HIV/AIDS: The Risk Is Not Knowing

Every year on December 1, people around the world commemorate World AIDS Day. The world unites to support those living with HIV and to remember those who have lost their lives to AIDS. First observed in 1988, the day remains as relevant today. It is essential to raise awareness of the impact of AIDS on people’s lives, to end stigma and discrimination and to improve the quality of life of people living with the virus.

It is said that AIDS is not spread by viruses but by ignorance and lack of awareness. So, as educated and considerate members of society, we need to understand the condition, its implications, and how we can help curb the spread of this deadly virus.

To understand what AIDS is and how a person gets it, we need to step back and learn about HIV. We’ve all heard of the prefix HIV being added before AIDS, but how many of us know why the disease is called that? Let’s dig.

What is HIV?

HIV stands for Human Immunodeficiency Virus. Scientists suspect that the simian immunodeficiency virus (SIV) jumped from chimpanzees and mutated into HIV when people consumed contaminated chimpanzee meat. HIV was endemic in Africa around the 1920s and migrated to other parts of the world over the following decades. It was in 1959 that researchers discovered HIV in human blood samples and it took another two decades for it to reach public consciousness!

As its name suggests, this virus attacks our immune cells called CD4 cells. CD4 cells are a special type of white blood cells called T cells that circulate in the body, detecting infections, defects and abnormalities in other cells.

HIV targets and infiltrates these CD4 cells and exploits them to create copies of themselves. Healthy cells are destroyed during this process, reducing the body’s ability to fight off other infections and diseases. This increases the risk and impact of opportunistic infections and some types of cancer which we will discuss later in the article.

So, now that we know what HIV is and how detrimental it is to our health, let’s proceed to decipher its association with the notorious disease called AIDS.

Making sense of AIDS

AIDS stands for Acquired Immune Deficiency Syndrome and is the third and most advanced stage of HIV. While healthy adults typically have a CD4 count of 500 to 1,600 per cubic millimeter, someone diagnosed with AIDS has a CD4 count of less than 200 cells per cubic millimeter.

Doctors also identify a person with AIDS if they have HIV and develop an opportunistic infection or cancer which is rare in people without HIV.

We have used the term “opportunistic infection” without clarifying what it actually means. So, before going any further, it is our responsibility to explain what an opportunistic infection is.

Understanding Opportunistic Infections

Stage 3 HIV, also called AIDS, reduces the body’s ability to fight infections and other associated complications. At this point, latent infections that once caused little or no health problems can cause serious problems. Those diseases that use the favorable scenario to attack an otherwise healthy person are called opportunistic infections.

Some of the common opportunistic infections, as indicated by the Center for Disease Control and Prevention are:

Pneumocystis pneumonia (PCP): This is a type of fungal lung infection that occurs in people with weakened immune systems. The first signs of infection are difficulty breathing, high fever and a dry cough.
Tuberculosis (TB): It is a communicable disease that spreads through the air when a person with TB coughs, sneezes or talks. Inhaling the bacteria can lead to infection of the lungs signaled by coughing, fatigue, weight loss, fever and night sweats.
Candidiasis (thrush): It is a fungal infection that affects the skin, nails and mucous membranes all over the body, such as the mouth and vagina.
Cytomegalovirus (CMV): CMV can infect many parts of the body and cause pneumonia, gastroenteritis (especially abdominal pain caused by infection of the colon), encephalitis (infection) of the brain, and sight-threatening retinitis (infection of the retina with the back of the eye). People with CMV retinitis have vision problems that get worse over time and lead to complete blindness if not treated quickly.
Herpes simplex virus (HSV): HSV is a common latent virus that usually causes no major problems in people with healthy immune systems. However, the virus can sometimes activate and cause painful sores in or around canker sores in or around the genitals or anus. In people with weakened immune systems, HSV can cause infection in the respiratory tract and swallowing and even cause pneumonia.
Mycobacterium Avium Complex (MAC): These bacteria live in our environment, including soil and dust particles. Infections with these bacteria spread throughout the body and can be life-threatening in people with weakened immune systems.
Wasting syndrome: Wasting is defined as the involuntary loss of more than 10% of one’s body weight (mainly muscle mass) while having diarrhea or weakness and fever for more than 30 days.
Progressive multifocal leukoencephalopathy: This rare disease of the brain and spinal cord is seen almost exclusively in people whose immune systems have been severely damaged by HIV.

