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Rona Sayed Josie Tierney-Fife English 9 Advanced 22 March 2011 HIV and AIDS

You have probably heard of it, but you might not know what it is or how it can affect you. HIV is a human immunodeficiency virus: human because it can only affect humans, immunodeficiency because it affects the immune system by weakening and destroying it, and a virus because it can reproduce itself and by taking over cells in the body. HIV is a type of STD, which is a sexually transmitted disease (Kane 95). This transfers into AIDS which is an acquired immuno deficiency syndrome: acquired because AIDS cannot be inherited, immuno because the immune system fights it off, deficiency because you can get it if your immune system is not working, and a syndrome because it is a collection of symptoms and has signs of disease(//Aids.Gov//).

What is it?

HIV is believed to have originated from a type of chimpanzee in western Africa. Humans hunted and ate the infected animals, which caused it to jump from monkeys to humans in the late 1800’s (//Aids.Gov//). In the 1980’s it was stated to be discovered in the United States (//Aids Healthcare Foundation//). There are two types of HIV: HIV-1 and HIV-2, in the United States HIV-1 is more common. In 1986 HIV-2 was discovered in West Africa, so there are many cases of the second type in Africa. HIV-2 increases slowly than the first type, it is immunodeficiency, so it works more slowly and milder in the development stage than the first type. It also is less infectious in the early stages (//Centers for Diseases Control and Prevention//). What this HIV virus does is that it destroys the cells, so your body can’t fight it off. Inside the body are CD4 and T-cells which are cells that send signals to the immune system to start to fight off bacterias and viruses. CD4 and T-cells refer to the same cell, doctors use the CD4 cells count to determine stages of the HIV virus. AIDS is the final stage of HIV, when people reach this stage their immune system is very badly damaged. So, people are going to have risks of opportunistic infections. You get Aids, if you have one or more infections, certain cancers, and a low number of CD4 cells. You need to get treatment quickly to prevent death (//Aids.Gov//). The difference between the two is that HIV leads to AIDS, you can’t necessary die from HIV, but you can die from AIDS because by then it’s kind of to late to save your immune system. The number has been rising ever since the spreading of this virus. Day after day people are dying, due to not having proper treatments because they can’t afford the drugs (Capone-Henriquez). The virus affects the body too fast for someone to find a cure for it, because it specifically affects the part of the body that is supposed to fight off the virus. There is no cure for HIV, you can’t get a vaccine to prevent it nor can you take medications to cure it. Although there are medications that you can take to reduce the amount of the harmful cells in your body (//Centers for Diseases Control and Prevention//). 33.3 million people worldwide have HIV, since thirty years ago when it first started(McNeil Jr.). AIDS has killed more than 25 million people since 1981. Every 9.5 minutes, a person in the United States has become infected with HIV. In the United States about one million people are living with HIV and one out of every five don’t know that they have it (Bersch and DiRamio). The CDC (Centers for Disease Control and Prevention) estimates that 56,000 Americans get HIV each year and more than 18,000 people die of Aids each year (//Centers for Diseases Control and Prevention)//. In the United States, homosexuals in Los Angeles and New York where the first to be discovered with HIV(Bersch and DiRamio). The cities with the highest HIV and AIDS burden in the country are New York City, Miami, New Orleans, and Washington D.C.