HIV AIDS: Complete guide to understanding this virus
HIV and AIDS are a rather big deal in the medical world and yet, in this day and age, they remain uncurable. They have a certain taboo about them, but what is HIV AIDS exactly? What is the difference between HIV and AIDS? What are the stages, symptoms, causes, transmission, diagnosis, prognosis, and treatment of them? How do they affect the body and the mind? Where is this viral disease found most throughout the world? How is it prevent and what are tips to prevent HIV? Keep reading to find out more.
What is HIV AIDS?
HIV AIDS are actually two different conditions. HIV is the virus while AIDS is the condition. HIV stands for human immunodeficiency virus and it attacks the immune system. AIDS stands for acquired immunodeficiency syndrome. Only humans can contract HIV. It’s spread by the exchange of bodily fluids. Thankfully, HIV doesn’t live in saliva, pee/urine, tears, or sweat. It does, however, live in blood, semen, vaginal fluid, and breastmilk. It can’t be found on public surfaces such a toilet seats or door handles because the virus can’t survive for long without the human body, it dies when the bodily fluid dries.
The history of HIV AIDS
The history of HIV AIDS starts in the Democratic Republic of Congo in Africa with one man. It’s thought that the virus was created through chimpanzee-to-human (bodily fluid) contact before 1931- probably during a “bush meat trading”. While hunting the chimps, the hunters would have easily come in contact with the animal blood. Before AIDS was identified as a disease of its own, it was often presented with other immunodeficiency conditions like Kaposi sarcoma (KS) and Pneumocystis jiroveci pneumonia (PCP). The year after AIDS was discovered to be a disease of its own standing, scientists discovered that advanced HIV was the cause.
There is a theory that in the U.S., HIV AIDS was first reported with a 16-year-old teenage boy who had never had a blood transfusion nor left the midwestern U.S. However, many other sources believe that the first documented case in the U.S. wasn’t until 1981. The HIV AIDS epidemic didn’t begin in the U.S. until the early 1980s. Before we knew much about it, people believed that only certain people could contract HIV. The media coined these people the “four-H club”.
- Heroin users and people who used dirty needles.
- Homosexual men because they had the highest reported incidences of HIV AIDS.
- Haitians (or people of a Haitian origin) because many of the cases of HIV AIDS were reported in the country of Haiti.
- Hemophiliacs are the people who received blood transfusions that were contaminated with the virus.
People then discovered a few years later that females can get HIV through sex (which rules out the homosexual men theory), there were 3,064 cases diagnosed in the U.S. in 1984 (which rules out the Haiti theory).
1995 became the year in which HIV AIDS was the leading cause of death. Roughly 50,000 Americans died from HIV AIDS-related causes and 49% of those were people of an African-American descent.
Since the epidemic began, the World Health Organization (WHO) estimates that HIV AIDS has taken over 35 million lives since its discovery. 1.1 million people in the U.S. are HIV positive and 1 in 7 people don’t even know it, In 2016 alone, roughly 39,782 people were diagnosed with HIV. After the use of medication therapy and knowledge of prevention, the death rate dropped from 38,780 (1996) to 14,499 (2000) to 6,465 (2015).
In 1997, the American Food and Drug Administration approved Combivir, a combined drug therapy. In 2003, they approved home test kits that can detect and identify HIV AIDS positive in 20 minutes.
What is the difference between HIV and AIDS?
We hear the combination of HIV AIDS frequently. So it makes sense that we would think they are the same thing. However, they aren’t. They are two different diagnoses, but they go hand-in-hand. HIV is a virus that leads to what we call AIDS. AIDS is a form of Stage 3 HIV. HIV is the virus while AIDS is the condition that the virus can cause. This means that someone who contracted HIV can get AIDS if it becomes developed and advanced enough.
Stages of HIV AIDS
HIV comes in three stages: acute, chronic, and AIDS.
After catching HIV, the symptoms begin to manifest themselves as flu-like for about two or four weeks. This small time period is known as acute infection– essentially Stage 1. The flu-type symptoms come from the increase of the virus in the body.
