last anywhere from a few months to many years. The third and final stage is AIDS. This is when the immune system is severally damaged and the opportunistic diseases set in.

The progressive breakdown of the immune system leads to death, usually within a few years. HIV causes a severe “wasting syndrome. ” A general decline in the health and in some cases, death. The virus infects the brain and the nervous system. It may cause dementia, a condition of sensory, thinking, or memory disorder. Infection of the brain may cause movement or coordination problems(Drotman 164). HIV can be present in the body for two to twelve years without any outward sign of illness. It can be transmitted to another person even if no symptoms are present(Drotman 164).

When HIV picks up speed, a variety of symptoms are possible. The symptoms include unexplained fever, fatigue, diarrhea, weight loss, enlarged lymph glands, loss of appetite, yeast infections of the mouth and vagina, night sweats lasting longer than several weeks, breathing difficulties, a dry cough, sore throat caused by swollen glands, chills, and shaking(Quackenbush 23). Pink or purple, flat or raised blotches or bumps occurring under the skin, inside the mouth, nose, eyelids or rectum are also symptoms. They resemble bruises, but don’t disappear. They are usually harder than the skin around them.

White spots or unusual blemishes in the mouth is another symptom(Quackenbush 24). There are two illnesses that commonly affect AIDS patients. One is a type of pneumonia called pneumocystis carinii. The other one is a type of cancer called kaposi’s sarcoma, which attacks the skin(What are HIV/AIDS 1). Pneumocystis carinii is a yeast infection in the esophagus. It causes severe pain when swallowing which results in weight loss and dehydration. It is the leading cause of death among AIDS patients. Kaposi’s sarcoma are tumors that look like bruises, but grow. These two diseases plus many other are called opportunistic diseases.

For decades cases declined in the U. S. until the mid-1980’s. Since the mid-80’s cases are growing especially in HIV infected people. People with AIDS eventually contract atleast one of the opportunistic diseases. These are the diseases that AIDS patients usually die from(Drotman 164). HIV is transmitted three ways. One way is through unprotected vaginal, anal, or oral sex. The most risky is anal sex because the anus doesn’t stretch. Therefore, it is easier for the skin to tear and bleed. This makes it easier for the infection to get into the bloodstream.

It can get soaked up by the mucous membranes that line the vagina, rectum, hole in the tip of the penis, mouth, and the throat(Johnson 17). The second way is through direct contact with infected blood. There are a couple ways of getting it through direct contact with infected blood. One way is by sharing a hypodermic needle with someone who is infected. A tiny drop of infected blood stays inside the needle and syringe. So if a person uses it he or she is actually shooting the infected blood directly into his or her bloodstream. That little droplet of infected blood is enough to give you HIV.

Sharing needles for skin-popping can spread HIV in the same way. This way a person is more likely to get infections such as abscesses. A person can also get HIV from sharing other drug “works” with someone who is infected. Containers or cookers such as spoons or bottle caps, crackpipes, cotton, or water for dissolving drugs or rinsing syringes are some of the “works. ” It doesn’t matter what a person is shooting in the needle-heroin, cocaine, speed, steroids, insulin, or any other drug. If a person shares a needle or “works” with someone who has HIV, he or she could get infected too(Johnson 20).

Another way is through a blood transfusion. Chances of getting HIV through a blood transfusion in the U. S. are now very low, but still possible. Testing began in 1985, of all blood and plasma that is donated. The tests that doctors use are over 99% accurate. Blood is destroyed if signs of the virus show up in the donated blood. Therefore, it is almost impossible to get infected through a blood transfusion. Before 1985, some people became infected through infected blood and certain blood products. In the U. S. every piece of equipment used to draw blood is brand new. It is only used once and then it is destroyed.

Therefore it is impossible for a donor to get HIV from giving plasma or blood(HIV/AIDS 2). The third way of getting HIV is an infected woman transmitting it to her fetus or baby. A pregnant woman with HIV can pass the virus to her child before or after birth. The way this happens is the fetus gets nourishment from its mother through the placenta and the umbilical cord. That is one of the ways. The other way is through breast feeding(Johnson 24). The only way to stem the spread of infection remains the public health approach, educating people on how to avoid infection or educating the infected people on how to avoid infecting someone else.

There are many ways to prevent the transmission and spread of AIDS. A person has to be aware, because most people who are infected don’t know they are(Nichols 3). One way to prevent infection is to not engage in the act of sexual intercourse with anyone who is or might be infected. If someone is going to , then he or she should atleast use a latex condom. It is medically proven that latex condoms can help to prevent HIV and other sexually transmitted diseases. HIV can not pass through the intact rubber film. It is almost impossible to catch the virus if the condom is used properly.

This means using a good quality condom, one with the kite mark, with a spermicide. The condom itself can kill the virus(HIV/AIDS 2). Condoms don’t completely eliminate the risk of being infected because they can tear, break, or slip off. Birth control pills and diaphragms will not protect a person or his or her partner from getting HIV either(HIV/AIDS 4). Drug users should seek professional help to stop doing drugs. They should never share hypodermic needles, syringes, or other injection equipment. Azidothymidine, commonly known as AZT, may reduce the risk of an infected woman transmitting it to her fetus or baby.

Also, infected women should not breast feed their infants, since HIV can be present in the breast milk of an infected woman(Drotman 164). There are a number of things that a person can not get HIV from, that people are skeptical about. A person can not get AIDS from handshakes, hugs, coughs, sneezes, sweat, tears, mosquitoes, or other insects, pets, eating food prepared by someone else, or just being around an infected person. A person can’t get it from sharing a cigarette, cigar, or pipe, drinking from the same fountain, or from someone spitting on him or her.

A person also can’t get it from using the same swimming pools, toilet seats, phones, computers, straws, spoons, or cups. Although the virus has been found in saliva, medical opinion states there is no evidence of contamination through “wet kissing”(What are HIV/AIDS 1). HIV is not spread through the air or water, unlike many other viruses(HIV/AIDS 2). No one has ever caught AIDS by going to a physician or an eye doctor who has treated AIDS patients. No one has ever caught AIDS by eating in a restaurant where AIDS patients have been, nor by sharing a dwelling in which AIDS victims live.

No one has caught AIDS by working, studying, or playing with an AIDS patient, unless bodily fluids were exchanged. No one has ever gotten AIDS from an insect bite, even where there are many people with AIDS and even where there are many people with dozens of mosquito bites(AIDS, Understanding 2). HIV is very fragile. It doesn’t live long or well outside the human body. It is easily killed with a 1:10 solution of bleach and water. It can be washed from skin with regular soaps. HIV will not survive outside the human body for more than a few hours at the most(Quackenbush 23). If a person thinks he or she might have HIV, he or she can get tested.

HIV tests determine the presence of antibodies to the AIDS virus. Antibodies are proteins produced by certain white blood cells to react with specific viruses, bacteria, or foreign substances that go into the body. The presence of antibodies to HIV indicates infection with the virus. The tests that detect the presence of HIV-1 became widely available in 1985. The tests that detect HIV-2 became widely available in 1992. All infected patients should get blood tests done periodically. They should also have their health monitored by a physician(Drotman 164). There is no cure for HIV or AIDS, but treatments have been developed.

The treatments help most people live longer. The infected people have to take medications to help them keep healthy and possibly postpone the development of AIDS(Johnson 33). Most of the medication has difficult side effects. Even with all of this, about 18 months after a person has been diagnosed with AIDS, he or she usually get quite sick and require hospital care(AIDS, Understanding 4). Scientists are not sure how, when, or where the AIDS virus originated. Researchers have shown that HIV-1 and HIV-2 are more closely related to simian immunodeficiency viruses than to each other.

Simian immunodeficiency viruses infect monkeys. It has been suggested that HIV evolved from viruses that originally infected monkeys in Africa. It was somehow transmitted to people. There are many arguments to this theory. One is that HIV has only been found in human beings. It has never been isolated from any other animal species. Scientists believe The infection became widespread after significant social changes took place in Africa. Somewhere around the 1960’s and the 1970’s. HIV was isolated as being the cause of AIDS in 1983, and 1984. Tests were then developed to detect the virus.

These tests have been used to analyze stored tissues from people who had undetermined deaths in the 60’s and the 70’s. Scientists found that some of these people died from AIDS. During the 1990’s an estimated one million people in the U. S. had the HIV infection or AIDS. There are millions more throughout the world(Drotman 165). AIDS deaths has dropped significantly for the first time since the epidemic began in the early 1980’s. They fell 13 percent in the first six months of 1996, to 22,000 people, down from 24,900 deaths in the same period a year earlier, reported by the Centers for Disease Control.

The number of people diagnosed with AIDS still continues to grow, but the growth rate is slowing. From 1995 to 1996 the growth rate was less than 2%. The growth rate from 1993 to 1994 was 5%. First signs of drop in deaths of AIDS victims came in January 1997, when New York City reported a 30 percent drop in the number of Aids deaths in 1996. The Center for Disease Control credits better treatments, new drugs, and better access to treatment through state and federal programs. Some think that the decline is unfortunately only a standstill, because for some patients the new drugs are not effective(Meyer A1).

Doctors and researchers have been doing research on the virus. They have studied several drugs that stop the growth of HIV in laboratories. One of the drugs is zidovudine, formerly called azidothymidine and commonly known as AZT. Research suggest that azidothymidine can delay the onset of opportunistic illnesses. This drug produces toxic side effects. Some other ones are didanosine(ddl), zalcitbine, which was formerly known as dideoxycytidine and commonly called ddc, and stavudine, which is commonly called D4T. These three drugs also produce dangerous side effects.

Researchers are investigating treatments to help restore normal function to the immune system. They believe that any eventual cure must stop the growth of the virus, prevent opportunistic illnesses, and restore the immune system(Drotman 164). Some vaccines are being tested on animals and as of 1993, one is being tested on people who are at very high risk(Nichols 11). “Magic” Johnson’s HIV is now undetectable, but not absent. Though he is not cured, powerful drugs have reduced the AIDS virus in his body to undetectable levels. Undetectable does not mean absent.

Activists hope that his progress encourages people to get tested and take advantage of improved treatment. Thousands of HIV patients have had their infections recede to undetectable levels after taking drugs called protease inhibitor. Even though a person with undetectable virus levels can still infect other people. Even if the virus is undetectable in blood or semen, it can still be present in other areas such as intestines. Protease inhibitors reduce illnesses in infected people. These drugs are taken on a strict schedule along with two other AIDS drugs.

It requires particular timing. Some drugs must be taken an hour before eating or two hours after. Even with this patients still get side effects. Some of the side effects are nausea, vomiting, headaches, backaches, and gastrointestinal problems. As many as forty percent of the people who take the concoction of drugs develop a resistance to them either because the virus becomes resistant after years of on other drugs, or because patients don’t or are unable to take the drugs as ordered. These wonder drugs are expensive costing between $12,000 and $15,000 a year.

Although these drugs are expensive it is still worth prolonging a person’s life. The virus infects children and newborns, too. Newborns become quite ill by age 1, because their immune system has not fully developed. Most babies that are infected die by 18 months(Quackenbush 23). Today kids need to know about HIV and AIDS. They need to know how a person gets the virus, how it is spread, how they won’t get it, what it is, how they can protect themselves from it, and what’s going to happen to them if they get it. The real risk of infection for them is through sexual molestation by an infected adult.

There are three main reasons why children need to know. One is natural curiosity. AIDS is now an undeniable part of the world. They are curious about the world. They have questions about the world. Another reason is the anxiety children may have about the disease. They understand that AIDS is a very serious disease. The thing they don’t understand is the concept of “not casually transmitted. ” The final reason is some children have family members or friends with HIV or AIDS. The kids that have an infected family member or friend face many personal challenges.

They get harassed by their peers because their peers don’t know what HIV or AIDS is. They think that the kid has cooties or something. Children need to know about HIV and AIDS so they can understand and so they don’t harass other kids about it(Quackenbush 27). In the United States, federal, state, and local government have provided funds for education, treatment, and research of AIDS. Public health clinics have counseling and HIV-antibody testing to people who have symptoms or are at risk of infection(Drotman 164). Community organizations hope that greater awareness will lead to more compassion and more funding.

One project is the AIDS quilt. It was begun in 1986 by an organization called the NAMES Project. This quilt consists of thousands of individually designed panels, which memorializes a person who died of AIDS. This quilt has been displayed in many cities throughout the world(Drotman 164). AIDS has killed many people. People need to be more aware and protect themselves so they don’t become another statistic, because HIV and AIDS are serious, deadly, and they will be with us for a long time. There will not be a cure found anytime soon, but hopefully there will be a cure found.

AIDS and HIV

The HIV virus poses one of the biggest viral threats to human society today. It is contracted through bodily fluids such as blood and semen, and sometimes even saliva and tears. AIDS kills 100% of its victims and puts them through agony before they die. It has been a threat for about 15 years, and it is not going to stop now. In fact, AIDS is just getting started: It consumes more people each year. There is no known treatment for it either, only antibiotics to slow the reproduction of the virus.

HIV is passed from one person to another by bodily fluids only. It is usually gotten through sexual intercourse or other ntimate contact, through the exchanging of unsterilized intravenous needles, or by the contact of HIV-infected bodily fluids and an open wound. It cannot permeate though intact skin, hence it cannot be spread through informal contact. AIDS has not been found to travel in insects or tame animals. In pregnant women, the virus only infects the infant near or at the time of birth.

The virus dies quickly without a host. AIDS (Acquired ImmunoDifficiency Syndrome) weakens the bodys immune system so it is sensitive to infection. The AIDS virus primarily attacks the T lymphocytes, which are a main part of the immune system. The virus is also incubated in cells called macrophages, where it is accidentally sent to other, healthy cells in the body like neurons and lymphatic cells. After HIV is contracted, the person looks and feels healthy for up to 20 years before symptoms start occurring.

During this time, the person can give the virus to another even though it cannot be detected by sight or smell. Usually, symptoms start developing within 1 to 2 years. Typical indications of the virus are fever, weariness, weight loss, skin rashes, a fungal mouth infection called thrush, lack of immunity to infection, and enlarged lymph nodes. When AIDS vertakes the body, the body becomes especially susceptible to tuberculosis, pneumonia, and a rare form of cancer called Kaposis Sarcoma. Once AIDS has fully taken hold, the body may suffer damage to the nerves and brain.

The life expectancy of an AIDS victim after the birth of symptoms is 1 to 5 years. AIDS was believed to have begun in Central Africa around 1979. Nearly all of the first AIDS patients were male homosexuals. However, after 1989 90% of all new cases of AIDS were from heterosexual intercourse. Public awareness rose as famous people began to die, like Rock Hudson, Perry Ellis, Michael Bennett, Robert Mapplethorpe, and Tony Richardson. Basketball star Magic Johnson also reported having AIDS.

The approximate number of AIDS cases in the U. S. lone is 65,000 and growing. So far, there is no treatment or vaccination for AIDS. With most viruses, the body produces antibodies that eventually destroy the virus. However, with HIV, natural antibodies are completely ineffective. Blood tests will not give accurate results of infection of HIV until between 2 weeks and 3 months after the initial infection. In 1987, the drug AZT (azidothymidine) had proved effective in slowing the growth of the virus, but it was lethal in large oses and some patients could not handle taking it at all.

There was a new HIV- fighting chemical scientists found called DDI (dideoxyinosine) that was not as harmful to the patient and could be used in AZTs place for more sensitive patients. In 1992 DDC (zalcitbine) was found to be useful for delaying the reproduction of HIV in patients with advanced AIDS, but only in conjunction with AZT. AIDS is one of an epidemic of super-deadly viruses like Ebola, Hanta Virus, and Dingae in Puerto Rico. In my opinion, this is natures way of fighting back from overpopulation. However, AIDS is a formidable disease and is a force to be reckoned with.

AIDS: The Millenial Bug

At the beginning of the 20th Century it was believed by many, including the United States Patent Office, that there was nothing else to invent. Now, 100 years later at the beginning of the new millenium the ancient Egyptian philosopher is more relevant, “there is nothing new under the Sun”. While HIV/AIDS may be a new disease, there is nothing new about a novel epidemic, which can potentially or actually decimate a population. In the late middle ages, the Black, now known as the Bubonic Plague, swept through Europe killing virtually half the population.

It was introduced by a single or small group of rats that came to Italy abroad a trading ship from what is now Turkey. Small Pox transmitted by trade goods from the Hudson Bay Company wiped out entire Native American tribes. There are other examples of diseases accidentally introduced to a population that had no genetic immunity to them. Not to mention NASA’s fear of an unbeatable super virus from outer space. Now as in previous diseases, one of the dangers of HIV/AIDS is not only in its plague proportions but also in the almost superstitious misunderstanding of the virus itself.

In the treatment of all illness, it is necessary to understand the emotional, economic, psychological and sometimes even political impact that is brought about by the disease. This is particularly true with a disease that is as devastating and heretofore misunderstood as HIV/AIDS. AIDS is the punishment of God on sinners. AIDS is a plot by the CIA and the South African Government to wipe out the population of black Africa. AIDS is the result of medical experimentation during the development of the polio vaccine employing the use of rieces monkeys as guinea pigs. AIDS is this, AIDS is that; AIDS is the end of the world.

There is nothing new under the Sun. As we enter a new millenium, we are still controlled by prejudice, fear and superstition. AIDS is not the end of the world, it is simply the latest challenge the medical community needs to meet. There are new things to invent including an immunization and cure for HIV/AIDS. But before that we must overcome the age-old superstitious fears of the unknown and rise above the prejudices that we harbor of, “those people”. Let us understand HIV/AIDS. AIDS, the acronym for acquired immunodeficiency syndrome, is the end stage disease of the human immunodeficiency virus (HIV).

The result of this disease is the destruction of the patient’s immune system. Since the infected person has no ability to fight off any infection because the virus is replicating in and destroying the cells that normally fight infection, he/she then becomes susceptible to all opportunistic disease. Ultimately death occurs as a result of the body’s inability to fight infection. In the early 1980″sThe Center for Disease Control and Prevention became aware that a new “virus” was effecting certain segments of society. In 1985 researchers isolated a virus believe to be responsible for AIDS.

Since that time the definition of this disease has changed many time. In 1993 the definition was expanded to include conditions more applicable to women and injecting illegal drug users. The new definition includes all HIV infected persons who have a CD4 cell count of 200 cells per microleter of blood. Also added were three clinical conditions. The current definition states that AIDS is an illness characterized by laboratory evidence of HIV infection coexisting with one or more indicator diseases. Most patients are diagnosed by these criteria.

HIV, as its name indicates is a virus and is therefore and obligate parasite. Such parasites can only replicate while inside another living cell, or host. Parenthetically, HIV carries its genetic material in RNA rather than DNA, and while in the host the virus converts RNA to DNA in order to replicate. In seeking hosts, HIV is typically attracted to cells with CD4 + molecules on their surface such as T-helper lymphocytes and similar cells. HIV reproduces at a phenomenal rate, which causes massive destruction to the host cells. Cell destruction grows geometrically as the virus replicates and seeks new host cells.

Immune system breakdown primarily results from the dysregulation and destruction of T-helper cells or CD4+lymphocytes. HIV is particularly sinister in its attack on T-helper cells since one of the functions of those cells is to recognize and alert the immune system to alien infections Initially the body’s immune system, to a certain degree combats the virus. However, since the virus virtually targets CD4+lymphatics or T-helper cells, the immune system begins to loose its ability to even recognize let alone defend the invading virus.

The immune system remains relatively healthy as long as its count of CD4 cells is greater than 500 per microliter of blood. Since CD4 + cells are designed to attack infection, they are ironically drawn to the virus where they are subsequently infected. Ultimately the infection spreads through the lymph system and lymphoid tissue becomes a reservoir for HIV replication. As the disease progresses viral particles begin to enter the blood, this results in the infection of body tissues where the virus begins to replicate in infected macrophages.

Massive reproduction of HIV in these cells causes the macrophage to burst allowing HIV to infect surrounding tissues. The skin, lymph nodes, CNS, lungs and possibly even bone marrow are infected in this manner. The virus at this point is well on its way to infecting every organ and tissue in the body. The symptoms of HIV, while highly identifiable to the patient, are general in nature and are attributable to any number of causes. Early signs are consistent with flu like viruses. They include abdominal pain, chills and fever, coughing, diarrhea, dyspnea, fatigue and headache.

Later symptoms are more severe and could be consistent with other diagnosis including cancer. Some symptoms include disorders of the lymphatic system, malaise, muscle and joint pain, night sweats, oral lesions, shortness of breath, skin rash, sore throat, weight loss and disorientation. Additionally in the majority of HIV cases there are neurological manifestations as well. In addition to symptoms preliminary diagnosis can be made by deduction in ascertaining whether or not the patient engages in high-risk behaviors.

If combinations of symptoms are present and are accompanied by high-risk behaviors, then immediate clinical testing is advised. The individual’s blood is tested with ELISA or enzyme immunoassay (EIA), antibody tests that detect the presence of HIV antibodies. If this test is positive than the same blood is tested a second time. If a second EIA test is positive a Western blot is performed. This is a more specific confirming test. Blood that tests positive to all three screenings is reported to be positive for HIV.

IF the results are inconclusive or indeterminate, the tests are repeated in 4 to 6 weeks. Again, if repeated and the results remain indeterminate a culture is done to determine the viral load, this is done through testing the DNA of the individual. These tests, whether positive or negative does not confirm nor dismiss the diagnosis of AIDS. That is done according to the 1993 CDC definition of HIV. A negative test is not an assurance that the individual is free of HIV since seroconversion takes up to three months after initial infection.

And if the individual continues to engage in risky behaviors, transmission of the disease is likely to occur. At the present time it is believed that the modes of transmission of the HIV virus are clearly identified and understood. Although generally perceived by the public as a sexually transmitted disease, the method of HIV transmission is far broader than simple sexual contact. As previously stated an obligate virus HIV requires a host organism to survive. Once leaving the human body the virus is extremely fragile and cannot survive outside of a host.

Thus, HIV is transferred from person to person through infected body fluids including blood, semen, cervicovaginal secretions, breast milk, pericardial, synovial, cerebrospinal, peritoneal and amniotic fluids. It has been discovered that not all body fluids, which contain HIV, transmit the virus. These fluids include saliva, urine, tears and feces. Further, the ability for HIV to be transmitted via an infected fluid from one human to another is mitigated by a variety of variables such as duration and frequency of exposure, the amount of the virus inoculated and the virulence of the organism.

The efficiency of the immune system is also a factor. Once the virus has been passed to another individual, the newly infected individual then is immediately capable of passing the virus to yet another individual. However, there are apparently cycles when the probability of transmission is greater than others. The greatest potential for transmission occurs immediately after infected and during their end stages of the disease. Nonetheless, it must be stressed that it is possible for HIV to be transmitted at anytime during the entire disease spectrum.

As a practical matter, the most common method of transmission of HIV is through sexual contact. Vaginal and anal intercourse are two of the three most common modes of HIV transmission. Throughout the world it is believed that 75% of the total AIDS cases were the result of sexual contact. Anal intercourse is the most frequent method of HIV transmission. This being the result of the frequent tearing of the rectal mucosa which allows for direct infusion of the infected semen into the blood stream.

In all cases of intercourse the receptive partner is far more susceptible than the insertive partner. This is not only true of anal and vaginal intercourse, but also for oral intercourse as well. HIV can also be transmitted through oral genital sexual contact but such cases are considered rare. The homosexual community was seriously impacted by HIV in the early days of the epidemic. This was the result of the tendency for unprotected and casual sexual encounters as well as a higher tendency for anal intercourse. The prostitution subculture was and still is seriously impacted by the HIV virus.

Causes of this include their numerous and varied sexual encounters, pre-existing sexually transmitted diseases in addition to life style issues such as alcohol, smoking and illegal drug use which weakens the immune system. Undoubtedly, the most powerful form of transmission from one human to another of the HIV virus is through direct blood transfusions employing infected blood. However, this has resulted in a miniscule number of cases. But the accidental or intentional use of contaminated injecting equipment is the third most common method of HIV transmission.

The frequency of transmission being in the deliberate and repeated use of contaminated syringes by infected persons generally occurs in users of illegal drugs. These users typically share syringes and or other improvised injecting paraphernalia. While any illegal drug can be injected, heroine and cocaine are the most widely used injectable illegal drug. Less frequent forms of HIV transmission are vertical transmission and occupational exposure. Vertical transmission occurs when a mother, either during pregnancy, at time of delivery, or after birth (through breast-feeding) infects an infant.

Occupational exposure is considered to be rare but does occur. Studies ending in 1996 found 52 documented cases and another 111 cases of possible occupational transmission. These cases, by enlarge, involved health care workers who acquired the disease after percutaneous injury, mucocutaneous exposure and exposure through open wounds. Most of these cases involve puncture wounds from needle stick type injuries. In addition to health care workers, at risk personal include police officers, fire fighters, military personal and prison employees.

Since often the infectious contact is the result of elective human behavior, there are strategies for preventing the continued spread of HIV virus. At the center of these strategies is education which must be world wide, multileveled, intercultural and, of course, non-judgmental. Modifying behavior through education would include teaching safe sex practices, including stressing the proper and consistent use of effective condoms. Similarly for the person who continues to use injected drugs, the use sterile needles must be taught.

Deactivation of HIV requires only a 30-second exposure to 100% bleach. Instruction in the cleaning methods used to deactivate HIV should be done. Education without resources can only achieve marginal results. Therefor, although problematic and controversial it is necessary after education to provide easy and in most cases free access to condoms, sterile needles, early HIV testing and follow up medical treatment. As discussed, while most but not all HIV transmission is the result of risky behavior, there are other causes of transmission as well.

Prevention then must entail education, discipline and procedures to minimize infection through transfusion and safety procedures to prevent accidental transmission to people engaged in certain occupations such as health care workers. On this last point herein lies another controversy which is beyond the scope of this paper. That subject deals with what level should a person who is living with the HIV infection have his/her medical and or other records reflect that fact. At what point is the individual’s right to privacy negated, if ever, in regards to the individuals who are charged with caring for the infected person.

The public at large uses interchangeably the terms HIV and AIDS. This sloppy inaccuracy is one of the basis for the gross misunderstanding of the disease. HIV is divided into two categories; type I, which is found throughout the world and has resulted in most of the reported cases of infection, and type 2, which is localized to Western African coastal nations and areas outside of Africa which have commercial and cultural relations with that region. HIV infection ultimately leads to the disease of AIDS. But it is not AIDS in and of itself. Within one to three weeks of initial exposure seroconversion occurs.

This is the detectable development of HIV antibodies. While the virus is usually detectable, acutely veril and can be passed along, the infected person shows few or no symptoms. From the initial exposure period or roughly from two to six months flu like symptoms will appear in the infected person. The individual will begin to develop antibodies to fight the infection. The individual will frequently appear to be acutely ill. Well before the end of the first year the HIV infection will become asymptomatic. (It should be noted that during this period of time the disease is not dorment but is systematically destroying t-helper cells).

Acquired Immune Deficiency Syndrome(AIDS)

In 1918 the United States experienced one of the worst epidemics in its history. With 500,000 dead in a matter of 6 months, the Spanish influenza left its mark. With approximately 11. 7 million dead worldwide, Acquired Immune Deficiency Syndrome(AIDS) is still leaving its mark. It is a pandemic the likes of which the world has always feared to see. The HIV virus comes in several varieties, yet they kill basically the same. Our understanding of this virus and how it works is essential to finding its cure, and to preventing its spread. Who it affects and the reasons for its spreading are also important to fight against it.

And finally, what can be done to treat and prevent it is essential. According to the World Health Organization we began to see what AIDS truly was in the late 1970s to early 80s, mostly in men and women with multiple sex partners located in East and Central Africa, but also in bisexuals and homosexuals in specific urban areas of the Americas, Ausrtalasia and Western Europe. Aids was and is spread still through infected hypodermic needles which drug abusers are affected by, but also through transfusion of the blood and its components.

And sadly, whenever a mother is infected, the unborn child will almost positively receive the virus before, during, or after the pregnancy. The viruses which cause AIDS, otherwise known as Human Immunodeficiecy Viruses(HIV) were first discovered in 1983 cooperatively by Dr. Robert Gallo of the National Cancer Institute and Dr. Luc Montagnier of the Pasteur Institute in France. Aids is caused mainly by the HIV-1 virus, while the HIV-2 virus is less pronounced among those infected.

Scientists are puzzled as to why this dominant HIV-1 virus has 10 different genetic subtypes, some think that it is so the virus will survive no matter what. HIV is part of a group of viruses called retroviruses. This category basically describes how the virus transmits and reproduces itself. Which is to say that upon entering the body the virus attaches itself to a T-4 cell(T-Helper cell), which is the type of cell that marks the bad things in our body so that another cell, the B-lymphocyte, can activate the production of antibodies, which are what would normally kill the virus.

So, after attaching itself to this cell it then injects its viral replicating DNA in, which then copies itself on to the cells DNA, thus changing the whole function of the cell from killing the foreign agents which enter our body, to producing more of the virus that will eventually lead to the death of our body, because the cell is then used as a manufacturing plant for the virus. The one cell that entered your body is thus turned into 500, which then turns into 25,000, then 12,500,000.

The virus is not strong merely because it replicates, however, it is strong because of what it replicates on, which is the helping cell of your immune system. But the most bizarre thing of the whole virus is that it doesnt kill you. It only weakens your immune system so other viruses and even bacteria can finish the job. The first set of symptoms are called AIDS-related complex(ARC). These symptoms include fever, diarrhea, weight loss, and fatigue. These are only signs that you might have the virus HIV, and are not the full-fledged symptoms of AIDS.

The two most common infections seen in AIDS patients are Pneumocystiscarinii Pneumonia(PCP), which is a parasitic infection of the lungs, and Karposis Sarcoma(KS), which is a type of cancer. The purplish dots on the skin that are usually associated with AIDS are from KS. Other common infections are non-Hodgekins lymphoma, primary lymphoma of the brain, severe infections with yeast, zytomegalovirus, herpes, and parasites such as taxoplasma or cryptosporidia. Some neurological disorders are: chronic aseptic meningitis,focal deficits, hallucinations, and progressive dementia.

So as one can see any way it can open you up to an infection, is a bad way. The full-blown AIDS patient is usually very fragile and weak, having to be placed in hospital care because they find it hard to breathe. The slightest breeze, sometimes sets their whole body into a shiver that might not go away for a minute or a day. They usually have a constant fever, and an even more persistent wheeze of a cough, wheeze, because they dont have enough strength in their body to actually cough right. It is estimated that one-quarter to one-half of all those infected will develop AIDS within 4-10 years.

This estimate, is said to be very shaky, because scientists are saying the percentage will be higher. People with the virus, however, can exhibit no symptoms, or mild symptoms for sometimes up to 20 years. It was once thought that homosexuals and bisexuals were the only ones infected and getting infected by HIV, but now it is known that it can be transmitted by any sex preference, gender, race, and nationality. The main HIV viruses are only transmittable through the direct exchange of bodily fluids like semen, vaginal excretions, and blood.

But there is a virus, though only reported a few times, that is transmitted through the saliva in our mouths. Could it be that AIDS is the ultimate punishment for promiscuity? Could this be Gods way of saying, stop messing around down there? By the end of 1997 11. 7 million were dead because of it, and 2. 7 of those million were under the age of 15. More recently a report from the United Nations Program on HIV/AIDS(UNAIDS) and the World Health Organization(WHO) stated that 50% of the 5. 8 million newly infected people in 1998 were in the age group of 15-24.

These are frightening statistics, because now HIV has become the plague of the younger generation, which means that it will spread undoubtedly. The treatment for AIDS has progressed immensely in the past few years alone. Getting told that you are HIV positive no longer means that you were just given a death sentence. Conventionally, the normal AIDS patient would have to require retroviral intervention in addition to lymphoma, or whatever else they might have, treatment, which would usually be chemotherapy and AZT or inosine pronobax which normally extends the ARC period of the patients life.

This treatment would probably still be in effect, if it werent for the increased pressure put on by the AIDS activists, polititans, and people. Now however, drug cocktails are the most effective. In June of 1997, a federal task force released new guidelines, calling for early treatment with the use of 2 nucleosid analogues(category to which AZT belongs) and 1 pro tease inhibitor. So if the government says its ok then it must be. This combining of different drugs is not a cure in the least, even though one doctor stated that with his patients all traces had been eliminated from the bloodstream!

Dont get to excited though, because he forgot to mention that there were traces still found in the lymph nodes! So the drugs are really only used to manage the life one would live if infected. The President made a statement challenging the scientists of the United States to find a cure by 2007. The scientific community was displeased with his comment, because he has yet to mandate the appropriate funds for this challenge. The reason AIDS is a pandemic and not an epidemic, is because it is prevalent throughout a whole country,continent and world. I think that a solution to this societal problem is quite a monumental task.

It would require at least half the worlds cooperation. But before any of the healing can start, the world as a whole must come to the decision that AIDS needs to be stopped, killed, annihilated, whatever, youd like to call it. And when I say the world, I dont mean its leaders, I mean the people, the masses. The societal opinion and feeling about AIDS needs to change. We need to address why it is spreading still, even though almost every person on Earth knows what it is. We need to bring out in the open, as Swift did in Gullivers Travels, the problems of our society.

More specifically, we need to talk with our youth and try to stop promiscuity before it happens. We need to make sure that our children know how to use protection, when they do have sex, even it makes us feel awkward, or like were showing them too early. The question becomes would we rather our children learn from people you dont even know, or would we rather teach them ourselves? The fate of many will depend less on science than on the ability of large numbers of human beings to change their behavior in the face of growing danger.

What happens when two people fall in love

We may think of love as a sweet heart throbbing fairy tail situation, but in reality, unexpected dreadful circumstances often occur. As a couple falls helplessly in love, they become sexually active. Because of this intimate, uncontrollable love, a couple, with extremely high endodorphine levels may make a poor choice about contraceptives. This poor choice may result in a STD or even the life-concluding virus, HIV/AIDS. In this situation the couple develops mixed emotions which may cause a painful breakup leading to depression, which is the number one cause of suicide.

Being in love is a sense of excitement, of heightened emotion, heightened senses, of being in the unknown, of abduction, of not being in control of yourselfits like an excuse, ‘I don’t now what I’m doing. I’m in love'”(Gochros and Ricketts 27). Every day, people all over the world experience this intense description of love. Dr. JM Morris explains this in profound detail. “The first step to falling in love is imprinting. Imprinting is finding a specific physical trait that attracts you to a certain person. Then there is a subliminal attraction, which is a personal quality, such as a person’s laugh.

Next is the hypotaemic stage. When experiencing this stage, a person becomes nervous and develops sweaty palms when their object of affection is close to them. Then chemical anvetamines in the brain such as dopamine, norepine, and phenye ethyeamine react, causing a natural drug rush. ” Now that the couple has fallen in love, certain addictions and attachments occur. Dr. Morris continues, “The brain chemical, oxytocin, otherwise known as the ‘cuddle chemical’ promotes a realxed satisfying attraction and strong bonds due to endodorphine levels urging the couple to make love.

Through this addiction, the couples brains actually begin to grow together. ” So now the endodrophine level is at its peak and it is the perfect time and place for the couple to have sex, but there is only one problem, they have no form of contraceptives. The couple, so in love and naturally drugged on endodorphine, cannot resist their feelings and proceed by engaging in unprotected sex. The use of contraceptives have become vital when considering that unprotected intercourse is likely to result in pregnancy and more importantly, it carries a high risk of acquiring a sexually transmitted disease (Contraception: choosing).

There are presently many forms of contraceptives available to fit persons cost, comfort and preference. When making this crucial choice, it is important to consider all your options. There are types of contraceptives, which are excellent for preventing pregnancy, but have absolutely no effectiveness against STD’s. The Combined pill, mini-pill, Depo-Provera, Norplant, IUD, and morning after pill are all in this category (Roland 6). Contraceptives, which prevent pregnancy and STD’s, include the male and female condom, spermicides and diaphragms. The male condom is the most common use of contraception for males.

It is a protective covering made of latex and polyurethane that fits over the penis. The condom keeps the semen from entering to vagina (Kronenfeld, Whicker 43). The female condom which is not commonly used, not only has a high cost, but is bulky and difficult for the female to insert. It is a polyurethane sheath that lines the entire vagina and partially covers the external genitals (Birth Control 2). Spermicides are another over the counter contraceptive. These products are a type of spermicidle jelly or foam in the form of a capsule, which are inserted into the vagina before intercourse.

There are no serious side effects but it may be messy. The woman can also use a diaphragm or cervical cap, which is a flexible rubber barrier used with spermicidal cream or jelly. It is inserted before intercourse to block and kill sperm moving toward the uterus (Emergency Contraceptives 2). All of these contraceptives are effective in stopping pregnancy and STD’s but the only thing that can completely prevent sexual mistakes is abstinence. If a couple decides not to use any of these methods of contraception they are at a high risk for sexually transmitted diseases and even HIV/AIDS.

