What is HIV?

HIV stands for Human Immunodeficiency Virus. HIV is the virus that causes AIDS (Acquired Immune Deficiency Syndrome).

HIV attacks the immune system's soldiers - the CD4 cells. When the immune system loses too many CD4 cells, you are less able to fight off infection and can develop serious opportunistic infections (OIs). A person is diagnosed with AIDS when he or she has less than 200 CD4 cells and/or one of 21 AIDS-defining OIs.

The HIV Test

There is only one reliable way to find out your HIV status and that is to take the HIV test. The most common test is an antibody test called ELISA. A positive result means you have antibodies for HIV and you are infected with the virus.

Why should I get tested if there is no cure for HIV?

There is no cure for HIV. But there are drugs that can slow down the virus and protect your immune system. There are also drugs to treat and prevent OIs. If you do not know your status you cannot get the health care and treatment you may need to stay well. You are also more likely to unknowingly pass HIV to others.

HIV Transmission

HIV is only spread through the following body fluids :

The most common ways HIV is passed from one person to another are :

To reduce the risk of HIV transmission :

Why do I need to get tested for HIV?

Many HIV+ people are unaware of their status. They may feel healthy and not think they are at risk. But anyone of any age, gender, race, sexual orientation, or social or economic class can become infected. It is what you do that puts you at risk. If you have used dirty needles or had unprotected sex, a sexually transmitted disease, or hepatitis C you should be tested.

Women and HIV

In the U.S., the proportion of AIDS cases among women more than tripled from 7 percent in 1985 to 25 percent in 2001. African-American and Hispanic women represent over 80 percent of AIDS cases reported among American women.

Certain gynecological (GYN) conditions are more common, more serious and/or more difficult to treat in HIV+ women than HIV- women :

HIV+ women should have regular GYN care and Pap smears since many GYN conditions do not have obvious symptoms and can get worse without your realizing it.

In Conclusion

It is important to get tested for HIV on a regular basis. If you test HIV- take steps to stay that way. If you test HIV+ seek on-going medical care. By taking advantage of good health care and treatment, you increase your chances of living a longer and healthier life.

What are Condoms?

A condom is a tube made of thin, flexible material. It is closed at one end. Condoms have been used for hundreds of years to prevent pregnancy by keeping a man's semen out of a woman's vagina.

Lambskin condoms can prevent pregnancy. However, they have tiny holes (pores) that are large enough for HIV to get through. Lambskin condoms do not prevent the spread of HIV.

Latex is the most common material for condoms. Viruses can not get through it. Latex is inexpensive and available in many styles. It has two drawbacks: oils make it fall apart, and some people are allergic to it.

Polyurethane is an option for people who are allergic to latex. One brand of female condom and one brand of male condom are made of polyurethane.

How are Condoms used?

Condoms can protect you during contact between the penis, mouth, vagina, or rectum. Condoms won't protect you from HIV or other infections unless you use them correctly.

Using a Male Condom

Using a Female Condom The female condom is a sleeve or pouch with a closed end and a larger open end. There are flexible rings at each end of the Reality condom, and a flexible v-shaped frame in the V-amour condom.

NONOXYNOL-9

Nonoxynol-9 is a chemical that kills sperm (a spermicide). It can help prevent pregnancy when it is used in the vagina along with condoms or other birth control methods. Nonoxynol-9 should not be used in the mouth or rectum.

Because nonoxynol-9 kills HIV in the test tube, it was considered as a way to prevent HIV infection during sex. Unfortunately, many people are allergic to it. Their sex organs (penis, vagina, and rectum) can get irritated and develop small sores that actually make it easier for HIV infection to spread. Nonoxynol-9 should not be used as a way to prevent HIV infection.

Condom MYTHS

Condoms don't work: Studies show condoms are 80% to 97% effective in preventing HIV transmission if they are used correctly every time you have sex.

Condoms break a lot: Less than 2% of condoms break when they are used correctly: no oils with latex condoms, no double condoms, no outdated condoms.

HIV can get through condoms: HIV can not get through latex or polyurethane condoms. Don't use lambskin condoms.

The bottom line

When used correctly, condoms are the best way to prevent the spread of HIV during sexual activity. Condoms can protect the mouth, vagina or rectum from HIV-infected semen. They can protect the penis from HIV-infected vaginal fluids and blood in the mouth, vagina, or rectum. They reduce the risk of spreading other sexually transmitted diseases.

Condoms must be stored, used and disposed of correctly. Male condoms are used on the penis. Female condoms can be used in the vagina or rectum.