(Bersch and DiRamio). “One in every ten New York High School student is sexually active (Bersch and DiRamio).” This can be a great risk factor. Atlanta, Georgia is the eighth state with a highest AIDS rate, blacks make the majority (Bersch and DiRamio). The first man in the world who was first tested for HIV was a man from the Republic of Congo, he came out to be HIV positive (Kane 58). 2.6 million people were newly infected with HIV as of 2009, which is 20% fewer than in the 1900’s (McNeil Jr.). People who have the highest risk for being infected in order are African Americans, Hispanic/ Latino, American Indians/Alaska Natives, Whites, and Asian/Pacific Islanders. For African Americans males, one in every sixteen have HIV, for women one in every thirty have HIV. African Americans have six times the risk than white men. African American women have fifteen times the risk than white women. Hispanics and Latinos have double the risk than white men. Hispanic and Latino women have more than four times the risk than white women (//Centers for Diseases Control and Prevention)//. The BBC (British Broadcasting Network) took a worldwide survey about HIV/AIDS in fifteen countries; the U.S., U.K., Brazil, Mexico, South Africa, Nigeria, Tanzania, Indonesia, Bangladesh, India, Lebanon, Trinidad, China, Russia, and the Ukraine. “Except for China nearly everyone knew about HIV and AIDS and the fact that you could get it through contact with sex and needles (Friedman).” One third of the people in the countries had no idea that it could be spread from mother to child and 1/3 of the people in China believed that it could be caught by using the same bathroom as an infected person. 18% in the U.S. believed that it could be caught by sharing cups and towels with an infected person, 23% in Brazil, 28% in China, and 39% in Indonesia. “53% of people say that their governments are not doing enough to control and prevent this virus (Friedman).” The United Nations stated that twenty-five countries are doing better at prevention, especially the South African nations. In fifty-nine countries 25% said that they had more than one partner in the last year. There is also a 50% reduction among young people in Africa, relations between parents and children sexuality talks are increasing. Also 5.2 million people are getting more treatments than ever before. Although 10 million still need treatments to live (Friedman). Even though people are trying very hard to control the virus there are some problems. “ In one out of every 100 people ages 15-49 worldwide are infected with HIV” (Kane 60). In Africa less than or equal to 14 million children are called “Aids Orphans” and less than or equal to 18 million have lost either one or both of their parents to Aids (Bersch and DiRamio). South Africa is the hardest hit place with Aids, its the world’s worst epidemic, in which they have 350,000 - 500,000 newly infections annually (McNeil Jr.). One out of five adults have the virus (Friedman). Eastern Europe and Central Asia are also not in a good stance due to their heroin injectors, the spread of Afghan and Southeast Asian heroin spreads the virus to countries who have little history of dealing with them (McNeil Jr.). People over 60 make up 19% of AIDS in new cases (Bersch and DiRamio). Many governments are urging sex workers and long haul truck drivers to be educated as well as gay men (McNeil Jr.). When the infection first started the rate was going up very fast in 1995, but when the first drug came out to control it, it went down quite a bit (Kane 41). In the 1990’s a man named Alexander Ilyen from Armenia was stated to come out with a new drug that cured the virus, he believed that it increased CD4 cells and it relieved symptoms. The western world took that drug and examined it, it was made out of Armenicum and iodine, they said that it had either no effect or a very low effect, to this day there is no scientific data about it (Friedman). In the past for every 100 people put on treatment for AIDS, 250 would become newly infected. Today for every 100 people put on treatment, 200 would become newly infected (McNeil Jr.). Now that we know quite a bit about the basics of the virus, lets continue on to see how it actually lives in your body and how you feel when you have it.