Present day, more than fifty organisms and syndromes are now recognized as sexually transmitted. These diseases can lead to serious health problems, and when untreated, can lead to major consequences (Anderson and Smith 22). Sexually transmitted diseases can cause pelvic inflamation, a woman who develops a serious case of this may die. But an even more serious STD that causes death is HIV/AIDS (Clinic). The two most common STD’s are Chlamydia and Syphilis. Although Chlamydia can be extremely painful for females in the lower abdomen, 80% of the infected have no symptoms at all. Chlamydia is curable with certain antibiotics.

Syphilis, although curable as well, can cause sever damage to the nervous system and other body organs, resulting in long term damage. Other STD’s cause painful blisters and warts to develop on the mouth and genitals and anus. Genital herpes, genital warts, and scabies are all included in this category. These sores are extremely painful and sometimes are incurable (Holmes and Mardh and Sparling and Wiesner). Other popular STD’s include Garderella Vaginits, Hepatitis A, B, C and D, and Gonorrhea, they all have symptoms including, vaginal discharge, pain while urinating, possible bleeding, ect.

Some people have no symptoms at all and most of these STD’s can be cured by antibiotics (Clinic). But one STD that cannot be cured by antibiotic or any other way is the life concluding disease, HIV/AIDS. HIV is the virus that causes AIDS, this infection damages the body’s immune system that protects the body from disease. As HIV forms to AIDS the immune system is extremely weak, when this happens, other diseases and infections enter the body, eventually causing death (Schettler 1-2).

The only guarantee to keep from getting a STD is to practice sexual abstinence, but on a more realistic note, it is extremely important to use contraceptives during sexual intercourse to lessen the chances of infection. Being infected with and STD is a very difficult situation. It causes hardship between the sexually active couple, it effects the victim’s family and friends who care about them, and if the victim is bearing a child at the time, it ould effect the baby’s health as well.

The STD might cause a difficult breakup between the two partners, or for teenagers, it creates a conflict between them and their parents. A person may be deeply bothered by long term scars that can effect their future, like women becoming unable to bear children because or the damage done, or even the embarrassment it causes. In many cases the victim falls in a stage of depression. Depression, effecting over one in five Americans in their lifetimes is the number one cause of suicide (Campbell51). People who have AIDS are at an extremely high risk of taking their own lives (Pahl 3).

They don’t want to go through the pain of a slow death or wish to face the humility. An infected person may feel dirty and unwanted; this type of depression often leads to suicide (Fagan 8). So now when we think of love, we may see it a little differently after being educated. We can see how love and death can tie together; love leads to sex, allowing high endodrophine levels to make a poor choice of contraceptives, which, in turn, leads to STD’s, HIV/AIDS, which causes depression, resulting in suicide.

United States’ Fight Against AIDS

On May 27, 2003, Bush signed a law committing $15 billion dollars to fight AIDS in fourteen of the most afflicted countries with this disease over the next five years ([1]&2). AIDS is a global problem that affects everyone in some way or another. Therefore, everyone benefits when someone fights this problem. The AIDS problem has grown so much that organizations and funds are no longer able to handle this problem by themselves. This has become a global problem and now states are the ones who need to take charge in fighting this issue.

This is exactly what the US is doing. The new ill will give much needed assistance to these fourteen countries that are hard hit by AIDS. The objectives are to “prevent 7 million new HIV/ AIDS infections, treat 2 million HIV-infected people, and care for 10 million HIV-infected individuals and AIDS orphans. 2” However, there are two important problems that arise from the aid the US is giving. The first problem is that there will be problems in coordination between the US and other developed nations in giving aid to countries that are hard hit by AIDS.

Other developed countries have an incentive to “free ride” on the US assistance. To solve this, there has to be coordination by multinational organizations such as the UN that will punish those nations that do not contribute money to this cause. Second, there are structural problems in the countries where the aid is going. The problems arise especially when corrupt government officials try to take advantage of the goods the US provides. For example, when the US sends block grants to these governments, corrupt officials can steal huge amounts of money.

To solve this problem the US should rely on international organizations such as UNAIDS and World Health Organization to go to the countries and actually mplement themselves the necessary aid instead of relying on the governments to do so by themselves. Thus the countries receiving the aid must allow for these international organizations to come into their countries and do the work. If these changes can be implemented the US assistance will be effective and good. Furthermore, a structure will be built by solving these two problems by which stronger foundations will stand on so that it will be easier to fight AIDS in the future.

Bush said in his statement regarding the aid given, “AIDS is a significant threat to global development and stability, the US is backing p that understanding with a commitment to substantial new resources. 2” One of the reasons why the US is helping these countries is morality. The US is the most powerful economy in the world and the countries that most suffer from AIDS are among the poorest of the world. Thus, it makes sense that the US should help these states. Nevertheless, there are benefits besides these moral ones that will benefit the US.

The first is that this bill will “highlight the softer side of US foreign policy in the wake of a sharp break with some traditional allies – including France, Germany, Canada and Mexico – over the war in Iraq. ” The economic assistance given will soften countries that are currently against the US and its foreign policies. This legislation will also calm international pressure that wants the US to increase the aid they currently give to these countries. Also, the countries the US will help will owe allegiance to the US. By giving this assistance, the US is creating allies all over the world.

Domestically the Republican Party will benefit because they are the main sponsors of this bill (as both congress and the president are republicans) as people like giving assistance to those who are worse off. This bill ill be especially popular among the African-American population. Furthermore, it will benefit the whole world. It is important to combat AIDS itself. One of the main arguments for fighting AIDS is that governments with, for example, one out of three adults is infected with AIDS become unstable and this becomes a major threat to the whole world, as terrorist organizations or civil wars could take over.

Furthermore, there is the threat that this disease will keep spreading and will eventually reach all over the world. Already this is proving to be a problem in the US and Europe. AIDS is one of the major threats to world stability. People who are infected by this disease will surely die within fifteen years. Therefore people who are infected should be taken care of. However, at this point it is more important to stop the disease from spreading any more. Also we must care for the AIDS orphans who will be left to their own means to survive.

On another note, experts argue that containing the AIDS epidemic today will cost the world a small fraction of the world’s wealth. If developed countries gave as little as one dollar per citizen annually, there would be enough wealth to provide testing, harm reduction interventions, and HIV ducation and prevention programs for the whole world. “The goal must be to immediately marshal sufficient resources to… effectively reverse the epidemic by decade’s end. [2]” As things are now, most of the capital that countries afflicted with AIDS spend on is “treatment, care and support” rather than “preventive measures. 3]”

This is dangerous, as this does not stop the epidemic from growing. Some examples of this are that in sub- Saharan Africa only six percent of people have access to AIDS testing and only one percent of pregnant women have access to “treatment to prevent other-to-child transmissions. [4]” In the Caribbean, most homosexuals do not have information about AIDS[5]. Coordination: One of the biggest threats of the US giving so much economic assistance to the AIDS problem is that other developed countries will stop contributing to this cause and “free-ride” on US assistance[6].

This is not only a problem for the US, but also for the world. The reason is that the US cannot amount for the whole cost of fighting AIDS and thence if other nations do not contribute, there will not be enough resources to fight AIDS properly. To give an idea, in 2002 3. billion dollars were needed to pay for prevention spending and also for care and support spending of AIDS. However, in 2005 it is expected that prevention costs will increase to 5. 7 billions and care and support costs to 5. 5 billions.

In 2007 the increases will be more dramatic, prevention will cost 6. 6 billions and care and support will cost 8. 5 billions. Obviously the new law will not be able to cover the total costs, or even a third of the costs presented here. Thus if other countries free ride on the assistance of the US the whole world will suffer, as the AIDS problem will not be addressed s it should be. AIDS is commonly regarded as a global problem; especially when it strikes in sub-Saharan Africa and other regions in the world that are low-income countries.

Everyone feels they should help this cause; however, seeing that the US is giving so much money other states will want to stop giving a part of their capital to this cause. Furthermore, many countries charge that since the US has such an overwhelming wealth it should contribute most or all of the international aid given to AIDS stricken countries[7]. One of the initial ways the US tried to combat the free-rider problem s that there is a part of the part of the new law states that the “maximum amount the U. S. can contribute… to the global fund… is limited to 33% of all contributions. 8]”

Thus with this the US tries to stop the free- rider problem in the fact that unless the rest of the world can match the other 66. 6% of the necessary money, the US will not give the total amount it is supposed to, but only the percentage that is 33% of the total. This is a good incentive to make other countries stop free riding. But even with this, other countries will free ride on the 33% that the US is paying. Therefore, there needs to be another way to fight free riding. The answer to this problem is to have multinational organizations make sure that all countries contribute to this cause.

The best way to do this is by having organizations such as the UN or the World Bank enforce penalties on those countries that do not contribute to the cause. The punishment might come in form of economic sanctions or grants or so on, but the main point is that the costs of the punishment have to be greater than the amount of money they have to pay, that way they will have an incentive to pay for this cause. Therefore this way it is ensured that no one will free-ride as costs will be established at the beginning and surely most countries will want to pay rather than face the sanctions.

As a matter of fact the US president is already pursuing this fact as he is lobbying other countries to contribute to the problem. The AIDS epidemic should be handled multilaterally, he said. “The US leader said he would deliver that message when he attends the June 1-3 Group of Eight summit in Evian, France, and comes face-to-face with leaders of the world’s seven major industrialized nations plus Russia. 9]” Thus unless there is coordination by an international organization in the coordination of giving aid, there will not be a maximization of the way that we will fight AIDS, and this will ultimately hurt the whole world.

Structural Problem: “The US president said that [his proposed] plan [to combat AIDS] would prevent seven million new HIV infections, treat at least two million with life-extending drugs, and provide care for millions who already have AIDS or were orphaned by the disease. 2” For the US to reach these goals it will have to overcome several structural problems in the countries receiving the id to effectively fight AIDS. Government obstructionism and indifference have proven to be the greatest deterrent in making a significant advance in combating AIDS in Africa[10].

According to Richard Tren, director of South Africa’s “Africa Fighting Malaria” organization, “Fifty [sic] percent of medical resources are stolen[11]” and corrupt government officials keep the block grants given by the US to fight AIDS. He further states that there is a lack of human capital and physical capacity in these countries. For example, there are not enough doctors to administer tests to see who has AIDS or even if there are, there are no buildings where they can administer the medicines. In some countries the governments have underplayed the threat that AIDS has on their population.

Government corruption is a major threat to the expedient and efficient effects of this law that hopes to combat AIDS. The harshest critics of programs to help the AIDS problem argue that “Western assistance to Africa often does more harm than good, owing to corrupt and inept governments, which are the recipients of this aid. [12]” They argue that giving these block grants to these countries makes it easy or government officials to steal goods. Relating to structural problems are social customs that are unlikely to change unless there is an active interest by the government or organizations into changing this.

For example, it is known that most HIV transmissions stem from heterosexual sexual behavior[13]. However, young women 15-24 are twice as likely as young men from being infected with AIDS. Furthermore, women account for 58% of all HIV infections. This is largely due to the fact that women can be raped or that women cannot force their male partner to use a condom in Africa. This important social inequality akes AIDS difficult to combat. Only by education will people learn the dangers of having unprotected sex. However, since there is not an active fighting of these norms, there will be no changes.

Besides the problems already listed, there are physical and industrial problems that will never be overcome if the capital by the US is not invested properly. An easy example is the difficulties of producing enough condoms and delivering them to the afflicted regions. “According to UNAIDS, the six to nine billion condoms that are distributed each year constitute as little as one quarter of what is needed to reach those in eed. [14]” First of all, factories would have to be built that would produce condoms that will stop AIDS.

Second, there must be a distribution system to get the condoms to the places they need to go. This is a difficult task but it can be solved if the governments are willing to help. Another example is that at this moment only 50,000 people in Africa are receiving AIDS-related quality treatment, and to increase this number to half a million in a short term, and 2 million in five years, there will need to be much training of doctors and much building of clinics. A large nvestment would have to be made to upgrade the medical infrastructure.

You cannot create doctors from one day to another, nor the hospitals or clinics they will work in, it will take time and money but it is possible if the money given is used correctly. Thus we see that there are many problems that must be overcome. However the proper solution to this is to have the governments that are affected by this allow organizations to come in and work themselves to solve these problems instead of relying on the governments to do so. Thus UNAIDS should get access to the countries and build the necessary uildings, train the necessary people, and educate where necessary.

There has to be an active participation in overlooking that all the money spent will go to the proper places. Furthermore, the UNAIDS can send its own doctors to administer tests or medicines if there are none in the countries. Only by making sure that the aid gets through will the money be used effectively to what it is meant to be. Otherwise we should not expect that we would meet Bush’s expectations. Fifteen billion dollars is a very large amount of money for African government officials to steal. However, t is even worse that the people who have AIDS do not get to enjoy its benefits.

Furthermore, not fighting the problem today will cause a global problem that may be uncontrollable in the future. If the US can overcome these structural problems this will maximize the amount and quality of aid given to AIDS stricken countries. Conclusion: The US spent approximately one billion dollars in 2002 in funding for HIV/ AIDS interventions in developing countries[15]. As it is, the “measure Bush signed would triple the annual [United States’] AIDS-fighting budget2” to three billion a year. Thus with this new measure we hope that the US will increase its effectiveness in fighting AIDS.

The AIDS epidemic is a global problem that must be solved, especially in those countries where the percentages of HIV infected people are very high. However, to effectively combat AIDS the US must overcome the coordination and the structural problems. I believe that coordination is a very important factor that must be overcome to effectively fight AIDS. The free-rider problem poses a huge threat to properly fighting AIDS. We need a multilateral effort whereby developed countries will contribute to this cause.

The best way to ensure that this gets done is by having an organization, such as the UN or the World Bank, make sure that developed countries pay a certain amount to combat the disease or they will suffer some punishment. Thus there needs to be a coordination in the world community to make sure that everyone plays its part in fighting this disease. The price of treating AIDS is rapidly increasing. Thus there is an urgent need to tackle this problem as soon as possible. Furthermore, there needs to be a way to overcome the structural problems that are caused by having the governments receiving aid not using t properly.

Only when organizations such as the UN or WHO come in and implement the programs themselves can we be sure that the assistance is getting through. Furthermore, if this can be properly executed, things will become easier in the future. Thus, for example if we build a condom factory today, it will work for many years to come; the same applies with building hospitals and training doctors. Thus paying a structural price today will help the future. Fighting AIDS is a good investment as it benefits everyone.

It is better to treat the problem now that the epidemic is still manageable than couple of years down the road when we will be unable to do anything. The US has taken an active step in fighting AIDS. However, we need to make sure that the problems of coordination and structure are faced so that the aid given is actually implemented to benefit those afflicted by the disease. Critics to giving this sort of aid to afflicted countries contend that giving aid to these countries is not sustainable. Only when these countries become democracies that embrace capitalism will they overcome the problem.

By having an open government and industry, a mass media, an ducational system, and all the other benefits that capitalist countries enjoy, the problem will be dealt with from within and eradicated more efficiently than if done by sporadic aid from abroad. This is definitively true but we need to see that these countries will not change from one day to another. Thus at this point, developed countries must take an active role in fighting the epidemic and also trying to open up and liberalize these countries. If we become passive in helping these countries out the AIDS problem might become too big for even the developed nations to handle.

United States Fight Against AIDS

On May 27, 2003, Bush signed a law committing $15 billion dollars to fight AIDS in fourteen of the most afflicted countries with this disease over the next five years ([1]&2). AIDS is a global problem that affects everyone in some way or another. Therefore, everyone benefits when someone fights this problem. The AIDS problem has grown so much that organizations and funds are no longer able to handle this problem by themselves. This has become a global problem and now states are the ones who need to take charge in fighting this issue.

This is exactly what the US is doing. The new bill will give much needed assistance to these fourteen countries that are hard hit by AIDS. The objectives are to prevent 7 million new HIV/ AIDS infections, treat 2 million HIV-infected people, and care for 10 million HIV-infected individuals and AIDS orphans. 2 However, there are two important problems that arise from the aid the US is giving. The first problem is that there will be problems in coordination between the US and other developed nations in giving aid to countries that are hard hit by AIDS.

Other developed countries have an incentive to free ride on the US assistance. To solve this, there has to be coordination by multinational organizations such as the UN that will punish those nations that do not contribute money to this cause. Second, there are structural problems in the countries where the aid is going. The problems arise especially when corrupt government officials try to take advantage of the goods the US provides. For example, when the US sends block grants to these governments, corrupt officials can steal huge amounts of money.

To solve this problem the US should rely on international organizations such as UNAIDS and World Health Organization to go to the countries and actually implement themselves the necessary aid instead of relying on the governments to do so by themselves. Thus the countries receiving the aid must allow for these international organizations to come into their countries and do the work. If these changes can be implemented the US assistance will be effective and good.

Furthermore, a structure will be built by solving these two problems by which stronger foundations will stand on so that it will be easier to fight AIDS in the future. Bush said in his statement regarding the aid given, AIDS is a significant threat to global development and stability, the US is backing up that understanding with a commitment to substantial new resources. 2″ One of the reasons why the US is helping these countries is morality. The US is the most powerful economy in the world and the countries that most suffer from AIDS are among the poorest of the world.

Thus, it makes sense that the US should help these states. Nevertheless, there are benefits besides these moral ones that will benefit the US. The first is that this bill will highlight the softer side of US foreign policy in the wake of a sharp break with some traditional allies – including France, Germany, Canada and Mexico – over the war in Iraq. 2 The economic assistance given will soften countries that are currently against the US and its foreign policies. This legislation will also calm international pressure that wants the US to increase the aid they currently give to these countries.

Also, the countries the US will help will owe allegiance to the US. By giving this assistance, the US is creating allies all over the world. Domestically the Republican Party will benefit because they are the main sponsors of this bill (as both congress and the president are republicans) as people like giving assistance to those who are worse off. This bill will be especially popular among the African-American population. Furthermore, it will benefit the whole world. It is important to combat AIDS itself.

One of the main arguments for fighting AIDS is that governments with, for example, one out of three adults is infected with AIDS become unstable and this becomes a major threat to the whole world, as terrorist organizations or civil wars could take over. Furthermore, there is the threat that this disease will keep spreading and will eventually reach all over the world. Already this is proving to be a problem in the US and Europe. AIDS is one of the major threats to world stability. People who are infected by this disease will surely die within fifteen years.

Therefore people who are infected should be taken care of. However, at this point it is more important to stop the disease from spreading any more. Also we must care for the AIDS orphans who will be left to their own means to survive. On another note, experts argue that containing the AIDS epidemic today will cost the world a small fraction of the worlds wealth. If developed countries gave as little as one dollar per citizen annually, there would be enough wealth to provide testing, harm reduction interventions, and HIV education and prevention programs for the whole world.

The goal must be to immediately marshal sufficient resources to effectively reverse the epidemic by decades end. [2] As things are now, most of the capital that countries afflicted with AIDS spend on is treatment, care and support rather than preventive measures. [3] This is dangerous, as this does not stop the epidemic from growing. Some examples of this are that in sub-Saharan Africa only six percent of people have access to AIDS testing and only one percent of pregnant women have access to treatment to prevent mother-to-child transmissions. [4] In the Caribbean, most homosexuals do not have information about AIDS[5].

Criminalization of Knowlingly Transmitting AIDS

Acquired Immune Deficiency Syndrome (AIDS) is caused by the Human Immunodeficiency Virus (HIV). The virus was discoverd independently in France in 1983 and in the United States in 1984. In the United States, it was initially identified in 1981. In 1986, a second virus, now called HIV-2, was also discovered in Africa. HIV-2 also causes AIDS. AIDS is transmitted in three ways: From sexual contact without protection, from the mixing of ones blood with infected blood, and from an infected pregnant woman to her fetus. Infection can occur from blood transfusions of infected blood, or sharing ‘dirty’ needles.

Needles already used, in this case, by a HIV positive person. The criminalization of intentionally spreading AIDS has been a big issue recently, and still remains so. As of September, 1991, legislation criminalizing AIDS transmission has been passed in 24 states. Among these states are California, Idaho, Ohio, Missouri, Michigan, and South Carolina. Under these current laws, it is a crime to knowingly transmit the virus through sex, sharing needles, donating infected blood, organs, or skin tissue. The first person to go to court under these laws in Michigan was Jeffrey Hanlon.

Hanlon was a gay man who infected another man from Michigan while he was in New York. The American Civil Liberties Union, who agreed to take the case, agrued that the AIDS disclosure law is unconstitutional. Privacy of those with AIDS is what they were worried about. Opponents argued that “they’re [those with AIDS] killing people. It’s like rape. ” The maximum sentence Hanlon could have recieved was four years in prison and a $2000 fine. In addition, under the current New York State law, which dates back well before June, 1987, the knowing transmission of a venerial disease is a felony.

However, at that time, and currently, AIDS was not classified as a venerial disease. Interviews Concerning the IssueMost people believe that the willful transmission of AIDS to others it virtually murder. I have interviewed **name** and **name**. Both of them feel that intentionally passing AIDS on to another person is murder. The recipient of the virus will, in almost every case, die rather quickly of an AIDS related disease. **name** feels that “if someone knowingly transmits AIDS to another person, it’s like committing murder. He or she should be punished to the full extent of the law.

In addition to personal interviews, I have found the opinions of Governor Cuomo and former President Ronald Reagan. On June 1, 1987, Cuomo revealed that state lawmakers would consider making the transmission of AIDS a crime. He was quoted at the time as saying:”If you know you have AIDS and you pass it on to someone who is not aware, that should be regarded as a very serious offense. I’m not talking about sins and morality; I’m talking about a sin against the community, a crime. We should look into that. ” However, nothing was proposed at the time.

Former President Ronald Reagan called for “routine” AIDS testing of prisoners, marriage license applicants, immigrants, and possibly some hospital patients. His purpose was only to identify carriers of the disease; no comment concerning the criminalization of the transmission of AIDS was made. Reasons for the Criminalization of Knowingly Transmitting AIDSThere are not many reasons for the criminalization of knowingly transmitting AIDS. However, they are very convincing arguments. The first and one of the most convincing arguments is because it will help stop the propogation of the virus.

Ideally, if people know that it is a crime to transmit the virus, then they will not. The only way that AIDS will remain an epidemic is if it is continually spread. This is because those with AIDS will in most cases die rather quickly of an AIDS related disease. If they do not spread it, then the number of people with the virus will decline steadily without fail. Another reason is that someone who is intentionally transmitting the disease is doing it for their own satisfaction and/or to hurt others. Such is the case with a drug pusher.

Many magazine articles have made reference to the analogy “a drug pusher is the same as an AIDS pusher. ” Their argument is that if drug pushers are treated as if they commit criminal acts, then so should the supposed ‘AIDS’ pushers. The Constitutional argument involoved is also a moral one. By transmitting the virus willingly one is usurping on others’ rights to life and happiness. It is also seen as wrong by the public. In effect, it is murder in the second or third degree. If it is done intentionally, it is murder in the first degree.

Obviously this should be illegal and those who break the proposed laws should be prosecuted as if they committed a crime. Another reason to criminalize the transmission of AIDS is because the money from fines incurred may be put towards research and development of cures, as well as education and prevention programs. This will help stop the problem and also speed up the process of finding a cure or immunization for AIDS. Reasons Against the Criminalization of Knowingly Transmitting AIDS There are many more reasons against the criminalization of willingly transmitting AIDS to others.

However, these are based not on morals but on facts and practicality. Criminalizing AIDS would divert millions of dollars to legal fees that could be better spent on AIDS programs such as prevention, education, and research and development in terms of finding a cure. “Criminalization is a short cut taken when not enough energy is given to prevention. ” Instead of helping erradicate the epidemic, criminalization would instill more fear among the people living with HIV. “It would create a witch hunt atmosphere,” stated William Ramirz, an attorney for a HIV positive client.

Criminalizing AIDS transmission would open doors for people to knowingly accuse others they know that have it just to get rid of them. The law would also be practically impossible to enforce. In some cases, intent would have to be proven. However, it is usually impossible to prove intent since it is not possible to go “inside” the minds of others to know what they were thinking in their moment of passion, whether it be intercourse or drug use. Even the United States Health Department opposes criminalization.

They fear that it would scare people from reporting that they have AIDS. This is because those that do report it may be accused of committing a crime sometime in the future. My Position and ConclusionI have mixed feelings on whether or not the transmission of AIDS should be a criminal act. I feel that it is morally wrong, and in effect, those who do it are committing murder. There is definitely a valid argument there. However, due to the validity of the arguments against the criminalization of passing AIDS on to others, I am partial to both sides.

I agree that it would divert millions of dollars that could be put to better use in research and other programs. I also agree that it would be legally and scientifically impossible to prove intent. I feel that because of these conflicting ideas that I believe, the best way to resolve the issue would be to make transmitting the virus a criminal act, but not subject to jail time. Instead of wasting the taxpayers money on giving free medical care and room and board to inmates, it should be put towards finding a cure for AIDS.

Instead of a jail term, those who transmit the disease should be fined very heavily so as to discourage them from repeating the offense. The money accrued from the fine should then be used for research and other related programs, including helping those that are infected. All in all, AIDS is an epidemic that is a part of the nineties. It is scary, but it must be dealt with. If the proper precautions are taken, then eventually it will be taken care of in the right way. However, there will unfortunately always be those that have malice towards society and insist upon spreading their pain and suffering.

AIDS Related Stigma

Since the appearance of AIDS in the late seventies and early eighties, the disease has had attached to it a significant social stigma. This stigma has manifested itself in the form of discrimination, avoidance and fear of people living with AIDS (PLWAs). As a result, the social implications of the disease have been extended from those of other life threatening conditions to the point at which PLWAs are not only faced with a terminal illness but also social isolation and constant discrimination throughout society. Various explanations have been suggested as to the underlying causes of this stigmatization.

Many studies point to the relationship the disease has with deviant behavior. Others suggest that fear of contagion is the actual culprit. Examining the existing literature and putting it into societal context leads one to believe that there is no one cause. Instead, there would appear to be a collection of associated factors that influence societys attitudes towards AIDS and PLWAs. As the number of people infected with HIV increases, social workers are and will be increasingly called upon to deal with and serve PLWAs.

Although not all social workers chose to work with PLWAs, the escalating incidence of HIV infection is creating a situation in which sera positive people are and will be showing up more often in almost all areas of social work practice. This paper aims to examine AIDS related stigma and the stigmatization process, hopefully providing insights into countering the effects of stigma and perhaps the possibility of destigmatization. This is of particular pertinence to the field of social work due to our growing involvement with the HIV positive population.

Association to Deviant/Marginal Behavior one of the most clearly and often identified causes of AIDS related stigma is its association to deviant behavior. The disease has had and still does have a strong association for many to homosexuality, IV drug use, sexual promiscuity and other sorts of sexual practice (OHare, et al. , 1996; Canadian Association of Social Workers, 1990; Quam, 1990 & Beauger, 1989). An especially strong association exists between homosexuality and AIDS. This is largely due to the fact that, in the early years of the disease, it was far more prevalent within the gay community and almost non-existent outside of it.

In fact, until 1982 the disease was referred to as GRID or Gay Related Immune Deficiency. Even today, AIDS is often referred to as “the gay plague” (Giblin, 1995). Even though AIDS is now far less prevalent in the homosexual community and increasingly more outside of it, this link still remains strong for many. Along with the historical context of AIDS, the media is partly to blame for this not so accurate association. The Canadian Association of Social Workers (1990) reports that, “often the media has not distinguished between gay and AIDS, so that public understanding of homosexuality and AIDS has become enmeshed” (p. 10).

In recent years, the media has started to make more accurate distinctions between homosexuality and AIDS, but messages are still mixed and often ambiguous. The situation is quite similar in regard to IV drug use, prostitution, and other activities commonly associated with AIDS. This focus that the media has put on specific groups incorrectly places emphasis on high risk groups rather than high risk activities. As a result, the word AIDS alone conjures, for many, images of those who stray from what society deems normal behavior. Many of the groups to which AIDS is associated have long histories of stigmatization before the appearance of AIDS.

Homosexuals, in western culture, have almost always suffered the effects of being a stigmatized population. The same is true of prostitutes, IV drug users, and people of color (OHare, et al. , 1996; Giblin, 1995 & CASW, 1990). It is significant to mention colored populations, as the parts of the world that are most severely effected by AIDS, such as countries in Sub-Saharan Africa, South East Asia, and Haiti, are mostly populated by races other than Caucasian. As a result, a strong association has also been made between AIDS and people of color (Quam, 1990).

The fact that AIDS is associated with already stigmatized groups has two principal effects. First and most obvious, is that societys negative attitudes towards the group in question are transferred to AIDS and PLWAs. Second, is an amplification of the existing negative feelings that society holds towards the groups associated with the disease (CASW, 1990). As a result, homosexuals, prostitutes, colored people and other groups associated to HIV infection are not only seen as deviant or undesirable, but also as potential carriers of the virus who are to be feared and avoided.

Some religious groups see AIDS as a punishment from God for sinful behaviour. As children, many people were told that of what could happen to them if they strayed from what their parents or religious doctrine considered appropriate behaviour. Quam (1990) writes, “Their parents and other parental authorities warned them that if they succumbed to pleasures of the flesh they would suffer dire consequences. Now AIDS would appear to fulfill such prophecies” (36). Such sentiment still exists publicly today.

When asked about his feelings about the AIDS epidemic, Jerry Falwell, a popular and quite influential televangelist said publicly, “When you violate moral, health, and hygiene laws, you reap the whirlwind. You can not shake your fist in Gods face and get away with it” (Giblin, 1995). Another factor influencing attitudes towards PLWAs is the fear of contagion. In fact, Bishop, Alva, Cantu, and Rittiman (1991) argue that this is a greater cause of stignatization than the association to deviant behaviour.

They found that many people expressed negative attitudes towards PLWAs regardless of how the virus was contracted or the persons background. The fact that there is no known cure for AIDS and as of yet the disease always ends in death validates this fear for many. As people are becoming more aware of how the virus is transmitted, they seem to be become less fearful of PLWAs. However, peoples fear and avoidance of PLWAs is still greatly effected depending on the mode of transmission (Borchert & Rickabaugh, 1995).

In recent years, a distinction has been made in our society between what we consider to be innocent and deserving victims of AIDS. Society tends to classify people who contract AIDS through blood transfusions, their mothers at birth, or other uncontrollable circumstances as innocent victims. On the other hand, homosexuals, IV drug users, the sexually promiscuous, and other deviants are seen as deserving of the condition they are in when they contract AIDS. The common attitude held towards the deserving victim is that of you play, you pay (Quam, 1990).

This mentality leads to feelings of fear and hostility towards and a great lack of compassion for those who are incorrectly and irrationally deemed as being deserving of the disease. Borchert and Rickabugh (1995) found that greater levels of AIDS related stigma were expressed towards PLWAs who played an active role in the contraction of HIV. They noticed that people actually expressed quite sympathetic feelings towards people who played no active role in contraction, the innocent victims. It is only since the beginning of this decade that we have begun to notice this phenomenon.

In the past, no distinction was made regarding mode of transmission. In the 1980s, school children who had contracted HIV through blood transfusions were stigmatized almost as badly as homosexuals and often not even allowed to attend public schools. It was only after the highly publicized case of Ryan White that we saw the shift in attitudes and the formation of the innocent/deserving distinction (Giblin, 1995). Social Implications The effects of stigma for PLWAs are many. They suffer discrimination from the general public in a variety of settings, including work, school and within the health care environment.

In the early years of AIDS, many PLWAs were actually refused service in North American hospitals and some were fired from their jobs upon announcing that they had AIDS. The fact that the Canadian Human Rights Commission felt it necessary to specifically address HIV/AIDS discrimination is a good indicator as to what point it exists. Many PLWAs also experience extreme social isolation due to their illness; because of the negative reactions of friends and family members, the seropositive person is often rejected by many members of their social entourage (Giblin, 1995; Bishop, et al. 991; CASW, 1990; lAssociation des Medecines de Langue Francaise du Canada, 1990 & Quam, 1990).

The situation for PLWAs has changed somewhat in recent years. Legislation has been passed in both Canada and the United States making it illegal to discriminate against people for having AIDS. A major turning point occurred in the U. S. in 1990 after the highly publicized case of Ryan White. Ryan was a child with AIDS who was not permitted to attend public school due to his condition. Shortly after his death, a law was passed (the Ryan White Act) to try to prevent such discriminatory actions from happening again.

Whites story is not unique. At the same time that he was being excluded from public schools, a family with two seropositive children was forced to leave the Florida town they were living in after threats of violence and an arson fire in their home (Giblin, 1995 & Quam, 1990). At approximately the same time as U. S. legislation was passed, the Canadian government included AIDS under its human rights commission anti- discrimination laws. Although some things have changed and laws have been passed, the effects if stigma are still prevalent. Many people still express feelings of fear and hostility towards PLWAs (OHare, et al. 996).

Most of the negative attitudes felt and expressed are irrational but the effects can be devastating. One effect is peoples tendency to avoid all contact with PLWAs which contributes to social isolation. Also, even though legislation has been passed, discrimination still does exist. When asked about the treatment he received at Montreal General Hospital, an HIV positive patient explained that AIDS discrimination is far from being eradicated and that PLWAs are treated in a very negative fashion in many situations and environments (personal interview, 1997).

Social workers are and will be called upon to serve clients with AIDS in almost all fields of practice. As the numbers of the HIV positive climb, PLWAs will be appearing in nearly every area that social workers practice and even if we do not desire or plan to work with this population we will be required to do so and unable to ignore the issues of PLWAs. There are many ways in which social workers can address the issue of stigma, both in trying to alleviate its effects and actually working towards removing stigma in our society.

What is disturbing, however, is that many social workers and social work students, when questioned, say that they do not want to have to come into contact with PLWAs and may even refuse to provide services to them (OHare, et al. , 1996). Therefore a second issue that must be addressed is the attitudes of social workers. One of the principal roles of the social worker is that of advocacy. This is of particular importance in relation to AIDS related stigma. As mentioned, PLWAs suffer from discrimination in a variety of settings.

By exercising their role of client advocate, social workers can help to ensure that their clients receive the services they are entitled to and the proper, non-discriminatory treatment when possible. This includes advocating client rights within the health care system, whether it be in hospitals or CLSCs, within the legal system, and in community organizations. Along with advocacy, social workers can push for further changes in legislation and policy to protect the rights of PLWAs (CASW, 1990). Social workers can help to alleviate the isolation experienced by PLWAs due to stigma through the establishing of support groups.

There are two forms of support groups that can be very useful in countering feelings of isolation: groups for PLWAs and those for the PLWA along with members of their social entourage. In creating support groups of PLWAs, a social lieu can be created for those who otherwise have little social contact and it can give a chance for members to exchange coping strategies. The drawback of this type of group is that, although it facilitates social interaction, it does not necessarily provide links to the non-seropositive population.

Groups that include the persons social entourage, such as family and friends, can be used to bridge gaps between the client and their social contacts that have been damaged due to AIDS related stigma. Skills that social workers already have in areas such as family counseling, combined with a knowledge of HIV/AIDS can help to facilitate this (CASW, 1990). Social workers are in a position where they can educate and sensitize colleague, other members of the professional community and the general public about AIDS and AIDS related issues (OHare, et al. , 1996).

The social workers role of educator can serve to actually reduce AIDS related stigma. Much of the existing AIDS education material focuses on medical aspects of the disease and prevention. These are extremely important issues but education aimed at sensitizing the public to PLWAs themselves is hard to come by. Social workers can help in the developing of education programs aiming for sensitization and destigmatization. Social work training and education is the key to ensuring that social workers adequately serve seropositive clients and successfully play a role in dealing with the issue of AIDS related stigma.

The fact that many social workers express an unwillingness to work with PLWAs needs to be addressed. It should be noted, that according to the Social Work Code of Ethics, all social workers are obliged to serve all clients regardless their situation and have no right to refuse to serve a PLWA (CASW, 1990). Considering that almost all social workers will at some point be asked to work with this population, it is important that they be sensitized to it and its related issues. Schools os social work and agencies that employ social workers can and should play a part in this process.

University programs could make available specialized curriculum to address these issues. OHare, et al. , 1996 feel that education for social workers is not enough and that experience is also essential. They write, “Although counselling and educational efforts that increase AIDS related knowledge can improve the general attitudes of social workers toward people with HIV and AIDS … the modest attitudinal or knowledge improvements wrought by these efforts do not ensure behavioral change … social experience may be a better teacher than educational efforts alone. ” (57).

This is reinforced by the findings of Herek and Capitanio (1997) who determined that contact with PLWAs is the strongest variable in lowering AIDS related stigma. Currently, many schools of social work provide no opportunity for students to come into contact with PLWAs. Stages in the field of HIV/AIDS could be provided and perhaps even be made mandatory. This may not seem realistic to suggest mandatory practice, but taking into account the high possibility that social workers will come into contact with PLWAs in their careers, it is perhaps not such a radical idea.

