TERM PAPER

Health & Diseases

Topic: AIDS

By: Nisha Moza,Regn No:3020070190

AIDS: Acquired immune deficiency
syndrome or acquired immunodeficiency
syndrome(AIDS) is a disease of the human
immune system caused by the human
immunodeficiency virus (HIV). This condition
progressively reduces the effectiveness of the
immune system and leaves individuals
susceptible to opportunistic infections and
tumors. HIV is transmitted through direct
contact of a mucous membrane or the
bloodstream with a bodily fluid containing
HIV, such as blood, semen, vaginal fluid,
preseminal fluid, and breast milk. This transmission can involve anal, vaginal or oral sex, blood
transfusion, contaminated hypodermic needles, exchange between mother and baby during
pregnancy, childbirth, breastfeeding or other exposure to one of the above bodily fluids.

Genetic research indicates that HIV originated in west-central Africa during the late nineteenth
or early twentieth century. AIDS was first recognized by the U.S. Centers for Disease Control
and Prevention in 1981 and its cause, HIV, identified in the early 1980s.

Symptoms

The symptoms of AIDS are primarily the result of conditions that do not normally develop in
individuals with healthy immune systems. Most of these conditions are infections caused by
bacteria, viruses, fungi
and parasites that are
normally controlled by
the elements of the
immune system that
HIV damages.
Opportunistic infections are common in people with AIDS. These infections affect nearly every
organ system.

People with AIDS also have an increased risk of developing various cancers such as Kaposi's
sarcoma, cervical cancer and cancers of the immune system known as lymphomas. Additionally,
people with AIDS often have systemic symptoms of infection like fevers, sweats (particularly at
night), swollen glands, chills, weakness, and weight loss. The specific opportunistic infections
that AIDS patients develop depend in part on the prevalence of these infections in the geographic
area in which the patient lives.
Causes:

AIDS is the ultimate clinical consequence of infection with HIV. HIV is a retrovirus that
primarily infects vital organs of the human immune system such as CD4+ T cells (a subset of T
cells), macrophages and dendritic cells. It directly and indirectly destroys CD4+ T cells.

Once HIV has killed so many CD4+ T cells that there are fewer than 200 of these cells per
microliter (µL) of blood, cellular immunity is lost. Acute HIV infection progresses over time to
clinical latent HIV infection and then to early symptomatic HIV infection and later to AIDS,
which is identified either on the basis of the amount of CD4 + T cells remaining in the blood,
and/or the presence of certain infections, as noted above. the absence of antiretroviral therapy,
the median time of progression from HIV infection to AIDS is nine to ten years, and the median
survival time after developing AIDS is only 9.2 months. However, the rate of clinical disease
progression varies widely between individuals, from two weeks up to 20 years.

Many factors affect the rate of progression. These include factors that influence the body's ability
to defend against HIV such as the infected person's general immune function. Older people have
weaker immune systems, and therefore have a greater risk of rapid disease progression than
younger people.

1) Sexual transmission

Sexual transmission occurs with the contact between sexual secretions of one person with the
rectal, genital or oral mucous membranes of another. Unprotected sexual acts are riskier for the
receptive partner than for the insertive partner, and the risk for transmitting HIV through
unprotected anal intercourse is greater than the risk from vaginal intercourse or oral sex.
2)Exposure to blood-borne pathogens
This transmission route is particularly relevant to intravenous
drug users, hemophiliacs and recipients of blood transfusions and
blood products. Sharing and reusing syringes contaminated with
HIV-infected blood represents a major risk for infection with
HIV. This route can also affect people who give and receive
tattoos and piercings.

3)Perinatal transmission

The transmission of the virus from the mother to the child can occur in utero during the last
weeks of pregnancy and at childbirth. In the absence of treatment, the transmission rate between
a mother and her child during pregnancy, labor and delivery is 25%.

Treatment:

There is currently no publicly available vaccine for HIV or cure for HIV or AIDS. The only
known methods of prevention are based on avoiding exposure to the virus or, failing that, an
antiretroviral treatment directly after a highly significant exposure, called post-exposure
prophylaxis (PEP). PEP has a very demanding four week schedule of dosage. It also has very
unpleasant side effects including diarrhea, malaise, nausea and fatigue.