After these few weeks of acute infection, the immune system is able to bring the viral infection under control which leads to a period of latency– meaning the symptoms go away. This period of latency is known as chronic HIV, essentially Stage 2 period. Although during this stage HIV in the body doesn’t multiply as quickly (thus the lack of or fewer symptoms), HIV is still transmittable.
Once the infection has progressed to Stage 3 HIV, it becomes known as AIDS. Medically, this progression means that the CD4 levels have decreased below 20 cells per cubic millimeter of blood.
Symptoms of HIV AIDS
HIV AIDS causes serious damage to the immune system. However, the overall symptoms range from person to person. The common symptoms during the acute infection stage are:
- Muscle pains
- A sore throat
- Swollen glands
- Fatigue (normally excessive)
- Maculopapular truncal rash
Sounds a lot like the common cold, right? The crazy thing is that in some cases, the symptoms are a complete lack of symptoms. This means that the person experiences nothing and has no idea about the viral infection nor do they feel ill.
Chronic HIV symptoms include:
- Weight loss
- High fever
- Coughing and difficulty breathing
However, like the acute infection period, some people experience no symptoms at all. These lack of symptoms are known as latent infection and can last for decades.
The common symptoms of AIDS/Stage 3 HIV are:
- Constant headaches
- Problems with memory and remembering
- Severe chills
- Night Sweats
- Coughing often
- Problems with breathing
- Incredible fatigue
- Anal or genital sores
- White spots in the mouth
- Rashes that can be pink, purple, red, or brown
- High fevers (over 100ºF/37.8ºC)
Causes of HIV AIDS
HIV is a type of virus known as a retrovirus that spreads the disease to the cells in the immune system and to the vital organs. Without treatment (the antiretroviral therapy) that slows down the virus, the virus continues to infect. However, the rates of progression vary among individuals.
Transmission of HIV AIDS
Because HIV AIDS is a virus, they can be transmitted between people like all other viruses. Think of herpes, influenza, some strains of the flu, and the common cold (rhinoviruses). Viruses are infectious organisms that have no actual capacity and ability to reproduce on their own (unlike bacteria). Instead, they infect the cells of living hosts (such as plants and humans) by hijacking the host’s cellular system to reproduce itself. These viruses are able to hijack the cells of the host by being transmitted through the exchange of bodily fluids. Most often, HIV is transmitted by shared/uncleaned needles and sex without condoms or some form of physical protection. However, it can also be transmitted from mother to child while in the womb, intrapartum, or through breastfeeding. In fact, mother-to-child transmission of HIV accounts for over 90% of the HIV infections in adolescents under the age of 15.
As an overview, HIV AIDS is not transmitted by:
- Being bit by an insect, such as a mosquito, that had also bit someone with HIV.
- Breathing the same air as someone who suffers from HIV.
- Touching the toilet seat or door handle that someone who is infected touched.
- Hugging, touching, holding hands with, or kissing someone infected with HIV.
How does HIV AIDS affect the body?
HIV causes the immune system to be unable to work as well as it should be able to because the virus attacks the immune system. Normally, our immune system is able to rid the body of viruses. However, with HIV that’s not the case. When HIV progresses to stage 3 HIV, it becomes known as AIDS. When Stage 3 HIV develops into AIDS, other conditions can begin to occur due to having an immune system so damaged that it can’t fight off much. These infections are known as opportunistic infections and include pneumonia and tuberculosis. Certain types of cancer tend to develop, as well, due to an immune system that doesn’t work effectively.
How does HIV AIDS affect the brain?
HIV doesn’t usually bring neurological complications with it until it reaches the most advanced stage: Stage 3- AIDS. The more advanced the virus becomes, the more damaged the body and brain become. While HIV doesn’t take over the cells in the nervous system, it does cause inflammation- significant inflammation. Inflammation to the point that it actually can damage the spinal cord (which is immensely connected to the brain). This inflammation prevents the nerve cells and neurotransmitters in the spinal cord and brain from working properly.
There are other neurological complications that can come with AIDS, but that isn’t directly caused by AIDS. For example, AIDS is known to cause neuropathy. While neuropathy causes nerve damage throughout the body, AIDS allows the neuropathy to run wild in the brain and body. Other neurological complications that arise due to AIDS are:
- Severe depression and anxiety
- Neurosyphilis is a type of untreated syphilis that targets the nervous system. It causes the nerve cells to fail and stop working correctly which can lead to a loss of hearing and vision, difficulty walking, and dementia.