With an understanding of the issue of AIDS related stigma, it is essential for the field of social work to address this issue. It is one of the many aspects of the HIV infection that PLWAs must face and also one of the many with which social workers can provide assistance. There are a variety of reasons for why this stigma exists and it is necessary to have some understanding of them in order to combat discrimination and the negative attitudes that surround AIDS.

With the knowledge of how the stigma has been formed, it is possible to try and counter its effects and to educate the public in order to possibly lower the levels of present stigma. Before social workers can be truly effective, however, it is necessary that education and training practices are modified to sensitize present and future social workers to the issues surrounding AIDS. With the proper tools, social workers can facilitate changes in society and fight AIDS related stigma.

HIV and AIDS

The first case of AIDS was identified in New York in 1979. The cause of the disease, a retro virus now called Human Immunodeficiency Virus, was identified in 1983-84 by scientists working at the National Cancer Institute in the United States and the Pasteur Institute in France. These workers also developed tests for AIDS, enabling researchers to follow the transmission of the virus and to study the origin and mechanism of the disease. Close relatives of the AIDS virus infect some African monkeys. This fact and the high incidence of infection of people in central Africa has led to the opinion that the AIDS virus originated there.

In 1990, the World Health Organization announced that 203,599 cases of AIDS were reported worldwide by the end of 1989, and estimated the actual number of cases to be 600,000. AIDS is part of everyday life for today’s young people, and they have many questions about this important and often confusing subject. AIDS stands for a condition called Acquired Immuno-Deficiency Syndrome. This is a very long name, but it is easy to understand if you take the different parts one at a time. The word acquired tells us that AIDS is something that a person gets, or acquires, from another person.

Although AIDS can be passed from an infected woman to her unborn child, it is not something that you can inherit from your parents like your height or the color of your eyes and hair. It is also not an illness that can occur with no apparent outward cause, as cancer is, or that is a result of the body’s aging process, like Alzheimer’s disease. Immunodeficiency is another long word, but it, too, is easy if you take it apart. Immuno refers to the body’s immune system. The immune system is the part of the body that fights off infections.

When your body is invaded by organism that cause diseases like measles, the flu, or colds, the immune system prevents you from getting sick by attacking and destroying these organism. A deficiency means that there is a lack of something, or not enough of it to work correctly. So immuno- deficiency means that a person’s immune system is not strong enough to work correctly and is lacking the ability to fight off disease-causing organisms that, normally, it would destroy easily. The last word, syndrome, means a group of conditions or symptoms that show, or indicate, that something is wrong.

If you put these three words together, you get a good definition of AIDS. A person with AIDS has a group of conditions or symptoms that indicate that she or he has become infected with a virus that is causing the immune system to become weakened to the point where substances that would normally be destroyed are now able to survive and cause infections and diseases. AIDS is caused by a virus called HIV. HIV stands for human immunodeficiency virus. If we look at each part of this word, we will get a definition, as we did for AIDS. In this case, we will start with the last word, virus.

A virus is a very small organism that invades a person’s body and causes disease. Different viruses cause different illnesses. For instance, the flu virus causes the flu and the measles virus causes measles. In this case, the virus HIV causes AIDS. We already know that immunodeficiency means that a person has a weakened immune system. If we link this to the word virus, we know that HIV is a virus that causes immunodeficiency, a breakdown in the body’s immune system. The first part of HIV, human, lets us know that this is a virus that affects only people, not animals.

Putting this all together, we can determine that HIV is a virus that causes the condition of immunodeficiency in humans. When a person has been infected by the AIDS virus, we say that he or she is HIV-POSITIVE, or seropositive. This means that the person’s blood has tested positive for the presence of HIV. Since their discovery, both HIV and AIDS have been called different things at different times. Since AIDS is caused by HIV, many people simply it HIV disease. Throughout this book, the virus that causes AIDS will be referred to as either HIV or the AIDS virus.

As HIV destroys more and more cells in the immune system, it is easier for opportunistic infections and cancers to invade the body. People with AIDS may get many opportunistic infections during the course of their illness, either one at a time or several at once. Eventually, the immune system is so suppressed that one or more of these infections or cancers develops and cannot be treated success- fully. When we say that someone has died of AIDS, we mean that he or she has died as a result of one of these opportunistic infections or cancers.

Normally, when a virus invades the body, the immune system recognizes the virus and produces antibodies, special proteins that are designed to attack and destroy foreign substances. For instance, when your body is attacked by a flu virus, your immune system recognizes the presence of the flu virus and generates antibodies that are equipped to destroy flu viruses. The immune system also mobilizes special cells called killer lymphocytes, which can attack both the invading virus and cells invaded by the virus.

The T-cells we discussed earlier help antibody-forming cells to recognize foreign invaders. They also release certain substances that attract other immune cells to the site of infection. When HIV destroys the T-cells, it is actually destroying the generals that run the battle between the immune system and the invading substances. Without their leaders, the other cells of the immune system become confused. They don’t know which cells to at tack, and the defenses fall. To make things worse, the AIDS virus may enter a cell and become dormant, waiting inside the cell to be used at a later time.

It can stay there as long as six months without the body recognizing its presence. HIV is also able to mutate, or change its form, very easily. This takes it very difficult for the immune system to design an effective plan of attack. The immune system forms defenses based on the invading substance’s structure. When that structure changes, whatever defenses have been designed become useless. When HIV mutates, the lymphocytes that have been programmed to attack and kill it no longer recognize it, and the AIDS virus can move freely throughout the body until new defenses are created.

HIV is transmitted only when the virus comes into direct contact with someone’s bloodstream. This can happen primarily in four ways: Through sexual intercourse, by using infected needles and syringes to inject intravenous drugs or steroids, from an infected mother to her unborn baby, or by receiving infected blood or blood products. Some people develop an acute flulike syndrome, similar to mononucleosis, within two to three weeks of becoming infected with HIV. This is then followed by a long period during which the person is asymptomatic, or has no symptom at all.

This period can last for many years. This is dangerous because during this time an infected person may unknowingly pass the virus on to other people. During this asymptomatic period, the virus will continue to multiply. Finally, maybe as long as eight to ten years after the initial infection, the person will once again develop symptoms of HIV infection. Being HIV-positive simply means that the body has been invaded by the AIDS virus. Just because a person is HIV-positive does not mean that he or she is sick. A person can be HIV-positive for many years before developing any serious infections.

A person is said to have full-blown AIDS when he or she meets certain requirements established by the Centers for Disease Control. In general, a person has to test positive for antibodies to the AIDS virus and have been severely affected by one or more of various opportunistic infections or cancers recognized by the CDC as resulting from immunosuppression. The opportunistic infections and cancers used by the CDC to diagnose full-blown AIDS are also called indicator diseases, because they show, or indicate, that a person has AIDS.

That depends on the person who is infected and how quickly the virus breaks down his or her immune system. Some people have been infected for over ten years without developing any major infections or complications. Others develop full-blown AIDS within a year or two of becoming infected. In general, it appears that about 30% of HIV-positive people develop an AIDS indicator disease within the first five years after testing positive, and 50% within nine years. AIDS is a relatively new disease, and we have been studying it for only a little over ten years.

Because of the long incubation period that AIDS has, no one is absolutely certain what percentage of people infected with HIV will actually develop full-blown AIDS. Until more time has gone by and researchers have had time to monitor the progress of people infected with in recent years, we won’t have any final answers. What is important to remember is that, even if an HIV-positive person never develops AIDS, he or she will always have the AIDS virus in his or her system for as long as he or she lives and will always be able to transmit the virus to other people.

AIDS: Is There a Cure

AIDS is a major disease that has threatened the worlds population but many scientists believe that a cure is in sight. These scientists say they have developed a vaccine that will cure a dying AIDS patient. They also believe that have created a vaccine that will prevent a person from contracting the virus. AIDS stands for Acquired Immunodeficiency Syndrome. Acquired stands for that the disease is not hereditary but develops after birth from contact with a disease causing agent in this case, HIV.

Immunodeficiency means that the disease is characterized by a weakening of the immune system. Syndrome means a group of symptoms that collectively indicate or characterize a disease. In AIDS this can include the development of certain infections and cancers, as well as a decrease in the number of certain cells in a persons immune system (What is AIDS). HIV is transmitted in many different ways. It can be spread by sexual contact with an infected person, or by sharing needles. It is less common now because blood is now screened for the virus through blood transfusion.

Babies that are born to HIV infected women may become infected before or during birth or through breast-feeding. Doctors and nurses have also been infected at the work place. They can be infected by being stuck with a needle containing HIV-infected blood. Sometimes workers can get infected through open wounds. There is only one case in the U. S. in which a patient has been infected by the worker (HIV and Its Transmission). This involved one infected dentist infecting six of his patients. Some people fear that HIV might be transmitted in other ways, but there is no proof to support it.

If HIV was being transmitted through other common ways such as through the air, water, or insects the cases of HIV and AIDS cases would be much higher than they already are (HIV and Its Transmission). Many people are ashamed to admit to family and, loved ones that they are infected or may be infected. For example, Monica was fifteen years old when she became infected. She wrote about how she became infected My best friend who is a male has AIDS and we were really close so one night we experimented and after the fact that we did it he told me he had AIDS. I was so angry at him and scared.

I told my mom and she took me to get tested right away. Unfortunely, I was HIV positive. I went in my room and cried for days. The only other thing I was worried about was my family and father, that they would be so ashamed of me (Personal Story of Women Living with HIV). Monica did the right thing; she told her mother what had happened. She quickly began to take medications in order to stay healthy for as long as possible. In many cases the infected patient wont tell his or her family and friends. This women did not state her name, but she is twenty-three.

She states Last year was supposed to be one of the best years of my life. I was having a baby girl, my husbands step mother was having a baby, and so was my sister. After two weeks of having my baby, I was looking for something in my sisters room and found her hospital discharged papers. Not in big letter, but as clear as day on the top it had discharge diagnosed HIV+ with a circle around it. I knew there was something going on with her, because my mother was giving me small hints. I asked her why she didnt breast feed and she said she cant. When I found out I almost fainted.

I quickly rushed home in complete tears and told my husband. I had mixed feelings about her HIV status. First, I was angry with her because I told her time and time to slow down, because she was having plenty of partners and having lots of unprotected sex. God only knows who she contracted it from, but she still has not given up her old patterns. Her child has tested negative, but she is in a state of denial. She knows I know her status, but hasnt said a word to me about it (Personal Story of Women Living with HIV). This woman is right about the fact her sister is in denial.

She is not helping the problem because she hasnt changed her old ways. She runs the risk of infecting many more people. There are other many different symptoms that can occur in those who are infected. First signs of the illness are most people develop flu like illness. A thick whitish color on your tongue could be caused by a yeast infection and sometimes can come with a sore throat. Vaginal yeast infections can occur over and over again. Rashes appear unexplained on the skin. Numbness occurs in the arms and legs. Reflexes are slowed an muscle strength is diminished.

An HIV+ person can also suffer from mood swings and mental deterioration. Hardening or swelling often occurs in the glands, throat, armpits and groin. Deep dry coughing is accompanied by shortness of breath. An HIV+ person may a get large purplish growth on their skin, and unexplained bleeding from the growths. Unexplained fatigue occurs with headaches and dizziness. An infected person will lose weight, and bruise more easily. Long lasting periods of diarrhea can occur. Fevers of night sweats will occur often. In the early progression of the disease boils or warts may spread all over the body.

The mouth may become infected by thrush or other problems. Shingles may develop or herpes. Chest infections are the most common infection. With HIV the most common chest infection is tuberculosis (What is AIDS). AIDS is a deadly disease that affects people of different ages and sexes. The larger a city is the more infected people. The state of Maryland is a little state and only has 25,358 people infected and New York there are 155,755 people infected. I think that is because the larger the state the more people doing drugs and have multiple partners.

Also, just that there just so many more people in New York than there is in Maryland. I think is more common in the city for the drug use than it is in the rural suburbs (United States). There are many different ways to come in contact with AIDS. The most cases occur among gay men. In December 2002, 384,492 gay males where infected with AIDS. This may be because there are gay men that wont admit that they are gay. They are in denial, so they will sleep with men and women, doubling their chances of becoming infected and infecting others.

Another common cause of infection is injection drugs. In December 2002, 209,800 people were infected with AIDS by sharing needles with other infected people. 12,431 heterosexual people also had been infected with AIDS in December 2002. This can be traced to people having unprotected sex with many different partners (HIV and AIDS cases by race/ethnicity, gender and exposure category through December 2002). There have been inclines in the number of AIDS case by year.

From 1998 the total infected number of people in the U. S was 288,194 and in 2002 the number of infected Americans climbed up to 384,323. That is a large climb for only a time period of four years. Large incline can be explained because of an increase in drug use. The incline is also because of people not knowing that they are infected. Those not knowing they are infected and infecting others (HIV and AIDS cases by race/ethnicity, gender and exposure category through December 2002). The most affect by the AIDS disease are people from the ages of thirty-five to forty-four. The next leading age group is people from ages twenty-five to thirty-four.

They have a high number of cases because they are still young and engage in sex with multiple partners. Men and women are using injection drugs and have multiple partners so their chance of getting infected is doubled (United States). There are different stages of AIDS. First, there is the Asymptomatic stage, followed by the Symptomatic stage, then the End of Life stage. There are different types, of treatment during these stages. The body is working hard to make the right antibodies to fight the infections, and the blood test will test positive at this stage (Kanabus).

The Asymptomatic stage is the first stage of HIV. If a person thinks they may be infected, they should get tested. If the test is positive he or she can start treatment right away. A major part of treatment is your food and nutrition. Nutritional care and support includes an adequate quantity and quality of food. But improved nutrition is not enough in itself to permanently keep people healthy. When is comes to vitamins and minerals, it is unclear to what extent these are helpful in the early stages but it doesnt hurt to take them.

Another important thing in this stage is to take care of your self, eat correctly, get plenty of rest, and to avoid stress (Kanabus). The Symptomatic stage is the stage in which you will suffer from reduction in food intake. This may be done to sores in the mouth, fatigue or depression. Changes in mental state and other psychological factors may also play a role by affecting a persons appetite and interest in food. Also the side effects from medications can also result in lower dietary intakes that can cause weight loss. A person will have more bouts of diarrhea that last for long periods of time.

When food is restricted, the body responds by altering insulin and glucagons production, which regulate the flow of sugar and other nutrients in the intestine, blood, liver and other body tissue. Over time, your body will use up the carbohydrates it stored. From muscle and liver tissue, it begins to break down body protein to produce glucose. This process causes protein loss and muscle wasting. Malnutrition can be reduced by treating the immediate sources of the problem: the oral thrush, mouth sores, or other infections. It is also important to provide soft foods and food tolerated by the infected person.

People suffering from diarrhea should take plenty of fluids or use oral rehydration solutions to avoid dehydration. If possible an infected person should try to eat as frequently as possible, even if it is in small amounts at a time. There are traditional healers and medications. Traditional medicine differs greatly from region to region and is often very specific to location. People with AIDS often become frustrated with management of their disease and many are willing to try anything in the hope of staying healthy for longer.

Traditional medicines should be should replace by more proven modern treatments if they are available. However, in the absences of such treatments, traditional medicine can be a feasible option if it relieves pain and makes the patient feel better (Kanabus). During the end of life stage the only thing an infected person can do during this stage is prepare for death. Infected persons should resolve old fights, tell all family and friends that they love them. They should tell them hopes for the future for them especially for young children left behind.

Make sure they know its okay to live their life to the fullest extent (Kanabus). Has a cure been found in Kenya? Black health officials have charged that white racism is to blame for the lack of publicity about a Kenyan drug hailed as an inexpensive cure for AIDS. The President of Kenya, Daniel Mol, announced in the early summer that a cure was found for AIDS, a drug called Kemron. It is marketed by the Kenyan government. They say that 1300 patients that have taken this drug that when they were close to death, recovered fully and tested HIV negative.

This is the first victory over AIDS and its coming out of Africa, yet you havent heard anything about it, said Gary Byrd, a New York radio talk show host who led a fact-finding mission in Kenya. Gary Byrd heard of this drug through the New York Native, a gay publication. He then put together a medical team, and a publication team, and asked Dr. Barbara Justice to come to Kenya to see if this drug was for real. Dr. Justice tested AIDS patient, Cedric Standifford. He was dying of AIDS When we left New York, Cedric could barely keep up. Today he is responding to the treatment and it looks like he will be okay.

Black health official say that the drug was not publicized like it should have been because of white distrust of African science. They also said that the drug was put down because it of posed the expensive AIDS drugs that are manufactured by the white medical establishment. Ronal Woodroof said this after being on the drug for hundred and twenty-two days, I dont know how this works but theres nothing else that can hold a candle to it. He also said that he feels better than even before he had AIDS (AIDS Cure in Kenya). On August 19, 2002 Washington AIDS researchers reported they had a vaccine.

The vaccine would protect people from getting infected by the virus. There are many different vaccines in development but this is the first truly protective vaccine. Dr. Robert Gallo who helped discover the AIDS virus said that there are many different types of the HIV viruses. There is HIV type A, B, C, D, and E. And these types are generally found in only certain people. Type B is found mostly in Europe, the Americas and Japan. While type A, C, D, and E are spreading all through Africa and Asia, so a vaccine in the United States may not work to protect Africans, who are hardest hit by AIDS.

He also stated that the strategy designed here has worked in laboratory test systems and that he had no reason to believe that man should be an exception, but one doesnt make claims without data (A Promising Twist on AIDS Cure). Our society has reason to believe that we are close to have a cure or vaccine to prevent and to kill the HIV and AIDS virus. We have come so far in the passed 20 years when the virus started to infect large numbers. Image in the next 20 years with all the technology we have and we will have a vaccine that will prevent and cure the AIDS and HIV virus.

The Nature, Transmission, Prevention, and Treatment of the HIV/AIDS

Arthur Ashe is an admirable and well known American tennis player who won many championships. He became the first African American male to win the mens Wimbledon title in 1975. Also, he was on the United States Davis Cup team from 1963 until 1984. Some of his other major accomplishments include helping to form what is now the Association of Tennis Professionals and winning the Australian Open, the United States Open, and the French Open. Ashe lived a wonderful and successful life: however, in 1983, disaster struck! Ashe acquired an incurable disease through a tainted blood transfusion. This disease killed him in 1993.

What is this incurable disease that still haunts the lives of so many people? This is a disease known as AIDS. AIDS is a fatal disease without a cure and a disease that responds to little treatment. How can the spread of AIDS be stopped? This paper will discuss the nature of the AIDS virus, the transmission and the prevention of transmission, as well as the available treatments for people with this disease. First of all, AIDS is an acronym for Acquired Immune Deficiency Syndrome. AIDS is acquired which means that it is not passed down from generation to generation through a persons genes.

AIDS is a disease that attacks the immune system, a system in the body that produces white blood cells in order to fight off diseases. This disease causes the immune system to be deficient, or weakened, so that it cannot properly fight off diseases. AIDS is a syndrome, or a group of illnesses with many possible symptoms that can occur together in a weakened condition. AIDS is a pandemic, meaning that it can be found on all continents. The disease was discovered in 1983, by a French cancer specialist, Luc Montagnier, along with other scientists, at the Pasteur Institute in Paris.

However, there were AIDS cases reported as early as the 1950s. “The 80s will go down as the decade that AIDS began. We want to know, – Why” (Bevan 27)? One of the reasons is the promiscuity of sexually active people during the 1980s and the sharing of intravenous hypodermic needles and syringes by drug users. Secondly, AIDS is caused by the human immunodeficiency virus, or HIV. This virus attacks the antibodies in a persons immune system, thereby disabling that system. HIV works in an unusual way because it uses the immune system to its advantage. Viruses cannot live unless they are inside of a living cell called a host.

The virus uses the host cell to reproduce themselves, causing the cell to die in the process. The new virii are then set free. The HIV virus attacks T4 lymphocytes, which are a special type of white blood cell. These cells are the bodys method of defense. Without them, humans are susceptible to disease and infection. It is not HIV that kills people, but the opportunistic infections people get because of a weakened immune system. Bevan characterizes HIV by saying, “Its the sneakiest virus of all. It goes for the crucial link in the immune system, the cells at the heart of the fightback effort” (Bevan 24).

This is why HIV is so dangerous. Being HIV positive does not mean that a person has full-blown AIDS, and not everyone who gets HIV develops full-blown AIDS. When one fully develops AIDS, the signs and symptoms become more evident. These symptoms include: “a failing immune system, persistent swollen lymph nodes and opportunistic infections” (Stine 114). A common example of a skin disorder caused by AIDS is Kaposis sarcoma. That is, “a multifocal, spreading cancer of connective tissue, principally involving the skin; it usually begins on the toes or the feet as reddish blue or brownish soft nodules and tumors” (Stine 442).

Lymph nodes are gland-like forms that help stop the spread of infection. When they become persistently swollen, one can develop lymphadenopathy syndrome or LAS. This condition can bring on mild symptoms of fever and weight loss. Other signs of full-blown AIDS include oral lesions such as thrush and hairy leukoplakia. People may also develop kidney disorders and gastrointestinal diseases like severe diarrhea that can cause weight loss. Since AIDS is such a serious incurable disease, it is important to know how the disease is transmitted. One method of transmission is via bodily fluids by having sex.

This includes all forms of sex: vaginal sex, anal sex, and oral sex. The transmission also occurs in many other sexual activities. The human immunodeficiency virus can be transmitted through vaginal secretions in women to men by way of the bloodstream. In the same way, men can pass HIV to women in their semen. Men can also pass it to other men by way of bodily fluids if the men are bisexual or homosexual The more sexual partners one has, the greater the risk of contracting HIV. “There is a saying, in terms of AIDS, that when you sleep with someone, you are in effect sleeping with all their partners over the past five years” (Bevan 35).

Another way that one can get HIV is by sharing hypodermic drug needles. “Each time a person uses a needle and syringe, a tiny trace of blood is left inside” (Bevan 10). The blood that is left inside of this needle could contain HIV. When the HIV infected needle or syringe is inserted into ones body, the virus is able to travel into that persons bloodstream, thereby transmitting HIV. Even if the needle appears to be clean, it can still contain HIV infected blood. “A drop of blood too small to be noticed can contain thousands of viruses” (Bevan 11).

Drug users have enough problems to worry about without having to worry about getting AIDS. However, many drug users continue to share their needles because of excuses, desperation, and because sharing needles has become a ritual to develop closeness. Some people believe that if they inject the needle into the right place and dont hit a vein that they will be safe. It doesnt matter where the needle is injected. As long as the needle is contaminated with HIV, there is a possibility of catching AIDS. Other drug users are so addicted and desperate that they would risk anything – even their lives to get high.

For some addicts, the chance of catching AIDS seems less important than missing the next fix” (Bevan 15). Finally, some users share needles in order to feel accepted into the group. People who use drugs are often looking for something to belong to, and they will do anything to feel like they are part of a group. They feel that they need to share needles in order to experience a special bond between themselves and others. It has become a ritual. However, no matter what the reason is that one has to share drug needles, there is never a good one.

It is also possible for someone to become infected with AIDS through a blood transfusion. Since a transfusion involves placing foreign blood directly into the recipients blood stream, the necessary condition for transmission is present, and that condition is the direct contact of potentially infected fluid with susceptible cells in the recipient. This is a method of AIDS transmission that the patient can do little about. Hemophiliacs who received blood transfusions before 1985 are the ones most at risk in this category. Today, there is only a small possibility of someone getting HIV through a blood transfusion.

This is because in June of 1985, hospitals began screening blood to see if it was HIV infected (Flynn 64). Presently, there is only a small chance that the tests will not notice the virus in the blood. “It is estimated that undetected HIV is present in fewer than one in four hundred fifty thousand to six hundred thousand units of blood” (Microsoft Corporation 7). Technicians also pasteurize the blood to assure elimination of HIV. Another way for AIDS to be transmitted is from an infected mother to her baby, either before or during childbirth, or through breast-feeding.

The blood supplies of the baby and the mother are closely linked during pregnancy. Even though the mothers and the childs bloodstream are separated by the placenta, preventing the exchange of cells, the exchange of nutrients, blood, and small particles like viruses are still exchanged. HIV infection during pregnancy mainly occurs during the third trimester because of small tears which sometimes occur in the placenta. “Current statistics indicate that there is about a 50% chance that an infected mother will produce an infected infant” (Conner 149). Most infected children die before the age of five years (Conner 151).

Even uninfected children born to HIV-infected mothers have an incidence of heart problems 12 times that of children in the general population” (Microsoft Corporation 7). It is important that people realize that they are not only putting themselves at risk, but also the lives of others. However, it is not possible for a person to contract AIDS by casual contact. AIDS cannot be transmitted by simply touching someone, going to school with someone, or even hugging someone. In order for HIV to be transmitted, an exchange of bodily fluids must occur. There is no other way.

Additionally, HIV is unable to reproduce outside its living host; therefore, it does not spread or maintain infectiousness outside its host” (Microsoft Corporation 7). It is also impossible for HIV to be spread by insects. Many people, however, believe that mosquitoes and other sucking insects can do so. However, HIV can only live for a short period of time outside of a cell, or host, and therefore, cannot infect the insect. So, if the insect is unable to be infected, then the insect is unable to infect human beings. Knowing the methods of transmission enables us to know how to prevent the AIDS virus.

One way to prevent the spread of AIDS is by practicing abstinence or by having safe sex. Abstinence is defined as not having sex at all, and it is the safest practice. However, if one feels that he must have sex, then safe sex should be practiced. Safe sex involves the use of a condom, according to the instructions on the packet. Latex condoms are the best condoms to use. One should also limit his sexual partners. The more sexual partners one has, the higher the risk of contracting AIDS. There are also many other sexual activities with a lower risk other than having actual sexual intercourse.

These activities include: “self masturbation, dry kissing, mutual masturbation, and wet, deep kissing” (Bevan 36). Anal sex is the riskiest form because the linings in the anus are more sensitive, and are more likely to tear, enabling HIV to travel into the body. If one refuses to practice abstinence or safe sex, he should be regularly examined by doctors in order to know if he has contracted AIDS or another sexually transmitted disease. By knowing, he can get treatment and can then be more careful when around others so that they will not get a disease, also.

Another way to prevent AIDS transmission is by not handling or sharing any hypodermic drug needles. Many people do not believe that AIDS is transmissible by sharing drug needles because the HIV seems to be taken outside of the body first and then passed on. This does occur, however, it is in a syringe, and blood cells are not exposed to the environment because of this. “Also, it is usually done within a very short period of time, usually within seconds, or, at most, minutes” (Conner 150). Thus, the safest way would be not participating in any drug activity.

Prevention of this mode of transmission involves breaking the link between individuals and the syringe. However, if drugs are used, and needles are shared, the needles should be properly sterilized. Having sterile needles available for free is in debate in many communities, and in some places in effect, especially in highly populated urban areas. A health worker says, “Free needles will support the drug community, but arrest AIDS spread” (Bevan 12). Finally, in order to prevent the spread of AIDS, one must be aware of the fact that it is possible for anyone to get HIV.

Many people believe that AIDS is a disease for certain stereotypes such as homosexuals and drug abusers. However, this is not true. Anyone can get HIV, no matter who he is. As mentioned earlier, Arthur Ashe, one of the worlds best tennis players, contracted HIV through a blood transfusion. He was not a homosexual and he did not share drug needles. However, he contracted HIV and it killed him. Another devastating case of AIDS was the well known movie star, Rock Hudson. Hudson is, “a Hollywood legend and undisclosed homosexual. He was the first major public figure to reveal he had AIDS.

Hudson died in 1985 at age 59” (Stine 59). Hudson, unlike Ashe, could have prevented his contraction of AIDS, however, he was frivolous and therefore contracted AIDS. If you ever have sex, use drugs in non-sterile needles, or come into contact with any form of bodily fluid, there is a possibility of contracting HIV. True, there are people who are more at risk than others. These people are: “Hemophiliacs who received contaminated blood before 1985. People who have lived or traveled to Central Africa (over the last 15 years) and had sexual relationships there. Homosexual and bisexual men.

People who share needles to inject drugs” (Bevan 51). However, just because one does not participate in any of these risky activities does not mean that he should not be careful. As stated before, one cannot tell if somebody has AIDS by looking at him. Therefore, people must be careful and protect themselves. Now that we know the methods of transmission, and the prevention of AIDS, we need to know what kind of treatments are available in case AIDS is acquired. One way to treat AIDS is by using a drug called retrovir zidovudine or asizidothymidine, which is commonly referred to as AZT.

As stated earlier, AIDS is an incurable disease. There is also no vaccine for AIDS. The drug AZT can delay the progression of AIDS in some patients. “Clinical benefits from AZT may be apparent within six weeks of therapy; and continued treatment prolongs survival” (Stine 131). Also, new research shows that women with AIDS who receive AZT drug therapy during their pregnancies and give birth a C-section delivery may be providing their babies the best protection against HIV infection. Unfortunately, the drugs capability to prolong the life of an AIDS patient declines with time.

Also, this drug does not stop the spread of HIV to other people. There are also other medicines available, and many are still in testing. Another form of treatment is alternating therapy. Alternating therapy consists of taking different drugs on and off. It gives peoples bodies an opportunity to mend from the side effects of each drug. Patients can alternate between AZT and other drugs. It is possible in some cases, not to suffer any side effects if the alternating drugs are taken correctly. Side effects can also be stopped before they start if alternating therapy is used.

A further method of treatment for AIDS is treatment of the opportunistic infections caused by the breakdown of the immune system. Most commonly, people die from the cancers and other opportunistic infections caused from AIDS rather than from the virus itself. “The most common opportunistic infection seen in AIDS is Pneumocytis carinii pneumonia (PCP), which is caused by a fungus that normally exists in the airways of all people” (Microsoft Corporation 4). This is a serious, life-threatening disease. Therefore, the better the infections are treated, the longer the person may live.

The bad point of this is, “treatment for an OI is lifelong because of relapse if it is stopped” (Stine 116). Since the immune system is what is being attacked, the body cannot fight off the disease without drugs. If treatment for opportunist infections is stopped, a relapse is almost definite. Some of the newest treatments include more antiviral therapies, immune system boosters, and triple drug therapy. These are still in testing. Each new approach and drug must be extensively evaluated for safety and effectiveness.

So far, the immune boosters are not very effective. These are used to help the immune system fight off HIV. However, the triple drug therapy, which consists of indinavir, zidovudine, and lamivudine, have been prosperous. Triple drug therapy, also known as cocktail therapy, can suppress HIV for at least two years. The main problem with these drugs is that testing is a long process. There have been many derogatory comments towards the FDA, or Federal Drug Administration, concerning the length of testing.

Therefore, policies have changed in order to give quicker approval. However, “early availability of a drug entails the risk that it may be used in people before its toxicity and side effects are fully understood” (Stine 337). However, many people with AIDS are willing to take this risk with the hope that the drug may prove effective. In conclusion, AIDS is an incurable disease with few treatments, caused by HIV, transmitted by way of bodily fluids. AIDS is mainly transmitted through sex and sexual activities, and by sharing hypodermic drug needles.

Sexual transmission is most dangerous if there are many sexual partners, and if there is not use of a condom. Transmission via blood transfusions has become almost absent, thanks to blood screenings. Scientists are working hard on treatments and are working for a cure, however, it is lacking to be found. A World Health Organization official says, “AIDS… will test our fundamental values and measure the moral strength of our cultures” (Bevan 6). We are the only ones who can stop this pandemic. There is a way.

History of AIDS

Debate around the origin of AIDS has sparked considerable interest and controversy since the beginning of the epidemic. However, in trying to identify where AIDS originated, there is a danger that people may try and use the debate to attribute blame for the disease to particular groups of individuals or certain lifestyles. The first cases of AIDS occurred in the USA in 1981, but they provide little information about the source of the disease. There is now clear evidence that the disease AIDS is caused by the virus HIV. So to find the source of AIDS we need to look for the origin of HIV.

The issue of the origin of HIV could go beyond one of purely academic interest, as an understanding of where the virus originated and how it evolved could be crucial in developing a vaccine against HIV and more effective treatments in the future. Also, a knowledge of how the AIDS epidemic emerged could be important in both mapping the future course of the epidemic and developing effective education and prevention programme. HIV is part of a family or group of viruses called lentiviruses. Lentiviruses other than HIV have been found in a wide range of nonhuman primates.

These other lentiviruses are known collectively as simian (monkey) viruses (SIV) where a subscript is used to denote their species of origin. So where did HIV come from? Did HIV come from an SIV? It is now generally accepted that HIV is a descendant of simian (monkey) immunodeficiency virus (SIV). Certain simian immunodeficiency viruses bear a very close resemblance to HIV-1 and HIV-2, the two types of HIV. For example, HIV-2 corresponds to a simian immunodeficiency virus found in the sooty mangabey monkey (SIVsm), sometimes known as the green monkey, which is indigenous to western Africa.

The more virulent strain of HIV, namely HIV-1, was until very recently more difficult to place. Until 1999 the closest counterpart that had been identified was the simian (monkey) immunodeficiency virus that was known to infect chimpanzees (SIVcpz), but this virus had significant differences between it and HIV. Are chimpanzees now known to be the source of HIV? In February 1999 it was announced1 that a group of researchers from the University of Alabama had studied frozen tissue from a chimpanzee and found that the simian virus it carried (SIVcpz) was almost identical to HIV-1.

The chimpanzee came from a sub-group of chimpanzees known as Pan troglodytes troglodytes, which were once common in west-central Africa. It is claimed by the researchers that this shows that these chimpanzees were the source of HIV-1, and that the virus at some point crossed species from chimpanzees to human. However, it is not necessarily clear that chimpanzees are the original reservoir for HIV-1 because chimpanzees are only rarely infected with SIVcpz. It is therefore possible that both chimpanzees and humans have been infected from a third, as yet unidentified, primate species.

In either case at least two separate transfers into the human population would have been required. It has been known for a long time that certain viruses can pass from animals to humans, and this process is referred to as zoonosis. The researchers from the University of Alabama have suggested that HIV could have crossed over from chimpanzees as a result of a human killing a chimp and eating it for food. Some other rather controversial theories have contended that HIV was transferred iatrogenically i. e. via medical experiments.

One particularly well publicised theory is that polio vaccines played a role in the transfer, as the vaccines were prepared using monkey kidneys. In February 2000 it was announced that the Wistar Institute in Philadelphia had discovered in its stores a phial of polio vaccine that had been used as part of a polio vaccination programme in the Belgian Congo in the 1950s. it was planned to test this vaccine for the presence of HIV. But crucial to the credibility of any of these alternative theories is the question of when the transfer took place. Is there any evidence of when the transfer took place?

During the last few years it has become possible not only to determine whether HIV is present in a blood or plasma sample, but also to determine the particular subtype of the virus. Studying the subtype of virus of some of the earliest known instances of HIV infection can help to provide clues about the time of origin and the subsequent evolution of HIV in humans. Three of the earliest known instances of HIV infection are as follows: 1. A plasma sample taken in 1959 from an adult male living in what is now the Democratic Republic of Congo 2.

HIV found in tissue samples from an African-American teenager who died in St. Louis in 1969. 3. HIV found in tissue samples from a Norwegian sailor who died around 1976. Analysis in 1998 of the plasma sample from 1959 was interpreted3 as suggesting that HIV-1 was introduced into humans around the 1940s or the early 1950s, which was earlier than had previously been suggested. Other scientists have suggested that it could have been even longer, perhaps around 100 years or more ago. In January 2000, the results of a new study presented at the 7th Conference on Retroviruses and Opportunistic Infections, suggested that the first case of HIV infection occurred around 1930 in West Africa.

The study was carried out by Dr Bette Korber of the Los Alamos National Laboratory. The estimate of 1930 (which does have a 20 year margin of error), is based on a complicated computer model of HIV’s evolution. Is it known where the emergence of HIV in humans took place? Many people now assume that because HIV has apparently developed from a form of SIV found in a type of chimpanzee in West Africa, that is was actually in West Africa that HIV first emerged in humans. It is then presumed that HIV spread from there around the world.

However, as discussed above, chimpanzees are not necessarily the original source of HIV and it is likely that the virus crossed over to humans on more than one occasion. 2 So it is quite possible that HIV emerged at the same time in say both South America and Africa, or that it even emerged in the Americas before it emerged in Africa. We will probably never know exactly when and where the virus first emerged, but what is clear is that sometime in the middle of the 20th century, HIV infection in humans developed into the epidemic of disease around the world that we now refer to as AIDS.

What caused the epidemic to spread so suddenly? There are a number of factors that may have contributed to the sudden spread including international travel, the blood industry, and widespread drug use. The role of international travel in the spread of HIV was highlighted by the case of ‘Patient Zero’. Patient Zero was a Canadian flight attendant called Gaetan Dugas who travelled extensively worldwide. Analysis of several of the early cases of AIDS showed that the infected individuals were either direct or indirect sexual contacts of the flight attendant.