Antiviral therapy
Current treatment for HIV infection consists of highly active antiretroviral therapy, or HAART.
This has been highly beneficial to many HIV-infected individuals since its introduction in 1996
when the protease inhibitor-based HAART initially became available. Current optimal HAART
options consist of combinations (or "cocktails") consisting of at least three drugs belonging to at
least two types, or "classes," of antiretroviral agents.

Standard goals of HAART include improvement in the patient’s quality of life, reduction in
complications, and reduction of HIV viremia below the limit of detection, but it does not cure the
patient of HIV nor does it prevent the return, once treatment is stopped, of high blood levels of
HIV, often HAART resistant. Moreover, it would take more than the lifetime of an individual to
be cleared of HIV infection using HAART.

Despite this, many HIV-infected individuals have experienced remarkable improvements in their
general health and quality of life, which has led to the plummeting of HIV-associated morbidity
and mortality. In the absence of HAART, progression from HIV infection to AIDS occurs at a
median of between nine to ten years and the median survival time after developing AIDS is only
9.2 months. HAART is thought to increase survival time by between 4 and 12 years[1].

Test Options

Earlier, the progression of HIV was gauged through T-cell counts. Tests now measure the virus
directly through a blood test, a much better indicator of the rate of HIV replication. This is done
by checking the viral load (the number of particles in a blood sample)-directly proportional to the
level of replication-that pinpoints HIV activity in a person`s body.

HIV antibodies are detectable only three weeks to six months after the first infection. This
invisible period is termed the `window period`. Any tests undertaken during this period may be
negative even if the person is infected.

 The ELISA (Enzyme-Linked Immunosorbent Assay) Test

 There is no test per se to detect AIDS. Prevalent tests simply detect the presence of HIV
antibodies in human blood, which our bodies produce to fight the invader. The ELISA, the
Rapid Simple and the Western Blot tests are currently used to detect HIV. Among these, the
ELISA (Enzyme-Linked Immunosorbent Assay) is the most common screening test. After a
person tests positive for this, it`s repeated to double-check the result. When an ELISA test
yields two or more positive results, the Western blot is used to confirm these results, which is
more specific than the ELISA. The two tests combined are more than 99.9 per cent accurate.

 Saliva and Other Tests

Besides blood tests, urine and saliva tests are also used to detect HIV. Some doctors voice
reservations about the efficacy of saliva tests contending that although saliva contains some
virus components, these may not be sufficient for transmission. The marketers of the saliva
kit, however, claim that a study by the Thai Red Cross found that results of blood tests and
saliva-kit tests were identical. Besides, the kits are said to be popular amongst a majority of
American states as they are easy to use, cheap, portable and call for minimal training of
employees. The biggest advantage these kits have over blood tests is the safety of medical
personnel, since they obviate the use of needles and the drawing of blood.

 Hospice Care

In terminal illnesses such as cancer and AIDS, hospice care centers are indispensable. In fact,
hospice care is an ancient concept practiced under ayurveda for millennia. The prime aim is
to provide a sanatorium-like ambiance for patients, which facilitates a life free of prejudice
and discrimination. Patients at a hospice care center can avail of subsidized or free medicines
depending on their pecuniary status.

Prevention
While AIDS is a high-risk disease it can be prevented if proper precautions are taken and greater
awareness meted out to those who are ignorant of the virus and its repercussions on the human
body. Here we have listed a few measures which can be adopted by everyone inorder to stave off
the insidious entry of HIV.

 Prevention is still the best bet. Promiscuous sexual behavior can leave a person highly
susceptible to contracting the virus. Where abstinence is not possible, always use latex
condoms. The female condom can also help protect both partners. Use only water-based
lubricants. Oil lubricants (such as Vaseline) might even tear latex condoms. Use
spermicidal (birth control) foams and jellies in addition to condoms. By themselves,
spermicides may not be effective in preventing HIV.

 Avoid alcohol or drugs during sex, you might lose control of your senses and engage in
unsafe sex. Stick to safer sex practices at all times and avoid having multiple partners.
Practice monogamy. If this is a tall order, serial relationships are a lesser evil than
multiple ones

 High-risk sexual behavior should be avoided at all costs. These include: oral genital sex
involving contact with semen or vaginal fluids, oral anal sex, vaginal sex without a
condom, anal sex sans a condom (active or passive), fisting or manual anal intercourse,
the sharing of sex toys, using saliva for lubrication and blood contact of any kind during
performance. If unable to resist oral sex, use a dental dam. If a woman is infected, avoid
sex during the menses as menstrual blood is infectious.