Diagnosis/Symptoms

Now, we can see what the lifecycle of the virus is in our body. It takes about 2 to 4 weeks after the exposure for people to feel a small illness (//Aids.Gov//). “Although it takes about 3 to 6 months for the virus to spread within the body and becomes detectable when an HIV test is done(//Aids Healthcare Foundation).”// People may have acute retroviral syndrome or (ARS) this is like having the worst flu ever. Around this time the virus is at a very high level and it can be easily transmitted to another person. Many people don’t get this syndrome only a few do. After this, there is another stage that the disease goes into called clinical latency. In this stage the virus is less active and the host has no symptoms (//Aids.Gov//). This period lasts for about a year to ten years (//Aids Healthcare Foundation//). Toward the middle and near ending period, the virus rises and the number of CD4 cells in your body begin to drop (//Aids.Gov)//. Three to ten years minor symptoms may appear. The last stage is when you reach Aids. “Eight to twelve years symptoms of AIDS begin to appear (//Aids Healthcare Foundation//).” Your body reaches this stage when your CD4 cells go below a certain limit in your body. After this your immune system is badly damaged and it can get infections. The only symptoms are from those that come from the infections.Without having treatment, people who are diagnosed with AIDS typically survive about three years (//Aids.Gov//). People who have a really dangerous infection, survive for about a year. Although with treatment people live for quite some time (//Aids.Gov//). The first step for the HIV lifecycle is Binding and Fusion. The HIV attaches itself to a CD4 cell and then injects its own material inside the cell. After that step, the next step is called Reverse Transcription. This is when a special protein that speeds up chemical reactions or enzyme changes the genetic material of the virus, so it can be integrated into the DNA of the body. After that, the virus then enters inside the nucleus of the cell and hides itself for a couple of years inside the body’s genetic material. When that’s over with, the next step is transcription, this is when the cell is activated and the virus uses the body’s own enzymes to make more genetic material that allows it to make longer proteins. Another step is called assembly. In this step another enzyme called protease cuts the longer HIV proteins into small pieces; when these come together with the virus’ own DNA a new virus is created. Budding is the last stage of the life cycle. The virus leaves the host cell with part of the cell’s membrane and goes and starts the process again (//Aids.Gov//). So, how can you actually get HIV? The answer is that it is mainly in fluids that contain the virus itself. Those fluids are blood, semen, pre-seminal fluid, vaginal fluid, and breast milk. “The common ways to get HIV is to have sex with an HIV positive person, sharing needles or injections, mother to child during pregnancy, after birth, and breast-feeding(//Aids.Gov)//.” The uncommon way to get it is getting struck by an HIV needle, “French” or open-mouth kissing, getting bitten by an HIV infected person, eating pre-chewed food by an HIV person, getting tattoos or body piercing by an HIV infected needle, and going to dental or medical practices where equipment is infected by HIV virus (//Centers for Diseases Control and Prevention).// The virus can enter the body through the lining or the rectum and anus, vagina and cervix, opening to penis, mouth where they’re sores or bleeding gums, cuts and sores, and syringes or needles(//Aids.Gov)//. This virus cannot spread outside the body like in the air or water, insects, saliva, sweat, tears, spitting, shaking hands, and closed mouth or social kissing. So, when you actually have the virus you feel as if you’re sick and have a really bad flu that doesn’t go away. Some symptoms are: memory loss, depression, brain disorders, rapid weight loss, dry cough, recurring fever, night sweats, unexplainable fatigue, swollen nymph glands in the neck, groin, and armpits, diarrhea for more than a week, an unexplainable tiredness, pneumonia, white spots on the tongue, throat, and red, pink, brown or purple blotches under or on the skin, mouth, and inside the eyelids (//Centers for Diseases Control and Prevention)//. Although the symptoms can be for other illnesses too, there is no way to actually tell if you have HIV other than to test your blood (//Aids Healthcare Foundation)//. Since the illnesses differ among people, many people might get extra fat in the abdomen, neck, breasts, and face. While other times people loss weight in the arms, legs, face and buttocks //(Aids.Gov//). Women tend to get chronic yeast infections (Capone-Henriquez). While infants and children get brain damage and develop more slowly than other healthy children. They tend to have loss of muscle control, get half paralysis, get hepatitis, and get heart and kidney damage. They tend to walk and talk later than normal children (Kane 42). Often people feel very sick when they progress to AIDS (//Aids.Gov)//. AIDS can cause people to get cancers and other diseases; the most common cancer that people get is skin cancer. People don’t really die from AIDS itself, but from the infections and cancers that their immune system cannot fight off (Kane 19). Some of the many HIV related illness are anal cancer, anemia, asthma, cervical cancer, buffalo hump, valley fever, herpes, hepatitis, high cholesterol, liver disease, kidney problems, thrush, shingles, wasting, diarrhea, influenza, and TB. So, that’s how you feel when you get the virus (//Aids Healthcare Foundation).// Now that you have seen some symptoms and know what goes on in your body, lets’ move on and see how we can protect ourselves.