These cases could be traced to several different American cities demonstrating the role of international travel in spreading the virus. It also suggested that the disease was probably the consequence of a single transmissible agent. As blood transfusions became a routine part of medical practice, this led to a growth of an industry around meeting this increased demand for blood. In some countries such as the USA paid donors were used, including intravenous drug users. This blood was then sent worldwide.

Also, in the late 1960’s haemophiliacs began to benefit from the blood clotting properties of a product called Factor VIII. However, to produce the coagulant, blood from thousands of individual donors had to be pooled. Factor VIII was then distributed worldwide making it likely that haemophiliacs could become exposed to new infections. The 1970s saw an increase in the availability of heroin following the Vietnam War and other conflicts in the Middle East, which helped stimulate a growth in intravenous drug use.

This increased availability together with the development of disposable plastic syringes and the establishment of ‘shooting galleries’ where people could buy drugs and rent equipment provided another route through which the virus could be passed on. What other theories have there been about the origin of HIV? Other theories put forward about the origin of HIV include a number of conspiracy theories. Some people have suggested that HIV was manufactured by the CIA whilst others believe that HIV was genetically engineered.

AIDS in the African people

Across the Atlantic Ocean there is a plague. Some may argue that is it not preventable, but it is. The plague that is in question here is Acquired Immune Deficiency Syndrome (AIDS), and it has hit Africa by storm. It is estimated that there are “4 to 5 million people who have tuberculosis are co infected with [Human Immunodeficiency Virus] HIV. ” (Columbia Encyclopedia) The world communities have turned their backs on many African nations in their time of need. The lack of political will on the part of western governments along side the incredible greed of the pharmaceutical industry, have resulted in needed drugs not getting to Africa, which has lead to the suffering and death of millions.

This issue will be addressed by looking at the impact that AIDS is having on African people; how the western governments have turned a blind eye to this issue and how the pharmaceutical industry has placed profits ahead of ethics. Solutions to this complex and treatable problem will also be offered. AIDS has devastated the African people. The death in many African nations is staggering. “Since the start of this pandemic to the end of 1999, some 14. 8 million people in Sub-Saharan Africa have died” (Secure the Future p. 1).

As a result in the increased death rate, “schooling in suffering as enrolment rates drop, poor families remove their children from school, and teachers and support staff succumb to the epidemic. A cornerstone of development— education— is being undermined. ” (UNAIDS) South Africa, Botswana, Namibia, Lesotho and Swaziland have been hit the hardest by the AIDS virus. For example, in Botswana a country with a population of only 1. 5 million people, 190,000 people are infected with Human Immunodeficiency Virus (HIV)/AIDS. In these countries life expectancy is projected to drop from 61 years of age to 39.

Secure the Future p. 2) Currently all over the globe there are approximately 40 million people living with AIDS. A staggering 36 million of these people do not have access to the proper drugs and treatment they need. AIDS has now become the number one killer in Africa (Secure the Future). These numbers seem unrealistic, yet behind each number there is a name and behind each name there is a family who has a devastating story to tell. There are countless stories of women losing their children and babies becoming orphans as a result of this devastating disease. Zena Salum, a citizen of

Tanzania, lost her daughter and son in law to AIDS, and now her infected grandson is near death. (Aids in Africa) These heart wrenching stories are all too common to the people of Africa. It is now estimated that 95 percent of all HIV-positive orphans are African (Secure the Future p. 3) One of the major problems concerns itself with mother to child transmission. The economic implications are unbelievable. AIDS not only kills, it can also tear an entire nation apart. Just as it kills [a] parents’ hope for their children, AIDS cuts down people in their prime working years thus eliminating family wage earners.

It shreds household income as survivors try to support the sick” (Brooks p. C3). In South Africa, it is predicted to cost the nation one percent of its gross domestic product by 2005, and deplete three quarters of the nation’s health budget. (Secure the Future p. 2) The world knows what is going on, however little is being done to stop this epidemic. One of the major problems lies with the inaction of the western governments and other international organizations such as the World Trade Organization (WTO). In June 2001 the Canadian government passed Bill S-17 which extended a number of pharmaceutical patents from 17 o 20 years.

This legislation was introduced in order to comply with WTO rulings. (Drug Cost p. 1) The WTO held a forum on AIDS, where Canada was among the many rich nations “opposing a deal that would give poor countries access to cheaper generic drugs during a health crisis” (Drug Cost p. 2). Canada’s generic companies are prevented from manufacturing drugs under the patent protection laws. These same companies cannot even make drugs to ship to other countries for humanitarian reasons. (Drug Cost p. 2) The American government is no better, maybe even worse. The United States, in roportion to its wealth is “the stingiest donor among rich countries”.

Institute for Public Accuracy (IPA)) Consequently, millions of people die needlessly because they do not have access to the proper treatment and medications. Zackie Achmat, an anti-apartheid leader, who is HIV positive said: Just because we are poor, just because we are black, just because we live far from you, does not mean that our lives should be valued any less. (IPA) Glaxo Kline Smith, the largest producer of AIDS- related drugs, chaired a dinner which rose over $30 million sdollars for the Republican Party. (IPA) That being stated, one has to wonder how influential the drug companies are with the Bush administration.

Stephen Lewis, the United Nations Secretary General’s Special Envoy for AIDS in Africa stated that: After September 11th, in a matter of months, the world raised over 100 billion dollars to fight the war on terrorism. In Africa last year, over 2 million people died of AIDS, and we have to grovel on our hands and knees, begging for pennies in response. There has never been a more outrageous moral lapse on the part of the rich nations all over the world. Why I ask you are African lives expendable while the war n terrorism is sacrosanct. (Lewis) It is quite apparent that governments have become subservient to huge multi- national corporations.

The WTO, who has been supporting pharmaceutical companies instead of the government is said to discriminate against the sick. They are legally responsible for not stopping this preventable disease, and seem to feel no remorse of guilt. The WTO has attempted to ban global exchange, which allows companies to import cheaper drugs from other countries. This practice could have horrific effects on many nations in Africa, making it extremely difficult for them to overcome the AIDS pidemic. (IRAFTA p. 1) Naomi Klein, a political activist and author, believes that globalization and free trade have played a large part in this epidemic.

Though this process is called globalization, it is actually an ideological belief system that holds that increased trade and investment, no matter what the immediate social cost will eventually lead to improved quality of life and environmental standards at home and around the world. According to this history, the role of the government is simply to pursue trade at all cost and the rest will take care of itself. (IRAFTA p. 1) Western governments and diversified economies all over the world can no longer continue to stay silent in the face of such injustice.

Governments must stand up to the large pharmaceutical industry and put policies in place that put lives before profit. The pharmaceutical industry is more concerned with protecting their intellectual property rights (profits) than releasing drugs on compassionate grounds to the African people. This industry is, by far, one of the most profitable industries in the world. The cases of AIDS are constantly on the rise, particularly in sub-Saharan Africa. At the same ime, the pharmaceutical industry is making it even more impossible for African nations to access the Antiretroviral (AVR) drugs.

These drugs have been on the market since 1996, but are too expensive for the African people to purchase. The pharmaceutical industry argues that allowing generic drugs on the market will “reduce pharmaceutical [company’s] incentives to do research and development”. (Aids in Africa) This is absurd because Africa accounts for only 13% of the world wide pharmaceutical market. (Aids in Africa) Another horrible action that these drug companies are trying to nforce is attempting to stop South Africa and other African nations from importing the cheaper version of the AIDS medications. (Institute South p. ) They do this by using the courts and international trade agreements to tie up the time and resources of African nations that challenge them.

This, in turn, diverts needed attention from their real problem; AIDS. With an appalling human tragedy unfolding in Africa, the multi national pharmaceutical industry has, in its South African lawsuit, decided to place its narrow propriety interests over life and death concerns of people with AIDS/HIV”. Brooks) The power of the multi national pharmaceutical industry is immense. They can unduly influence the foreign policy of industrialized nations.

Years ago it was colonization, the super power of England, the reeked havoc throughout the third world. Now it is multi national corporations whose economic imperialism pulls the strings on the international level. All of these companies are located in developed countries such as Canada and the United States. They do not see or care about what is going on outside of their borders. For the huge pharmaceutical companies such as Glaxo Smith Kline and Bristol-Myers Squibb, they see no need to help the dying people in Africa because there is simply no profit in it for them. Secure the Future)

These are unethical corporations that are making decisions about the future of the entire world. It is up to the citizens of the world to stand up and take action against the greed of the pharmaceutical industry and the inaction of the western industrialized nations to stop these profit hungry corporations. The AIDS epidemic is a complex problem, but with it comes solutions. First, the richer nations need to put their money where their mouths are.

Governments need to start giving much more foreign aid with a “no strings attached” policy. Governments in developing countries have to mobilize promised resources for the Global Fund to Fight AIDS” (IPA) As well, the World Health Organization (WHO) should assume some responsibility for this pandemic and create a patent pool for essential medications. This would pool health patents together and license then to low cost producers, in return for a royalty which would be paid to the pool and divided back to the patent holders. (IPA) Africa must have access to the drugs and treatments that are ecessary for them to win their battle against AIDS.

This means generic competition, and clear guidelines for pricing would be needed. The ARV drug instructions and requirements should be simplified, for example; to a one a day dose. On top of international aid, new policies must be created. Grass root community development projects have been implemented, particularly in those with a high rate of HIV infection. Changing behaviour by educating African communities to practice abstinence or safe sex is key in controlling the increased spread of AIDS. Some of these grass root rograms include; voluntary support counseling, HIV testing and mother to child prevention efforts.

These all play a large part in the solution. The foremost solution is prevention. “Young people are a vital factor in halting the spread if HIV/AIDS and many of then are playing a significant role in the fight against it. ” (UNICEF) There must be “appropriate political and institutional choices concerning not only paths that biomedical research has to follow but also a coherent global development strategy in which health, economic and social policies are meshed together. ” (International p. ) All of these solutions are crucial in the fight against AIDS.

However, if the global community remains indifferent to this plague, nothing will change. Thabo Mbeki, South Africa’s Vice President says: The power to defeat the spread of HIV/AIDS lies in our partnership- as youth, as women, as men, as business people, as workers, as religious people, as parents and teachers, as students, as healers, as farmers, as the unemployed and the professional, as the rich and the poor- in fact all of us. (Secure the Future p. 3) The plague may be occurring many miles away but AIDS as we know is a isease that can affect anyone, no matter age, sex, race or nationality.

The world must become more aware, no one can afford to remain indifferent. If people all over the world stood up for the nations’ that have been plagued by AIDS, it would guarantee that this epidemic would be exterminated. The fight against AIDS is one that everyone, across the world, should be involved in. The absence of political will by western nations combined with the enormous greed of the pharmaceutical companies has led to needed drugs not reaching Africa. Consequently, millions of people in Africa are dying.

One must look at the direct implication this is having on the African people; how their cries have fallen on the deaf ears of many rich nations, and why the pharmaceutical companies put profits before lives. Finally, one must try to understand the solution to this complex problem. AIDS has ravaged the African people, and has been the holocaust of the twenty first century. However this epidemic is preventable. The whole world knows what is going on. It is time to take action and implement viable solutions that will aid Africans in rebuilding their nation.

AIDS – Acquired Immune Deficiency Syndrome

Since the first AIDS cases were reported in 1981, through mid-1994 more than 402,000 AIDS cases and more than 241,000 deaths have been reported in the United States alone. This is only the tip of the iceberg of HIV infection, however. It is estimated that nearly 1 million Americans had been infected with the virus through the mid-1990s but had not yet developed clinical symptoms. In addition, although the vast majority of documented cases have occurred in the United States, AIDS cases have also been reported in almost every country in the world.

Sub-Saharan Africa in particular appears to suffer a heavy burden of this illness. No cure or vaccine now exists for AIDS. Many of those infected with HIV may not even be aware that they carry and can spread the virus. Combating it is a major challenge to biomedical scientists and health-care providers. HIV infection and AIDS represent among the most pressing public-policy and public- health problems worldwide. COSTS I think that the AIDS epidemic is having a profound impact on many aspects of medicine and health care.

The U. S. Public Health Service estimates that in 1993, he lifetime cost of treating a person with AIDS from infection to death is approximately $119,000. Outpatient care, including medication, visits to doctors, home health aids, and long-term care, accounted for approximately 32 percent of the total cost. Persons exposed to HIV may have difficulty in obtaining adequate health-insurance coverage. Yearly AZT expenses can average approximately $6,000, although in 1989 the drug’s maker did offer to distribute AZT freely to HIV- infected children. The yearly expense for DDI is somewhat less at $2,000.

Therefore, if the AIDS epidemic is not controlled, its cost to American taxpayers will become overwhelming. I feel that the effects of the epidemic on society at large are increasingly evident. AIDS tests are now required in the military services. Various proposals have been made for mandatory screening of other groups such as health-care workers. A number of nations, including the United States, have instituted stringent rules for testing long-term foreign visitors or potential immigrants for AIDS, as well as testing returning foreign nationals.

In the United States one frequent phenomenon is the effort to keep school-age children with AIDS isolated from their classmates, if not out of school altogether. Governmental and civil rights organizations have countered restrictive moves with a great deal of success. There is little doubt in my mind that the ultimate physical toll of the AIDS epidemic will be high, as will be its economic costs, however the social issues are resolved. Concerted efforts are under way to address the problem at many levels, and they offer hope for successful strategies to combat HIV-induced disease.

Politics and AIDS In the United States, I feel that AIDS provoked a grass-roots political response, as well as government action. First evident in urban gay men, AIDS moved an already politically organized gay community to create service, information, and political organizations, such as Gay Men’s Health Crisis (GMHC) and AIDS Coalition to Unleash Power (ACT UP). Those groups have lobbied the federal government for funding and favorable policies. ACT UP was formed in 1987 to urge speed in drug approval and to protest high prices for AIDS drugs.

By uccessfully promoting reforms, ACT UP and other advocates have provided a model for other disease groups, particularly breast cancer advocates. During the 1980s, AIDS groups accused the government of neglecting its duty in responding to AIDS. Critics cite government reluctance to promote condom use as a prevention method, and the fact that President Ronald Reagan did not mention AIDS publicly until April 1987, six years after the epidemic began. The epidemic’s spread to people of color, often drug users and their intimates, introduced race into the politics of AIDS.

Competition for funding and influence arose between gay and minority groups. Disagreements emerged about prevention methods, in particular needle exchange programs. Many African Americans and Hispanics viewed needle exchange as promoting drug use in their communities, while others cited its role in curbing HIV transmission. The AIDS activists have helped increase federal funding for AIDS from an initial $5. 6 million in 1982, to over $2 billion in 1992. The 1990 Americans with Disabilities Act included protection from discrimination for people with HIV; the Ryan White Comprehensive AIDS Resources

Emergency Act was passed to provide funds to cities hard hit by AIDS. CONCLUSION As you can see, AIDS does not discriminate by color nor socio-economic status as was once believed. It has become an epidemic for the entire nation and will need the cooperation of everyone to control. Already, many private and government organizations have been created to help deal with the problem. And millions of dollars are being spent in research and treatment, as well as in helping people cope with the problem. The social impact of AIDS is substantial and it can no longer be ignored.

AIDS In Africa

Johannesburg, the largest metropolitan area in the continent of Africa. The population of the main metropolitan area is 1,907,229 ( WorldBook encycl. 130). Johannesburg is also one of the world richest gold fields. Despite these positive aspects, Johannesburg is a city with a dismal future, because it is suffering from one of the world’s worst AIDS epidemics. Every Saturday, nearby cemeteries are busy with the arrival of people who have died from AIDS. Funeral directors state that about 30 or 40 people are buried every week, as a result of AIDS.

It is said that in South Africa, one of every ten people has AIDS. Some 17 million people in Africa have died representing almost 80% of AIDS deaths world wide. This is the equivalent of the combined populations of New York City and Los Angeles (www. Time/2001/aidsafrica). There is a conspiracy of silence fueling the spread of HIV in South Africa. Johannesburg is the largest city in South Africa, and has one of the fastest growing infection rates AIDS is now South Africa’s leading cause of death. Last year it accounted for 40% of all deaths between the ages of 15 and 49 (US. ws2. yimg. com).

By the year 2010, HIV prevalence in adults is projected to reach 25% of the total population. South Africa is projected to have the highest AIDS death rate until 2015. At that point, the population will have decreased to the point that the death rate will no longer be as high as in other areas. South Africa has a population close to 40 million people – an estimated 4. 2 million (10. 5%) are infected with HIV. Of these, half are women ages 15-49. Over 40% of pregnant women are HIV-positive. The impact of AIDS in South Africa is overwhelming.

The disease has orphaned 370,952 children 95,000 children have been infected with AIDS. The adult prevalence rate of HIV is 20%. While there are limits in extrapolating the general population, it is estimated that 4. 2 million people were HIV positive in 1999, compared to approximately 3. 6 million in 1998. (www. securethefuture. com). Statement of Need: Understanding who is Affected by AIDS Demographics show that those most affected by AIDS are women and children. African women and children have been particularly hard hit by AIDS.

There are now 16 million African children who have lost at least one parent to AIDS. Johannesburg medical agencies state in their reports that in the next 10 years, that number will reach 28 million. This is a heartbreaking statistic, but an even more compelling message comes from one of those most affected by the crisis: “I’m actually an orphan and I’m infected,” says 11-year old Nkosi Johnson. “I am a very lucky little boy, and I am living with a in the world and ironically AIDS is a word not spoken at ground zero of humanity’s deadliest disease. ster family, but I am strong and healthy.

That’s just what I want for all orphans to have”(www. cnn. com/health/aids). When the children’s parents die the relatives don’t want them because it is already hard to make a living for their own families. As a result, the children end up in an orphan camp. Many children get infected through breast-feeding as infants. Due to food supply shortages, most mothers breast-feed their children to keep them from starving to death. Most women get aids from sexual intercourse with their husbands or through rape.

Wives, girlfriends and even prostitutes in this part of the country say it is not easy to say no to sex in a male dominated culture. Women do not have choices due to their cultural traditions. It is said that if a woman asks a man to use a condom, she is considered a whore and an outcast. When it comes to sex in South Africa, the man is always in charge. Girls and women are often forced to have sex and are punished if they resist. There is a belief in some areas that having sex with a virgin can cure an infected man. As a result, 12-year-old girls become infected.

Men rarely know they have AIDS, because males widely refuse testing until they fall ill. Many men who think they may have AIDS just embrace it as if nothing is wrong until they get sick. They take the attitude that “I’m already infected, I can sleep around because I can’t get it again. ” Meanwhile, they may be passing on the infection to unsuspecting African women. The women then unknowingly pass it on to their children. Men tested in Johannesburg clinics were found to have an HIV rate close to 19% HIV infected women outnumber HIV infected men by a ratio of more than 6-to-5

By the turn of the century, the epidemic will have left behind 11. 2 million orphans (www. usaid. gov/pop_health/aids/country). South Africa is the eye of the storm in terms of the AIDS epidemic. 60 percent of men, 80 percent of women, and 90 percent of the children infected worldwide live in the South African region. Statement of Need: Understanding Nature of the Epidemic Many people are not even aware of what the AIDS virus is. AIDS stands for Acquired Immune Deficiency Syndrome, and is known as HIV in its earlier stage. Although technically it is not a disease, it is often referred to as one.

AIDS is an all encompassing term for the many medical conditions that arise from a weakened immune system that can no longer fight infection (World Book encycl. 163). What people fail to understand is that people do not die from AIDS. Most people with AIDS die from infections or sometimes from a common cold. This epidemic is the single most important health and development issue the world faces today. Many books have been written on the subject, but people still remain unaware about what HIV is and how it is spread. AIDS is first and foremost a biomedical condition.

HIV is one of a family of retroviruses that enter the bloodstream and attack the body’s immune system, compromising its ability to fight infection. Scientists are not certain how, when, or where this virus came from or when it first infected mankind. There are many different studies of how it came forth, but this is not a primary concern right now. AIDS infects certain white blood cells, including T- helper cells and macrophages, which play key roles in the immune system (WorldBook encycl…163). The virus attaches itself to CD4 receptor molecules on the surface of these cells.

AIDS enters CD4 cells and inserts its own genes into the cell’s reproductive system. The cell then produces more HIV, which spreads to other CD4 cells. Eventually, infected cells die (WorldBook encycl. 163). The immune system tries to reproduce more CD4 cells, but the HIV destroys them as fast as they are produced. People who get infected have certain symptoms including enlarged lymph glands, fatigue, fever, loss of appetite and weight, diarrhea, yeast infections of the mouth and vagina, and night sweats ( WorldBook encycl. 163).

There are four stages of HIV infection. The first of which is Acute Retroviral Syndrome, f ollowed by Seroconversion, the Asymptomatic period, and finally full-blown AIDS. HIV can be transmitted during all stages of infection, even when no symptoms occur. The first stage is known as the Acute Retroviral Syndrome. The body’s initial immune response develops a small measure of control over the virus. This stage lasts up to three weeks during which up to 90% of people will develop non-specific symptoms common to many viral infections.

These can include such symptoms as night sweats, fever, malaise, headaches, and enlarged lymph glands. At this point the infected person’s blood will test positive for the HIV antibodies even though the main symptoms will not show until 2 to 15 years later and sometimes even longer. During this stage the person usually keeps a normal amount of CD4 cells. During this stage the victim’s body still has considerable control over its immune system. The second stage of this virus is called Seroconversion. This is the period where the body develops antibodies to ward off HIV.

Even though HIV will ultimately win the battle, the immune system is able to keep the virus in check for a number of years. This stage lasts for a period of 6 to 12 weeks during which the antibodies are not detectable. A blood test during this time will return negative results. This period is often referred to as the “window period,” and is the most dangerous time because a person can easily infect another person even though they have tested negative for HIV (WorldBook encycl. 164). Once the antibodies are detected, the blood test result will be positive and Serconversion will have taken place.

While the antibodies reduce the concentrations of HIV, they do not destroy it entirely, and the person will still have this deadly virus in their system and can infect others with the virus. This stage also has some major symptoms that includes fatigue, enlarged lymph glands, yeast infections, skin rashes and dental disease. During this stage the CD4 blood cells decline, ranging from 500 to 200 CD4 cells per microliter of blood ( WorldBook encycl. 164). The next stage is known as the Asymptomatic stage. This stage is also known as the silent but deadly stage.

During this stage an HIV positive person will generally remain clinically healthy. While in this stage, the virus slowly but surely spreads throughout the body. The way one can tell that the disease is spreading is by counting the CD4 cells in the blood. A person who does not have the HIV virus normally has 700 to 1300 CD4 cells per milliliter of blood. As the virus spreads, it destroys CD4 cells. At the later end of this stage, the body reaches a point where it only has 300 to 200 CD4 cells, marking the final stage of the Asymptomatic stage. Due to the low count of CD4 cells, the body has a hard time fighting off infections.

A common cold can last for months with an HIV positive person. Some common symptoms of this stage are thrush, shingles, tuberculosis coupled with weight loss, diarrhea, fever, and fatigue (WorldBook encycl. 164-165). In most third world countries, people can go through this stage without actually knowing they are sick with the virus. The final stage is full-blown AIDS. This is the stage where the CD4 cells drop below 200, and a person becomes open to infections such as drug resistance pneumonia, tuberculosis, meningitis, and other bacteria infections ( WorldBook encycl. 4).

This is the stage where the person moves from having HIV to full blown AIDS. During this stage medical costs increase and jobs are lost, placing enormous strain on the finances of the victim. Most deaths occur when the CD4 cell levels fall below 50. At this point the body can no longer fight off infection. The breakdown of the immune system eventually leads to death (WorldBook encycl. 164). This disease has many ways of being transferred from one individual to another. Researchers say they have identified three ways in which HIV is transmitted:

Sexual intercourse Direct contact with infected blood Transmissions from an infected woman to her fetus or baby (WorldBook Encycl. 164). In South Africa, AIDS is primarily contracted through sexual intercourse. People who share needles during drug use provide another way to tranfer this disease. Another mode of transmission that is common in Johannesburg is mother-to-child transmission. Sexual intercoure is the main method of transmission for this virus. In third world countries, sexual tansmission accounts for the higest percentage of infection.

The greatest concentration of the virus is found in the blood, secretions, and semen of infected persons. HIV is transmitted through all forms of sexual intercourse including genital, anal, and oral sex. Many men in this part of Africa consider the use of sexual prophelactics to be a taboo. Therefore, unprotective sex is one of the main methods of transmission for this virus. Another mode of transmission is blood-to-blood. Blood-to-blood transmission occurs when HIV-contaminated blood comes into contact with uninfected blood. The main transmission comes through sharing drug injection equipment.

Drug injections are a major reason for the high number of AIDS victims in Johannesburg. The problem with sharing needles is that it gives people direct contact with the virus as the needle penatrates directly into the blood stream. Disimilar from industrialized nations, blood transfusions in third world countries are dangerous. Industrialized countries have sophisticated screening mechanisms that have been introduced to ensure that blood products are HIV negative. Third world countries do not have the same kind of sophistcated devices to ensure that their tranfusions are safe.

One of the most serious modes in South Africa is the mother to child transmission. This can occur in two ways. The first way is when the infant comes into contact with the blood of an infected mother in the utterus. The second is when an infected mother breast feeds her infant. It is estimated that about 50 to 65% of child infections occur at birth (www. cia/publication/factbook). Another dismal aspect involves the fact that even if they escape infection at birth, the risk is still there because most South African women breast feed their infants.

A woman infected with HIV can pass the virus on to her baby during pregnancy, while giving birth, or when breast feeding. Another problem is how to prevent babies from getting HIV. A woman who is infected with HIV has 1 chance in 4 of having an infected infant. Medical treatment with a drug called AZT during pregnancy can reduce the risk of a baby getting infected to 1 in 12 (www. cdcnpin. org). Pregnant mothers who are infected must be told to avoid breast feeding, and the baby must also receive AZT treatments for the first several weeks of its life.

This might slow down the number of infected children being infected but it will not eliminate it. There is a need for encouragement to mothers who think they maybe infected with the virus to get tested. There are also many counseling programs that have been set up as AIDS clinics all over South Africa to educate people about the epidemic that is sweeping through their country. There are also some new intervention strategies that are planned but not quite in action yet. Many nations around the world are searching to find an effective vaccine for this virus.

Others are provi ing condoms, drug therapy, safe blood supplies, needle exchange programs, and other beneficial AIDS prevention services. Many people have come up with programs to slow the transmission of the virus. Some programs have developed HIV/AIDS strategies that improve the approach, system, and tools available to prevent the spread of the pandemic by treating those infected while providing care and support for children and families affected by AIDS. has been on changing behavior, supporting children affected by AIDS, and encouraging the use of condoms. One main way to prevent AIDS is to educate people about effective prevention.

Educating people about AIDS has become a primary approach to preventing infection. One way to prevent the spread of HIV is to educate people about safe sex. Abstaining from sex is the only way to fully prevent the sexual transmission of HIV. One must also be realistic and understand that people are going to continue having sex, despite whatever risk may be apparent. For those who are sexually active, the consistent and correct use of latex condoms is encouraged. Condoms must be made of latex because they are most effective in preventing sexually transmitted diseases.

Another encouraged technique involves checking on a partner’s sexual history before becoming sexually involved. People are also encouraged to avoid any transaction of body fluids with infected persons. Efforts have been made to create an understanding that people should not share razors, toothbrushes, or any devices that may contain blood, semen, or vaginal fluids. Also, people are told that if they feel that they have participated in acts through which the virus could have been contracted, they should refrain from donating blood, plasma, body organs, or tissues (www. cdcnpin. org).

Despite all of the afore mentioned prevention and treatment strategies, AIDS remains more potent than ever in South Africa. The biggest problem with traditional AIDS prevention strategies is that they are dependent on an audience that is open to listening to information about AIDS, and acknowledging the need to take action. In South Africa and many other developing nations, AIDS is not a matter that is appropriate for discussion. Those who are discovered to have AIDS are ostracized from their culture. It is clear that efforts need to be made to destroy cultural taboos on the subject of AIDS.

This project infiltrates the popular culture of South Africa with underlying themes directly involving AIDS. Gradually, it will become easier for South Africans to discuss and acknowledge the AIDS epidemic. At that point, other prevention and treatment methods will be much more successful. The first step must be to establish a forum that establishes the presence of AIDS in the popular culture of South Africa. This project is one very effective method of establishing dialogue and awareness regarding AIDS in an otherwise close minded and ignorant society.

The future does not look too bright for South Africa if lifestyles do not change. The primary contributor to this epidemic is ignorance, followed by poverty, lack of development, and the low status of women. It’s not just their behaviors that need to be changed, but many of their traditions, beliefs, and customs. The epidemic has climaxed to the point that the average life expectancy for a South African has gone from 65 to 56, and is expected to drop to 30 in the next 10 years (www. cnn. com/health).

The U. S census Bureau projects that by 2010 South Africa will have 71 million fewer people than it would have had without AIDS (www. cnn. com/health). Projections for 2010 have the adult HIV prevalence rate reaching 25%. In the next 10 years, the number of AIDS related orphans is expected to reach 28 million (www. cnn. com). It is projected that everyday for the next 5 years, 1600 babies will be born with HIV. After taking all of these horrible statistics into account, it is obvious that traditional str ategies and campaigns are not enough, and a a new approach needs to be considered.

AIDS, A Life And Death Issue

AIDS is a life and death issue. To have the AIDS disease is at present a sentence of slow but inevitable death. I’ve already lost one friend to AIDS. I may soon lose others. My own sexual behavior and that of many of my friends has been profoundly altered by it. In my part of the country, one man in 10 may already be carrying the AIDS virus. While the figures may currently be less in much of the rest of the country, this is changing rapidly. There currently is neither a cure, nor even an effective treatment, and no vaccine either.

But there are things that have been PROVEN immensely effective in slowing the spread f this hideously lethal disease. In this essay I hope to present this information. History and Overview: AIDS stands for Acquired Immune Defficiency Disease. It is caused by a virus. The disease originated somewhere in Africa about 20 years ago. There it first appeared as a mysterious ailment afflicting primarily heterosexuals of both sexes. It probably was spread especially fast by primarily female prostitutes there. AIDS has already become a crisis of STAGGERING proportions in parts of Africa.

In Zaire, it is estimated that over twenty percent of the adults currently carry the virus. That igure is increasing. And what occurred there will, if no cure is found, most likely occur here among heterosexual folks. AIDS was first seen as a disease of gay males in this country. This was a result of the fact that gay males in this culture in the days before AIDS had an average of 200 to 400 new sexual contacts per year. This figure was much higher than common practice among heterosexual (straight) men or women.

In addition, it turned out that rectal sex was a particularly effective way to transmit the disease, and rectal sex is a common practice among gay males. For these reasons, the disease pread in the gay male population of this country immensely more quickly than in other populations. It became to be thought of as a “gay disease”. Because the disease is spread primarily by exposure of ones blood to infected blood or semen, I. V. drug addicts who shared needles also soon were identified as an affected group.

As the AIDS epidemic began to affect increasingly large fractions of those two populations (gay males and IV drug abusers), many of the rest of this society looked on smugly, for both populations tended to be despised by the “mainstream” of society here. But AIDS is also spread by heterosexual sex. In addition, it is spread by blood transfusions. New born babies can acquire the disease from infected mothers during pregnancy. Gradually more and more “mainstream” folks got the disease. Most recently, a member of congress died of the disease.

Finally, even the national news media began to join in the task of educating the public to the notion that AIDS can affect everyone. Basic medical research began to provide a few bits of information, and some help. The virus causing the disease was isolated and identified. The AIDS virus turned out to be a very nusual sort of virus. Its genetic material was not DNA, but RNA. When it infected human cells, it had its RNA direct the synthesis of viral DNA. While RNA viruses are not that uncommon, very few RNA viruses reproduce by setting up the flow of information from RNA to DNA.

Such reverse or “retro” flow of information does not occur at all in any DNA virus or any other living things. Hence, the virus was said to belong to the rare group of virues called “Retro Viruses”. Research provided the means to test donated blood for the presence of the antibodies to the virus, astronomically reducing the chance of ones getting AIDS from a blood transfusion. This was one of the first real breakthroughs. The same discoveries that allowed us to make our blood bank blood supply far safer also allowed us to be able to tell (in most cases) whether one has been exposed to the AIDS virus using a simple blood test.

The Types of AIDS Infection: When the AIDS virus gets into a person’s body, the results can be broken down into three general types of situations: AIDS disease, ARC, and asymptomatic seropositive condition. The AIDS disease is characterized by having one’s immune system devastated by the AIDS virus. One is said to have the *disease* if one contracts particular varieties (Pneumocystis, for example) of pneumonia, or one of several particular varieties of otherwise rare cancers (Kaposi’s Sarcoma, for example). This *disease* is inevitably fatal.

Death occurs often after many weeks or months of expensive and painful hospital care. Most folks with the disease can transmit it to others by sexual contact or other exposure of an uninfected person’s blood to the blood or semen of the infected person. There is also a condition referred to as ARC (“Aids Related Complex”). In this situation, one is infected with the AIDS virus and one’s immune system is compromised, but not so much so that one gets the (ultimately lethal) cancers or pneumonias of the AIDS disease. One tends to be plagued by frequent colds, enlarged lymph nodes, and the like.

This condition can go on for years. One is likely to be able to infect others if one has ARC. Unfortunately, all those with ARC are currently felt to eventually progress to getting the full blown AIDS disease. There are, however, many folks who have NO obvious signs of disease what so ever, but when their blood serum is tested they show positive evidence of having been exposed to the virus. This is on the basis of the fact that antibodies to the AIDS virus are found in their blood. Such “asymptomatic but seropositive” folks may or may not carry enough virus to be infectious.

Most sadly, though, current research and experience with the disease would seem to indicate that EVENTUALLY nearly all folks who are seropostive will develop the full blown AIDS disease. There is one ray of hope here: It may in some cases take up to 15 years or more between one’s becoming seropositive for the AIDS virus and one’s developing the disease. Thus, all those millions (soon to be tens and hundreds of millions) who re now seropositive for AIDS are under a sentence of death, but a sentence that may not be carried out for one or two decades in a significan fraction of cases.

Medical research holds the possibility of commuting that sentence, or reversing it. There is one other fact that needs to be mentioned here because it is highly significant in determining recommendations for safe sexual conduct which will be discussed below: Currently, it is felt that after exposure to the virus, most folks will turn seropositive for it (develop a positive blood test for it) within four months. It is currently felt that if ou are sexually exposed to a person with AIDS and do not become seropositive within six months after that exposure, you will never become seropositive as a result of that exposure.

Just to confuse the issue a little, there are a few folks whose blood shows NO antibodies to the virus, but from whom live virus has been cultured. Thus, if one is seronegative, it is not absolute proof one is not exposed to the virus. This category of folks is very hard to test for, and currently felt to be quite rare. Some even speculate that such folks may be rare examples of those who are immune to the effects of the virus, but this emains speculation. It is not known if such folks can also transmit the virus.

Transmission of AIDS: The AIDS virus is extremely fragile, and is killed by exposure to mild detergents or to chlorox, among other things. AIDS itself may be transmitted by actual virus particles, or by the transmission of living human CELLS that contain AIDS viral DNA already grafted onto the human DNA. Or both. Which of these two mechanisms is the main one is not known as I write this essay. But the fact remains that it is VERY hard to catch AIDS unless one engages in certain specific activities. What will NOT transmit AIDS? Casual contact (shaking hands, hugging, sharing tools) cannot transmit AIDS.

Although live virus has been recovered from saliva of AIDS patients, the techniques used to do this involved concentrating the virus to extents many thousands of times greater than occurs in normal human contact, such as kissing (including “deep” or “French” kissing). Thus, there remains no solid evidence that even “deep” kissing can transmit AIDS. Similarly, there is no evidence that sharing food or eating utensils with an AIDS patient can transmit the virus. The same is true for transmission by sneezing or coughing. There just s no current evidence that the disease can be transmitted that way.

The same may be true even for BITING,though here there may be some increased (though still remote) chance of transmitting the disease. The above is very important. It means that there is NO medical reason WHAT SO EVER to recommend that AIDS suffers or AIDS antibody positive folks be quarrantined. Such recommendations are motivated either by ignorance or by sinister desires to set up concentration camps. Combined with the fact that the disease is already well established in this ountry, the above also means that there is no rational medical basis for mmigration laws preventing visits by AIDS suffers or antibody positive persons.

The above also means that friends and family and coworkers of AIDS patients and seropostive persons have nothing to fear from such casual contact. There is no reason to not show your love or concern for a friend with AIDS by embracing the person. Indeed, there appears still to be NO rational basis for excluding AIDS suffers from food preparation activity. Even if an AIDS suffer cuts his or her finger and bleeds into the salad or soup, most of the cells and virus will die, in most cases, before the food is consumed. In addition, it is extremely difficult to get successfully attacked by AIDS via stuff you eat.

