The HIV/AIDS Epidemic
AIDS is widely considered an epidemic throughout the world. How and when did the epidemic start? How is it spread? What are the symptoms? The statistics of AIDS differs across parts of the world, races, gender and sexual orientation. Some countries have been able to control it more than others. There are different strategies among different cultures for diagnosing, communicating and preventing. With the global epidemic of AIDS there are many challenges and responsibilities. This is something that affects everyone, no matter where you are.
The first cases of AIDS were discovered in the United States. A number of gay men in New York and California suddenly began to develop rare infections that seemed stubbornly resistant to any treatment. At this time, AIDS did not yet have a name, but it quickly became obvious that all the men were suffering from the same thing. “The Centers for Disease Control announced in 1981 that it had identified a new disease that attacked the immune system.”(6, pg. 7) It was named Acquired Immune Deficiency Syndrome (AIDS). The discovery of HIV, the Human Immunodeficiency Virus was made soon after. It became clear that HIV causes AIDS so, in order to find the source of AIDS, it is necessary to look for the origin of HIV, and find out how, when and where HIV first began to cause disease in humans
Although there are many theories and debates about the origin of HIV, it is believed to have started with a virus that was carried by an African primate. This virus is believed to jump species through varies routes even today. The virus transferred to humans as a result of chimps being killed and eaten or their blood getting into cuts or wounds of a human, most likely a hunter. In addition, butchering and consumption of primate meat could also cause the transfer to the general public, (non-hunters). Although it seems it seems highly likely that Africa was the continent where the transfer of HIV to humans first occurred, where the 'epidemic' officially developed has always been controversial. Today it seems more important to understand the virus, how it spread so rapidly and prevention in order to fight it.
There are many factors that may have contributed to the rapid spread of HIV. For its initial spread, travel, both local and international certainly contributed. People were traveling from city to city, state to state and country to country. The blood industry was a major path for the spread. Before transmission was known, blood donors were not screened. Some of the donors who were paid to give blood were in a high-risk group by the use of tainted needs. The blood donations were sent worldwide and the recipients became infected. “By late 1986, the Centers for Disease Control estimated (using statistical modeling) that 12,000 Americans had probably been infected with AIDS through blood transfusions.” (1, pg.34) Intravenous drug users shared needles as disposable syringes became available contributed to the spread. Most users could not afford new syringes so they were shared. Medical instruments that were not properly sterilized, most often in third world countries were a contributing factor. Promiscuous sexual behavior combines with unprotected sex. “It was efficiently spread by prostitutes.”(1, pg. 35) While AIDS is not just a disease for Gay men or a gay plaque as some have asserted, gay men became more open about their sexual orientation and it seemed to spread rapidly through their community. A smaller group spreading HIV were pregnant women where the virus was transferred to the unborn child they carried.
Today we know an infected person can spread HIV through the exchange of bodily fluids: semen; vaginal fluid; blood; other bodily fluids containing blood (for example, menses, and bloody saliva,) breast milk. In America, the most common causes of HIV infections are: unprotected vaginal, anal, or oral sex, unsafe sex, with an HIV-positive person or sharing needles or syringes with an HIV-positive person. For third world countries there are additional ways it continues to be spread. For example through the use of unsterilized medical instruments, but the number one reason is the lack of education.
There are many different signs and symptoms used to diagnosis HIV/AIDS. There are early symptoms and there are later symptoms. According to USA Today, “the earlier symptoms can last from five to ten days, the early symptoms include; low grade fever, rash, muscle aches, headache, fatigue, and sometimes no symptoms will appear. The later symptoms of HIV/AIDS can last from anywhere from a couple of years to decades. The later symptoms are as follows:
· Extreme fatigue
· Rapid weight loss from an unknown cause
· Appearance of swollen or tender glands in the neck, armpits or groin, this will last for more than four weeks
· Persistent diarrhea
· High fever
· Night sweats
· Marked change in an illness pattern
· Appearance of one or more purple spots on the surface of the skin, inside mouth, anus, or nasal passage
· Whitish coating on the tongue, throat or vagina
· Forgetfulness, confusion and other signs of mental deterioration”(7)
There are many resources for statistics on HIV/AIDS, but all are in agreement that HIV/AIDS is growing every day. The number of people living with HIV has risen from around 8 million in 1990 to 33 million today, and is still growing. The latest statistics on global HIV/AIDS were published by UNAIDS in November 2009, and refer to the end of 2008. More than 25 million people have died of AIDS since 1981. According to UNAIDS.org web site, globally, there were an estimated 33.4 million adults and children living with HIV/AIDS in 2008. Although HIV and AIDS are found in all parts of the world, some areas are more afflicted than others. The worst affected region is sub-Saharan Africa, where in a few countries more than one in five adults is infected with HIV. The epidemic is spreading most rapidly in Eastern Europe and Central Asia, where the number of people living with HIV has increased 67% between 2001 and 2008. The numbers for Africa alone are staggering. Around 67% of people living with HIV/AIDS are in sub-Saharan Africa. Of the 33.4 million diagnosed over 22 million were in Africa. Newly diagnosed people with HIV/AIDS in the world were 2.7 million. Over half the number, 1.9 million was in Africa. Of the 2.0 million deaths globally from HIV/AIDS, 1.5 million were from Africa. The deaths were despite recent improvements in access to antiretroviral treatment. Sadly, Africa has over 14 million AIDS orphans. (Children orphaned by AIDS are defined as people under the age of 18 who are alive and have lost one or both parents to AIDS). (8)
As referenced in the charts below, HIV/AIDS is no longer seen as a homosexual, (gay men) disease. HIV has proven to be passed between genders. The spread is not limited to anal sex as originally thought. At the end of 2008, women accounted for 50% of all adults living with HIV worldwide. The epidemic is spreading most rapidly in Eastern Europe and Central Asia, where the number of people living with HIV increased between 2001 and 2008. Several million children are infected HIV/AIDS or have died from AIDS. Today the key groups who have been particularly affected by HIV/AIDS epidemic are: children, women, men who have sex with men, injecting drug users and sex workers.