Prevention/Treatment

Prevention and getting treatment is one of the most important steps that we need to take in life. By protecting ourselves we are basically saving our lives. What makes HIV different from any other virus is that there is no cure for it and there is no vaccine that you can take to prevent it, the only way to actually protect yourself is to eliminate risk factors. People need to stop sharing needles, like for tattoos, body piercing, and acupuncturing, these all have risks even though you might not have any clue (Kane 65). The only way to be certain that you have HIV is to have your blood checked out. Some ways to prevent yourself from this disease is to limit your sex partners, not to inject drugs, to use condoms, also to engage yourself in risk reduction programs (//Centers for Diseases Control and Prevention)//. Many people use spermicides, they believe that these sperm killing products can limit the risk, well in the case of HIV that’s not accurate. HIV was tested with spermicides in a laboratory and the product had no chance against the virus, it was not effective (Kane 65). Being able to protect yourself from this disease is very important. A certain drug called Methamphetamine or meth is very highly addictive, it increases sexual arousal, which is a risk for HIV. When this happens people are unprotected and have a great risk of spreading the virus from one to another (//Aids.Gov)//. People who have low education have a high risk of getting the virus, they have no idea about it (Kane 55). Healthy skin is another great barrier between the virus and yourself, it can’t enter through unbroken skin. Many health professionals have gotten HIV through blood donations. The healthcare workers come in contact with needles that contain the virus. Many also get infected when blood that is contaminated is splashed into their eyes, nose, mouth, and an open cut or sore. They also can get it through fluids like Amniotic, cerebrospinal, and synovial fluids. Amniotic is a clear yellowish liquid that surrounds the fetus during pregnancy, “ the bag of water.” Cerebrospinal is a cushion that protects the spine and brain. Synovial is a straw colored liquid that lubricants the joints. All of these liquids can come in contact with the workers skin and body and they can get the virus through these fluids (//Aids.Gov)//. Since 1987, the first anti-retroviral drug came out, azidothymidine (Azt). After this drug more than 22 drugs were produced to help with controlling the virus. Since there is no way to fight off the virus, there are drugs that can help to keep the numbers low and to help make you stay healthy (//Aids Healthcare Foundation)//. There are certain types of tests that people can take to see if they have HIV, the first one is a rapid HIV antibody test, antibody is a protein made in your immune system that starts to produce when it notices that an invader has entered your body. It’s like a company that quickly makes as many weapons as it can to fight of an enemy. So, in these tests doctors are looking for the production of antibodies, this will tell than that a virus is in the body and the immune system is getting prepared to fight it off. The rapid antibody test takes about 10-20 minutes for the result to show and it requires blood, oral fluid, or urine to detect HIV antibodies. Another test is called Enzyme immunoassay (EIA) this tests the same things as the rapid test, but the results can take up to two weeks. If a person comes out positive for both of these tests, than they need to take the Western blot test, which confirms the result of the previous test and takes up to two weeks to confirm. Other tests include Antigen and PCR tests, Antigen are not really as common than the antibody tests, they diagnose the infection earlier about 1-3 weeks after someone is first infected, this also requires a blood sample. While the PCR detects the genetic material of the virus itself, not the antibodies. PCR stands for polymerase chain reaction test, what happens is that a laboratory replicates tiny amounts of DNA and measures and examines it. There are three kinds of treatment drugs for HIV the “cocktail”, antiretrovirals (ARVs), and highly active antiretrovirals therapy (Art or Haart) (//Aids.Gov)//. Haart is a very highly active antiretroviral therapy, some side effects include nerve damage, inflammation of pancreas, liver failure, nausea, and diarrhea (Kane 23). Antiretrovirals means that something interferes with something bad, in this case HIV, and tries to make sure that it doesn’t make any more of itself (//Aids Healthcare Foundation)//. There are five classes of antiretrovirals, they are nucleoside reverse transciptase inhibitors(NRTIS), non-nucleoside reverse transciptase inhibitors (NNRTIS), Protease Inhibitors, Fusion inhibitors, and Integrase inhibitors. The first three work by interfering with the replications of HIV cells and the last two prevent HIV from getting into the cell and blocks its process. Nucleoside reverse transcriptase or nukes is a drug that blocks a very important step in the HIV reproduction process. This drug blocks the virus to use and to build DNA that the virus needs to make copies of itself. Non-nucleoside reverse transcript inhibitors or non-nukes prevent the HIV from making its own DNA.The drug directly acts to prevent it from functioning properly. Like stated before the HIV replicates long strands of material of itself, which gets cut up into two to make more, it is called protease.While the protease inhibitors blocks enzyme to prevent those strands of genetic material from being cut up. Fusion inhibitors block the virus from entering the cells in the first place, this is because the virus needs a way to attach to your CD4 cells. “Integrase inhibitors block this enzyme and prevents the virus from adding its DNA into the DNA in your CD4 cells.” This stops it from replicating itself, HIV uses your DNA to make its own DNA (//Aids.Gov)//. Many people get side effects from the drugs some include change in fat distribution in the body, high blood sugar, high cholesterol levels, lactic acidod or energy producing elements of cells, and damage to organs like the liver and kidneys (//Aids Healthcare Foundation)//. As you have just learned there are many different treatments for the virus, but for now let’s just protect ourselves.

