HIV Infection and AIDS: An Overview

    AIDS (acquired immunodeficiency syndrome) was first reported in the United
    States in 1981 and has since become a major worldwide epidemic. AIDS is caused
    by HIV (human immunodeficiency virus). By killing or damaging cells of the
    body’s immune system, HIV progressively destroys the body’s ability to fight
    infections and certain cancers. People diagnosed with AIDS may get
    life-threatening diseases called opportunistic infections, which are caused by
    microbes such as viruses or bacteria that usually do not make healthy people
    sick.

    More than 900,000 cases of AIDS have been reported in the United States since
    1981. As many as 950,000 Americans may be infected with HIV, one-quarter of whom
    are unaware of their infection. The epidemic is growing most rapidly among
    minority populations and is a leading killer of African-American males ages 25
    to 44. According to the Centers for Disease Control and Prevention (CDC), AIDS
    affects nearly seven times more African Americans and three times more Hispanics
    than whites. In recent years, an increasing number of African-American women and
    children are being affected by HIV/AIDS. In 2003, two-thirds of U.S. AIDS cases
    in both women and children were among African-Americans.

    TRANSMISSION

    HIV is spread most commonly by having unprotected sex with
    an infected partner. The virus can enter the body through the lining of the
    vagina, vulva, penis, rectum, or mouth during sex.

    Risky behavior

    HIV can infect anyone who practices risky behaviors such as

    • Sharing drug needles or syringes
    • Having sexual contact, including oral, with an infected person without using
      a condom
    • Having sexual contact with someone whose HIV status is unknown

    Infected blood

    HIV also is spread through contact with infected blood. Before donated blood
    was screened for evidence of HIV infection and before heat-treating techniques
    to destroy HIV in blood products were introduced, HIV was transmitted through
    transfusions of contaminated blood or blood components. Today, because of blood
    screening and heat treatment, the risk of getting HIV from such transfusions is
    extremely small.

    Contaminated needles

    HIV is frequently spread among injection drug users by the sharing of needles
    or syringes contaminated with very small quantities of blood from someone
    infected with the virus.

    It is rare, however, for a patient to give HIV to a health care worker or
    vice-versa by accidental sticks with contaminated needles or other medical
    instruments.

    Mother to child

    Women can transmit HIV to their babies 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 mother
    takes certain drugs during pregnancy, she can significantly reduce the chances
    that her baby will get infected with HIV. If health care providers treat
    HIV-infected pregnant women and deliver their babies by cesarean section, the
    chances of the baby being infected can be reduced to a rate of 1 percent. HIV
    infection of newborns has been almost eradicated in the United States due to
    appropriate treatment.

    A study sponsored by the National Institute of Allergy and Infectious
    Diseases (NIAID) in Uganda found a highly effective and safe drug for preventing
    transmission of HIV from an infected mother to her newborn. Independent studies
    have also confirmed this finding. This regimen is more affordable and practical
    than any other examined to date. Results from the study show that a single oral
    dose of the antiretroviral drug nevirapine (NVP) given to an HIV-infected woman
    in labor and another to her baby within 3 days of birth reduces the transmission
    rate of HIV by half compared with a similar short course of AZT
    (Azidothymidine). For more information on preventing transmission from mother to
    child, go to http://aidsinfo.nih.gov/guidelines.

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