- Lymphomas are tumors that occur in the brain. They are also related to the herpes virus. However, if the HIV treatment is well-managed, lymphomas are able to be kept under control.
- Fungal and parasitic infections can occur. Parasites can cause infections in the brain such as toxoplasma encephalitis which is associated with seizures, headaches, and confusion. A fungus causes serious inflammation to the brain and spinal cord known as Cryptococcal meningitis.
- Viral infections and cytomegalovirus infections such as herpes and shingles are caused due to the immune system being down. These infections can also cause brain inflammation and spinal cord inflammation.
- Progressive leukoencephalopathy (PML) is caused by a virus but can be controlled with antiretroviral medications such as those used to treat Stage 1 and Stage 2 HIV.
- Dementia, when associated with HIV AIDS, is known as HIV-associated dementia or AIDS dementia complex. Cognitive thinking and cognitive function are impaired. This type of dementia is actually life-threatening but can be prevented by taking the antiretroviral medications correctly.
- Vascular myelopathy is a condition that causes little tiny holes to develop in the fibers of the nerves in the spinal cord. It results in difficulty walking- more so the more advanced the vacuolar myelopathy gets. It’s common in children with HIV and people with AIDS who aren’t being treated
Diagnosis of HIV AIDS
Once HIV is transmitted, the immune system begins to produce antibodies against the virus. A test of either saliva or blood can detect those antibodies and see if they are fighting the virus. However, it can take up to several weeks after being transmitted for the HIV antibodies test to result positive and sometimes can cause a false negative for people who have X-linked agammaglobulinemia. Another test used looks at the antigens, the proteins produced by the virus, as well as the antibodies. This test is able to detect the virus after just a few days of being infected.
While the tests are quite accurate, severe depression has been proven to delay the symptoms and testing positive for HIV patients. Anxiety was proven to delay symptoms of HIV AIDS. The U.S. Preventive Services Task Force reviewed the HIV AIDS testing methods in 2005 and concluded that “A large study of HIV testing in 752 U.S. laboratories reported a sensitivity of 99.7% and specificity of 98.5% for enzyme immunoassay, and studies in U.S. blood donors reported specificities of 99.8% and greater than 99.99%. With confirmatory Western blot, the chance of a false-positive identification in a low-prevalence setting is about 1 in 250 000 (95% CI, 1 in 173 000 to 1 in 379 000) ” Essentially, this means that out of every 1,000 people tested for HIV, only 15 people will receive a false-negative. There are also many other studies that come to the same conclusion: HIV testing is rather accurate and has false-positive rates of 0.0004 to 0.0007, and false-negative rates of 0.003 in the overall population. Check out these studies here, here, here, here, and here.
The AIDS testing and diagnosis is a bit more complicated than the simple HIV testing because doctors need to find out if the HIV latency has progressed to Stage 3 HIV (AIDS) or not. Due to the fact that HIV destroys the immune cells (known as CD4 cells), doctors can do a count of the CD4 cells to determine if the count is normal or lower due to HIV AIDS. Someone without HIV has an average of 500-1,200 CD4 cells. Once the cell number has dropped below 200, someone who was already diagnosed with HIV is considered to have AIDS/Stage 3 HIV. Doctors also look for the opportunistic infections that arise due to a weakened immune system. These infections are actual diseases that are caused by bacteria, fungi, or other viruses that wouldn’t occur in someone who has a healthy immune system. For example, pneumonia and tuberculosis.
Treatment of HIV AIDS
There is no cure for HIV AIDS. However, there are treatments that help decrease the symptoms and keep the virus more at bay. Because HIV attacks the immune system, medications are used that are able to control HIV by interrupting its viral life cycle. These medications are known as antiretroviral therapy.
Are we close to a cure, though? There are numerous clinical studies going on and lots of money being poured into finding a treatment for this not-easily-curable disease. Scientists were looking into a vaccine, but have yet to find an effective one. In 2009, a study published found an experimental vaccine that had prevented 31% of new infections. However, the research was stopped due to too many dangerous risks.