Living with HIV and myths Now that you know quite a bit about this deadly virus, let’s look at some ways for people who are HIV positive to keep themselves and others healthy. Also you would be able to see some myths about this virus. The more you know about the virus, the more decisions you can make about yourself and you can also find ways to relieve your symptoms (//Aids Healthcare Foundation)//. Some healthy steps that you can take are having healthy nutrition, having good mental health, getting enough exercise, having access to medications, relaxing a lot, being on diets, and having a good place to live (Capone-Henriquez). Also the most important can be to avoid alcohol, smoking, and illicit drugs, so basically keeping you immune system healthy and strong to prevent damage (//Aids Healthcare Foundation)//. Another thing is that, people who have AIDS should avoid food that have viruses, parasites, and bacteria (Kane 23).This is because your immune system is so weak that these types of things are strong and your immune system couldn’t hold it off. Most of the money used for prevention education go toward young adults, which is not necessary wise because many seniors also have it, and if you are not educated and don’t know any of the tips you can get infected. Everyone should know about the virus it’s not only the young (Bersch and DiRamio). People who have the virus should avoid having sex with people who too have the virus. Even though they both have it, people tend to believe that nothing can go wrong, but this is false, you can reinfect yourself (Capone-Henriquez//)//. If you have a partner who is HIV positive then you need to avoid sharing sex toys, needles, razors, toothbrushes, and need to avoid unsafe sex. Things like sharing sports equipment, phones, dishes, food, clothes, bathrooms, and swimming pools don’t have risk to transmit. What’s really important for women who have HIV is that anti-retrovirals make birth control pills less effective, so you can technically still get pregnant. Also if yo u’re untreated with HIV there is a 25% chance that you can pass it to your baby and if you are treated then there is a 2% chance of passing it to your baby. Mothers who are HIV positive must not breastfeed their babies for they can pass the HIV to the child. Women can also have greater risk of getting a cervical cancer (//Aids Healthcare Foundation)//. Even though we must try hard to protect ourselves there are some things that are difficult for people to get and tasks that they need to accomplish. The cost of drug therapy and medical services for infected people is very expensive, some people don’t have insurance or the money to pay for the services. It costs about $12,000 a year for drug therapy and $20,000 a year for medical services (Kane 57-58). Another troubling thing is that some clinics are low on money and it is hard for them to get supplies needed for their patients. For instance, in Las Vegas a clinic was low on money and the provider reused the needles which caused 40,000 people infected with HIV (Bersch and DiRamio). When people first find out that they have this virus, it is almost immediate shock or denial, it’s always why me (Capone-Henriquez). During these tough times one needs to strengthen themselves and need to battle this virus.What many people don’t do is that they don’t tell anyone that they have it. So, what’s really important is to make sure that your healthcare providers know that you have it. In some states it’s the law that you tell your partner about the virus (//Aids.Gov)//. Another important fact is that if you have a job and have HIV, you can’t necessarily get your colleagues infected unless their is contact with body fluids. It is also illegal for an employer to treat you differently if you have HIV (Kane 56-57). Some myths that people have created about HIV are totally wrong and tend to confuse people. For instance “HIV is the same as Aids,” this is not technically correct. Aids is when the HIV virus attacks the immune system aggressively and damages the system. Another myth is “HIV diagnosis is a death threat.” The statement is false, the people who receive medications and treatments live for decades and are generally healthier than people with diabetes and heart disease. HIV deadly if it is unnoticed and not treated right away. Another myth is, “HIV can be cured.” This is totally false, it can’t, but medications and treatments can control the illness and symptoms.When people feel as if these are gone they believe that they can’t transmit the disease, but they still can. People have also said that “HIV primarily affects white gay men and drug users.” NO; everyone can get it, 1/2 more in teen girls and seven times higher in African Americans. Another false statement is, “there is not much we can do to stop the spread of HIV.” False, yes we can, before campaigns in the U.S. there were 150,000 cases of new infections each year, after the campaigns the number lowered to 40,000 per year. Another myth is, “people over 50 don’t get HIV.” 11% of people over 50 have HIV. Since the educations are targeted more for teens, the seniors believe that they don’t really need the programs.Yet another false statement is “women who have HIV cannot give birth to healthy children.” Without proper precautions it can be transmitted, but other than that no it can’t. Another myth is, “HIV is not the real cause of AIDS.” Actually AIDS is formed by having the HIV virus lead into it. Another myth is, “HIV was created in a laboratory as a conspiracy to kill off blacks, gays, and junkies.” This is not correct at all. HIV was discovered to man in 1959, although it existed before that. The virus came to be known somewhere in the twentieth century in African villages, it died out before it could spark an epidemic.Then soon through airline travels it spread around the world. Lastly, “people should not take HIV medications because the side effects are worse than the illness.” This is generally wrong because the medications have decreased many death rates and are good for you, even though some of them do have side effects than can be monitored. For untreated people with HIV the virus makes 10 billion copies a day with no symptoms. So, you’re better off with your medication. Many people have made up these myths, but once again the more we know about this virus the better positions we can put ourselves in (Friedman).