The charts below are from www.avert.org (10)
Global HIV/AIDS Estimates, End of 2008
| | Estimate | Range |
| People living with HIV/AIDS in 2008 | 33.4 million | 31.1-35.8 million |
| Adults living with HIV/AIDS in 2008 | 31.3 million | 29.2-33.7 million |
| Women living with HIV/AIDS in 2008 | 15.7 million | 14.2-17.2 million |
| Children living with HIV/AIDS in 2008 | 2.1 million | 1.2-2.9 million |
| People newly infected with HIV in 2008 | 2.7 million | 2.4-3.0 million |
| Children newly infected with HIV in 2008 | 0.43 million | 0.24-0.61 million |
| AIDS deaths in 2008 | 2.0 million | 1.7-2.4 million |
| Child AIDS deaths in 2008 | 0.28 million | 0.15-0.41 million |
* Proportion of adults aged 15-49 who were living with HIV/AIDS
Global trends
Regional statistics for HIV & AIDS, end of 2008
| Region | Adults & children | Adults & children | Adult prevalence* | Deaths of |
| Sub-Saharan Africa | 22.4 million | 1.9 million | 5.2% | 1.4 million |
| North Africa & Middle East | 310,000 | 35,000 | 0.2% | 20,000 |
| South and South-East Asia | 3.8 million | 280,000 | 0.3% | 270,000 |
| East Asia | 850,000 | 75,000 | <0.1% | 59,000 |
| Oceania | 59,000 | 3900 | 0.3% | 2,000 |
| Latin America | 2.0 million | 170,000 | 0.6% | 77,000 |
| Caribbean | 240,000 | 20,000 | 1.0% | 12,000 |
| Eastern Europe & Central Asia | 1.5 million | 110,000 | 0.7% | 87,000 |
| North America | 1.4 million | 55,000 | 0.4% | 25,000 |
| Western & Central Europe | 850,000 | 30,000 | 0.3% | 13,000 |
| Global Total | 33.4 million | 2.7 million | 0.8% | 2.0 million |
* Proportion of adults aged 15-49 who were living with HIV/AIDS
There is still no cure or vaccination for HIV/AIDS, but treatment for people with HIV is in a highly dynamic state and has improved enormously since the mid-1990s. Individuals are advised to seek out experts in their local community. Antiretroviral medications are used to control the reproduction of the virus and to slow or halt the progression of HIV. Those who take a combination of three antiretroviral drugs sometimes referred to as a "cocktail" can expect to recover their health and live for many years without developing AIDS, as long as they keep taking the drugs every day. Anti-HIV medications do not cure HIV infection and individuals taking these medications can still transmit HIV to others. Unfortunately, in developing and transitional countries, where there are people in immediate need of life-saving AIDS drugs; only a small percentage of them have access to or are receiving medications.
Even with the advancement of treatment for HIV/AIDS there is much that can be done to reduce the impact of AIDS. Across the world, a small but growing number of countries have reduced HIV prevalence through sound prevention efforts. The high rates of transmission of HIV result largely from failure to use the available and effective prevention strategies and tools, and poor coverage of HIV prevention programs. There are known ways to prevent the transmission of HIV/AIDS
The number one way to prevent the spread of HIV/AIDS is sexual abstinence. Since this seems unlikely, the next best way is to abstain from sex outside of a mutually faithful relationship with a partner whom the person knows is not infected with the virus. Averting sexual transmission involves encouraging safer sexual behavior including delayed first sex, partner reduction and condom use.