A person living with HIV also has a higher chance of developing various forms of cancer. These include:

Lymphoma: It is cancer of the lymph nodes and other lymphoid tissues in the body.
Kaposi’s sarcoma (SK): It is a type of viral infection, commonly called herpesvirus8, which causes abnormal growth of small blood vessels. It appears as pink, purple, or black patches on the skin that may be raised or flat. KS can be life-threatening when it affects organs inside the body, such as the lungs, lymph nodes, or intestines.
Invasive cervical cancer: Cervical cancer starts in the cervix (the lower part of the uterus at the top of the vagina) and spreads (becomes invasive) to other parts of the body. A recent study found that women living with HIV have a higher risk of cervical cancer than HIV-uninfected women. Receiving an early diagnosis can help limit the spread of cancer.

Although these opportunistic infections are obvious indicators of HIV infection, various other symptoms signal the presence of this infection at all three stages. Let’s take a look at the stages, their features, and their symptoms.

Stages and Symptoms of HIV

Stage 1: acute infection stage

This includes the first few weeks someone contracted the virus. The virus replicates rapidly in this phase to which the person’s immune system responds by producing antibodies. The viral load, ie the amount of HIV found in the blood, is highest in this phase and therefore the risk of transmission is also greatest.

Some people may not have any symptoms at first and others may not realize the severity of the symptoms, as these are very similar to those of a cold or the flu. Also, the symptoms disappear within a few weeks or months as the person progresses to the second stage of HIV. The following symptoms of the first stage of HIV infection are collectively called retroviral syndrome.

Symptoms of Acute HIV Infection

Fever and chills
Sore throat
Headache
Nausea
Stomach ache
Swollen lymph nodes
General aches and pains
itchy skin
Night sweats

Stage 2: clinical latency stage/asymptomatic HIV

After the apparent disappearance of the retroviral syndrome, the HIV virus enters the second phase of infection which can last from a few years to decades depending on the level of treatment. Although people may “feel” well and “look” healthy during this phase, the virus continues to damage the immune system and internal organs. Some people have no symptoms during this phase, while others may have minimal or nonspecific symptoms.

Clinical latency stage symptoms

Body aches and pains
Fatigue
Nausea
itchy skin
Relapsing fever
Recurrent pneumonia
Recurring formation of oral or vaginal yeast
Diarrhea
rapid weight loss
Swollen lymph nodes

Stage 3: AIDS infection

If a person living with HIV does not receive effective treatment, the virus weakens the body’s ability to fight infection, ultimately leading to AIDS. According to the CDC, a person’s life expectancy is reduced to 3 years without proper treatment. However, with effective and timely medications, HIV may never even progress to its next stages.

Also, the chances of HIV progressing to AIDS vary from person to person depending on various factors such as age, underlying medical condition, genetic resistance to the particular strain of HIV and strain of HIV.

Various opportunistic infections and cancers help doctors identify this stage of HIV infection. Along with this, there are other symptoms as well.

Symptoms of AIDS infection

Night sweats
Fatigue
Dry cough
White patches on the tongue or mouth
Shortness of breath
Swollen glands
Chronic diarrhea
Persistent fever

Even though most of these symptoms are not gender related and there are a few as well.

HIV symptoms in men and women

The footnote is that for both sexes, the risk of STIs increases if they are already infected with HIV. That said, there are a few specifics based on the type of genitals a person has.

In those who have a penis, HIV infection can cause sores on their genitals. In the case of those with a vagina, HIV multiplies their vulnerability to a number of health problems such as pelvic inflammatory disease, human papilloma virus (HPV) and changes in the menstrual cycle.

We have now discussed the main indicators of this potentially deadly disease. But what about its distribution? How is it transmitted? What are the main channels? Let’s find out!

Channels of HIV transmission

HIV is transmitted when bodily fluids containing the virus come into contact with a permeable barrier or small breaks in moist tissue in certain areas of the body.