AIDS cannot be transmitted by the act of GIVING blood to a blood bank. All equipment used for such blood donation is sterile, and is used just once, and then discarded. How is AIDS transmitted? Sexual activity is one of the primary ways AIDS is transmitted. AIDS is transmitted particulary by the transmission of blood or semen of an infected person into contact with the blood of an uninfected person. Sex involving penetration of the penis into either the vagina of a woman or the rectum of either woman or a man has a very high risk of transmitting the disease.

It is felt to be about four times MORE likely for an infected male to transmit AIDS to an uninfected woman in the course of vaginal sex than it is likely for an infected woman to transmit AIDS to an uninfected male. This probably relates to the greater area of moist tissue in a woman’s vagina, and to the relative liklihood of microscopic tears to occur in that tissue during sex. But the bottom line is that AIDS can be transmitted in EITHER direction in the case of heterosexual sex. Transmission among lesbians (homosexual females) is rare.

Oral sex is an extremely common form of sexual activity among both gay and straight folks. Such activity involves contact of infected semen or vaginal secretions with the mouth, esophagus (the tube that connects the mouth with the stomach) and the stomach. AIDS virus and infected cells most certainly cannot survive the acid environment of the stomach. Yet, it is still felt that there is a chance of catching the disease by having oral sex with an infected person. The chance is probably a lot smaller than in the case of vaginal or rectal sex, but is still felt to be significant.

As mentioned above, AIDS is also transmitted among ntravenous drug users by the sharing of needles. Self righteous attitudes by the political “leaders” of this country at local, state, and national levels have repeatedly prevented the very rational approach of providing free access to sterile intravenous equipment for IV drug users. This measure, when taken promptly in Amsterdam, was proven to greatly and SIGNIFICANTLY slow the spread of the virus in that population. The best that rational medical workers have succeeded in doing here in San Francisco is distribute educational leaflets and cartoons to the I.

V. drug abusing population instructing them in he necessity of their rinsing their “works” with chlorox before reusing the same needle in another person. Note that even if you don’t care what happens to I. V. drug abusers, the increase in the number of folks carrying the virus ultimately endangers ALL living persons. Thus, the issue is NOT what you morally think of I. V. drug addicts, but one of what is the most rational way to slow the spread of AIDS in all populations. Testing of donated blood for AIDS has massivly reduced the chance of catching AIDS from blood transfusions.

But a very small risk still remains. To further reduce that risk, efforts ave been made to use “autotransfusions” in cases of “elective surgery” (surgery that can be planned months in advance). Autotransfusion involves the patient storing their own blood a couple of weeks prior to their own surgery, to be used during the surgery if needed. Similary, setting up donations of blood from friends and family known to be antibody negative and at low risk for AIDS prior to schedualed surgery further can decrease the already small risks from transfusion.

AIDS and SEX: What are the rational options? The “sexual revolution” of the 1960’s has been stopped dead in its tracks by the AIDS epidemic. The danger of ontracting AIDS is so real now that it has massively affected the behavior of both gay and straight folks who formerly had elected to lead an active sexual life that included numerous new sexual contacts. Abstinence The safest option regarding AIDS and sex is total abstinence from all sexual contact. For those who prefer to indulge in sexual contact, this is often far too great a sacrifice. But it IS an option to be considered.

Safe Sex For those who wish to have sexual contact with folks on a relatively casual basis, there have been devised rules for “safe sex”. These rules are very strict, and will be found quite bjectionable by most of us who have previously enjoyed unrestricted sex. But to violate these rules is to risk unusually horrible death. Once one gets used to them, tho, the rule for “safe sex” do allow for quite acceptable sexual enjoyment in most cases. For those who wish to indulge in pentration of the vagina or rectum by a penis: The penis MUST be sheathed in a condom or “rubber”.

This must be done “religiously”, and NO exceptions are allowed. A condom must be used by a man even when he is receiving oral sex. Cunnilingus (oral stimulation of a womans gentitals by the mouth of a lover) is NOT considerd to be safe ex. Safe sex includes mutual masturbation, and the stimultion of one genitals by another’s hand (provided there are no cuts in the skin on that hand). But manual stimulation of another’s genitals is NOT safe if one has cuts on one’s hands, unless one is wearing a glove.

Note that even when one is conscientiously following the recommendations for safe sex, accidents can happen. Condoms can break. One may have small cuts or tears in ones skin that one is unaware of. Thus, following rules for “safe sex” does NOT guarantee that one will not get AIDS. It does, however, greatly reduce the chances. There are many examples of sexaully active couples where one member has AIDS disease and the other remains seronegative even after many months of safe sex with the diseased person.

It is particularly encouraging to note that, due to education programs among San Francisco gay males, the incidence of new cases of AIDS infection among that high risk group has dropped massively. Between practice of safe sex and a significant reduction in the number of casual sexual contacts, the spread of AIDS is being massively slowed in that group. Similar responsible action MUST be taken by straight folks to urther slow the spread of AIDS, to give our researchers time to find the means to fight it. Monogamy For those who would have sexual activity, the safest approach in this age of AIDS is monogamous sex.

Specifically, both parties in a couple must commit themselves to not having sex with anyone else. At that time they should take AIDS antibody tests. If the tests are negative for both, they must practice safe sex until both members of the couple have been greater than six months since sexual contact with anyone else. At that time the AIDS blood test is repeated. If both tests remain negative six months after one’s last sexual contact with ny other party, current feeling is that it is now safe to have “unprotected” sex.

Note that this approach is recommended especially for those who wish to have children, to prevent the chance of having a child be born infected with AIDS, getting it from an infected mother. Note also that this approach can be used by groups of three or more people, but it must be adhered to VERY strictly. What to AVOID: Unscrupulous folks have begun to sell the idea that one should pay to take an AIDS antibody test, then carry an ID card that certifies one as AIDS antibody negative, as a ticket to being acceptable in a singles bar.

This is criminal greed and stupidity. First, one can turn antibody positive at any time. Even WEEKLY testing will not pick this change up soon enough to prevent folks certified as “negative” from turning positive between tests. Much worse, such cards are either directly or implicitly promoted as a SUBSTITUTE for “safe sex” practices. This can only hasten the spread of the disease. If you want to learn your antibody status, be sure to do so ANONYMOUSLY. Do NOT get the test done by any agency that requires your real name, address, or any other identifying information.

Fortunately, in San Francisco, there is a public lace to get AIDS antibody testing where you may identify yourself only as a number. Tho that place has a three month long waiting list for testing, there are other private clinics where one may have the test done for cash, and may leave any false name one wishes. The reason I suggest this is that currently there are some very inappropriate reactions by government and business to folks known to be antibody positive.

Protect yourself from such potential persection by preventing your antibody status from being a matter of record. That information is for you, your lover(s), and (if need be) your physician. And or NO one else. There currently is NO treatment for AIDS (this includes AZT) that shows significant promise. In Conclusion: It is my own strongly held view, and that of the medical and research community world wide, that the AIDS epidemic is a serious problem, with the potential to become the worst plague this species has ever known.

This is SERIOUS business. VASTLY greater sums should be spent on searching for treatments and vaccines. On the other hand, we feel strongly that this is “merely” a disease, not an act by a supernatural power. And while it does not seem likely we will find either a cure or a accine in the forseeable future, it may be that truly effective treatments that can indefinitely prolong the life of AIDS victims may be found in the next few years.

When science and technology do finally fully conquer AIDS, we can go back to deciding what sort and how much sex to have with who ever we choose on the basis of our own personal choice, and not by the coercion of a speck of proteins and RNA. May that time come soon. In the mean time, we must all do what we can to slow the spread of this killer. This article is intended to help accomplish that. Please circulate it as widely as possible.

The new faces of HIV/AIDS: Our Children

The condition known as leprosy was very well known in ancient history. Usually because of the fear associated with the disease and ignorance of the disease most societies were quick to label anyone with leprosy as an outcast. In fact, Jewish religion and law classified anyone who exhibited the symptoms of leprosy as unclean. In addition to having an ailment, which could be quite uncomfortable at times, people with leprosy had to suffer the indignities and humiliation associated with being unwanted by society.

Neither they nor their belongings were to come in contact with those who were free of the disease. They often went ignored. Victims of misunderstood diseases usually become nothing more than a statistic a nameless face in a sea of individuals who have had the good fortune to avoid the same problem. Modern medicine has since discovered the cause and cure for leprosy and a myriad of other socially isolating diseases, to include tuberculosis. Unfortunately, there is still a nameless face commonly overlooked today.

While the AIDS virus has become more manageable by the medical profession, the people with HIV/AIDS have continued to be labels as outcasts by society. The fear, dread, and ignorance associated with diseases of the past has now attached itself to the clean individuals of todays society. People living with HIV/AIDS have no clear features in society mainly because of the depersonalization, which has been applied to the condition and the victims of this new leprosy. The avoidance of this disease is painfully obvious when one considers how it is effecting our youth now and how it will affect our youth in the future.

Any disease carries some stigma and stereotype because of people’s desire to separate themselves from anything that reminds them of illness, disfigurement, disability, and, worst of all, death. People have, throughout history, stigmatized and stereotyped certain diseases more than others. These selected diseases have not necessarily been the most lethal or the most contagious. Leprosy, the prototype of a stigmatized disease, has low levels of both contagion and fatality. The primary characteristics associated with someone who is diagnosed with HIV/AIDS is that they are either gay or an IV drug user.

The reality is that HIV/AIDS is prevalent in a multitude of groups. Yes, the homosexual community, as well as the drug community, has been hit extremely hard by this disease. In fact, awareness by these groups of their vulnerability has resulted in numerous extremely effective organizations being created to emphasis education and prevention. However, other groups affected just as hard, if not harder, include African American communities, Native American Communities, homeless communities, women and seniors.

These groups were heavily affected mainly because society chose to continue to hold on to the commonly held beliefs that this was a disease that affected homosexuals and drug users resulting in slow reaction time regarding education and prevention. Tragically, this propensity for turning a blind eye is resulting in the slow awareness that this disease is in a position to slaughter the youth of the world. HIV/AIDS is the leading cause of death among people in the United States between the ages of 25 and 44 and the sixth leading cause among people ages 15 to 24.

Due to the long period of incubation between HIV and AIDS diagnosis, most in the age range between 20 and 24 were infected during their teens. The Centers for Disease Control and Prevention (CDC) reported that as of December 1997, 3,130 teenagers between the ages of 13 and 19 had been infected and between the ages of 20 and 24, 22,953 cases were reported (CDC, HIV/AIDS Surveillance Report 1997). That same report given as of December 1999 indicated the number has risen to 4,796 teenagers between the ages of 13 and 19 (CDC, HIV/AIDS Surveillance Report 1999).

In the United States, a third of all new HIV infections are estimated to occur in people under the age of 21. Of course, this issue cannot be limited to the United States alone. UNAIDS has estimated that of the approximately 30 million people living with HIV globally, at least 30 percent are between the ages of 10 and 24 (Advocates for Youth). Zimbabwe is one of many international countries being heavily affected by HIV/AIDS. In 1997, approximately 360,000 children were orphaned as a result of the AIDS epidemic in Zimbabwe and the number is expected to increase to 1 million within the next 5 years.

The UN Population Division has projected that between the years 2000 and 2005 approximately 50 percent of all child deaths will be as a result of AIDS. The land of positive individuals is ever changing. Presently, 1,800 babies a day are born infected with HIV. Approximately, thirty million children will watch one or both parents die of AIDS during this decade (U. S. News). In the U. S. , among white females and males, it continues to be the seventh leading cause of death, sixth among Latino males and females, fifth among African American males, and third among African American females (Advocacy for Youth).

Vulnerability to AIDS is often engendered by a lack of respect for the rights of women and children, the right to information and education, freedom of expression and association, the rights to liberty and security, freedom from inhuman or degrading treatment, and the right to privacy and confidentiality. Where human rights such as these are compromised, individuals at risk of HIV infection may be prevented or discouraged from obtaining the necessary information, goods and services for self-protection.

Where people with AIDS risk rejection and discrimination, those who suspect they have HIV may avoid getting tested and taking precautionary measures, for fear of revealing their infection; they may even avoid seeking health care. Warnings about the growing threat of HIV and AIDS date back to the early and mid-1980s. But many people, from members of affected communities to leaders of global organizations, have failed to take them seriously. The Land of Poz is growing and our children are quickly becoming the major inhabitants.

HIV/AIDS in the USA

Human Immunodeficency Virus (HIV), virus of the retrovirus family, the agent that causes Acquired Immune Deficiency Syndrome (AIDS). A person infected with HIV gradually loses immune function and becomes vulnerable to numerous infractions that can lead to AIDS.

The virus was discovered in association with AIDS by three separate teams of researchers: first in 1983 by Luc Montagnier and scientists at the Pasteur Institute in Paris, and then in 1984 by Robert Gallo and his colleagues at the National Cancer Institute, on the National Institutes of Health in Bethesda, Maryland, and by Jay Levy and his colleagues at the University of California at San Francisco. The virus undergoes an incubation period before disease onset, they infect blood cells and the nervous system and suppress the immune system.

Then, the virus does a process known as reverse transcription, which converts their genomic RNA into DNA. Currently there are two identified types of HIV, HIV 1 and HIV 2. HIV infects white blood cells such as CD4 T-lymphocytes. The HIV uses the CD4 as a receptor to which it attaches to. This causes the HIV to fuse with the cell membrane; fusion allows the virus to enter the cell eventually killing the CD4 T-lymphocytes. This is what paralyzes the immune system and causes AIDS. Acquired Immune Deficiency Syndrome (AIDS), specific group of diseases or conditions that result from suppression of the immune system related to infection with HIV.

A person with HIV gradually loses their CD4 T-lymphocytes (T-cells) and becomes vulnerable to pneumonia, fungus infections and other common ailments. With the loss of immune function, a clinical syndrome develops over time and eventually results in death due to opportunistic infections or cancers. When a person is diagnosed as HIV-positive it does not necessarily mean that they have AIDS, although people who are HIV often are mistakenly said to have AIDS. An HIV-positive person can live up to ten years without developing any of the clinical illnesses that define and a diagnosis of AIDS.

It is estimated that in 1995, worldwide, 18. 4 million people were living with HIV or AIDS. – The cumulative number of reported AIDS cases from the beginning of the epidemic in 1981 – 148,705 cases were reported in the United State in the past year. – 343,000 deaths from reported AIDS cases have occurred since the beginning of the epidemic. In the United States, the cumulative total number of reported AIDS cases among the following White, not Hispanic (46. 80% of total case count)256,461 African-American (34. % of total case count)189,004 Hispanic/Latino (17. 1% of total case count)96,613 Asian/Pacific Islander (0. 7% of total case count)3826 American Indian/Alaskan Native (0. 3% of total case count)1439 – The cumulative number of cases among women is 78,654, or 14. 4% of total case count. – The cumulative number of cases among men is 462,152, or84. 3%oftotalcasecount. – The percentage of the cumulative total number of reported AIDS cases among the following age group is: Progression from the point of HIV to AIDS may take six to ten or more years.

The progression is monitored by using surrogate markers and clinical endpoints. Surrogate markers for various stages of HIV include the declining number of CD4 T-cells. In 1996, it became evident that the actual amount of HIV in a persons blood – called the viral burden – could be used to predict the progression to AIDS, regardless of the persons CD4 T-cell count. Also, a persons immune response to the virus – that is, the persons ability to produce antibodies against HIV is also used to determine the progression of AIDS.

Within 1 to 3 weeks after infection, most people experience flu-like symptoms such as fever, headache, skin rash, tender lymph nodes and a vague feeling of discomfort which last about 1 to 2 weeks. During this phase, the acute retroviral syndrome phase, HIV reproduces very high concentrations into the blood, mutates frequently, circulates through the blood and establishes infections throughout the body, especially in the lymphoid organs. Following this phase, the person enters a asymptomatic phase (symptom free) with can last ten or more years.

However, the virus is replicating and causing destruction of the immune system. Eventually, the immune system weakens and enters early symptomatic phase, which can last from a few months to several more years. The CD4 T-cells are now rapidly falling and infections may occur. After a persons CD4 T-cells fall under 200 per cub mm of blood, AIDS is defined. Excessive weight loss and debilitating fatigue occurs and the immune system is in a severe state of failure. Eventually, advanced AIDS sets in and the CD4 T-cell number falls below 50 per cubic mm of blood.

Death due to severe life-threatening opportunistic infections and cancers occurs within one to two years. The most common infections is Pneumocystis carinii pneumonia (PCP) caused by a fungus. A bacterial pneumonia, such as, tuberculosis, and Mycobacterium avium causes fever, weight loss, anemia and diarrhea. Gastrointestinal tract infedtions commonly cause diarrhea, weight loss, anorexia, and fever. A disease caused by protozoal parasites, especially toxoplasmosis of the nervous system, are common.

Thrush of the mouth by the fungus Candida albicans; Crytococcus which is a major cause of meningitis with 13% of people with AIDS get; Histoplasma capsulatum with 10% of people with AIDS causing weight loss, fever and respiratory complications or severe central nervous system complications if the infection reaches the brain. Viral infections such as herpes are common in AIDS; cytomegalovirus infects the eyesight and can cause blindness; Epstein-Barr with results in cancerous transformation of blood cells; also, herpes simplex virus types 1 and 2 with result in progressive sores around the mouth and anus.

Cancerous infections, being B-cell lymphoma and Kapoks Sarcoma which are common in homosexual gay man. HIV is spread through the exchange of body fluids, primarily semen, and blood products. It is most commonly spread by sexual contact with an infected person. The virus is spread to the bloodstream of the uninfected person by way of small abrasions that may occur as a consequence of sexual intercourse. It is also spread by sharing needles or syringes; most commonly intravenous drugs. A rare form of contraction is blood transfusions or use of blood-clotting factors (1 in 450,000 to 600,000 unit of blood).

Infected mothers can passed it to the child either before or during childbirth or through breastfeeding. Health-care workers have been infected after being stuck with needles containing HIV-infected blood or less frequently after blood contacts the workers open cut or splashes into a mucous membrane (eyes or nose). Only one case demonstrated that a health-care provider passed to patients (a dentist to six patients). The actual risk of a health care provider passing the virus to a patient is minimal.

Fear continues to concern the potential transmission of other means, such as casual contact (kissing an infected person) in a household, school, workplace, or food-service settings. No scientific evidence to support any of these fears has been found. Saliva has a protein called secretory leukocyte protease inhibitor which prevent HIV from infecting white blood cells. Nor is there any evidence that insects can transmit the disease. There are different treatments to help suppress the HIV virus. One class of anti-HIV drugs is RT inhibitors.

The RT inhibitors, which are licensed by the United States Food and Drug Administration, are AZT (zidovudine), ddi (didanosine), ddC (zalcitabine), d4T (stavudine), and 3TC (lamivudine). The drugs work as DNA-chain terminators. The most effective time to take these drugs is when first infected. Because the virus mutates rapidly and there are many different strains of HIV, some people may become drug-resistant to RT inhibitors. The combination of AZT and 3TC have been shown effective in preventing the AIDS virus from developing resistance to AZT.

The combination has also shown a boost in CD4 T-cell counts and lower levels of HIV in the blood. Protease inhibitors were approved by the FDA in 1995 and have shown to cripple a key enzyme called protease, which is vital to reproduction of HIV. When protease is blocked, HIV makes copies of itself that cannot infect new cells. HIV infection does not spread inside the body as quickly as it does without protease inhibitors. These drugs can reduce up to 99% of the virus in the blood, but more viruses can remain elsewhere in the body.

The virus will become dormant or latently infected meaning they are infected but still waiting to make new virus. One drug will not win the battle alone, therefore, researchers believe other anti-HIV need to be administered. Bone marrow xenotransplantation has also been performed. A man with AIDS received a bone marrow transplant from a baboon (baboons are resistant to HIV) in hopes to restore the patients immune system. Not enough time has elapsed to support or dismiss the possible hope of a new, improved life for the man. Gene therapy and immunization are other possible alternatives in helping to prevent the virus from spreading.

Also, the HIV Notification Law, which congress and some physicians are trying to pass. They feel that to prevent the spread of HIV, sex partners should be notified for testing. They believe that by doing so, this would break the cycle of transmission by identifying those at risk. The law would require physicians to not only confidentially report positive results but also the names of the patients sex partners to local state health departments. Then the department would contact the partners without revealing the patients name.

Thirty-three states require physicians to report the names of people who test seropositive and 42 states require or permit partner notification. A federal law already mandates notification of spouses. On the other hand, the Anonymous HIV testing options has proven that people sought testing and medical care earlier in the course of HIV disease than did persons tested confidentially. This option is a safety valve for those who dont wish to have their names reported. Educating the public about routes of HIV transmission and personal measures that reduce the risk of infection.

Safe sex, abstinence or monogamy and the use of latex condoms are one measure. Another one is needle-exchange programs which have been implemented by the government. Health care settings with include protective clothing and proper instrument disposal. Medical interns and residents follow universal precautions and treat every patient as a possible source of exposure to blood-borne diseases and are required to attend orientation that include presentations about the use of gloves, masks, and gowns as well as other safety precautions.

Researchers have found the elective cesarean sections performed before the onset of labor can reduce HIV transmission from mother to baby. Women who were pregnant with HIV, had good CD4 count and viral load, were given AZT after the first trimester which reduce the transmission rate to 1%. Reducing perinatal transmission is the biggest success story of the HIV epidemic, says Lynne Mofenson, of the National Institute of Child Health and Human Development. AIDS falls from top ten causes of death; teen deaths, infant mortality, homicide all decline.

Age adjusted death rates from HIV infection in the US declined an unprecedented 47% from 1996 to 1997, and HIV infection fell from 8th to 14th among leading causes of death in the US over the same time. Ages 25-44, HIV dropped from leading cause of death in 1995 to the third-leading in 1996 and in 1997 fifth-leading. Age-adjusted HIV death rate of 5. 9 deaths per 100,000 is the lowest rate since 1987. The 1997 rate is less than half the 1992 rate (12. 6) and almost one-third the rate in 1995 (15. 6).

Gay, Lesbian and Bisexual Issues – AIDS and HIV

Being one of the most fatal viruses in the nation, AIDS (Acquired Immunodeficiency Syndrome) is now a serious public health concern in most major U. S. cities and in countries worldwide. Since 1986 there have been impressive advances in understanding of the AIDS virus, its mechanisms, and its routes of transmission. Even though researchers have put in countless hours, and millions of dollars it has not led to a drug that can cure infection with the virus or to a vaccine that can prevent it.

With AIDS being the leading cause of death among adults, individuals are now taking more precautions with sexual intercourse, and edical facilities are screening blood more thoroughly. Even though HIV ( Human Immunodeficieny Virus) can be transmitted through sharing of non sterilize needles and syringes, sexual intercourse, blood transfusion, and through most bodily fluids, it is not transmitted through casual contact or by biting or blood sucking insects.

Development of the AIDS Epidemic The first case of AIDS were reported in 1982, epidemiologists at the Center of Disease Control immediately began tracking the disease back wards in time as well as forward. They determined that the first cases of AIDS in the United States probably occurred in 1977. By early 1982, 15 states, the District of Columbia, and 2 foreign countries had reports of AIDS cases, however the total remained low: 158 men and 1 woman. Surprising enough more then 90 percent of the men were homosexual or bisexual.

Knowing this more then 70 percent of AIDS victims are homosexual or bisexual men, and less then 5 percent are heterosexual adults. Amazing enough by December of 1983 there were 3,000 cases of AIDS that had been reported in adults from 42 states, the District of Columbia, and Puerto Rico, and the isease had been recognized in 20 other countries. Recognizing the Extent of Infection The health of the general homosexual populations in the area with the largest number of cases of the new disease was getting looked at a lot closer by researchers.

For many years physicians knew that homosexual men who reported large numbers of sexual partners had more episodes of venereal diseases and were at higher risk of hepatitis B virus infection than the rest of the population, but conicidentally with the appearance of AIDS,. other debilitating problems began to do appear more frequently. The most common was swollen glands, often accompanied by extreme fatigue, weight loss, fever, chronic diarrhea, decreased levels of blood platelets and fungal infections in the mouth. This condition was labeled ARC (AIDS Related complex).

The isolation of HIV in 1983 and 1984 and the development of techniques to produce large quantities of the virus [paved the way for a battery of tests to determined the relationship between AIDS and ARC and the magnitude of the carrier problem. Using several different laboratory tests, scientists looked for antibodies against the HIV in the blood of AIDS and ARC patients. They found that almost 100 percent of those with AIDS or ARC had the antibodies-they were seriopostive. In contrast less then one percent of persons with no known risk factors were seropositive.

Definition of AIDS AIDS is defined as a disease, at least moderately predictive of defects in cell-meditated immunity, occurring in a person with no known cause for diminished resistance to that disease. Such diseases include Kaposi’s Sarcoma, Pneumocystis carnii pneumonia, and serious other opportunistic infections. After the discovery of HIV and the development of HIV-antibody test, the case efinition of AIDS was updated to reflect the role of the virus in causing AIDS, but the scope of the definition remained almost the same.

Transmission HIV is primarily a sexually transmitted disease, it is transmitted by both homosexual and bisexual and heterosexual activity. The first recognized case was among homosexual and bisexual men. Many numbers of studies have shown that men who have sexual partners and those who practice receptive anal intercourse are more likely to be infected with HIV than other homosexual men. Researchers found a strong connection between HIV infection and rectal trauma, nemas before sex, and physical signs of disruption of the tissue lining the rectum.

Homosexual women tend to have a very low incidence of venereal disease in general, an AIDS is no exception. Female-to-female transmission is highly uncommon, however it has been reported in one case and suggested in another. In the reported case, traumatic sex practices apparently resulted in transmission of HIV from a woman who had acquired the virus through IV drug abuse to her non- drug-using sexual partner. 1983 was when the first heterosexual (Male to female; female to male) transmission was reported.

In 1985, 1. percent of the adult cases of AIDS reported to the CDC (Center for Disease Control) were acquired through heterosexual activity; projections suggest that by 1991 the proportion will rise to 5 percent. Heterosexual contact is the only transmission category in which women outnumber men with AIDS. Heterosexual contacts accounts for 29 percent of AIDS cases among women in the United States, but for only 2 percent of cases among men. Estimates of the risk of HIV transmission in unprotected intercourse with a person known to be infected with HIV are 1 in 500 for a single sexual ncounter and 2 in 3 for 500 sexual encounters.

The use of a condom reduces these odds to 1 in 5,000 for a single encounter and to 1 in 11 for 500 encounters. Routes NOT Involved in Transmission of HIV A study of more than 400 family members of adult and pediatric AIDS patients demonstrate that the virus is not transmitted by any daily activity related to living with or caring for an AIDS patient. Basically meaning that personal interactions typical in family relationships, such as kissing on the cheek, kissing on the lips, and hugging, have not resulted in transmission of the virus. Patterns There are three different geographic patterns of AIDS transmission.

The first one is characteristic of industrializing nations with large numbers of reported AIDS cases, such as the United States, Canada, countries in Western Europe, Australia, New Zealand, and parts of Latin America. In these areas most AIDS cases have been attributed to homosexual or bisexual activity and intravenous drug abuse. The second pattern is seen in areas of central, eastern, and southern Africa and in some Caribbean countries. Unlike pattern one most AIDS cases in these areas occur among heterosexuals, and the male-to-female ratio approaches 1 to 1.

The third pattern of transmission occurs in regions of Eastern Europe, the Middle East, Asia, and most of the Pacific. It is believed that HIV was introduced to these areas in the early to mid-1980s. Any study associated with AIDS must begin with the understanding that AIDS is only one outcome of infection with HIV-1. People infected with the virus may be completely asymptomtic; they may have mildly debiliating symptoms; or they may have life-threatening conditions caused by progressive destruction of the immune system, the brain, or both.

One of the first signs of HIV-1 infection in some patients is an acute luelike disease. The condition lasts from a few days to several weeks and is associated with fever, sweats, exhaustion, loss of appetite, nausea, headaches, soar throat, diarrhea, swollen glands, and a rash on the torso. Some of the symptoms of the acute illness may result from HIV-1 invasion of the central nervous system. In some cases the clinical findings have correlated with the presence of HIV-1 in the cerebrospinal fluid. Symptoms disappear along with the rash and other sings of acute viral disease.

When the blood test for HIV-1 antibodies become available, researchers demonstrated the ymphadenopathy was a frequent consequence of infection with the virus. Scientist do not know what causes the wasting syndrome, but some experts believe that it might result from the abnormal regulation of proteins called monokines. Between 5 and 10 percent of patients with AIDS and HIV-related conditions have bouts of acute aseptic meningtis. About two-thirds of AIDS patients have a degenerative brain disease called subacute encephalitis.

HIV infection also have been associated with degeneration of the spinal cord and abnormalities of the peripheral nervous system. Symptoms include progressive oss of coordination and weakness. Involvement of the peripheral nervous system may result in shooting pains in the limbs or in numbness and partial paralysis. HIV destroys the body’s defense capabilities, opening itself to whatever disease-producing agents are present in the environment. The diagnosis of secondary infection in AIDS patients and others with HIV infection is complicated because some of the standard diagnostic tests may not work.

Often such tests detect the immune response to a disease-producing microorganism rather than the organism itself. The most common life threatening opportunistic infection in AIDS atients is Pneumocystis carinii Pneumonia, a parasitic infection previously seen almost exclusively in cancer and transplant patients receiving immunosuppressive drugs. The first signs of disorder are moderate to severe difficulty in breathing, dry cough, and fever. Infection Infection with HIV is a 2-step process consisting of binding and fusion.

The larger protein, glycoprotein120, is responsible for the binding activity. Its target is a receptor molecule called CD4, found on the surface of some human cells. The tight complex formed by glycoprotein120, and CD4 receptor brings the iral envelope very close to membrane of the target cell. This allows the smaller envelope protein, glycoprotein41, to initiate a fusion reaction. The envelope of the virus actually fuses with the cell membrane, allowing the viral core direct access to the inner mechanisms of the human cell.

Once the viral core is inside the cell, the viral RNA genome is reverse transcribed into DNA and then integrated into the host genome cells. Cells infected with HIV carry envelope proteins lodged in their membrane. These cell-bound proteins can bind to CD4 receptors on uninfected cell. Fusion f the two cell membranes allow partially formed viral particles to move from the infected cell to the uninfected cell. Thus, HIV theocratically could spread through the body without leaving host cells. Cell Death HIV infects many different cell types, but it preferentially kills the T4 lymphocyte.

There have been suggestions the T4 cells are more vulnerable to HIV-induced cell death than other cells because they have a higher concerntration of CD4 receptors. There is speculation that cell death occurs when viral envelope proteins lodged in the membrane of an infected cell bind to CD4 receptors embedded in the same membrane. Multiple self fusion reactions could destabilize the cell membrane and kill the cell. The massive depletion of T4 cells involves the cell-to-cell fusion reaction described above.

A single infected cell with a high concentration of viral envelope proteins on its surface can bind to hundreds of uninfected T4 cells. The fused cells form giant, mulitnucleated structures called syncytia, which are extremely unstable and die within a day. One cell with a productive viral infection can cause the death of up to 500 normal cells. Cell death might be related to the presence of free-floating viral envelope proteins in the loodstream. These could bind to uninfected T4 cells, leading to their elimination by the immune system.

Other autoimmune mechanisms also may play a roll in T-cell depletion. HIV infection also may directly or indirectly suppress the production of new T4 cells. Direct suppression would occur if HIV damaged T precursor cells in the bone marrow. Indirect suppression would result if HIV interfered with the production of specific growth factors. On the other hand, infected cells may secrete a toxin that shortens the lifespan of T4 cells or other cells required for their survival. Immune System The Immune response to HIV infection, does not appear to halt the progression of disease.

Part of the explanation for this failure probably relates to the structure of the envelope proteins. The most effective way to stop HIV infection would be to block the binding reaction between the glycoprotein120 and the CD4 receptor. However, antibodies from infected patients rarely do this. Scientists speculate that 2 or 3 regions of the glycoprotein120 molecule involved in the binding reaction may form a recessed pocket. The inability of antibodies to get inside such a pocket could explain the lack of protective immune response. The envelope proteins also are heavily coated with sugar residues.

The human immune system does not recognize the sugar residues as foreign because they are products of the host cell rather then the virus. The sugar residues form a protective barrier around sections of the glycoprotein120 that might otherwise elicit a strong immune response. Regulatory Genes There has been recent studies that indicate HIV’s unusual regulatory genes contributing to its ability to evade the immune system. In the simplest retroviruses the replication rate is controlled by interactions between the host cell and elements in the viral LTR. The virus itself has no way of regulating when, here, or how much virus is produced.

In contrast, the human immunodeficiency viruses have elaborate regulatory control mechanisms in the form of specific genes. Some of the genes permit explosive replication; other appear to inhibit production of virus. Mechanisms that suppress the production of certain viral proteins, such as the envelope proteins, may allow HIV to hide inside infected cells for long periods without eliciting antibodies or other host immune responses. Conclusion As stated above in the last few pages, AIDS is the leading cause of eath in homosexual, and bisexual adult men.

However, these statistics were from 1986, 11 years later it has grown to more, not just in homosexual and bisexual men, but also in heterosexual sexual intercourse. At this point in time there is no cure, nor is there a vaccination. However, there are ways to prevent HIV, some of those ways are: abstinence, condoms, not sharing needles used for IV drugs. Public concern is higher then it was 10 years ago, but that’s because people are starting to realize that not everyone is immune to it, as of right now the only ones immune to the HIV virus are baboons.

AIDS: The millenium bug

At the beginning of the 20th Century it was believed by many, including the United States Patent Office, that there was nothing else to invent. Now, 100 years later at the beginning of the new millenium the ancient Egyptian philosopher is more relevant, \”there is nothing new under the Sun\”. While HIV/AIDS may be a new disease, there is nothing new about a novel epidemic, which can potentially or actually decimate a population. In the late middle ages, the Black, now known as the Bubonic Plague, swept through Europe killing virtually half the population.

It was introduced by a single or small group of rats that came to Italy abroad a trading ship from what is now Turkey. Small Pox transmitted by trade goods from the Hudson Bay Company wiped out entire Native American tribes. There are other examples of diseases accidentally introduced to a population that had no genetic immunity to them. Not to mention NASA’s fear of an unbeatable super virus from outer space. Now as in previous diseases, one of the dangers of HIV/AIDS is not only in its plague proportions but also in the almost superstitious misunderstanding of the virus itself.

In the treatment of all illness, it is necessary to understand the emotional, economic, psychological and sometimes even political impact that is brought about by the disease. This is particularly true with a disease that is as devastating and heretofore misunderstood as HIV/AIDS. AIDS is the punishment of God on sinners. AIDS is a plot by the CIA and the South African Government to wipe out the population of black Africa. AIDS is the result of medical experimentation during the development of the polio vaccine employing the use of rieces monkeys as guinea pigs. AIDS is this, AIDS is that; AIDS is the end of the world.

There is nothing new under the Sun. As we enter a new millenium, we are still controlled by prejudice, fear and superstition. AIDS is not the end of the world, it is simply the latest challenge the medical community needs to meet. There are new things to invent including an immunization and cure for HIV/AIDS. But before that we must overcome the age-old superstitious fears of the unknown and rise above the prejudices that we harbor of, \”those people\”. Let us understand HIV/AIDS. AIDS, the acronym for acquired immunodeficiency syndrome, is the end stage disease of the human immunodeficiency virus (HIV).

The result of this disease is the destruction of the patient’s immune system. Since the infected person has no ability to fight off any infection because the virus is replicating in and destroying the cells that normally fight infection, he/she then becomes susceptible to all opportunistic disease. Ultimately death occurs as a result of the body’s inability to fight infection. In the early 1980\”sThe Center for Disease Control and Prevention became aware that a new \”virus\” was effecting certain segments of society. In 1985 researchers isolated a virus believe to be responsible for AIDS.

Since that time the definition of this disease has changed many time. In 1993 the definition was expanded to include conditions more applicable to women and injecting illegal drug users. The new definition includes all HIV infected persons who have a CD4 cell count of 200 cells per microleter of blood. Also added were three clinical conditions. The current definition states that AIDS is an illness characterized by laboratory evidence of HIV infection coexisting with one or more indicator diseases. Most patients are diagnosed by these criteria.

HIV, as its name indicates is a virus and is therefore and obligate parasite. Such parasites can only replicate while inside another living cell, or host. Parenthetically, HIV carries its genetic material in RNA rather than DNA, and while in the host the virus converts RNA to DNA in order to replicate. In seeking hosts, HIV is typically attracted to cells with CD4 + molecules on their surface such as T-helper lymphocytes and similar cells. HIV reproduces at a phenomenal rate, which causes massive destruction to the host cells. Cell destruction grows geometrically as the virus replicates and seeks new host cells.

Immune system breakdown primarily results from the dysregulation and destruction of T-helper cells or CD4+lymphocytes. HIV is particularly sinister in its attack on T-helper cells since one of the functions of those cells is to recognize and alert the immune system to alien infections Initially the body’s immune system, to a certain degree combats the virus. However, since the virus virtually targets CD4+lymphatics or T-helper cells, the immune system begins to loose its ability to even recognize let alone defend the invading virus.