Promoting condom use is an essential tool in the prevention. Use of condoms is one of the most effective in reducing the spread of the HIV virus. “ Condoms must be readily available universally, either free or at low cost, and promoted in ways that help over come social and personal obstacles to their use.” (4, pg. 27) High-risk groups in particular need to have condoms available to them.
The spread of HIV through injecting drug use can be slowed by outreach work, needle exchange and drug substitution treatment. Many political and social groups are opposed to making needles available to intravenous drug users. If those opposed to the practice of needle exchange and the intravenous drug users are not educated a decrease in transmission of HIV/AIDS for this at risk group will not occur.
Another at risk group is women with HIV/AIDS who are pregnant. There is a great risk to the child of being born with HIV. “Every year over a half of a million babies are born with the AIDS virus. The number one cause of death for children under the age of ten is the transmission of AIDS from mother to child.”(3, pg. 56) Today, mother-to-child transmission can be almost eliminated through use of medicines and avoidance of breastfeeding.
The number one worldwide prevention of HIV/AIDS is knowledge. Successful educational programs and campaigns for HIV prevention need to not only give information, but also build skills and provide access to essential commodities such as condoms or sterile injecting equipment. Promoting widespread awareness of HIV through basic HIV and AIDS education is vital for preventing all forms of HIV transmission. Specific programs need to target key groups who have been particularly affected. Communication of prevention should be targeted to the needs of the many different cultures. In many of the developing countries, oral communication is going to be the most effective.
Yet although it is known how to prevent and treat AIDS, few people have access to the necessary services. Most rich countries and a few middle-income nations have nearly achieved universal treatment access. Access to prevention tools such as HIV education, condoms, clean needles and programs to prevent mother-to-child transmission is inadequate in other areas.
There are many challenges in tackling the global AIDS epidemic. Inadequate funding, weak infrastructure and shortages of health workers in the worst affected countries are some of the large obstacles. Political or cultural attitudes are also significant: for example some authorities are opposed to condom promotion, while others refuse to support needle exchanges for injecting drug users. Many are reluctant to provide young people with adequate education about sex and sexual health.
Another very serious issue is stigma and discrimination. People known to be living with HIV are often shunned or abused by community members, employers and even health workers. As well as causing much personal suffering, this sort of prejudice discourages people from seeking HIV testing, treatment and care.
In recent years, efforts to fight AIDS around the world have stepped up, with much greater funding being supplied by the US, other rich nations and developing country governments. But the amount of money available is barely half what is needed for an effective response. Based on recent trends it is likely that AIDS around the world will keep getting worse for many years to come. Millions more will become infected with HIV and millions will die of AIDS. The only way to turn things around is to rapidly scale up the measures we already know are effective, but which are currently reaching far too few of those in need.
Although the how and when the AIDS epidemic started are not clear, it is probably not as important anymore. It is most important to know how it is spread, what are the symptoms and how can it be treated and more importantly prevented. The statistics of AIDS differs across parts of the world, races, gender and sexual orientation are surprising with developing countries, Africa in particular having the highest number of cases and deaths. Africa has not been able to contain or decrease its numbers because of the resources that are available to richer countries are not available to them. There needs to be different strategies among different cultures for diagnosing, communications and preventing due to the different ways to access to information. Even though there are many challenges, all countries need to participate in the elimination of the virus for the world. The responsibility is a global one and this is something that affects everyone, no matter where or who you are.
Cite Page
1. Engel, Jonathan. The Epidemic. New York: HarperCollins Publishers Inc, 2006. 34-35.
2. Epstein, Helen. The Invisible Cure Africa, The West, and The Fight Against AIDS. New York: Farrar, Straus and Giroux, 2007.
3. Helms, Jesse. “Reducing Mother-to-Child HIV Transmission Can Help Fight AIDS,” Responding to the AIDS Epidemic. Michigan, Greenhaven Press, 2006. 56-58.
4. World Health Organizations et al. “Promoting Condom Use Will Reduce the Spread of AID,” Responding to the AIDS Epidemic. Michigan, Greenhaven Press, 2006. 26-29.
5. Lowry, Rich. “Promoting Sexual Abstinence Will Reduce the Spread of AIDS,” Responding to the AIDS Epidemic. Michigan, Greenhaven Press. 2006. 23-25.
6. Responding to the AIDS Epidemic, Michigan, Greenhaven Press. 2006. 7-10
7. Various Authors, USA Today, http://www.healthscout.com/ency/68/101/main.html#SymptomsofAIDSandHIVInfection
8. Various Authors, UNAIDS.org
9. HealthScout.com
10. Various Authors, www.Avert.org
11. Hivaidssierraleone.org