In conclusion, HIV is a disease that is quite unheard of, but is one of the most deadliest. People should all unite and come together as a whole to fight this virus off. For those who have it they need our support, so they can fight through this malignant virus. This virus is spreading around very quickly, everyone should do everything that they can to protect themselves and others. HIV has changed the lives of many people and has ruined many relationships. Remembering that protecting yourself, is like preserving one healthy soul one step at a time.

Works Citied

//Aids.Gov.// U.S. Department of Health & Human Services, 8 Nov. 2010. [|Web. 31] Jan. 2011. //Aids Healthcare Foundation.// Aids Healthcare Foundation//,// 2008. [|Web. 31] Jan. 2011. Bersch, Carren and Denise DiRamio. "The Changing Face of HIV/AIDS." //MLO:Medical Laboratory Observer// 42.12 (2010): 10-14. //Academic Search Complete//. Web. 13 Feb. 2011. Capone-Henriquez, Elizabeth. Personal Interview. 17 Feb. 2011. //Department of Health and Human Services: Centers for Diseases Control and Prevention//. Department of Health & Human Services, July 2010. [|Web. 31] Jan. 2011. Friedman, Gillian. "HIV and AIDS: Dispelling the Myths." //Ability//. (2006): 45-48. //SIRS Researcher.// Web. 9 Feb. 2011. Kane, William M. Ed. //Health Matters! Volume 7 HIV Infections, AIDS, And STDs//. Danbury, CT: Grolier Educational, 2002. Print. McNeil Jr., Donald G. "U.N. Reports Decrease in New H.I.V. Infections." //New York Times//. (24 Nov. 2010): A.4. //SIRS Researcher.// Web. 10 Feb. 2011.