The immune system remains relatively healthy as long as its count of CD4 cells is greater than 500 per microliter of blood. Since CD4 + cells are designed to attack infection, they are ironically drawn to the virus where they are subsequently infected. Ultimately the infection spreads through the lymph system and lymphoid tissue becomes a reservoir for HIV replication. As the disease progresses viral particles begin to enter the blood, this results in the infection of body tissues where the virus begins to replicate in infected macrophages.

Massive reproduction of HIV in these cells causes the macrophage to burst allowing HIV to infect surrounding tissues. The skin, lymph nodes, CNS, lungs and possibly even bone marrow are infected in this manner. The virus at this point is well on its way to infecting every organ and tissue in the body. The symptoms of HIV, while highly identifiable to the patient, are general in nature and are attributable to any number of causes. Early signs are consistent with flu like viruses. They include abdominal pain, chills and fever, coughing, diarrhea, dyspnea, fatigue and headache.

Later symptoms are more severe and could be consistent with other diagnosis including cancer. Some symptoms include disorders of the lymphatic system, malaise, muscle and joint pain, night sweats, oral lesions, shortness of breath, skin rash, sore throat, weight loss and disorientation. Additionally in the majority of HIV cases there are neurological manifestations as well. In addition to symptoms preliminary diagnosis can be made by deduction in ascertaining whether or not the patient engages in high-risk behaviors. If combinations of symptoms are present and are accompanied by high-risk behaviors, then immediate clinical testing is advised.

The individual’s blood is tested with ELISA or enzyme immunoassay (EIA), antibody tests that detect the presence of HIV antibodies. If this test is positive than the same blood is tested a second time. If a second EIA test is positive a Western blot is performed. This is a more specific confirming test. Blood that tests positive to all three screenings is reported to be positive for HIV. IF the results are inconclusive or indeterminate, the tests are repeated in 4 to 6 weeks. Again, if repeated and the results remain indeterminate a culture is done to determine the viral load, this is done through testing the DNA of the individual.

These tests, whether positive or negative does not confirm nor dismiss the diagnosis of AIDS. That is done according to the 1993 CDC definition of HIV. A negative test is not an assurance that the individual is free of HIV since seroconversion takes up to three months after initial infection. And if the individual continues to engage in risky behaviors, transmission of the disease is likely to occur. At the present time it is believed that the modes of transmission of the HIV virus are clearly identified and understood.

Although generally perceived by the public as a sexually transmitted disease, the method of HIV transmission is far broader than simple sexual contact. As previously stated an obligate virus HIV requires a host organism to survive. Once leaving the human body the virus is extremely fragile and cannot survive outside of a host. Thus, HIV is transferred from person to person through infected body fluids including blood, semen, cervicovaginal secretions, breast milk, pericardial, synovial, cerebrospinal, peritoneal and amniotic fluids.

It has been discovered that not all body fluids, which contain HIV, transmit the virus. These fluids include saliva, urine, tears and feces. Further, the ability for HIV to be transmitted via an infected fluid from one human to another is mitigated by a variety of variables such as duration and frequency of exposure, the amount of the virus inoculated and the virulence of the organism. The efficiency of the immune system is also a factor. Once the virus has been passed to another individual, the newly infected individual then is immediately capable of passing the virus to yet another individual.

However, there are apparently cycles when the probability of transmission is greater than others. The greatest potential for transmission occurs immediately after infected and during their end stages of the disease. Nonetheless, it must be stressed that it is possible for HIV to be transmitted at anytime during the entire disease spectrum. As a practical matter, the most common method of transmission of HIV is through sexual contact. Vaginal and anal intercourse are two of the three most common modes of HIV transmission. Throughout the world it is believed that 75% of the total AIDS cases were the result of sexual contact.

Anal intercourse is the most frequent method of HIV transmission. This being the result of the frequent tearing of the rectal mucosa which allows for direct infusion of the infected semen into the blood stream. In all cases of intercourse the receptive partner is far more susceptible than the insertive partner. This is not only true of anal and vaginal intercourse, but also for oral intercourse as well. HIV can also be transmitted through oral genital sexual contact but such cases are considered rare. The homosexual community was seriously impacted by HIV in the early days of the epidemic.

This was the result of the tendency for unprotected and casual sexual encounters as well as a higher tendency for anal intercourse. The prostitution subculture was and still is seriously impacted by the HIV virus. Causes of this include their numerous and varied sexual encounters, pre-existing sexually transmitted diseases in addition to life style issues such as alcohol, smoking and illegal drug use which weakens the immune system. Undoubtedly, the most powerful form of transmission from one human to another of the HIV virus is through direct blood transfusions employing infected blood.

However, this has resulted in a miniscule number of cases. But the accidental or intentional use of contaminated injecting equipment is the third most common method of HIV transmission. The frequency of transmission being in the deliberate and repeated use of contaminated syringes by infected persons generally occurs in users of illegal drugs. These users typically share syringes and or other improvised injecting paraphernalia. While any illegal drug can be injected, heroine and cocaine are the most widely used injectable illegal drug. Less frequent forms of HIV transmission are vertical transmission and occupational exposure.

Vertical transmission occurs when a mother, either during pregnancy, at time of delivery, or after birth (through breast-feeding) infects an infant. Occupational exposure is considered to be rare but does occur. Studies ending in 1996 found 52 documented cases and another 111 cases of possible occupational transmission. These cases, by enlarge, involved health care workers who acquired the disease after percutaneous injury, mucocutaneous exposure and exposure through open wounds. Most of these cases involve puncture wounds from needle stick type injuries.

In addition to health care workers, at risk personal include police officers, fire fighters, military personal and prison employees. Since often the infectious contact is the result of elective human behavior, there are strategies for preventing the continued spread of HIV virus. At the center of these strategies is education which must be world wide, multileveled, intercultural and, of course, non-judgmental. Modifying behavior through education would include teaching safe sex practices, including stressing the proper and consistent use of effective condoms.

Similarly for the person who continues to use injected drugs, the use sterile needles must be taught. Deactivation of HIV requires only a 30-second exposure to 100% bleach. Instruction in the cleaning methods used to deactivate HIV should be done. Education without resources can only achieve marginal results. Therefor, although problematic and controversial it is necessary after education to provide easy and in most cases free access to condoms, sterile needles, early HIV testing and follow up medical treatment.

As discussed, while most but not all HIV transmission is the result of risky behavior, there are other causes of transmission as well. Prevention then must entail education, discipline and procedures to minimize infection through transfusion and safety procedures to prevent accidental transmission to people engaged in certain occupations such as health care workers. On this last point herein lies another controversy which is beyond the scope of this paper. That subject deals with what level should a person who is living with the HIV infection have his/her medical and or other records reflect that fact.

At what point is the individual’s right to privacy negated, if ever, in regards to the individuals who are charged with caring for the infected person. The public at large uses interchangeably the terms HIV and AIDS. This sloppy inaccuracy is one of the basis for the gross misunderstanding of the disease. HIV is divided into two categories; type I, which is found throughout the world and has resulted in most of the reported cases of infection, and type 2, which is localized to Western African coastal nations and areas outside of Africa which have commercial and cultural relations with that region.

HIV infection ultimately leads to the disease of AIDS. But it is not AIDS in and of itself. Within one to three weeks of initial exposure seroconversion occurs. This is the detectable development of HIV antibodies. While the virus is usually detectable, acutely veril and can be passed along, the infected person shows few or no symptoms. From the initial exposure period or roughly from two to six months flu like symptoms will appear in the infected person. The individual will begin to develop antibodies to fight the infection. The individual will frequently appear to be acutely ill.

Well before the end of the first year the HIV infection will become asymptomatic. (It should be noted that during this period of time the disease is not dorment but is systematically destroying t-helper cells). During this phase, which will last perhaps into the eighth year of infection, the infected individual will manifest no symptoms of disease. But, nonetheless, will be infectious. Between the eighth and tenth year of infection symptoms of HIV disease will manifest. After ten to fourteen years HIV disease advances into its terminal stage which is known as AIDS.

This stage is epitomized by the body’s inability to fight any infection. Thus any infection is potentially fatal to the AIDS patient. In no way to make light of the subject, it is reminiscent of the turn of the century novel by HG Wells, \”War of the Worlds\”. In this first science fiction story that deals with an alien invasion of earth by undefeatable machines, human bacteria proves lethal to these unstoppable forces. Similarly, the most mundane infection is a potential lethal agent to the AIDS patient. However, some opportunistic infections are more frequently associated with AIDS patients than others.

Of these opportunistic infections the most frequently encountered are those that are respiratory in nature, particularly pneumoncystic carinii pneumonia and Kaposi’s sarcoma. Interestingly, prior to the discovery of HIV/AIDS these two diseases were extremely rare and the dramatic increased occurrence of chronic ailments lead to the discovery of HIV/AIDS. While respiratory system diseases or organisms are most typical other OI can, with fatal consequences strike AIDS patients. The OI can attach any of the body’s systems including the integumentary, gastrointestinal and neurologic systems.

For any of these diseases a variety of diagnostic tests are appropriate and similarly with each disease a variety of treatment regimes have been established. However, there is no cure for AIDS. This is not to say that in the early stage of the disease the OI may be successfully resolved. But in the final analysis the OI that strikes the late stage AIDS patient will at some point become fatal. There are several drugs that are available for the treatment and management of opportunistic disease associated with AIDS. Prophylactically used these medications have contributed to the decrease morbidity associated with HIV infection.

The individual must take these medications throughout their lives to attempt to control the opportunistic disease as the body’s immune system degenerates. These drugs are more effective if used in combination with each other, combination therapy has become the standard of care. These \”cocktails\” are more effective than single drug therapy. Since patients have become resistant to many drugs over the long periods of time they must take them, studies have shown that combinations of antiviral drugs may reverse the resistance that has taken place.

However, the side effects of these medications are severe, at best. Nucleoside Analogues: zidovudine is the drug of choice to be used initially in combination therapy. Side effects of headache and nausea usually resolve within one month. Other side effects can be more serious such as granulocytopenia, thrombocytopenia, seizures, bone marrow suppression and anemia. Some of these side effects only occur after long term use. This class of drugs inhibits replication of HIV virus by incorporating into cellular DNA thereby terminating the cellular DNA chain.

Didanosine, which is in the same classification and acts the same as zidovudine but is used in patients who cannot tolerate zidovudine. Life threatening side effects are pancreatitis, peripheral neuropathy, seizures, CAN depression, leukopenia, granulocytopenia, thrombocytopenia and anemia. Other treatable side effects are nausea and vomiting, diarrhea, abdominal pain, constipation, stomatitis, liver abnormalities, oral thrush and many more usually resolve in a month. These drugs must be taken around the clock to maintain a therapeutic blood level.

Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIS) a class of drugs which binds directly to reverse transcriptase and blocks RNA, DNA conversion causing a disruption of the enzyme site. Nevirapine is used in combination therapy along with other antiviral drugs. Side effects include but are not limited to; rash, thrombocytopenia, fever, headache, nausea, hepatitis, myalgia, etc. The patient must be instructed to report any rash immediately since a rash may progress to Stevens-Johnsons syndrome, which may result in death.

Delavirdine is in the same class of drugs as nevirapine. This drug interferes with DNA synthesis that is needed for viral replication. Some side effects of the drug are; fatal metabolic encephalopathy, blood dyscrasias and acute renal failure. Common side effects are nausea and vomiting, headache, vaginitis, rash and elevated LFT’s. Again, this drug is used in combination therapy. Protease Inhibitors, another class of drugs inhibits HIV protease, which prevents the maturation of the infectious virus. Saquinavir is generally well tolerated because of low absorption rate.

This is used in combination with nucleoside analogues, NNRTIS and other protease inhibitors. Side effects are; pain, rash, diarrhea, buccal mucosa ulceration, abdominal pain, nausea, parathesia, headache and hyperglycemia. This drug should not be used in children, pregnancy, lactation and with caution in patients with liver disease. The patients must understand that adherence to the drug regimes is extremely important since inadequate adherence can lead to drug resistance and ultimately drug failure. There is little question that early detection is essential to optimum therapeutic management.

An obvious benefit of early detection would be corrective treatment of other sexually transmitted diseases, tuberculosis and immunization against the onset of OD and viruses. Lastly, it must be recognized that often life style issues and high-risk behaviors have seriously damaged and weakened the AIDS patient’s immune system and health prior to onset of AIDS. Therefore, along with medication life style adjustment is an intricate part of AIDS treatment. Cessation of risky behavior, abstinence from alcohol, tobacco and illegal drugs is essential aspects of the treatment program.

Additionally, it is believed that an interdisciplinary approach incorporating acupuncture, massage therapy and other non traditional remedies may be useful if only in raising the mental attitude of the patient. Interestingly AIDS may be the vehicle for western medicine to entertain more seriously the various treatments of non-traditional therapies, if only to underscores the relationship between health and a positive attitude. CONCLUSIONS In 1985 AIDS was viewed as an immediate death sentence, and a horrific one at that, to the infected person.

There was apocalyptic terror that this epidemic could wipe out mankind. Now, although there is still no cure for AIDS, education and other aggressive actions are stemming the spread of the disease. On an individual basis, the length and quality of life of people living with the AIDS virus is dramatically increasing. Medicine will ultimately conquer AIDS and with the confidence of having done so, medical practitioners will be better prepared and equipped to meet the next plague when and if it comes.

A serious risk of HIV infection

Today adolescents of both sexes face a serious risk of HIV infection, which is the cause of AIDS. AIDS is a chronic and most often fatal disease. Despite growing understanding and awareness, HIV infection is a serious threat to both heterosexual and homosexual teens. When adolescents take certain risks, they are more likely to become infected with HIV and develop AIDS: These are the most important facts about AIDS: . AIDS is most often fatal . Anyone can get AIDS – many teens (both boys and girls) have been infected . Condoms can reduce the risk of getting AIDS .

You can get AIDS from use of even one contaminated needle or one exual act with a partner who has HIV/AIDS Risk of AIDS is increased by: . an increased number of sexual partners . IV drug use . anal intercourse . any sex (oral, anal or vaginal) without condoms . alcohol and other drug use (sex is more impulsive and use of condoms less likely if under the influence of alcohol or other drugs) . tattoos and body piercing with contaminated (unsterile) needles or instruments AIDS (Acquired Immune Deficiency Syndrome) is a chronic illness caused by infection with HIV (human immunodeficiency virus).

Millions of Americans are believed to be infected with HIV. Some of them have AIDS, but most have no symptoms at all, and many do not know they are infected. Despite significant advances in available medical treatment for HIV, there are no definitive cures or vaccines that can prevent the disease. New treatments have enabled many people with AIDS to live longer. AIDS can be prevented by avoiding risk behaviors. HIV is transmitted through exchange of certain bodily fluids such as blood, semen, vaginal secretions, and breast milk. To produce an infection, the virus must pass through the skin or mucous membranes into the body.

HIV infection is preventable. Knowledge about HIV is an important aspect of prevention. Parents should educate their children and also work closely with schools, churches, youth organizations, and health care professionals to ensure that children and teens receive sex education and preventive drug abuse courses which include material on HIV. The HIV virus dies quickly when it is outside the human body. It cannot be transmitted by day-to-day or even close social contacts not mentioned above. Family members of an individual infected with HIV will not catch the virus if they share drinking glasses with the person.

There is no known nstance in which a child infected with HIV has passed the virus to another child in the course of school activities. HIV infection occurs in all age groups. Twenty-five percent of the babies born to untreated mothers infected with HIV develop HIV infection themselves. Many of these children die within one or two years, but some live for years, although their development is slowed and they can get many infections. Mothers-to-be with HIV must get special treatment to try to prevent transmission of the virus to their fetuses.

New treatments for pregnant women may reduce the transmission of the virus to fewer than one n ten babies of HIV-positive mothers Drug and/or alcohol abuse, premature and/or promiscuous sexual activity are serious risk behaviors. Evaluation by a child and adolescent psychiatrist can be an important first step in helping a family respond effectively to high risk behaviors in their children and adolescents. 45,736,287 number of people men/women and children living with aids today AIDS (acquired immunodeficiency syndrome) results from infection with the human immunodeficiency virus (HIV).

HIV infects and destroys lymphocytes, a type of white blood cell involved in the body’s immune (infection-fighting) esponse to invading germs. The virus attacks specific lymphocytes called T helper cells (CD4 cells, also known as T-cells), taking over the machinery of these cells to make more copies of itself. This process begins to destroy the CD4 cells. Over time, the total number of CD4 cells in the body drops off, lowering the body’s resistance to invading germs and disease.

When the population of CD4 cells falls to a very low level, people with HIV get infections (known as opportunistic infections) and/or certain types of cancer that a healthy immune system would otherwise successfully fight off. This weakened immunity (or immune deficiency) is known as AIDS and can result in severe life-threatening infections, some forms of cancer, and the deterioration of the nervous system. Although AIDS is always the result of an HIV infection, not everyone with HIV has AIDS. In fact, adults who become infected with HIV will appear healthy for years before they get sick with AIDS.

HIV/AIDS Statistics The first case of AIDS was reported in 1981, but the disease may have existed unrecognized for many years before that. HIV infection leading to AIDS has been a major cause of illness and death among children, teens, and oung adults worldwide. Nationally, AIDS has been the sixth leading cause of death in the United States among 15- to 24-year-olds since 1991. In recent years, AIDS infection rates have been increasing rapidly among teens and young adults. Half of all new HIV infections in the United States occur in people under 25 years of age; thousands of teens in the United States become infected each year.

According to the Centers for Disease Control and Prevention (CDC), the majority of new HIV cases in younger people are transmitted through unprotected sex; one third of these cases re from injection drug usage – the sharing of dirty, blood-contaminated needles. In 2000, the CDC reported that more than 90% of current cases of AIDS in children – and almost all new HIV infections reported in young children in the United States – resulted from transmission of the HIV virus from the mother to her child during pregnancy, birth, or through breastfeeding.

Fortunately, medicines currently given to HIV-positive pregnant women have reduced mother-to-child HIV transmission tremendously in the United States. These drugs (discussed in detail in the Treatment section of this article) re also used to slow or reduce some of the effects of the disease in people who are already infected. As a result, transmission from mother to child has been almost eliminated in the United States. Unfortunately, these medicines have not been readily available worldwide, particularly in the poorer nations hardest hit by the epidemic.

According to UNAIDS (the Joint United Nations Programme on HIV and AIDS) and the World Health Organization, in developing countries, where 95% of people with HIV live, only about 5% of those who needed treatment could get it in 2002. In Africa, that percentage was even lower. Providing access to these life-saving treatments has become an issue of global importance. Causes HIV is transmitted through direct contact with the blood or body fluid of someone who is infected with the virus. The three main ways the HIV virus is passed to a very young child are: . while the baby develops in the mother’s uterus (intrauterine) . t the time of birth . during breastfeeding Among teens, the virus is most commonly spread through high-risk behaviors including: . unprotected sexual intercourse (oral, vaginal, or anal sex) . sharing needles used to inject drugs or other substances (including ontaminated needles used for injecting steroids and tattooing and body art) HIV can also be transmitted by direct contact with an open wound of an infected person (the virus may be introduced through a small cut or tear on the body of the healthy person), but this is very rare. Blood transfusions can also transmit the virus, but again, this is rare.

Since 1985, the U. S. blood supply has been carefully screened for HIV. Signs and Symptoms Although there are no immediate physical signs of HIV infection at birth, children born with HIV can develop opportunistic infections (infections hat take advantage of a person’s weakened immune system), such as Pneumocystis carinii pneumonia (PCP), in the first months of life. They also can have much more severe bouts of other common childhood infections, such as Epstein-Barr virus (EBV) infection, which causes mild illness in most kids but can cause fatal pneumonia in children with HIV/AIDS.

In developing countries, tuberculosis has been a particularly common problem and often the cause of death of children and adults. A baby born with HIV infection most likely will appear healthy. But sometimes, within 2 to 3 months after birth, an infected baby may begin to ppear sick, with poor weight gain, repeated fungal mouth infections (thrush), enlarged lymph nodes, enlarged liver or spleen, neurological problems, and multiple bacterial infections, including pneumonia. Teens and young adults who contract HIV usually show no symptoms at the time of infection.

In fact, it may take up to 10 years or more for symptoms to show. During this time, they can pass on the virus without even knowing they have it themselves. Once the symptoms of AIDS appear, they can include rapid weight loss, intense fatigue, swollen lymph nodes, persistent diarrhea, night sweats, or pneumonia. They, too, will be susceptible to life-threatening opportunistic infections. Long-Term Care of Children With HIV/AIDS Cases of HIV infection and AIDS in children are complicated and should be managed by experienced health care professionals.

Children will need to have their treatment schedules closely monitored and adjusted regularly. Any infections that could become life-threatening must be quickly recognized and treated. Medicines are adjusted in relation to the child’s viral load. The child’s health is also monitored by frequent measurement of T-cell levels because these are the cells that the HIV virus destroys. A good T-cell count is a positive sign that medical treatments are working to keep the disease under control.

Children will need to visit their health care providers often for blood work, physical examinations, and discussions about how they and their families are coping socially with any stress from their disease. Some immunizations during routine visits may be slightly different for infants or children with HIV/AIDS (they will only receive the live virus vaccines – measles-mumps-rubella and varicella [chicken pox] – if their immune systems are not severely compromised). All other routine immunizations are given as usual, and a yearly influenza vaccine (flu shot) is recommended as well.

If a family seeks health care in a hospital emergency department, parents should be sure to tell the nurse who registers the child that the child has HIV; this will alert medical caregivers to look closely for any signs of diseases from opportunistic infections. Outlook There is no known cure for HIV or AIDS. Although current treatments can slow the progression of the HIV disease, life expectancy is still reduced significantly. Children who acquire HIV at birth develop AIDS sooner and end to have more serious complications than adults with the virus.

At this time, no children who were infected with HIV at birth have survived into adulthood, though much progress is being made in AIDS research and treatment. Although all children, teens, and adults with HIV will eventually become sick, recent medical advances have prolonged their survival. Drug treatments can allow people living with HIV to remain free of symptoms for longer and can improve quality of life for people living with AIDS. The search goes on for a vaccine that might prevent HIV infection. But even if uch a vaccine is developed, it is likely years away.

That’s why prevention of HIV remains of worldwide importance today. Prevention Despite much research, there is no vaccine that will prevent HIV infection. Only the avoidance of risky behaviors can do this. Among U. S. teens and adults, HIV transmission is almost always the result of sexual contact with an infected person or sharing contaminated needles. Infection can be prevented by: . abstaining from sex (not having oral, vaginal, or anal sex) . never sharing needles Risk can be substantially reduced by: . lways using latex condoms for all types of sexual intercourse, orrectly and every time . avoiding contact with the bodily fluids through which HIV is transmitted: blood, semen, vaginal fluids, and breast milk Avoidance of alcohol and drugs is also key in preventing the spread of HIV – not because a person can get HIV directly from drinking and doing drugs, but because drinking and drug use often leads to risky behaviors that are associated with an increased risk of infection (such as having unprotected sex and sharing needles).

The most important means of preventing HIV/AIDS in infancy is to test all pregnant women for the virus. If the result is positive, treatment can mmediately begin before the baby is born to prevent HIV transmission. Talking With Your Child About HIV and AIDS Talking about HIV and AIDS means talking about sexual behaviors – and it’s not always easy for parents to talk about sexual feelings and behavior to their teens. Similarly, it’s not always easy for teens to open up or to believe that issues like HIV and AIDS can affect them.

Doctors and counselors suggest that parents become knowledgeable and comfortable discussing sex and other difficult issues early on, even before the teen years. After all, the issues involved – understanding the body and exuality, adopting healthy behaviors, respecting others, and dealing with feelings – are topics that have meaning at all ages (though how parents talk with their children will vary according to the child’s age and ability to understand). Open communication and good listening skills are vital for parents and children.

Schools can help. Providing age-appropriate information about HIV/AIDS that has been designed to educate children about the disease is required by every state. Studies show that such education makes a tremendous difference in stopping risk-taking behavior by young people. Parents who are well informed about the behaviors that can prevent the spread of HIV and who talk with their children regularly about healthy behaviors, feelings, and sexuality play an important part in HIV/AIDS prevention.

HATRED Love to Hate America’s Obsession with Hatred and Violence Jody Roy “In bringing together disparate strands of culture in an insightful configuration, Roy’s work makes an original and significant contribution to our understanding of the relationship between rhetoric and popular culture. The book addresses a timely and engrossing subject in a way that will appeal to the general reader, as well as to scholars n culture studies, mass media, and communication; it stands as an excellent example of the application of sound scholarship to social problems. -James R. Andrews, professor emeritus of American Studies, Indiana University “Love to Hate is a skillfully written depiction of how we Americans have gotten ourselves caught up in a seemingly endless cycle of intrigue with hatred and violence. Roy’s many cleverly related examples and her introduction to the basic thought processes at work make you ask, ‘wow -do I do this? ‘” -Kathy Stewart, chair, Board of Directors, Students Talking About Respect, Inc. “A commentary on America’s obsession with violence. ” – Youth Today Why? s the simple, impulsive question we ask when confronted by horrible acts of hatred and violence. Why do students shoot fellow students or employees their coworkers? Why do mothers drown their children or husbands stalk and kill their wives? Love to Hate challenges us to turn this question upon ourselves at a deeper level. Why, as a culture, are we so fascinated by these acts? Why do we bestow celebrity on the perpetrators, while allowing the victims to fade into a second death of obscurity? Are e, as Pope John Paul II famously accused, “a culture of death”?

And if so, how can we break free of this unacknowledged aspect of the cycle of violence? Unlike those who point solely to media imagery, splintered families, or lax gun control laws in search of the roots of America’s endemic violence, Jody M. Roy suggests that we all must be held responsible. She argues that we reveal our love affair with hatred and violence in the ways we think and speak in our daily lives and in our popular culture. The very words we use function as building blocks of callousness and contempt, betraying our mmersion in subtexts of violence and hatred.

These subtexts are further revealed in our complex attitudes toward street gangs, school shooters, serial killers, and hate groups and the paroxysms of violence they unleash. As spectators, driven by our impulse to watch, we become an integral part of the equation of violence. In the book’s final section, “Freeing Ourselves of Our Obsession with Hatred and Violence,” Roy offers practical steps we can take -as parents, consumers, and voters -to free ourselves from linguistic and cultural complicity and to help create in America a culture of life.

AIDS – one of the most fatal viruses in the nation

Being one of the most fatal viruses in the nation, AIDS (Acquired Immunodeficiency Syndrome) is now a serious public health concern in most major U. S. cities and in countries worldwide. Since 1986 there have been impressive advances in understanding of the AIDS virus, its mechanisms, and its routes of transmission. Even though researchers have put in countless hours, and millions of dollars it has not led to a drug that can cure infection with the virus or to a vaccine that can prevent it.

With AIDS being the leading cause of death among adults, individuals are now taking more precautions with sexual intercourse, and medical acilities are screening blood more thoroughly. Even though HIV ( Human Immunodeficieny Virus) can be transmitted through sharing of non sterilize needles and syringes, sexual intercourse, blood transfusion, and through most bodily fluids, it is not transmitted through casual contact or by biting or blood sucking insects.

Development of the AIDS Epidemic The first case of AIDS were reported in 1982, epidemiologists at the Center of Disease Control immediately began tracking the disease back wards in time as well as forward. They determined that the first cases of AIDS in the United States robably occurred in 1977. By early 1982, 15 states, the District of Columbia, and 2 foreign countries had reports of AIDS cases, however the total remained low: 158 men and 1 woman. Surprising enough more then 90 percent of the men were homosexual or bisexual.

Knowing this more then 70 percent of AIDS victims are homosexual or bisexual men, and less then 5 percent are heterosexual adults. Amazing enough by December of 1983 there were 3,000 cases of AIDS that had been reported in adults from 42 states, the District of Columbia, and Puerto Rico, and the disease had been recognized in 20 other countries. Recognizing the Extent of Infection The health of the general homosexual populations in the area with the largest number of cases of the new disease was getting looked at a lot closer by researchers.

For many years physicians knew that homosexual men who reported large numbers of sexual partners had more episodes of venereal diseases and were at higher risk of hepatitis B virus infection than the rest of the population, but conicidentally with the appearance of AIDS,. other debilitating problems began to do appear more frequently. The most common was swollen glands, often accompanied y extreme fatigue, weight loss, fever, chronic diarrhea, decreased levels of blood platelets and fungal infections in the mouth. This condition was labeled ARC (AIDS Related complex).

The isolation of HIV in 1983 and 1984 and the development of techniques to produce large quantities of the virus [paved the way for a battery of tests to determined the relationship between AIDS and ARC and the magnitude of the carrier problem. Using several different laboratory tests, scientists looked for antibodies against the HIV in the blood of AIDS and ARC patients. They found that lmost 100 percent of those with AIDS or ARC had the antibodies-they were seriopostive. In contrast less then one percent of persons with no known risk factors were seropositive.

Definition of AIDS AIDS is defined as a disease, at least moderately predictive of defects in cell- meditated immunity, occurring in a person with no known cause for diminished resistance to that disease. Such diseases include Kaposi’s Sarcoma, Pneumocystis carnii pneumonia, and serious other opportunistic infections. After the discovery of HIV and the development of HIV-antibody test, the case definition of AIDS was pdated to reflect the role of the virus in causing AIDS, but the scope of the definition remained almost the same.

Transmission HIV is primarily a sexually transmitted disease, it is transmitted by both homosexual and bisexual and heterosexual activity. The first recognized case was among homosexual and bisexual men. Many numbers of studies have shown that men who have sexual partners and those who practice receptive anal intercourse are more likely to be infected with HIV than other homosexual men. Researchers found a strong connection between HIV infection and rectal trauma, enemas before ex, and physical signs of disruption of the tissue lining the rectum.

Homosexual women tend to have a very low incidence of venereal disease in general, an AIDS is no exception. Female-to-female transmission is highly uncommon, however it has been reported in one case and suggested in another. In the reported case, traumatic sex practices apparently resulted in transmission of HIV from a woman who had acquired the virus through IV drug abuse to her non-drug- using sexual partner. 1983 was when the first heterosexual (Male to female; female to male) transmission was reported. In 1985, 1. ercent of the adult cases of AIDS reported to the CDC (Center for Disease Control) were acquired through heterosexual activity; projections suggest that by 1991 the proportion will rise to 5 percent.

Heterosexual contact is the only transmission category in which women outnumber men with AIDS. Heterosexual contacts accounts for 29 percent of AIDS cases among women in the United States, but for only 2 percent of cases among men. Estimates of the risk of HIV transmission in unprotected intercourse with a person known to be infected with HIV are 1 in 500 for a single sexual encounter and 2 in 3 for 500 sexual encounters.

The use of a condom reduces these odds to 1 in 5,000 for a single encounter and to 1 in 11 for 500 encounters. Routes NOT Involved in Transmission of HIV A study of more than 400 family members of adult and pediatric AIDS patients demonstrate that the virus is not transmitted by any daily activity related to living with or caring for an AIDS patient. Basically meaning that personal interactions typical in family relationships, such as kissing on the cheek, kissing on the lips, and hugging, have not resulted in transmission of the virus. Patterns There are three different geographic patterns of AIDS transmission.

The first one is characteristic of industrializing nations with large numbers of reported AIDS cases, such as the United States, Canada, countries in Western Europe, Australia, New Zealand, and parts of Latin America. In these areas most AIDS cases have been attributed to homosexual or bisexual activity and intravenous drug abuse. The second pattern is seen in areas of central, eastern, and southern Africa and in some Caribbean countries. Unlike pattern one most AIDS cases in these areas occur among heterosexuals, and the male-to-female ratio approaches 1 to 1.

The third attern of transmission occurs in regions of Eastern Europe, the Middle East, Asia, and most of the Pacific. It is believed that HIV was introduced to these areas in the early to mid-1980s. Any study associated with AIDS must begin with the understanding that AIDS is only one outcome of infection with HIV-1. People infected with the virus may be completely asymptomtic; they may have mildly debiliating symptoms; or they may have life-threatening conditions caused by progressive destruction of the immune system, the brain, or both.

One of the first signs of HIV-1 infection in some patients is an acute fluelike isease. The condition lasts from a few days to several weeks and is associated with fever, sweats, exhaustion, loss of appetite, nausea, headaches, soar throat, diarrhea, swollen glands, and a rash on the torso. Some of the symptoms of the acute illness may result from HIV-1 invasion of the central nervous system. In some cases the clinical findings have correlated with the presence of HIV-1 in the cerebrospinal fluid. Symptoms disappear along with the rash and other sings of acute viral disease.

When the blood test for HIV-1 antibodies become available, researchers demonstrated the lymphadenopathy was a requent consequence of infection with the virus. Scientist do not know what causes the wasting syndrome, but some experts believe that it might result from the abnormal regulation of proteins called monokines. Between 5 and 10 percent of patients with AIDS and HIV-related conditions have bouts of acute aseptic meningtis. About two-thirds of AIDS patients have a degenerative brain disease called subacute encephalitis.

HIV infection also have been associated with degeneration of the spinal cord and abnormalities of the peripheral nervous system. Symptoms include progressive loss of coordination and weakness. Involvement of the peripheral nervous system may result in shooting pains in the limbs or in numbness and partial paralysis. HIV destroys the body’s defense capabilities, opening itself to whatever disease-producing agents are present in the environment. The diagnosis of secondary infection in AIDS patients and others with HIV infection is complicated because some of the standard diagnostic tests may not work.

Often such tests detect the immune response to a disease-producing microorganism rather than the organism itself. The most common life threatening opportunistic infection in AIDS patients is Pneumocystis carinii Pneumonia, a parasitic infection previously seen almost exclusively in cancer and transplant patients receiving immunosuppressive drugs. The first signs of disorder are moderate to severe difficulty in breathing, dry cough, and fever. Infection Infection with HIV is a 2-step process consisting of binding and fusion.

The larger protein, glycoprotein120, is responsible for the binding activity. Its target is a receptor molecule called CD4, found on the surface of some human cells. The tight complex formed by glycoprotein120, and CD4 receptor brings the viral envelope very close to membrane of the target cell. This allows the smaller envelope protein, glycoprotein41, to initiate a fusion reaction. The envelope of the virus actually fuses with the cell membrane, allowing the viral core direct access to the inner mechanisms of the human cell.

Once the viral core is inside the cell, the viral RNA genome is reverse transcribed into DNA and then integrated into the host genome cells. Cells infected with HIV carry envelope proteins lodged in their membrane. These cell-bound proteins can bind to CD4 receptors on uninfected cell. Fusion of the two cell membranes allow partially formed viral particles to move from the nfected cell to the uninfected cell. Thus, HIV theocratically could spread through the body without leaving host cells. Cell Death HIV infects many different cell types, but it preferentially kills the T4 lymphocyte.

There have been suggestions the T4 cells are more vulnerable to HIV- induced cell death than other cells because they have a higher concerntration of CD4 receptors. There is speculation that cell death occurs when viral envelope proteins lodged in the membrane of an infected cell bind to CD4 receptors embedded in the same membrane. Multiple self fusion reactions could destabilize he cell membrane and kill the cell. The massive depletion of T4 cells involves the cell-to-cell fusion reaction described above.

A single infected cell with a high concentration of viral envelope proteins on its surface can bind to hundreds of uninfected T4 cells. The fused cells form giant, mulitnucleated structures called syncytia, which are extremely unstable and die within a day. One cell with a productive viral infection can cause the death of up to 500 normal cells. Cell death might be related to the presence of free- floating viral envelope proteins in the bloodstream. These could bind to uninfected T4 cells, leading to their elimination by the immune system.

Other autoimmune mechanisms also may play a roll in T-cell depletion. HIV infection also may directly or indirectly suppress the production of new T4 cells. Direct suppression would occur if HIV damaged T precursor cells in the bone marrow. Indirect suppression would result if HIV interfered with the production of specific growth factors. On the other hand, infected cells may secrete a toxin that shortens the lifespan of T4 cells or other cells required for their survival. Immune System The Immune response to HIV infection, does not appear to halt the progression of disease.

Part of the explanation for this failure probably relates to the structure of the envelope proteins. The most effective way to stop HIV infection would be to block the binding reaction between the glycoprotein120 and the CD4 receptor. However, antibodies from infected patients rarely do this. Scientists speculate that 2 or 3 regions of the glycoprotein120 molecule involved in the binding reaction may form a recessed pocket. The inability of antibodies to get inside such a pocket could explain the lack of protective immune response. The envelope proteins also are heavily coated with sugar residues.

The human immune system does not recognize the sugar residues as foreign because they are products of the host cell rather then the virus. The sugar residues form a protective barrier around sections of the glycoprotein120 that might otherwise elicit a strong immune response. Regulatory Genes There has been recent studies that indicate HIV’s unusual regulatory genes contributing to its ability to evade the immune system. In the simplest retroviruses the replication rate is controlled by interactions between the host cell and elements in the viral LTR. The virus itself has no way of regulating when, here, or how much virus is produced.