 For transfusions, use disposable syringes and needles. Ensure you get blood that is
screened and certified as HIV-free. Better still, get blood from close family members
rather than professional donors whose medical antecedents are nebulous.

 The presence of sexually transmitted diseases (STDs) increases the risk of contracting
HIV from an infected partner. STDs could cause breaks in the skin of the vagina, penis or
anus permitting the virus to enter your bloodstream. If you ever contract an STD of any
kind, ensure you get prompt treatment.
  The CDC recommends that an HIV-positive woman should not breast-feed her baby. The
infant should be given AZT for the first several weeks to substantially reduce the risk of
infection.

Myths & Facts:

 Say `AIDS` and dime-a-dozen misconceptions abound. The chart topper is that AIDS is
supposedly a disease of gay men and intravenous drug users. The facts are otherwise. No
doubt in the early years many HIV-positive cases were reported amongst the Western gay
community. In recent years, however, prevalence rates among gays have leveled off.
Instead, heterosexual transmission has been forging ahead of all other modes of
transmission.

 The AIDS virus is NOT contracted through touching, hugging, kissing, massage, sharing
toilet seats, drinking or eating from utensils used by an infected person or any other mode
of casual contact. Nor does working, socialising and living with infected people cause the
disease.

 Repeated sexual contact without proper precautions with an infected person, using an
infected syringe, exposure to infected blood or sexual fluids are ways through which the
disease can be transmitted.

 Donating blood also does not run the risk of disease contraction since needles used for
such purposes are always sterile. Since the AIDS virus is unable to survive outside the
human body beyond a short duration, dried blood is not infectious For this reason,
mosquitoes are incapable of transmitting HIV as the virus cannot replicate itself in the
intestine of insects.

 Although medical personnel are potentially at risk from infection, this is minimal if
protective gear such as gloves, masks and goggles are always used when handling
potentially infected material [2].
Awareness program
Creating awareness about AIDS amongst the vulnerable, illiterate, rural populace requires an
innovative approach. Given the dynamics of rural India, a three pronged program package needs
to be developed and implemented for the rural populace of India. This should include

1. Mass contract programs in villages.

2. Participation in major village Fairs.

3. Counselling for the shy ones at a private place.

4. An entertainment based interactive communication package consisting of Folk songs, Plays,

etc., interwoven with AIDS messages needs to be executed by a team of young counsellors
equipped with the necessary audio equipment in community centres in all villages of the project
areas[3].

AIDS Awareness Programme in Industry:

Industrial Population” is a “High Risk” community for AIDS because of:

— easy availability of cash
— alcoholism
— other addictions
— many workers remain away from their families
So there is a need for awareness in the industry sector prevention and control of HIV/AIDS
among Industrial workers & the general objective is
(a) To impart knowledge on AIDS to the Industrial workers.
(b) To empower peer group leaders to run the programme for HIV/AIDS.
(c) To ascertain the level of awareness of preventive practices relating to AIDS.

This awareness among workers of industry covers a large amount of population & inturn
educates their families & clearly indicates that effective preventive measures will not only
enrich, enlighten, educate and empower the peer group leaders but it also makes effective two
way communication to reach their homes. The beneficiaries are industries and society thus
giving economic stability and higher GDP.[4]

The risks which can lead to AIDS:

 [5]
The only way to control AIDS is to prevent AIDS by making ourselves aware about the facts
related to AIDS. One of the reasons that HIV is so dangerous is that a person can have the virus
for a long time without knowing it. That person can then spread the virus to others through high-
risk behaviors. HIV transmission can be prevented by:
• abstaining from sex (not having oral, vaginal, or anal sex)
• always using latex condoms for all types of sexual intercourse
• avoiding contact with the bodily fluids through which HIV is transmitted
• never sharing needles[6]

There's no vaccine to prevent HIV infection and no cure for AIDS. But it's possible to protect
yourself and others from infection. That means educating yourself about HIV and avoiding any
behavior that allows HIV-infected fluids — blood, semen, vaginal secretions and breast milk —
into your body.
If you're HIV-negative:
Educate yourself and others.
Know the HIV status of any sexual partner.
 Use a new latex or polyurethane condom every time you have sex.
Use a clean needle.
Be cautious about blood products
Get regular screening tests

If you're HIV-positive:
Follow safe-sex practices.
Tell your sexual partners you have HIV.
If your partner is pregnant, tell her you have HIV
Don't share needles or syringes.
Don't donate blood or organs.
Don't share razor blades or toothbrushes.
If you're pregnant, get medical care right away.