The general consensus about HIV AIDS nowadays by medical professionals is that if it’s undetectable, it’s untransmittable.
In psychology, the social-cognitive prevention of HIV AIDS is one of the leading ways to fix behavior to help prevent the virus. It consists of the importance of information given about HIV AIDS, the development of skills and abilities to broaden our minds and teach these skills and abilities to people who are from social classes that have a high-risk factor in catching the virus (e.x. the gay community, people who deal with needles a lot, etc.) and teaching them how to prevent the virus. The social-cognitive prevention theory was used as a general base for one of the biggest AIDS-Prevention interventions.
Other models that are used are the Health Belief Model (HBM) and the Theory of Planned Behavior. These models suggest that the likelihood of doing a certain behavior is dependent on the strength of the intention to perform the behavior (which is also influenced by behavioral attitudes). For instance, behavioral attitudes concerning HIV and AIDS would be that the person could believe that (negatively) “HIV testing isn’t confidential”, or (positively) “HIV testing helps people get medication if they are HIV-positive.” The relationship that happens between getting tested (and thus, treated) and the psychological factors are actually moderated by non-psychological factors (e.x. testing context, nature of the population, and regional resource availability).
Prognosis of HIV AIDS
At one point in time, being diagnosed with HIV or AIDS was considered to be a death sentence. However, thanks to lots of research and new treatments, people can now live with HIV (at any stage) and have a long life. Someone who is HIV-positive and who goes through regular antiretroviral treatment can live an almost normal lifespan.
Once someone’s HIV has progressed to AIDS, they have a life expectancy of about three years.
HIV doesn’t have to progress to Stage 3 if the person adheres to the treatment plans. People with HIV can live years without developing AIDS- if developing it at all. Like what we all learned in math class that a square is a rectangle but a rectangle isn’t a square, someone who has AIDS has HIV, but someone who has HIV doesn’t necessarily have AIDS. While there is no cure for the HIV infection, it will never completely go away.
Where is HIV AIDS in the world?
The part of the world where HIV affect the most amount of people is in the Sub-Saharan Africa (southern Africa). According to the United Nations’ UNAIDS office and the World Health Organization (WHO), more than 1/3 of Sub-Saharan adults suffer from HIV. However, HIV-2 (the stage of HIV before AIDS) is the most common type of HIV seen in Western Africa. Asia and Eastern Europe have rising numbers, too, due to injection drug use.
Prevention of HIV AIDS
Since there is no cure for HIV AIDS, it’s best to cure it by preventing it in the first place. Because HIV AIDS is transmitted through the exchange of bodily fluids, it can be difficult to prevent. That said, there are ways to prevent this virus.
- Don’t share needles or syringes. If using a needle, be sure that it’s clean. If someone who used it before has HIV, even if there is no blood on the needle, HIV can still be transmitted. So whether you are sharing drugs, getting a tattoo, or getting a piercing, be aware that there is a potential risk of HIV AIDS.
- Pregnancy (prepartum), delivery (intrapartum), and breastfeeding (postpartum) can also carry risk. While it’s rare for a mother to give HIV to her child if she’s taking the proper medication, mothers who aren’t taking any preventative measures or taking any treatment can easily give their child HIV AIDS.
- Use protection. HIV can be transmitted through semen, blood, vaginal secretions, or anal secretions. It’s important to use protection during sex to prevent the sharing of bodily fluids infected with HIV AIDS. While dangerous for both parties, the “receptive sexual partner” (the person who is being penetrated) is more likely to catch HIV. That doesn’t mean that there isn’t a risk for the “insertive partner”, though. Along with using condoms and other preventive measures that don’t allow the exchange of fluids, pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP) can be used for prevention. According to the CDC, daily PrEP reduces the risk of getting HIV from sex by over 90%. It’s important to be aware that if you already have a sexually transmitted infection or disease (STI, STD), you’re more likely to catch HIV, as well. In some cases, such as those with herpes and syphilis, the STD causes sores or ulcers to develop which can break open and make it easy for HIV to enter the body.
Get tested and get your partner tested to be sure that neither of you has HIV and to ensure that if you do, you’re able to treat it and keep it from spreading to other people.
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Anna is a freelance writer who is passionate about translation, psychology, and how the world works.