In contrast, the human immunodeficiency viruses have elaborate regulatory control mechanisms in the form of specific genes. Some of the genes permit explosive replication; other appear to inhibit production of virus. Mechanisms that suppress the production of certain viral proteins, such as the envelope proteins, may allow HIV to hide inside infected cells for long periods without eliciting antibodies or other host immune responses. Conclusion As stated above in the last few pages, AIDS is the leading cause of death in omosexual, and bisexual adult men.

However, these statistics were from 1986, 11 years later it has grown to more, not just in homosexual and bisexual men, but also in heterosexual sexual intercourse. At this point in time there is no cure, nor is there a vaccination. However, there are ways to prevent HIV, some of those ways are: abstinence, condoms, not sharing needles used for IV drugs. Public concern is higher then it was 10 years ago, but that’s because people are starting to realize that not everyone is immune to it, as of right now the only ones immune to the HIV virus are baboons.

AZT drug to cure AIDS

The AIDS virus is one of the most deadly and most wide spread diseases in the modern era. The disease was first found in 1981 as doctors around the United States began to report groups of young, homosexual men developing a rare pneumonia caused by an organism called Penumocystis carini. These patients then went on to develop many other new and rare complications that had previously been seen only in patients with severely damaged immune systems. The Center for Disease Control in the United States named this new epidemic the acquired immunodeficiency syndrome and defined it by a specific set of symptoms.

In 1983, esearchers finally identified the virus that caused AIDS. They named the virus the human immunodeficiency virus, or HIV. AIDS causes the immune system of the infected patient to become much less efficient until it stops working altogether. The first drug that was approved by the American Food and Drug administration for use in treating the AIDS virus is called AZT, which stands for azido-thymidine. AZT was released under the brand name of Retrovir and it’s chemical name is Zidovudine, or ZDV. The structural name of AZT is 3′-azido-3′- deoxythymidine. AZT works by inhibiting the process of copying DNA in cells.

More specifically, AZT, inhibits the reverse transcriptase enzyme, which is involved in the DNA replication process. When DNA is replicating in a cell, there is a specific enzyme that works along one side of the original DNA strand as the DNA is split into two strands, copying each individual nucleotide. This enzyme is only able to work in one direction along the nucleotide string, therefore a different enzyme, or rather a series of different enzymes is required to work in the opposite direction. Reverse transcriptase is one of the enzymes that is required to work in the opposite direction.

AZT works by bonding to the reverse transcriptase enzyme, thereby making it unable to bond with the nucleotide string and making it unable to fulfill it’s role. This whole process is used by the HIV virus to replicate itself so that it can continue to infect more cells. AZT was originally developed over 20 years ago for the treatment of lukemia. The concept behind this was that the AZT was supposed to terminate the DNA synthesis in the growing lukemia lymphocytes, thereby stopping the disease. AZT was rejected at this point because it failed to lengthen the lives of test nimals.

The problem with the AZT drug is that it is not perfect. First of all, AZT will not bond to each and every reverse transcriptase enzyme in the body, and therefore it cannot shut down the HIV production completely. The reason for this is because to put enough AZT in the patient to completely shut down the HIV production would probably kill the patient. The second, and most serious problem with AZT is that it also goes into normal, healthy cells and will inhibit their reverse transcriptase enzyme and will therefore inhibit their ability to produce new, healthy cells.

However, AZT does have an ability to specifically target HIV infected cells to a certain degree so that it does not kill each and every cell it gets into. However, it does kill a high proportion of the cells that it gets into, thereby giving it a high toxicity level. The formula for AZT is C H N O . The molar mass of AZT is 267. 24 grams per mole. AZT’s melting point is between 106 C and 112 C. AZT is soluble in water, which is important so that it may dissolve into the human blood and be distributed to the cells. AZT is usually taken in a pill format, but it is bsorbed by the skin, which can make it dangerous for people handling the drug.

There is quite a bit of controversy about the effectiveness of AZT. Most experts agree that AZT delays the progression of HIV disease; the drug may also prolong the disease-free survival period. However, many doctors still disagree with using AZT as a treatment for AIDS. Peter Duesberg, a professor of molecular biology at the university of California, Berkley, says that “In view of this, [the cytotoxicity level of AZT] there is no rational explanation of how AZT could be beneficial to AIDS patients, even if HIV were proven to cause AIDS. This comment stems from the fact that AZT has a very high cytotoxicity level, which means that while it kills the infected cells, it will also kill perfectly healthy cells. According to Dr. Duesberg, AZT will kill approximately nine hundred and ninety nine healthy cells for each infected cell that it kills. Most of this opposition to AZT stems from the fact that the initial testing for the drug had severe problems associated with it. These initial tests were performed with two groups of AIDS patients.

The volunteering patients were secretly divided into two groups using a double-blind system, where neither the patients or the doctors are aware of who is in the placebo, or control group, and who is in the AZT group. These tests were performed by the FDA at twelve medical centers throughout the United States. The study actually became unblinded almost immediately as some patients discovered a difference in taste between the placebo and AZT caplets and other patients took the capsules to chemists to have them analyzed.

The doctors found out the differences between AZT patients and the placebo patients by very obvious differences in blood profiles. An FDA meeting was convened and the decision was made to keep all of the useless data, nd therefore the bad data was thrown in with the good data and it ended up making all of the data virtually useless. In fact, according to some sources, AZT ended up shortening the lifespans of many of the patients taking it. AZT is also thought to be a possible carcinogen, although it has not been around long enough for any conclusive results to be obtained.

After AZT was approved for use, mortality statistics were taken, they showed a mortality rate of 10% after 17 weeks, with the original number of patients being 4805. The FDA tests, with their skewed statistics, showed only a 1% mortality rate. AZT also had some trange side-effects that were reported with it’s use, such as raising the IQs of 21 children who took the drug by 15 points, 5 of the children died. The newest treatments with AZT are combining AZT with other drugs, such as ddI.

These tests were being performed, once again in the double-blind format, just like the original FDA tests. Three different groups were tested, ones taking only AZT, ones taking only ddI and ones taking a combination of both ddI and AZT. The Data Safety Monitoring Board (DSMB), and organization that monitors all testing in the United States secretly unblinded the test, as they do with ll double-blind tests, and found that the AZT patients had a much higher mortality rate than those in the straight ddI and the ddI and AZT tests.

The DSMB found the difference in the tests to be high enough to stop the trials early. In August of 1994, the FDA approved AZT for use by pregnant, AIDS infected women. Once again it was conducted in a double-blind method and was placebo controlled. The therapy was begun 14-34 weeks after pregnancy. However, in this testing it was found that in the AZT mothers, the AIDS transmission rate to the babies was about 8. 3% while the placebo group was about 25. 5%. Therefore he AZT was reducing the AIDS transmission by two thirds.

It is still not clear as to the effectiveness of AZT to stop or hinder the progress of the AIDS virus. Most experts today consider AZT to be a valid way to treat AIDS and HIV infection, but they are constantly experimenting with new combinations of different drugs such as ddI and AZT to try to better treat AIDS patients. The massive administrative errors in the initial testing have set the AZT research back and have fostered unlooked for antipathy. As the treatments become more sound and more reliable, AZT will find it’s place in AIDS treatments.

Acquired Immune Deficiency Syndrome

Acquired immune deficiency syndrome, or AIDS, is a recently recognized disease. It is caused by infection with the human immunodeficiency virus (HIV), which attacks selected cells in the IMMUNE SYSTEM and produces defects in function. These defects may not be apparent for years. They lead, however, to a severe suppression of the immune system’s ability to resist harmful organisms. This leaves the body open to invasion by various infections, which are therefore called opportunistic diseases, and to the development of unusual cancers.

The virus also tends to reach certain brain cells. This leads to so-called neuropsychiatric abnormalities, or psychological disturbances caused by physical damage to nerve cells. Since the first AIDS cases were reported in 1981, through mid-1994 more than 402,000 AIDS cases and more than 241,000 deaths have been reported in the United States alone. This is only the tip of the iceberg of HIV infection, however. It is estimated that nearly 1 million Americans had been infected with the virus through the mid-1990s but had not yet developed clinical symptoms.

In addition, although the vast majority of documented cases have occurred in the United States, AIDS cases have also been reported in almost every country in the world. Sub-Saharan Africa in particular appears to suffer a heavy burden of this illness. No cure or vaccine now exists for AIDS. Many of those infected with HIV may not even be aware that they carry and can spread the virus. Combating it is a major challenge to biomedical scientists and health-care providers. HIV infection and AIDS represent among the most pressing public-policy and public-health problems worldwide.

Definition of AIDS The U. S. CENTERS FOR DISEASE CONTROL AND PREVENTION has established criteria for defining cases of AIDS that are based on laboratory evidence such as T4 cell count, the presence of certain opportunistic diseases, and a range of other conditions. The opportunistic diseases are generally the most prominent and life-threatening clinical manifestations of AIDS. It is now recognized, however, that neuropsychiatric manifestations of HIV infection of the brain are also common. Other complications of HIV infection include fever, diarrhea, severe weight loss, and swollen lymph nodes.

When HIV-infected persons experience some of the above symptoms but do not meet full criteria for AIDS, they are given the diagnosis of AIDS-related complex, or ARC. The growing feeling is that ARC and HIV infection without symptoms should not be viewed as distinct entities but, rather, as stages of an irreversible progression toward AIDS. Historical Background In the late 1970s, certain rare cancers and a variety of serious infections were recognized to be occurring in increasing numbers of previously healthy persons.

Strikingly, these were disorders that would hardly ever threaten persons with normally functioning immune systems. First formally described in 1981, AIDS was observed predominantly to be affecting homosexual and bisexual men. Soon thereafter, intravenous drug users, hemophiliacs, and recipients of blood transfusions were recognized as being at increased risk for disease as well. It was also noted that sexual partners of persons with AIDS could contract the disease. Further study of AIDS patients revealed marked depletion of certain white BLOOD cells, called T4 lymphocytes.

These cells play a crucial role in coordinating the body’s immune defenses against invading organisms. It was presumed that this defect in AIDS patients was acquired in a common manner. Then, in 1983, a virus that attacks T4 cells was separately discovered by Robert Gallo at the U. S. National Institutes of Health and Luc Montagnier at France’s Pasteur Institute. The virus was at first given various names: human lymphotropic virus (HTLV) III, lymphadenopathy-associated virus (LAV), and AIDS-associated retrovirus (ARV).

It is now officially called human immunodeficiency virus (HIV), and considerable evidence demonstrates that it is indeed the causative agent for AIDS. A second strain that has been identified, HIV-2, is thus far relatively rare outside of Africa. Little is known about the biological and geographical origins of HIV. Apparently, however, this is the first time in modern history that the virus has spread widely among human beings. Related viruses have been observed in animal populations, such as certain African monkeys, but these do not appear to produce disease in humans. The Nature of the Virus HIV is an RNARETROVIRUS.

Viewed in an electron microscope, it has a dense cylindrical core that encases two molecules of viral RNA genetic material. A spherical outer envelope surrounds the core. Like all retroviruses, HIV possesses a special enzyme, called reverse transcriptase, that is able to make a DNA copy of the viral RNA. This enables the virus to reverse the normal flow of genetic information (see GENETIC CODE) and to incorporate its viral genes into the genetic material of its host. The virus may then remain in a latent form for a variable and often lengthy period of time until it is reactivated.

Further knowledge of the mechanisms and triggers of the activation process is important to the efforts being made to control HIV infection. A critical step in HIV infection is the binding of the virus to a receptor on the cell it attacks, enabling it to gain entrance. A molecule called CD4, found on the surface of the T4 cell, serves as a receptor, and almost any other cell with the CD4 surface molecule can become infected with HIV. Research has shown that a coreceptor called CD26 helps the HIV virus invade cells.

Thus blood cells known as monocytes and macrophages are very important additional targets. Modes of Transmission Researchers have isolated HIV from a number of body fluids, including blood, semen, saliva, tears, urine, cerebrospinal fluid, breast milk, and cervical and vaginal secretions. Strong evidence indicates, however, that HIV is transmitted only through three primary routes: sexual intercourse, whether vaginal or anal, with an infected individual; exposure to infected blood or blood products; and from an infected mother to her child before or during birth.

At least 97 percent of U. S. AIDS cases have been transmitted through one of these routes, with transmission between homosexual men accounting for about 53 percent of the cases. Heterosexual transmission in the United States accounts for about 7 percent of cases but is on the increase; it is a significant mode of transmission in Africa and Asia. About 25 percent of AIDS cases occur in intravenous drug users exposed to HIV-infected blood through shared needles.

Current practices of screening blood donors and testing all donated blood and plasma for HIV antibodies have reduced the number of cumulative cases caused by transfusion to about 1 percent. The number of new cases of AIDS in women of reproductive age is increasing at an alarming rate. AIDS has become the leading cause of death for women between the ages of 20 and 40 in the major cities of North and South America, Western Europe, and sub-Saharan Africa. In the United States, AIDS has hit hardest among black and Hispanic women, who represent 17 percent of the female population but make up 74 percent of women with AIDS.

AIDS is also having a devastating impact on infant mortality, since over 89 percent of HIV-infected children under the age of 13 acquired HIV from their infected mothers. Between 24 and 33 percent of children born to infected women will develop the disease. No scientific evidence supports transmission of HIV through ordinary nonsexual contact. Careful studies show that despite prolonged household contact with infected individuals, family members have not become infected–except through the routes described above.

Health-care workers have been infected with HIV from exposure to contaminated blood or by accidentally sticking themselves with contaminated needles. Clinical Signs Following infection with HIV, an individual may show no symptoms at all or may develop an acute but transient mononucleosislike illness. The period between initial infection and the development of AIDS is currently observed to vary from about 6 months to 11 years. Various estimates indicate that somewhere between 26 to 46 percent of the infected individuals will go on to develop full-blown AIDS within a little more than seven years following infection.

Once AIDS sets in, the clinical course generally follows a rapid decline; most people with AIDS die within three years. Opportunistic Infections and Cancers Because the T4 cell is involved in almost all immune responses, its depletion renders the body highly susceptible to opportunistic infections and tumorous growths. The most predominant and threatening complication is Pneumocystis carinii PNEUMONIA, which is frequently the first infection to occur and is the most common cause of death.

Other infections include the parasites Toxoplasma gondii (see TOXOPLASMOSIS) and Cryptosporidiosis; fungi such as Candida (see CANDIDIASIS) and Cryptococcus (see FUNGAL DISEASES); mycobacteria such as Mycobacterium avium, intracellulare, and tuberculosis (see TUBERCULOSIS); and viruses such as cytomegalovirus and herpes simplex and zoster (see HERPES). Increased susceptibility to bacterial infection is noted particularly among children with AIDS. Many AIDS patients develop CANCERS, including Kaposi’s sarcoma (KS), non- Hodgkin’s lymphoma, and HODGKIN’S DISEASE.

KS occurs in patients who manifest hardly any evidence of immunological impairment, indicating that other factors may also be at work. Among the non-Hodgkin’s lymphomas are immunoblastic and Burkitt’s-type as well as primary brain lymphomas. These tumors tend to be unusually aggressive and poorly responsive to chemotherapy, particularly in AIDS patients who have already experienced opportunistic infections. Other HIV-Related Disorders and Cofactors Neuropsychiatric manifestations occur in about 60 percent of HIV-infected persons.

It is now well established that HIV can exist and proliferate within the brain, spinal cord, and peripheral nerves. This results in a broad range of symptoms, including meningoencephalitis (see ENCEPHALITIS) and DEMENTIA. Evidence thus far indicates that circulating HIV-infected blood cells of the kind called monocytes may be responsible for the initiation of infection in the brain. There is little evidence to support direct infection of neuron tissue by HIV. Blood-cell abnormalities of HIV patients include ANEMIA, reduced white-blood- cell counts, and platelet deficiencies.

Researchers have also been able to show direct infection of bone-marrow cells–the precursors of circulating blood cells–and the proliferation of the virus within these cells. Thus bone marrow may represent an important reservoir of HIV in an infected person and provide a potential mechanism for spreading the virus through the body. Other HIV-related syndromes include nephritis (see KIDNEY DISEASE), ARTHRITIS, and lung inflammation (pneumonitis). Certain cofactors appear to play an important role in HIV infection and AIDS by increasing susceptibility to infection and by enhancing viral-disease activity.

Other sexually transmitted diseases appear to be of particular significance. Damage to genital skin and mucous membranes may facilitate transmission of the virus. In addition, laboratory studies show that certain other microbes frequently found in AIDS patients, such as mycoplasmas, also probably act as cofactors. Treatment of HIV Two major avenues are being pursued by biomedical scientists in the fight against HIV infection and AIDS. One strategy is to develop a vaccine that can induce neutralizing antibodies against HIV and protect uninfected individuals if exposed to the virus itself.

The second approach involves the discovery and development of therapeutic agents against HIV infection and AIDS. At present no vaccine exists to protect against infection, although recent advances have led some experts to predict that a vaccine should be available within the next ten years. Obstacles still remain, however, primarily because of the variability of the virus itself. Many different strains of HIV exist, and even within a given individual’s body the virus can undergo mutations rapidly and easily. A number of candidate vaccines were in the early phases of testing in human volunteers by the early 1990s around the world.

Progress is also being made in the treatment of HIV infection. The focus has been on two major areas: antiviral drugs with a direct effect against the causative agent; and immunomodulators, or substances that act to reconstitute or enhance immune-system function. Efforts to develop and improve treatments of specific opportunistic infections and tumors continue, and more new drugs have been approved. Because of the complex life cycle of HIV, however, the successful development of antiviral and immune-enhancement therapies represents an enormous scientific challenge.

Unlike most known disease-producing microorganisms, HIV infects the very cells that are intended to lead the immune system’s attack against invaders. This makes it technically very hard to kill the virus without destroying the already threatened immune system. Furthermore, there may be several important reservoirs in the body for HIV that will be difficult to deal with while not causing fundamental damage to the host cells involved. For example, macrophage cells can support HIV replication while harboring the virus from the body’s immune surveillance.

Circulating blood cells of the kind called macrophages appear to play an important role in the propagation of HIV throughout the body, including the brain. In seeking effective therapies, other important considerations are involved. Thus, since the brain is an important target of HIV infection, an effective anti-HIV agent should be able to cross the blood-brain barrier (see BRAIN). It would also be desirable if therapies could be taken orally, since it is likely that AIDS drugs would have to be taken for a long period and perhaps a lifetime.

Dozens of agents have been tested in humans, but only two have been licensed by the U. S. Food and Drug Administration (FDA): azidothymidine (AZT) and dideoxyinosine (DDI). AZT interferes with virus replication and has been found to prolong life in some patients, but its ability to delay the onset of full-blown AIDS in persons with no symptoms has been questioned. AZT’s potentially toxic side effects may preclude uses in many cases. DDI acts similarly but is recommended for those who cannot tolerate AZT. Other drugs are in clinical trials.

Some drugs are available to fight major opportunistic infections. Eye infections can be treated with ganciclovir or foscarnet, which also helps patients live longer, while aerosolized pentamidine fights Pneumocystis carinii pneumonia and protects the patient from AIDS dementia. The slow process of FDA approval of new AIDS drugs has developed into a political issue. AIDS activists are demanding that the government speed up authorization by postponing certain tests comparing efficacy and ability to prolong life until after the drug is on the market.

While a faster approval rate may expose patients to unforeseen side effects, activists argue that patients with life-threatening diseases who have no alternative therapy should still be entitled to choose these drugs. Efforts at Prevention In the absence of an effective vaccine or therapy, education and risk reduction remain the most powerful tools in the fight against AIDS. Because of the limited number of transmission routes, the further spread of AIDS could virtually be stopped by avoiding behaviors that place persons at risk.

Education can help to achieve this, through development and dissemination of materials by local community groups, statewide organizations, and national governments. In 1988, for example, the U. S. Public Health Service produced a simple, straightforward brochure containing information about HIV infection and AIDS. The brochure was mailed to every household in the nation. Although behavior change is often very hard to achieve, studies have provided encouraging indications that such change is beginning to occur. In March 1983 the major U. S. lood-banking organizations instituted procedures to reduce the likelihood of HIV transmission by asking all individuals at increased risk of AIDS to stop donating blood. They expanded screening procedures to exclude anyone with a history of risk behavior for AIDS or symptoms suggestive of AIDS. In early 1985 blood banks began using a test to screen blood directly for antibodies to HIV. The presence of antibodies, which generally takes weeks or months to develop, means that a person has been infected by the virus. It does not indicate whether that individual has or will develop AIDS, although this is almost certain.

All blood intended for transfusion or the manufacture of blood products is now tested for the antibody. The procedure involves the use of the ELISA (enzyme- linked immunosorbent assay) screening test, with confirmation of positive results with a more specific test known as the Western Blot. Blood that tests positive is eliminated from the blood-donation pool. Tissue and organ banks use a similar process. The act of donating blood does not pose any risk of HIV infection, because sterile equipment is always used. Costs The AIDS epidemic is having a profound impact on many aspects of medicine and health care.

The U. S. Public Health Service estimates that in 1993, the lifetime cost of treating a person with AIDS from infection to death is approximately $119,000. Outpatient care, including medication, visits to doctors, home health aids, and long-term care, accounted for approximately 32 percent of the total cost. Persons exposed to HIV may have difficulty in obtaining adequate health- insurance coverage. Yearly AZT expenses can average approximately $6,000, although in 1989 the drug’s maker did offer to distribute AZT freely to HIV- infected children. The yearly expense for DDI is somewhat less at $2,000.

The effects of the epidemic on society at large are increasingly evident. AIDS tests are now required in the military services. Various proposals have been made for mandatory screening of other groups such as health-care workers. A number of nations, including the United States, have instituted stringent rules for testing long-term foreign visitors or potential immigrants for AIDS, as well as testing returning foreign nationals. In the United States one frequent phenomenon is the effort to keep school-age children with AIDS isolated from their classmates, if not out of school altogether.

Governmental and civil rights organizations have countered restrictive moves with a great deal of success. There is little doubt that the ultimate physical toll of the AIDS epidemic will be high, as will be its economic costs, however the social issues are resolved. Concerted efforts are under way to address the problem at many levels, and they offer hope for successful strategies to combat HIV-induced disease. Politics and AIDS In the United States, AIDS provoked a grass-roots political response, as well as government action.

First evident in urban gay men, AIDS moved an already politically organized gay community to create service, information, and political organizations, such as Gay Men’s Health Crisis (GMHC) and AIDS Coalition to Unleash Power (ACT UP). Those groups have lobbied the federal government for funding and favorable policies. ACT UP was formed in 1987 to urge speed in drug approval and to protest high prices for AIDS drugs. By successfully promoting reforms, ACT UP and other advocates have provided a model for other disease groups, particularly breast cancer advocates.

During the 1980s, AIDS groups accused the government of neglecting its duty in responding to AIDS. Critics cite government reluctance to promote condom use as a prevention method, and the fact that President Ronald Reagan did not mention AIDS publicly until April 1987, six years after the epidemic began. The epidemic’s spread to people of color, often drug users and their intimates, introduced race into the politics of AIDS. Competition for funding and influence arose between gay and minority groups. Disagreements emerged about prevention methods, in particular needle exchange programs.

Many African Americans and Hispanics viewed needle exchange as promoting drug use in their communities, while others cited its role in curbing HIV transmission. The AIDS activists have helped increase federal funding for AIDS from an initial $5. 6 million in 1982, to over $2 billion in 1992. The 1990 Americans with Disabilities Act included protection from discrimination for people with HIV; the Ryan White Comprehensive AIDS Resources Emergency Act was passed to provide funds to cities hard hit by AIDS.

Acquired Immune Deficiency Syndrome (AIDS)

Acquired Immune Deficiency Syndrome (AIDS) is a specific group of diseases or conditions that result from suppression of the immune system, related to infection with the human immunodeficiency virus (HIV). By killing or impairing cells of the immune system, HIV progressively destroys the body’s ability to fight infections and certain cancers. A person infected with HIV gradually loses immune function along with certain immune cells called CD4 T-lymphocytes or CD4 T-cells, causing the infected person to become vulnerable to pneumonia, fungus infections, and other common ailments.

With the loss of immune function, a clinical syndrome (a group of various illnesses that together characterize a disease) develops over time and eventually results in death due to opportunistic infections (infections by organisms that do not normally cause disease except in people whose immune systems have been greatly weakened) or cancers. Transmission HIV is spread most commonly by sexual contact with an infected partner. The virus can enter the body through the lining of the vagina, vulva, penis, rectum or mouth during sex. HIV also is spread through contact with infected blood.

Prior to the screening of blood for evidence of HIV infection and before the introduction in 1985 of heat-treating techniques to destroy HIV in blood products, HIV was transmitted through transfusions of contaminated blood or blood components. Today, because of blood screening and heat treatment, the risk of acquiring HIV from such transfusions is extremely small. HIV frequently is spread among injection drug users by the sharing of needles or syringes contaminated with minute quantities of blood of someone infected with the virus.

However, transmission from patient to health-care worker or vice-versa via accidental sticks with contaminated needles or other medical instruments is rare Women can transmit HIV to their fetuses during pregnancy or birth. Approximately one-quarter to one-third of all untreated pregnant women infected with HIV will pass the infection to their babies HIV also can be spread to babies through the breast milk of mothers infected with the virus. If the drug AZT is taken during pregnancy, the chance of transmitting HIV to the baby is reduced significantly. Symptoms Many people do not develop any symptoms when they first become infected with HIV.

Some people have a flu-like illness within a month or two after exposure to the virus. They may have fever, headache, malaise and enlarged lymph nodes (organs of the immune system easily felt in the neck and groin). Some people develop frequent and severe herpes infections that cause mouth, genital or anal sores, or a painful nerve disease known as shingles. Children may have delayed development or failure to thrive. One of the first such symptoms experienced by many people infected with HIV is large lymph nodes or “swollen glands” that may be enlarged for more than three months.

Other symptoms often experienced months to years before the onset of AIDS include a lack of energy, weight loss, frequent fevers and sweats, persistent or frequent yeast infections (oral or vaginal), persistent skin rashes or flaky skin, pelvic inflammatory disease that does not respond to treatment or short-term memory loss. Treatment When AIDS first surfaced in the United States, no drugs were available to combat the underlying immune deficiency and few treatments existed for the opportunistic diseases that resulted.

Over the past 10 years, however, therapies have been developed to fight both HIV infection and its associated infections and cancers. The Food and Drug Administration has approved a number of drugs for the treatment of HIV infection. The first group of drugs used to treat HIV infection, called nucleoside analog reverse transcriptase inhibitors (NRTIs), interrupt an early stage of virus replication. Included in this class of drugs are zidovudine (also known as AZT), zalcitabine (ddC), didanosine (ddI), stavudine (D4T), lamivudine (3TC) and abacavir succinate.

These drugs may slow the spreads of HIV infection and delay the onset of opportunistic infections. A third class of anti-HIV drugs, called protease inhibitors, interrupts virus replication at a later step in its life cycle. They include ritonavir, saquinivir, indinavir and nelfinavir. Currently available antiretroviral drugs do not cure people of HIV infection or AIDS, however, and they all have side effects that can be severe. AZT may cause a depletion of red or white blood cells, especially when taken in the later stages of the disease. If the loss of blood cells is severe, treatment with AZT must be stopped.

DdI can cause an inflammation of the pancreas and painful nerve damage. A number of drugs are available to help treat opportunistic infections to which people with HIV are especially prone. These drugs include foscarnet and ganciclovir, used to treat cytomegalovirus eye infections, fluconazole to treat yeast and other fungal infections, and TMP/SMX or pentamidine to treat Pneumocystis carinii pneumonia (PCP). Children are given PCP preventive therapy when their CD4+ T-cell counts drop to levels considered below normal for their age group.

Regardless of their CD4+ T-cell counts, HIV-infected children and adults who have survived an episode of PCP are given drugs for the rest of their lives to prevent a recurrence of the pneumonia. HIV-infected individuals who develop Kaposi’s sarcoma or other cancers are treated with radiation, chemotherapy or injections of alpha interferon, a genetically engineered naturally occurring protein. Prevention Since no vaccine for HIV is available, the only way to prevent infection by the virus is to avoid behaviors that put a person at risk of infection, such as sharing needles and having unprotected sex.

Because many people infected with HIV have no symptoms, there is no way of knowing with certainty whether a sexual partner is infected unless he or she has been repeatedly tested for the virus or has not engaged in any risky behavior. CDC recommends that people either abstain from sex or protect themselves by using male latex condoms whenever having oral, anal or vaginal sex. The risk of HIV transmission from a pregnant woman to her fetus is significantly reduced if she takes AZT during pregnancy, labor and delivery, and her baby takes it for the first six weeks of life.

Drugs and society

The correlation of drugs and drug-using behavior is linked to crime in several fashions. Most directly, it is a crime to use, possess, manufacture, or distribute drugs classified as illegal. Illegal drug sales is also accompanied by violence, which leads to deadlier crimes. Violence against rival traffickers influences each of us daily. More broadly, drugs bear about drug-related behavior. The generation of violence was the result of the effects of drugs. The abuser may be engaging in criminal activities in order to obtain money for the drugs.

Drugs also cause individuals to become more violent, aggressive and sexually aroused (which may lead into rape) while under the influence of drugs. In 1996 the National Center on Addition and Substance Abuse (CASA) estimated that of the $38 billion in correctional expenditures; more than $30 billion was spent incarcerating individuals who had a history of drug and/or alcohol abuse. Those who were convicted of drug and/or alcohol violations, were high on drugs and/or alcohol at the time of their crime, or committed their crime to get money to buy drugs.

Substance abuse and addiction have fundamentally changed the nature of America’s prison population. State prisons, federal prisons, and local jails are bursting at the bars with alcohol and drug abusers and addicts and those who sell illegal drugs. In America, crime, drugs, and substance abuse are joined at the hip. The chemical dependent is most effected by drugs. The penal system has implement several programs in order to keep substance abusers/ chemical dependents from relapsing.

Such programs will identify the offenders/chemical dependent, assess their treatment and training needs, separate them from criminal incorrigibles and give them the hand up they need to become productive and responsible citizens. Treatment for chemical dependency educates the person that it is their biochemical reaction to the toxins, which causes the loss of control, similar to an allergy. Emphasis is placed on rebuilding self-esteem, increasing awareness of feelings, and making lifestyle changes to obtain more lasting and more satisfying happiness without chemicals.

The most important message of treatment is the comfort and safety felt within a group of people who share in the same struggle. By doing so crime will be reduced. Reducing alcohol and drug abuse and addiction is the key to the major reduction in crime and the prison population. Chemical Dependency (alcoholism and drug addiction) part I. Chemical Dependency is the compulsively repetitive conversion of brain chemistry. This alteration is achieved by means of a toxin (drug or alcohol).

The alteration is accomplished in order to produce temporary relief from frustration, grief, or pain quickly without changing the thoughts or behavior that cause these negative feelings. There are several characteristics of the chemically dependent/ drug abuser. Chemically dependent people typically have low self-esteem; they are lacking coping skills, and social skills. The drug abuser more often come from abusive, chemically dependent, and dysfunctional family systems. They appear to be bored, confused, lonely, depressed, and angry.

Although they feel guilty about their loss of control over their using and their behavior, thoughts, and feelings; the chemical dependent tend to blame others or external circumstances. The drug abuser will deny that they have a problem. Chemical dependency is labeled as a disease. Although there is no know cure. Chemical dependency is a treatable disease. This disease can be held in remission through a basic lifestyle change (i. e. not associating with drug abusers). The tendency to relapse is always present. The degree of dependency on chemicals always increases, even when the person is not using.

Drug abuse can be fatal if allowed to progress. Chemical dependency is generally defined as the use of a drug with such frequency that the abuser has physical or mental harm or it impairs social abilities. There are three basic characteristics that indicate that an individual is dependent on a drug. First, the abuser continues to use the drug for an extended period of time. Second, the abuser finds it difficult to stop using the drug. They may drop out of school, steal, go to jail, lose their jobs, or leave their families in order to keep using. Finally, the abuser has withdrawal symptoms when drug use is stopped.

They may undergo physical pain or mental distress. The drug mimics a natural process in the brain called neurotransmission. This is when a brain cell releases a signal to another brain cell. The signal then returns to the first brain cell. The signal is called a neurotransmitter. One major neurotransmitter is called dopamine, which is involved in feelings of pleasure. When the drug is released into the brain, it blocks the dopamine from returning to the first brain cell. Repeated use changes the brain cells so that normal messages can’t be sent between brain cells. The drug must always be present in order for neurotransmissions to take place.

The abuser is only able to feel pleasure from the cocaine rather than the things he/she used to find pleasurable. Hence we have drug addiction or chemical/drug dependency. Psychoactive drugs those drugs that influence or alter the workings of the mind, affect moods, emotions, feelings, and thinking processes. There are four categories of psychoactive drugs. These categories are hallucinogens or psychedelics, stimulants, opiate narcotics, and sedative- hypnotic chemicals. These groups are then categorized into two groups, stimulants and depressants. Stimulants are drugs that speed up signals through the nervous system.

They produce alertness, arousal and excitability. They also inhibit fatigue and sleep. They include the amphetamines, such as cocaine, caffeine, and nicotine. Depressants slow down the signals through the nervous system. They produce relaxation, lowering of anxiety, drowsiness, and sleep. They include sedatives (such as barbiturates, alcohol, and tranquilizers) and narcotics (heroin, morphine, opium, codeine), which dull the mind’s perception of pain. Some drugs are not included in the stimulant/depressant categories. An example is the hallucinogens, such as PCP and LSD, which produce unusual mental states such as psychedelic visions.

There are four stages that the drug abuser will experience. In the first stage, the drug abuser will experience no superficial behavioral changes caused by the use of drugs. The drug use is considered normal. In the second stage, the abuser actively seeks the euphoric effects of the drug by using it more frequently. A reliable source of the drug is established. The abuser may add mid-week use rather than only on weekends or at parties. In younger abusers, a general lack of motivation is noticed, along with changes in friends and lower grades.

In the third stage, the abuser is extremely preoccupied with the desire to experience the effects of the drug. The drug is used daily. There may be thoughts of suicide and/or depression. There may be family problems or trouble with the law. In the fourth and final stage, the abuser has become addicted. They are dependent on the drug just to feel normal. Crimes and Physical Signs of Drug Abuse There are physical signs related to drug use. Some of the physical signs associated to drug use are frequent sore throats, coughing, fatigue, and weight loss. They may be experiencing overdosing and blackouts more frequently.

A drug addict may also contract disease such as sexually transmitted diseases, AIDS, and HIV. Alcohol one major drug that physically effects the abuser is alcohol. It causes damage to the brain, pancreas, and kidney. It also causes high blood pressure and may heighten the risk of heart attacks and strokes. Other consequences of alcohol abuse are possible alcoholic hepatitis, cirrhosis of the liver, stomach and duodenal ulcers, colitis, irritable colon, impotence and infertility, birth defects and Fetal Alcohol Syndrome (retardation, low birth weight, small head size, limb abnormalities), and premature aging.

The abuser may also experience diminished immunity to disease, sleep disturbances, muscle cramps, and edema. While under the influence of alcohol, a person may exhibit more aggressive and violent behavior. This can lead to criminal acts. The most common cause of death and violence is alcohol. Studies have shown that the number one cause of crime is alcohol and half of all offenders who committed a violent crime were under the influence of alcohol. One of the most widely used drugs is marijuana. Marijuana is an extremely harmful drug.

This is especially because the potency of marijuana available has over the last decade increased by 275 percent. Some marijuana abusers have chronic lung disease. Many people do not realize that marijuana is more dangerous than cigarettes. There are more known cancer causing agents/toxins in marijuana smoke than cigarette smoke. One marijuana cigarette is as damaging to the lungs as four tobacco cigarettes. Small doses of marijuana diminish motor skills, hamper judgment, distort perception, and impair memory function. Chronic marijuana may cause brain damage, accelerated heartbeat, and increased blood pressure.

Mood changes occur. There is a decline in school work, difficulty in concentrating, diminished ability to carry out long-term plans, loss of effectiveness, loss of ambition, and increased apathy. Although, there is no substantiation that marijuana is not habitual to the point to where the user may steal in order to obtain money for the purchase of marijuana. Studies have shown that there is no clear evidence that attributes marijuana to violent or property crimes. Actually, there is confirmation, which shows that marijuana causes the user to be not as violent while under the influence, than user of any other drug.

Cocaine one of the most powerfully addictive and deadly drugs is cocaine. It can be injected, snorted, or smoked. It carries the risk of HIV if it is injected. Cocaine significantly speeds up the neurotransmissions in the nervous system. It accelerates the heart rate while simultaneously constricting the blood vessels, which are trying to adjust to the heightened blood flow. Temperature and blood pressure rise. Pupils dilate. A stroke, respiratory arrest, cardiac arrest, or seizures may accompany the physical changes induced by the use of cocaine. Cocaine may trigger paranoia, anxiety, irritability, and restlessness.