We can make questionnaires to make people aware of the facts related to AIDS & remove myths
related to AIDS in colleges & working places:
Q1) What is the difference between HIV and AIDS?
A. HIV is a virus and AIDS is a bacterial disease
B. There is no difference between HIV and AIDS
C. HIV is the virus that causes AIDS
Q2) Is there a cure for AIDS?

A. Yes

B. No

C. Only available on prescription

Q3) Can you get AIDS from sharing the cup of someone with HIV?

A. Yes

B. No

C. Only if you don't wash the cup

Q4) Can insects transmit HIV?

A. Yes

B. No

C. Only mosquitoes

Q5) HIV can make a person ill because?

A. It makes a person lose weight very suddenly

B. It reduces the body's core temperature

C. It attacks the immune system

Q6) Does HIV only affect gay people?

A. Yes

B. No

C. Only gay men

D. Only gay women

Q7) HIV is believed to have evolved from a similar virus found in which animal?

A. Baboon

B. Chimpanzee

C. Elephant

D. Guinea pig

Q8) If someone with HIV has a CD4 count of 200 or less, what does this mean?

A. Their immune system is very healthy

B. They no longer have HIV

C. They should probably start antiretroviral treatment

D. They will die within a week

Q9) What is the risk of transmitting HIV during oral sex?

A. Just the same as anal or vaginal sex

B. There is a 50% chance that HIV will be transmitted if one person is HIV positive

C. The risk is very low, but increased if either person has cuts or sores on their mouth or
genitals

Frequently Asked Questions :

What are the main routes of HIV transmission?
Can I be Infected If my partner does not have HIV?
Is deep kissing a route of HIV transmission?
Can I become infected with HIV through normal social contact?
If blood splashes into my eyes, or Iget some in my mouth, can Ibecome infected with
HIV?
Can I be infected with HIV through contact with animals s/a dogs and cats?
Can I transmit HIV to my baby during pregnancy or breastfeeding?
 If I am taking antiretroviral drugs & have an undetectable viral load, am i still infectious?
[5]

We can organize camps in colleges to make students aware of preventive measures which can
stop transmission of AIDS very frequently, girls need to be educated more about the facts related
to AIDS, because if u educate a girl you educate a whole family. Pamphlets can be prepared &
distributed among common people on area level will also help to create awareness among people
about HIV & AIDS.

We can eradicate myths about AIDS which are prevalent in the society like:

HIV is not transmitted by:

Coughing, sneezing

Insect bites

Touching, hugging

Water, food

Kissing

Public baths

Handshakes

Work or school contact

Using telephones

Sharing cups, glasses, plates, or other utensils[5]

By knowing such facts people will not behave badly with those
who are HIV+ & AIDS, these people need care, support,
understanding, respect, right to be equal in society. Even in
villages people treat a person who is HIV+ with hatred &
disrespect, we need to change such thinking of people by creating awareness which is the best
cure for AIDS. To have an effective control on AIDS it becomes the duty of every person to
make his/her fellow being aware of the facts related to AIDS. We should all be working on such
objective as following:

Increase awareness of HIV/AIDS

Prevent the spread of HIV
Eliminate discrimination, stigma and prejudice associated with HIV/AIDS
Promote and protect the rights of those made vulnerable by HIV/AIDS
Ensure the highest possible quality of life for those with HIV/AIDS
Provide care and support to individuals with HIV/AIDS[6]

To eradicate this deadly disease from our society we need to be commited to

this awareness program & stick to your commitment :

BE AN ADVOCATE

BE EDUCATED

BE SAFE

BE HEALTHY

BE HAPPY[5]

References:

1 http://en.wikipedia.org/wiki/AIDS

2 http://www.lifepositive.com/body/body-holistic/aids/aids.asp
3 http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102230299.html

4 http://medind.nic.in/iay/t04/i1/iayt04i1p11.pdf

5http://www.scribd.com/document_downloads/direct/40096891?
extension=ppt&ft=12

6 http://www.scribd.com/doc/37727953/Aids