To put it more precisely, HIV can be transmitted by:

some blood
sperm
pre-seminal fluid
vaginal or fluids
rectal fluids
breastmilk

The few common ways HIV is transmitted from person to person are:

Intercourse – vaginal and anal (most common)
Sharing needles, syringes and other injection equipment for drug use
Use the same tattoo equipment without sterilizing it between uses
Maternity and childbirth (mother to baby)
Breastfeeding
Premastication (chewing a baby’s food before feeding)
Exposure to semen, vaginal and rectal secretions, blood, or breast milk from an HIV-infected person, such as a needle stick.

Sounds scary, doesn’t it? And probably this fear is the reason for so many myths that surround the spread of this infamous virus. Let us break some for you.

Busting Common HIV Myths

HIV CAN BE transmitted through oral sex and blood or organ transfusions. However, hospitals rigorously test blood, organ and tissue donors for HIV, leaving a negligible chance of the virus spreading through this route. Next, to research suggests that it is extremely rare but possible for HIV to be spread through oral sex when there are open sores or bleeding gums in the person’s mouth.
HIV CANNOT live long outside the human body. There are scientific proof that 90-99% of the virus dies within hours of being exposed to air. Additionally, the CDC says HIV does not survive in water. This means you can’t get HIV. And finally, you can’t get HIV from touching a surface previously touched by someone with HIV.
Studies suggest that HIV CANNOT be transmitted through saliva, so kissing and sharing food, water or cutlery is safe.
Sweat CANNOT contain HIV. Shaking hands, hugging, high fives and other similar types of physical contact will not transmit the virus.
Tears CANNOT carry HIV, so when you see someone with HIV crying, don’t hesitate to wipe away their tears.
Mosquito bites CANNOT spread HIV. To transmit HIV, a mosquito or other insect would have to bite an HIV-positive person and then pump the blood back into another person’s body. Mosquitoes do not reinject blood and therefore this route of transmission is virtually impossible. Also, HIV does not survive in mosquitoes due to the different genetic makeup than human DNA.

Knowing the channels of infection has made it easier to know what we can do to stop its spread.

Prevent HIV

Get tested for HIV – Knowing your HIV status is crucial for your health and well-being, as it can allow you to quickly access the necessary treatment and prevent complications.
Get tested for STIs – STIs increase the risk of contracting HIV, so it is important to keep an eye on your general health.
Practice safer sex – Use condoms. Learn the correct way to put on a condom and use it when you have sex, whether it’s vaginal or anal sex. It is important to keep in mind that pre-seminal fluids (which come out before male ejaculation) can also contain HIV. You can also use condoms or dental dams during oral sex to reduce the risk minimal.
Never share needles or similar paraphernalia. HIV is transmitted through blood and can be contracted by using materials that have come into contact with the blood of an HIV-positive person.
Consider Preparation – A person who has a higher risk of getting HIV should talk to their healthcare provider about pre-exposure prophylaxis (PrEP). If taken regularly, it can reduce the risk of contracting HIV. PrEP is a combination of two drugs available in pill form.

Helping Each Other

It is ironic that the disease called AIDS is subject to such incredible stigma. Together, let’s help each other to eradicate AIDS. On World AIDS Day, let’s all pledge to show empathy to those struggling with the disease.

In the words of the late Princess Diana, HIV does not make people dangerous, so shake their hands and hug them, because heaven knows they need it! Governments and various NGOs around the world are taking initiatives to educate people about AIDS and eradicate the disease.

All we need is an open mind and a clear heart for a better future. Remember that HIV is not a death sentence, just a chronic disease that can be controlled with proper treatment. Your loved ones can live a long life even after being infected with HIV or even AIDS as long as they take their medicine consciously and lead a healthy life.

Here are the contact details for the AIDS Helpline for those in need.

India (National AIDS Control Organization)

Toll-free number: 1097

Telephone: 011-43509999, 011-23731778

Email ID: dgnaco@gmail.com

Telephone: 0800 137 437

United States

Phone: 1800 448 0440

Email ID: ContactUs@HIVinfo.nih.gov

Let’s understand the disease so as not to be afraid of it anymore, because who is afraid of the known anyway?