Depression occurs when denied of the drug. Cocaine requires abusers to take more and more to reach the same level of stimulation. It may also cause nasal problems such as congestion and runny nose. The mucous membrane in the nose may disintegrate with prolonged usage. The nasal septum may also collapse. Different kinds of cocaine include free-base and crack. Free-base is smoked. It is extremely dangerous because the cocaine reaches the brain almost instantly, causing a sudden and intense high. However, when it disappears, it leaves the abuser with an enormous craving, resulting in increased usage.

Crack is a kind of cocaine that is snorted. It comes in small lumps or shavings. It has become a major problem because it is very inexpensive and easily transported. While under the influence of Cocaine. The drug addict may become more violent. Like marijuana there is no evidence which links cocaine use to crime. However, cocaine users have a history of either being involved in the sale of drugs, the use of drugs, crime not related to drugs, or any combination of the three. Evidence has also show that there is a relationship between cocaine users and the variety of illegal dealings.

Heroin is an illegal opiate drug, which is extremely addictive. It requires persistent, repeated use and, if the abuser attempts to stop, there are painful physical withdrawal symptoms. Heroin use causes insomnia, panic, nausea, and shallow breathing. Heroin is generally injected into a vein. Because of this kind of drug entry, the risk of contracting diseases such as HIV is high. Contamination of heroin with cutting agents, equipment that is not sterile, uncertain dosage levels and the use of heroin in addition to other drugs can cause cardiac disease, inflammation of the veins, skin abscesses and serum hepatitis.

There is no way to tell the potency of the drug, so any trip could lead to overdose coma or possible death. Heroin during pregnancy is associated with miscarriages and stillbirths. Babies who are born by addicted mothers must undergo withdrawal symptoms after birth and usually have development problems. Symptoms include nausea, respiratory depression (which can progress until breathing stops), and drowsiness. Symptoms of a heroin overdose include coma, convulsions, clammy skin, pinpoint pupils, and shallow breathing. Heroin is the most commonly used drug related to crime. Heroine addicts are not generally violent.

Heroine addicts generally commit money-producing crimes. Heroine addicts often are seeking funds, by any means in order to obtain another fix. PCP is a hallucinogen. It alters consciousness, mood, and sensation and distorts visual sensation, taste, smell, touch, or hearing. The abuser experiences a profound departure from reality. He/she is capable of severe disorientation and bizarre behavior. These PCP-induced effects may lead to injuries or death while under the influence. When it is used regularly or chronically, judgment, concentration, perception functions, and memory are affected.

It may lead to permanent changes in thinking, memory, and motor skills. Addicted mothers deliver babies who have motor, auditory, and visual problems. They may also have reactions similar to that of someone who is under the influence of PCP. People, who are chemically dependent of PCP, are usually committing crimes that generate funds. These crimes are generally not committed to support their habit. PCP is the most commonly drug used among the correctional population. The last physical change resulting form drug use is withdrawal.

Withdrawal stems from the discontinuance of administration of a drug. When withdrawal transpires, there are certain physical symptoms that occur when the abuser is dependent on the drug. The physical symptoms the chemical dependent may have are nausea, diarrhea, and pain, but they vary between drugs. Cocaine abusers report depression when denied the drug. Since heroin is a very addictive drug, it has many withdrawal symptoms. Example are, insomnia, muscle cramps, nausea, sweating, chills, panic, tremors, loss of appetite, yawning, runny nose, and watery eyes.

Many inmates participate in outpatient drug treatment, which includes a range of protocols, from highly professional psychotherapy to informal peer discussions. Counseling services vary considerably and include individual, group, or family counseling; peer group support; vocational therapy; and cognitive therapy. Aftercare, considered necessary to prevent relapse, typically consists of 12-step meetings, periodic group or individual counseling, recovery training or self-help and relapse prevention strategies, and/or vocational counseling.

For those needing more intensive rehabilitative services during the transition or aftercare phase, residential treatment is sometimes provided. Many inmates in the judicial system are offer alternatives to their drug problem. Those who utilize these alternatives do so that they may not have to serve jail time. One such organization that offers this type of program is the Behavioral Health Service Inc. The Behavior Health Services Inc. offer this type of structure at the Pacifica House. Behavioral Health Services Inc. s an establishment that provides a compreshensive, system of healthcare programs and community education which enhance the prevention and rehabilitation of conditions that reduce the individual to live to the fullest extent. The Behavioral Health Services, Inc. has prided provided a continuum of substance abuse treatment services, which meets the needs of most chemically dependent patients, since 1973. The Behavioral Health Services, Inc. programs are based on the philosophy that recovery from addiction is a life long process.

Their services are based on abstinence, 12-step involvement, and family participation and relapse prevention. Pacifica House (Drug and Alcohol Treatment Program) The Behavioral Health Services Inc. has several treatment centers. One of which is called the Pacifica House. The Pacifica House is located in Hawthorne California. This treatment center services chemically dependent men and women. The men and women who enter the program are sometime mandated by the court to enter the program. The Pacifica House is a residential coed drug and alcohol abuse treatment program.

The Pacifica House offers long term and short term treatment services for the chemical dependent individual. The length of stay is dependent upon the individual. The Pacifica House is funded by the Los Angeles County Department of health Services, Alcohol and Drug Programs Administration. Services offered by the Pacifica House are in a structured environment. Participants are offered comprehensive treatment services including individualized treatment planning, educational groups, individual and group counseling. The services are available in Spanish and English. The Pacifica House accepts men and women 18 years of age and older.

The individual must be detoxified and capable of self-care upon entering the program. Once accepted the individual will be assessed. Individual are able to participate in a wide variety of programs. Programs such as family counseling, dual diagnose groups, relapse prevention, urinalysis/ drug screen testing, referral to community services (i. e. job placement), HIV/AIDS education, aftercare, 12 step groups and alumni services. For several decades, drug use has shaped the criminal justice system. Drug and drug-related offenses are the most common crime in nearly every community.

Drug offenders move through the criminal justice system in a predictable pattern: arrest, prosecution, conviction, and incarceration, release. In a few days, weeks, or months, the same person may be picked up on a new charge and the process begins again. Studies have shown successes for inmates in treatment programs. This proves the need to attack drug crime with treatment programs. The results say loud and clear that intensive, institutional drug treatment, when followed by structured transitional support and supervision, makes our communities safer and gives offenders a real opportunity to turn their lives around.

It is extremely a difficult and complex to prove that crimes that are caused by the drug user, are caused because of the drug use. The drug user may be prone to a life of crime regardless of the drugs, however the drug use only enhances the individuals unfortunate and terrible situation. What is most important is through the proper drug treatment a drug offender can become a productive, positive member of society.

AIDS and You

AIDS is a life and death issue. To have the AIDS disease is at present a sentence of slow but inevitable death. I’ve already lost one friend to AIDS. I may soon lose others. My own sexual behavior and that of many of my friends has been profoundly altered by it. In my part of the country, one man in 10 may already be carrying the AIDS virus. While the figures may currently be less in much of the rest of the country, this is changing rapidly. There currently is neither a cure, nor even an effective treatment, and no vaccine either.

But there are things that have been PROVEN immensely effective in slowing the spread of this hideously lethal disease. In this essay I hope to present this information. History and Overview: AIDS stands for Acquired Immune Defficiency Disease. It is caused by a virus. The disease originated somewhere in Africa about 20 years ago. There it first appeared as a mysterious ailment afflicting primarily heterosexuals of both sexes. It probably was spread especially fast by primarily female prostitutes there. AIDS has already become a crisis of STAGGERING proportions in parts of Africa.

In Zaire, it is estimated that over twenty percent of the adults currently carry the virus. That figure is increasing. And what occurred there will, if no cure is found, most likely occur here among heterosexual folks. AIDS was first seen as a disease of gay males in this country. This was a result of the fact that gay males in this culture in the days before AIDS had an average of 200 to 400 new sexual contacts per year. This figure was much higher than common practice among heterosexual (straight) men or women.

In addition, it turned out that rectal sex was a particularly effective way to transmit the disease, and rectal sex is a common practice among gay males. For these reasons, the disease spread in the gay male population of this country immensely more quickly than in other populations. It became to be thought of as a “gay disease”. Because the disease is spread primarily by exposure of ones blood to infected blood or semen, I. V. drug addicts who shared needles also soon were identified as an affected group.

As the AIDS epidemic began to affect increasingly large fractions of those two populations (gay males and IV drug abusers), many of the rest of this society looked on smugly, for both populations tended to be despised by the “mainstream” of society here. But AIDS is also spread by heterosexual sex. In addition, it is spread by blood transfusions. New born babies can acquire the disease from infected mothers during pregnancy. Gradually more and more “mainstream” folks got the disease. Most recently, a member of congress died of the disease.

Finally, even the national news media began to join in the task of educating the public to the notion that AIDS can affect everyone. Basic medical research began to provide a few bits of information, and some help. The virus causing the disease was isolated and identified. The AIDS virus turned out to be a very unusual sort of virus. Its genetic material was not DNA, but RNA. When it infected human cells, it had its RNA direct the synthesis of viral DNA. While RNA viruses are not that uncommon, very few RNA viruses reproduce by setting up the flow of information from RNA to DNA.

Such reverse or “retro” flow of information does not occur at all in any DNA virus or any other living things. Hence, the virus was said to belong to the rare group of virues called “Retro Viruses”. Research provided the means to test donated blood for the presence of the antibodies to the virus, astronomically reducing the chance of ones getting AIDS from a blood transfusion. This was one of the first real breakthroughs. The same discoveries that allowed us to make our blood bank blood supply far safer also allowed us to be able to tell (in most cases) whether one has been exposed to the AIDS virus using a simple blood test.

The Types of AIDS Infection: When the AIDS virus gets into a person’s body, the results can be broken down into three general types of situations: AIDS disease, ARC, and asymptomatic seropositive condition. The AIDS disease is characterized by having one’s immune system devastated by the AIDS virus. One is said to have the *disease* if one contracts particular varieties (Pneumocystis, for example) of pneumonia, or one of several particular varieties of otherwise rare cancers (Kaposi’s Sarcoma, for example). This *disease* is inevitably fatal.

Death occurs often after many weeks or months of expensive and painful hospital care. Most folks with the disease can transmit it to others by sexual contact or other exposure of an uninfected person’s blood to the blood or semen of the infected person. There is also a condition referred to as ARC (“Aids Related Complex”). In this situation, one is infected with the AIDS virus and one’s immune system is compromised, but not so much so that one gets the (ultimately lethal) cancers or pneumonias of the AIDS disease. One tends to be plagued by frequent colds, enlarged lymph nodes, and the like.

This condition can go on for years. One is likely to be able to infect others if one has ARC. Unfortunately, all those with ARC are currently felt to eventually progress to getting the full blown AIDS disease. There are, however, many folks who have NO obvious signs of disease what so ever, but when their blood serum is tested they show positive evidence of having been exposed to the virus. This is on the basis of the fact that antibodies to the AIDS virus are found in their blood. Such “asymptomatic but seropositive” folks may or may not carry enough virus to be infectious.

Most sadly, though, current research and experience with the disease would seem to indicate that EVENTUALLY nearly all folks who are seropostive will develop the full blown AIDS disease. There is one ray of hope here: It may in some cases take up to 15 years or more between one’s becoming seropositive for the AIDS virus and one’s developing the disease. Thus, all those millions (soon to be tens and hundreds of millions) who are now seropositive for AIDS are under a sentence of death, but a sentence that may not be carried out for one or two decades in a significan fraction of cases.

Medical research holds the possibility of commuting that sentence, or reversing it. There is one other fact that needs to be mentioned here because it is highly significant in determining recommendations for safe sexual conduct which will be discussed below: Currently, it is felt that after exposure to the virus, most folks will turn seropositive for it (develop a positive blood test for it) within four months. It is currently felt that if you are sexually exposed to a person with AIDS and do not become seropositive within six months after that exposure, you will never become seropositive as a result of that exposure.

Just to confuse the issue a little, there are a few folks whose blood shows NO antibodies to the virus, but from whom live virus has been cultured. Thus, if one is seronegative, it is not absolute proof one is not exposed to the virus. This category of folks is very hard to test for, and currently felt to be quite rare. Some even speculate that such folks may be rare examples of those who are immune to the effects of the virus, but this remains speculation. It is not known if such folks can also transmit the virus.

Transmission of AIDS: The AIDS virus is extremely fragile, and is killed by exposure to mild detergents or to chlorox, among other things. AIDS itself may be transmitted by actual virus particles, or by the transmission of living human CELLS that contain AIDS viral DNA already grafted onto the human DNA. Or both. Which of these two mechanisms is the main one is not known as I write this essay. But the fact remains that it is VERY hard to catch AIDS unless one engages in certain specific activities. What will NOT transmit AIDS? Casual contact (shaking hands, hugging, sharing tools) cannot transmit AIDS.

Although live virus has been recovered from saliva of AIDS patients, the techniques used to do this involved concentrating the virus to extents many thousands of times greater than occurs in normal human contact, such as kissing (including “deep” or “French” kissing). Thus, there remains no solid evidence that even “deep” kissing can transmit AIDS. Similarly, there is no evidence that sharing food or eating utensils with an AIDS patient can transmit the virus. The same is true for transmission by sneezing or coughing. There just is no current evidence that the disease can be transmitted that way.

The same may be true even for BITING,though here there may be some increased (though still remote) chance of transmitting the disease. The above is very important. It means that there is NO medical reason WHAT SO EVER to recommend that AIDS suffers or AIDS antibody positive folks be quarrantined. Such recommendations are motivated either by ignorance or by sinister desires to set up concentration camps. Combined with the fact that the disease is already well established in this country, the above also means that there is no rational medical basis for immigration laws preventing visits by AIDS suffers or antibody positive persons.

The above also means that friends and family and coworkers of AIDS patients and seropostive persons have nothing to fear from such casual contact. There is no reason to not show your love or concern for a friend with AIDS by embracing the person. Indeed, there appears still to be NO rational basis for excluding AIDS suffers from food preparation activity. Even if an AIDS suffer cuts his or her finger and bleeds into the salad or soup, most of the cells and virus will die, in most cases, before the food is consumed. In addition, it is extremely difficult to get successfully attacked by AIDS via stuff you eat.

AIDS cannot be transmitted by the act of GIVING blood to a blood bank. All equipment used for such blood donation is sterile, and is used just once, and then discarded. How is AIDS transmitted? Sexual activity is one of the primary ways AIDS is transmitted. AIDS is transmitted particulary by the transmission of blood or semen of an infected person into contact with the blood of an uninfected person. Sex involving penetration of the penis into either the vagina of a woman or the rectum of either a woman or a man has a very high risk of transmitting the disease.

It is felt to be about four times MORE likely for an infected male to transmit AIDS to an uninfected woman in the course of vaginal sex than it is likely for an infected woman to transmit AIDS to an uninfected male. This probably relates to the greater area of moist tissue in a woman’s vagina, and to the relative liklihood of microscopic tears to occur in that tissue during sex. But the bottom line is that AIDS can be transmitted in EITHER direction in the case of heterosexual sex. Transmission among lesbians (homosexual females) is rare.

Oral sex is an extremely common form of sexual activity among both gay and straight folks. Such activity involves contact of infected semen or vaginal secretions with the mouth, esophagus (the tube that connects the mouth with the stomach) and the stomach. AIDS virus and infected cells most certainly cannot survive the acid environment of the stomach. Yet, it is still felt that there is a chance of catching the disease by having oral sex with an infected person. The chance is probably a lot smaller than in the case of vaginal or rectal sex, but is still felt to be significant.

As mentioned above, AIDS is also transmitted among intravenous drug users by the sharing of needles. Self righteous attitudes by the political “leaders” of this country at local, state, and national levels have repeatedly prevented the very rational approach of providing free access to sterile intravenous equipment for IV drug users. This measure, when taken promptly in Amsterdam, was proven to greatly and SIGNIFICANTLY slow the spread of the virus in that population. The best that rational medical workers have succeeded in doing here in San Francisco is distribute educational leaflets and cartoons to the I.

V. drug abusing population instructing them in the necessity of their rinsing their “works” with chlorox before reusing the same needle in another person. Note that even if you don’t care what happens to I. V. drug abusers, the increase in the number of folks carrying the virus ultimately endangers ALL living persons. Thus, the issue is NOT what you morally think of I. V. drug addicts, but one of what is the most rational way to slow the spread of AIDS in all populations. Testing of donated blood for AIDS has massivly reduced the chance of catching AIDS from blood transfusions.

But a very small risk still remains. To further reduce that risk, efforts have been made to use “autotransfusions” in cases of “elective surgery” (surgery that can be planned months in advance). Autotransfusion involves the patient storing their own blood a couple of weeks prior to their own surgery, to be used during the surgery if needed. Similary, setting up donations of blood from friends and family known to be antibody negative and at low risk for AIDS prior to schedualed surgery further can decrease the already small risks from transfusion.

AIDS and SEX: What are the rational options? The “sexual revolution” of the 1960’s has been stopped dead in its tracks by the AIDS epidemic. The danger of contracting AIDS is so real now that it has massively affected the behavior of both gay and straight folks who formerly had elected to lead an active sexual life that included numerous new sexual contacts. Abstinence The safest option regarding AIDS and sex is total abstinence from all sexual contact. For those who prefer to indulge in sexual contact, this is often far too great a sacrifice. But it IS an option to be considered.

Safe Sex For those who wish to have sexual contact with folks on a relatively casual basis, there have been devised rules for “safe sex”. These rules are very strict, and will be found quite objectionable by most of us who have previously enjoyed unrestricted sex. But to violate these rules is to risk unusually horrible death. Once one gets used to them, tho, the rule for “safe sex” do allow for quite acceptable sexual enjoyment in most cases. For those who wish to indulge in pentration of the vagina or rectum by a penis: The penis MUST be sheathed in a condom or “rubber”.

This must be done “religiously”, and NO exceptions are allowed. A condom must be used by a man even when he is receiving oral sex. Cunnilingus (oral stimulation of a womans gentitals by the mouth of a lover) is NOT considerd to be safe sex. Safe sex includes mutual masturbation, and the stimultion of one genitals by another’s hand (provided there are no cuts in the skin on that hand). But manual stimulation of another’s genitals is NOT safe if one has cuts on one’s hands, unless one is wearing a glove. Note that even when one is conscientiously following the recommendations for safe sex, accidents can happen.

Condoms can break. One may have small cuts or tears in ones skin that one is unaware of. Thus, following rules for “safe sex” does NOT guarantee that one will not get AIDS. It does, however, greatly reduce the chances. There are many examples of sexaully active couples where one member has AIDS disease and the other remains seronegative even after many months of safe sex with the diseased person. It is particularly encouraging to note that, due to education programs among San Francisco gay males, the incidence of new cases of AIDS infection among that high risk group has dropped massively.

Between practice of safe sex and a significant reduction in the number of casual sexual contacts, the spread of AIDS is being massively slowed in that group. Similar responsible action MUST be taken by straight folks to further slow the spread of AIDS, to give our researchers time to find the means to fight it. Monogamy For those who would have sexual activity, the safest approach in this age of AIDS is monogamous sex. Specifically, both parties in a couple must commit themselves to not having sex with anyone else. At that time they should take AIDS antibody tests.

If the tests are negative for both, they must practice safe sex until both members of the couple have been greater than six months since sexual contact with anyone else. At that time the AIDS blood test is repeated. If both tests remain negative six months after one’s last sexual contact with any other party, current feeling is that it is now safe to have “unprotected” sex. Note that this approach is recommended especially for those who wish to have children, to prevent the chance of having a child be born infected with AIDS, getting it from an infected mother.

Note also that this approach can be used by groups of three or more people, but it must be adhered to VERY strictly. What to AVOID: Unscrupulous folks have begun to sell the idea that one should pay to take an AIDS antibody test, then carry an ID card that certifies one as AIDS antibody negative, as a ticket to being acceptable in a singles bar. This is criminal greed and stupidity. First, one can turn antibody positive at any time. Even WEEKLY testing will not pick this change up soon enough to prevent folks certified as “negative” from turning positive between tests.

Much worse, such cards are either directly or implicitly promoted as a SUBSTITUTE for “safe sex” practices. This can only hasten the spread of the disease. If you want to learn your antibody status, be sure to do so ANONYMOUSLY. Do NOT get the test done by any agency that requires your real name, address, or any other identifying information. Fortunately, in San Francisco, there is a public place to get AIDS antibody testing where you may identify yourself only as a number.

Tho that place has a three month long waiting list for testing, there are other private clinics where one may have the test done for cash, and may leave any false name one wishes. The reason I suggest this is that currently there are some very inappropriate reactions by government and business to folks known to be antibody positive. Protect yourself from such potential persection by preventing your antibody status from being a matter of record. That information is for you, your lover(s), and (if need be) your physician. And for NO one else.

There currently is NO treatment for AIDS (this includes AZT) that shows significant promise. In Conclusion: It is my own strongly held view, and that of the medical and research community world wide, that the AIDS epidemic is a serious problem, with the potential to become the worst plague this species has ever known. This is SERIOUS business. VASTLY greater sums should be spent on searching for treatments and vaccines. On the other hand, we feel strongly that this is “merely” a disease, not an act by a supernatural power.

And while it does not seem likely we will find either a cure or a vaccine in the forseeable future, it may be that truly effective treatments that can indefinitely prolong the life of AIDS victims may be found in the next few years. When science and technology do finally fully conquer AIDS, we can go back to deciding what sort and how much sex to have with who ever we choose on the basis of our own personal choice, and not by the coercion of a speck of proteins and RNA. May that time come soon. In the mean time, we must all do what we can to slow the spread of this killer.

This article is intended to help accomplish that. Please circulate it as widely as possible. * PLEASE UPLOAD THIS FILE TO EVERY INFORMATION SERVICE AND BULLETIN BOARD * Category: Science AIDS and YOU AIDS is a life and death issue. To have the AIDS disease is at present a sentence of slow but inevitable death. I’ve already lost one friend to AIDS. I may soon lose others. My own sexual behavior and that of many of my friends has been profoundly altered by it. In my part of the country, one man in 10 may already be carrying the AIDS virus.

While the figures may currently be less in much of the rest of the country, this is changing rapidly. There currently is neither a cure, nor even an effective treatment, and no vaccine either. But there are things that have been PROVEN immensely effective in slowing the spread of this hideously lethal disease. In this essay I hope to present this information. History and Overview: AIDS stands for Acquired Immune Defficiency Disease. It is caused by a virus. The disease originated somewhere in Africa about 20 years ago. There it first appeared as a mysterious ailment afflicting primarily heterosexuals of both sexes.

It probably was spread especially fast by primarily female prostitutes there. AIDS has already become a crisis of STAGGERING proportions in parts of Africa. In Zaire, it is estimated that over twenty percent of the adults currently carry the virus. That figure is increasing. And what occurred there will, if no cure is found, most likely occur here among heterosexual folks. AIDS was first seen as a disease of gay males in this country. This was a result of the fact that gay males in this culture in the days before AIDS had an average of 200 to 400 new sexual contacts per year.

This figure was much higher than common practice among heterosexual (straight) men or women. In addition, it turned out that rectal sex was a particularly effective way to transmit the disease, and rectal sex is a common practice among gay males. For these reasons, the disease spread in the gay male population of this country immensely more quickly than in other populations. It became to be thought of as a “gay disease”. Because the disease is spread primarily by exposure of ones blood to infected blood or semen, I. V. drug addicts who shared needles also soon were identified as an affected group.

As the AIDS epidemic began to affect increasingly large fractions of those two populations (gay males and IV drug abusers), many of the rest of this society looked on smugly, for both populations tended to be despised by the “mainstream” of society here. But AIDS is also spread by heterosexual sex. In addition, it is spread by blood transfusions. New born babies can acquire the disease from infected mothers during pregnancy. Gradually more and more “mainstream” folks got the disease. Most recently, a member of congress died of the disease.

Finally, even the national news media began to join in the task of educating the public to the notion that AIDS can affect everyone. Basic medical research began to provide a few bits of information, and some help. The virus causing the disease was isolated and identified. The AIDS virus turned out to be a very unusual sort of virus. Its genetic material was not DNA, but RNA. When it infected human cells, it had its RNA direct the synthesis of viral DNA. While RNA viruses are not that uncommon, very few RNA viruses reproduce by setting up the flow of information from RNA to DNA.

Such reverse or “retro” flow of information does not occur at all in any DNA virus or any other living things. Hence, the virus was said to belong to the rare group of virues called “Retro Viruses”. Research provided the means to test donated blood for the presence of the antibodies to the virus, astronomically reducing the chance of ones getting AIDS from a blood transfusion. This was one of the first real breakthroughs. The same discoveries that allowed us to make our blood bank blood supply far safer also allowed us to be able to tell (in most cases) whether one has been exposed to the AIDS virus using a simple blood test.

The Types of AIDS Infection: When the AIDS virus gets into a person’s body, the results can be broken down into three general types of situations: AIDS disease, ARC, and asymptomatic seropositive condition. The AIDS disease is characterized by having one’s immune system devastated by the AIDS virus. One is said to have the *disease* if one contracts particular varieties (Pneumocystis, for example) of pneumonia, or one of several particular varieties of otherwise rare cancers (Kaposi’s Sarcoma, for example). This *disease* is inevitably fatal.

Death occurs often after many weeks or months of expensive and painful hospital care. Most folks with the disease can transmit it to others by sexual contact or other exposure of an uninfected person’s blood to the blood or semen of the infected person. There is also a condition referred to as ARC (“Aids Related Complex”). In this situation, one is infected with the AIDS virus and one’s immune system is compromised, but not so much so that one gets the (ultimately lethal) cancers or pneumonias of the AIDS disease. One tends to be plagued by frequent colds, enlarged lymph nodes, and the like.

This condition can go on for years. One is likely to be able to infect others if one has ARC. Unfortunately, all those with ARC are currently felt to eventually progress to getting the full blown AIDS disease. There are, however, many folks who have NO obvious signs of disease what so ever, but when their blood serum is tested they show positive evidence of having been exposed to the virus. This is on the basis of the fact that antibodies to the AIDS virus are found in their blood. Such “asymptomatic but seropositive” folks may or may not carry enough virus to be infectious.

Most sadly, though, current research and experience with the disease would seem to indicate that EVENTUALLY nearly all folks who are seropostive will develop the full blown AIDS disease. There is one ray of hope here: It may in some cases take up to 15 years or more between one’s becoming seropositive for the AIDS virus and one’s developing the disease. Thus, all those millions (soon to be tens and hundreds of millions) who are now seropositive for AIDS are under a sentence of death, but a sentence that may not be carried out for one or two decades in a significan fraction of cases.

Medical research holds the possibility of commuting that sentence, or reversing it. There is one other fact that needs to be mentioned here because it is highly significant in determining recommendations for safe sexual conduct which will be discussed below: Currently, it is felt that after exposure to the virus, most folks will turn seropositive for it (develop a positive blood test for it) within four months. It is currently felt that if you are sexually exposed to a person with AIDS and do not become seropositive within six months after that exposure, you will never become seropositive as a result of that exposure.

Just to confuse the issue a little, there are a few folks whose blood shows NO antibodies to the virus, but from whom live virus has been cultured. Thus, if one is seronegative, it is not absolute proof one is not exposed to the virus. This category of folks is very hard to test for, and currently felt to be quite rare. Some even speculate that such folks may be rare examples of those who are immune to the effects of the virus, but this remains speculation. It is not known if such folks can also transmit the virus.

Transmission of AIDS: The AIDS virus is extremely fragile, and is killed by exposure to mild detergents or to chlorox, among other things. AIDS itself may be transmitted by actual virus particles, or by the transmission of living human CELLS that contain AIDS viral DNA already grafted onto the human DNA. Or both. Which of these two mechanisms is the main one is not known as I write this essay. But the fact remains that it is VERY hard to catch AIDS unless one engages in certain specific activities. What will NOT transmit AIDS? Casual contact (shaking hands, hugging, sharing tools) cannot transmit AIDS.

Although live virus has been recovered from saliva of AIDS patients, the techniques used to do this involved concentrating the virus to extents many thousands of times greater than occurs in normal human contact, such as kissing (including “deep” or “French” kissing). Thus, there remains no solid evidence that even “deep” kissing can transmit AIDS. Similarly, there is no evidence that sharing food or eating utensils with an AIDS patient can transmit the virus. The same is true for transmission by sneezing or coughing. There just is no current evidence that the disease can be transmitted that way.

The same may be true even for BITING,though here there may be some increased (though still remote) chance of transmitting the disease. The above is very important. It means that there is NO medical reason WHAT SO EVER to recommend that AIDS suffers or AIDS antibody positive folks be quarrantined. Such recommendations are motivated either by ignorance or by sinister desires to set up concentration camps. Combined with the fact that the disease is already well established in this country, the above also means that there is no rational medical basis for immigration laws preventing visits by AIDS suffers or antibody positive persons.

The above also means that friends and family and coworkers of AIDS patients and seropostive persons have nothing to fear from such casual contact. There is no reason to not show your love or concern for a friend with AIDS by embracing the person. Indeed, there appears still to be NO rational basis for excluding AIDS suffers from food preparation activity. Even if an AIDS suffer cuts his or her finger and bleeds into the salad or soup, most of the cells and virus will die, in most cases, before the food is consumed. In addition, it is extremely difficult to get successfully attacked by AIDS via stuff you eat.

AIDS cannot be transmitted by the act of GIVING blood to a blood bank. All equipment used for such blood donation is sterile, and is used just once, and then discarded. How is AIDS transmitted? Sexual activity is one of the primary ways AIDS is transmitted. AIDS is transmitted particulary by the transmission of blood or semen of an infected person into contact with the blood of an uninfected person. Sex involving penetration of the penis into either the vagina of a woman or the rectum of either a woman or a man has a very high risk of transmitting the disease.

It is felt to be about four times MORE likely for an infected male to transmit AIDS to an uninfected woman in the course of vaginal sex than it is likely for an infected woman to transmit AIDS to an uninfected male. This probably relates to the greater area of moist tissue in a woman’s vagina, and to the relative liklihood of microscopic tears to occur in that tissue during sex. But the bottom line is that AIDS can be transmitted in EITHER direction in the case of heterosexual sex. Transmission among lesbians (homosexual females) is rare.

Oral sex is an extremely common form of sexual activity among both gay and straight folks. Such activity involves contact of infected semen or vaginal secretions with the mouth, esophagus (the tube that connects the mouth with the stomach) and the stomach. AIDS virus and infected cells most certainly cannot survive the acid environment of the stomach. Yet, it is still felt that there is a chance of catching the disease by having oral sex with an infected person. The chance is probably a lot smaller than in the case of vaginal or rectal sex, but is still felt to be significant.

As mentioned above, AIDS is also transmitted among intravenous drug users by the sharing of needles. Self righteous attitudes by the political “leaders” of this country at local, state, and national levels have repeatedly prevented the very rational approach of providing free access to sterile intravenous equipment for IV drug users. This measure, when taken promptly in Amsterdam, was proven to greatly and SIGNIFICANTLY slow the spread of the virus in that population. The best that rational medical workers have succeeded in doing here in San Francisco is distribute educational leaflets and cartoons to the I.

V. drug abusing population instructing them in the necessity of their rinsing their “works” with chlorox before reusing the same needle in another person. Note that even if you don’t care what happens to I. V. drug abusers, the increase in the number of folks carrying the virus ultimately endangers ALL living persons. Thus, the issue is NOT what you morally think of I. V. drug addicts, but one of what is the most rational way to slow the spread of AIDS in all populations. Testing of donated blood for AIDS has massivly reduced the chance of catching AIDS from blood transfusions.

But a very small risk still remains. To further reduce that risk, efforts have been made to use “autotransfusions” in cases of “elective surgery” (surgery that can be planned months in advance). Autotransfusion involves the patient storing their own blood a couple of weeks prior to their own surgery, to be used during the surgery if needed. Similary, setting up donations of blood from friends and family known to be antibody negative and at low risk for AIDS prior to schedualed surgery further can decrease the already small risks from transfusion.

AIDS and SEX: What are the rational options? The “sexual revolution” of the 1960’s has been stopped dead in its tracks by the AIDS epidemic. The danger of contracting AIDS is so real now that it has massively affected the behavior of both gay and straight folks who formerly had elected to lead an active sexual life that included numerous new sexual contacts. Abstinence The safest option regarding AIDS and sex is total abstinence from all sexual contact. For those who prefer to indulge in sexual contact, this is often far too great a sacrifice. But it IS an option to be considered.

Safe Sex For those who wish to have sexual contact with folks on a relatively casual basis, there have been devised rules for “safe sex”. These rules are very strict, and will be found quite objectionable by most of us who have previously enjoyed unrestricted sex. But to violate these rules is to risk unusually horrible death. Once one gets used to them, tho, the rule for “safe sex” do allow for quite acceptable sexual enjoyment in most cases. For those who wish to indulge in pentration of the vagina or rectum by a penis: The penis MUST be sheathed in a condom or “rubber”.

This must be done “religiously”, and NO exceptions are allowed. A condom must be used by a man even when he is receiving oral sex. Cunnilingus (oral stimulation of a womans gentitals by the mouth of a lover) is NOT considerd to be safe sex. Safe sex includes mutual masturbation, and the stimultion of one genitals by another’s hand (provided there are no cuts in the skin on that hand). But manual stimulation of another’s genitals is NOT safe if one has cuts on one’s hands, unless one is wearing a glove.

Note that even when one is conscientiously following the recommendations for safe sex, accidents can happen. Condoms can break. One may have small cuts or tears in ones skin that one is unaware of. Thus, following rules for “safe sex” does NOT guarantee that one will not get AIDS. It does, however, greatly reduce the chances. There are many examples of sexaully active couples where one member has AIDS disease and the other remains seronegative even after many months of safe sex with the diseased person.

It is particularly encouraging to note that, due to education programs among San Francisco gay males, the incidence of new cases of AIDS infection among that high risk group has dropped massively. Between practice of safe sex and a significant reduction in the number of casual sexual contacts, the spread of AIDS is being massively slowed in that group. Similar responsible action MUST be taken by straight folks to further slow the spread of AIDS, to give our researchers time to find the means to fight it. Monogamy For those who would have sexual activity, the safest approach in this age of AIDS is monogamous sex.

Specifically, both parties in a couple must commit themselves to not having sex with anyone else. At that time they should take AIDS antibody tests. If the tests are negative for both, they must practice safe sex until both members of the couple have been greater than six months since sexual contact with anyone else. At that time the AIDS blood test is repeated. If both tests remain negative six months after one’s last sexual contact with any other party, current feeling is that it is now safe to have “unprotected” sex.

Note that this approach is recommended especially for those who wish to have children, to prevent the chance of having a child be born infected with AIDS, getting it from an infected mother. Note also that this approach can be used by groups of three or more people, but it must be adhered to VERY strictly. What to AVOID: Unscrupulous folks have begun to sell the idea that one should pay to take an AIDS antibody test, then carry an ID card that certifies one as AIDS antibody negative, as a ticket to being acceptable in a singles bar.

This is criminal greed and stupidity. First, one can turn antibody positive at any time. Even WEEKLY testing will not pick this change up soon enough to prevent folks certified as “negative” from turning positive between tests. Much worse, such cards are either directly or implicitly promoted as a SUBSTITUTE for “safe sex” practices. This can only hasten the spread of the disease. If you want to learn your antibody status, be sure to do so ANONYMOUSLY. Do NOT get the test done by any agency that requires your real name, address, or any other identifying information.

Fortunately, in San Francisco, there is a public place to get AIDS antibody testing where you may identify yourself only as a number. Tho that place has a three month long waiting list for testing, there are other private clinics where one may have the test done for cash, and may leave any false name one wishes. The reason I suggest this is that currently there are some very inappropriate reactions by government and business to folks known to be antibody positive.

Protect yourself from such potential persection by preventing your antibody status from being a matter of record. That information is for you, your lover(s), and (if need be) your physician. And for NO one else. There currently is NO treatment for AIDS (this includes AZT) that shows significant promise. In Conclusion: It is my own strongly held view, and that of the medical and research community world wide, that the AIDS epidemic is a serious problem, with the potential to become the worst plague this species has ever known.

This is SERIOUS business. VASTLY greater sums should be spent on searching for treatments and vaccines. On the other hand, we feel strongly that this is “merely” a disease, not an act by a supernatural power. And while it does not seem likely we will find either a cure or a vaccine in the forseeable future, it may be that truly effective treatments that can indefinitely prolong the life of AIDS victims may be found in the next few years.

When science and technology do finally fully conquer AIDS, we can go back to deciding what sort and how much sex to have with who ever we choose on the basis of our own personal choice, and not by the coercion of a speck of proteins and RNA. May that time come soon. In the mean time, we must all do what we can to slow the spread of this killer. This article is intended to help accomplish that. Please circulate it as widely as possible.