En Espanol

Human immunodeficiency virus or HIV is a retrovirus that causes Acquired Immune Deficiency Syndrome (AIDS), a condition in which the immune system begins to fail, leading to life-threatening opportunistic infections. Previous names for the virus include Human T-Lymphotropic Virus-III (HTLV-III) and lymphadenopathy-associated virus (LAV). Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, Cowper's fluid or breast milk. Within these body fluids HIV is present as both free virus particles and virus within infected immune cells. The three major routes of transmission are unprotected sexual intercourse, contaminated needles and transmission from an infected mother to her baby at birth or through breast milk. Screening of blood products for HIV in the developed world has largely eliminated transmission through blood transfusions or infected blood products in these countries.

HIV infection in humans is now pandemic. As of January 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimate that AIDS has killed more than 25 million people since it was first recognized on December 1, 1981, making it one of the most destructive pandemics in recorded history. In 2005 alone, AIDS claimed an estimated 2.4-3.3 million lives, of which more than 570,000 were children. A third of these deaths are occurring in sub-Saharan Africa, retarding economic growth and increasing poverty. According to current estimates, HIV is set to infect 90 million people in Africa, resulting in a minimum estimate of 18 million orphans. Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but routine access to antiretroviral medication is not available in all countries.

HIV primarily infects vital cells in the human immune system such as helper T cells (specifically CD4 + T cells), macrophages and dendritic cells. HIV infection leads to low levels of CD4 + T cells through three main mechanisms: firstly, direct viral killing of infected cells; secondly, increased rates of apoptosis in infected cells; and thirdly, killing of infected CD4 + T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4 + T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections. If untreated, eventually most HIV-infected individuals develop AIDS and die; however about one in ten remain healthy for many years, with no noticeable symptoms. Treatment with anti-retrovirals, where available, increases the life expectancy of people infected with HIV. It is hoped that current and future treatments may allow HIV-infected individuals to achieve a life expectancy approaching that of the general public (see Treatment).

The AIDS epidemic was discovered June 5, 1981, when the U.S. Centers for Disease Control and Prevention reported a cluster of Pneumocystis carinii pneumonia (now classified as Pneumocystis jiroveci pneumonia) in five homosexual men in Los Angeles. The disease was originally dubbed GRID, or Gay-Related Immune Deficiency, but health authorities soon realized that nearly half of the people identified with the syndrome were not homosexual men. In 1982, the CDC introduced the term AIDS to describe the newly recognized syndrome, though it was still casually referred to as GRID.

In 1983, scientists led by Luc Montagnier at the Pasteur Institute in France first discovered the virus that causes AIDS. They called it lymphadenopathy-associated virus (LAV). A year later a team led by Robert Gallo of the United States confirmed the discovery of the virus, but they renamed it human T lymphotropic virus type III (HTLV-III). The dual discovery led to considerable scientific disagreement, and it was not until President Mitterrand of France and President Reagan of the USA met that the major issues were resolved. In 1986, both the French and the US names for the virus itself were dropped in favour of the new term, human immunodeficiency virus (HIV).

HIV was classified as a member of the genus lentivirus, part of the family of retroviridae. Lentiviruses have many common morphologies and biological properties. Many species are infected by lentiviruses, which are characteristically responsible for long-duration illnesses with a long incubation period. Lentiviruses are transmitted as single-stranded, positive-sense, enveloped RNA viruses. Upon entry of the target cell, the viral RNA genome is converted to double-stranded DNA by a virally encoded reverse transcriptase that is present in the virus particle. This viral DNA is then integrated into the cellular DNA by a virally encoded integrase so that the genome can be transcribed. Once the virus has infected the cell, two pathways are possible: either the virus becomes latent and the infected cell continues to function, or the virus becomes active and replicates, and a large number of virus particles are liberated that can then infect other cells.

Two species of HIV infect humans : HIV-1 and HIV-2. HIV-1 is thought to have originated in southern Cameroon after jumping from wild chimpanzees (Pan troglodytes troglodytes) to humans during the twentieth century. HIV-2 may have originated from the Sooty Mangabey (Cercocebus atys), an Old World monkey of Guinea-Bissau, Gabon, and Cameroon. HIV-1 is the most virulent. It is easily transmitted and is the cause of the majority of HIV infections globally. HIV-2 is less transmittable and is largely confined to West Africa. HIV-1 is the virus that was initially discovered and termed LAV.

Three of the earliest known instances of HIV-1 infection are as follows :

Transmission

Since the beginning of the pandemic, three main transmission routes for HIV have been identified:

Transmission

HIV in India

India is one of the largest and most populated countries in the world, with over one billion inhabitants. Of this number, at least five million are currently living with HIV. According to some estimates, India has a greater number of people living with HIV than any other nation in the world.

HIV emerged later in India than it did in many other countries, but this has not limited its impact. Infection rates soared throughout the 1990s, and have increased further in recent years. The crisis continues to deepen, as it becomes clearer that the epidemic is affecting all sectors of Indian society, not just the groups – such as sex workers and truck drivers – that it was originally associated with.

In a country where poverty, illiteracy and poor health are rife, the spread of HIV presents a daunting challenge.