The Truth about Transmission
When AIDS was first discovered, there were many misconceptions about transmission. People wondered if they could get AIDS through using public bathrooms, holding hands, or kissing. Separating fact from fiction, there are three primary ways that HIV is transmitted:
- Sexual intercourse (including oral sex)
- Contaminated blood (including blood transfusions, sharing of syringes and needles among drug users)
- Mother to child transmission during pregnancy and childbirth or breastfeeding
HIV is NOT transmitted through the following:
- Coughing or sneezing
- Casual skin contact such as hugging
- Sharing of food, water, toilet seats, etc.
- Sharing of clothes, towels, etc.
- Public swimming pools
- Pets or insect bites
- Playing on sports teams (assuming there is no contact with blood)
- Dry kissing
The Center for Disease Control found that in 2015, the new number of HIV diagnoses in the United States was almost 40,000. This large number underscores the importance of continued focus on HIV prevention. In the table below, you can see that sexual contact continues to be the most common way that HIV is transmitted among adults.
- (CDC, 2015): https://www.cdc.gov/hiv/statistics/overview/
Current Treatments for HIV/AIDS
As mentioned earlier, there is no “cure” for HIV or AIDS. However, a variety of global efforts and medical research has resulted in significant headway in HIV/AIDS prevention and treatment. Before treatments were developed, HIV could progress to AIDS and death within just a few years.
Today, HIV can be controlled through medication called antiretroviral therapy – referred to as ART. ART drastically improves the lifespan of people infected with HIV, even to the point that lifespan is very similar to those who do not have HIV. ART is actually a combination of medication that prevent the HIV from multiplying, thus reducing the amount of HIV in the body.
ART has been accessible in developed, high income countries since the mid 1990’s. However, in the developing world, ART was often unavailable, primarily due to the high cost of medication. However, in the last decade, laws were changed to promote drug manufacturers to produce ART drugs at reduced prices, and to increase the generic ART drugs produced. Today, there are more people across the word receiving ART than at any point in time. However, this continues to remain dependent on international funding and continued joint efforts to keep ART accessible. (Loue, 2013).
Although HIV is always present, taking ART medication reduces the risk of transmitting the disease to others because the amount of HIV in one’s body is also reduced. ART is recommended for all people with HIV. There are in fact more than 25 medications that are approved to treat HIV. The following factors impact the medications that are chosen for a particular person:
(HIV.gov, 2017): https://www.aids.gov/hiv-aids-basics/just-diagnosed-with-hiv-aids/treatment-options/overview-of-hiv-treatments/
- Any other diseases or conditions that the person may have
- Side effects of the medication
- Potential interaction between the HIV medication and other medications
- Result of drug-resistance testing – which identifies which medicines won’t be effective for the individual
- Convenience (for example, combining 2 medications into one pill)
- The individual’s’ lifestyle needs
- Cost
Once the person starts taking these medications, they could have an undetectable level of the HIV virus within 3-6 months. It is important to emphasize that “undetectable level” does not mean the person is cured, but that the ART is working effectively.
The chart below clearly show that although the number of people living with HIV globally has increased overall, the number of people accessing treatment has also increased – substantially. From less than a million people receiving treatment in 2000, over 17 million people were receiving treatment in 2015 (UNAIDS, 2016).
Prevalence of HIV and AIDS Today
The Center for Disease Control estimates that in the United States, there are about 1.2 million people over the age of 13 living with HIV – including an estimated 161,000 who had had not yet been diagnosed. Although the rate of death continues to decrease due to ART medications, there were an estimated 13,000 AIDs-related deaths in 2014. In total, through 2014, the cumulative number of deaths from AIDS in the United States is almost 700,000.
It is important that we take an international perspective when considering the impact of HIV and AIDS. Over 40 years after the epidemic began, HIV continues to be a complex and prevalent global health challenge. Worldwide, there are about 2 million new cases of HIV every year.
HIV and AIDs are a major health concern and the cause of death in many areas of Africa. In fact, sub-Saharan Africa has the most serious HIV and AIDs epidemic in the word. In 2013, an estimated 24.7 million people in Sub-Saharan Africa were living with HIV – accounting for 71% of the global total (Avert, 2017)
Here are some key facts about HIV/AIDS, as provided by the World Health Organization (2017) http://www.who.int/mediacentre/factsheets/fs360/en/
- HIV continues to be a major global public health issue, having claimed more than 35 million lives so far. In 2015, 1.1 (940 000–1.3 million) million people died from HIV-related causes globally.
- There were approximately 36.7 (34.0–39.8) million people living with HIV at the end of 2015 with 2.1 (1.8–2.4) million people becoming newly infected with HIV in 2015 globally.
- Sub-Saharan Africa is the most affected region, with 25.6 (23.1–28.5) million people living with HIV in 2015. Also sub-Saharan Africa accounts for two-thirds of the global total of new HIV infections.
- It is estimated that currently only 60% of people with HIV know their status. The remaining 40% or over 14 million people need to access HIV testing services. By mid-2016, 18.2 (16.1–19.0) million people living with HIV were receiving antiretroviral therapy (ART) globally.
- Between 2000 and 2015, new HIV infections fell by 35%, AIDS-related deaths fell by 28% with some 8 million lives saved. This achievement was the result of great efforts by national HIV programs supported by civil society and a range of development partners.
- Expanding ART to all people living with HIV and expanding prevention choices can help avert 21 million AIDS-related deaths and 28 million new infections by 2030.
Young People and AIDS
Here are some facts from UNICEF (2003) about Young People and AIDS:
■ Nearly 12 million young people, aged 15-24, are living with HIV or AIDS.
■ About half of all new infections now occur in young people. Every day, nearly 6,000 young people become infected with HIV. While infection rates among 10- to14-year-olds are not generally known, studies indicate that a significant proportion of younger adolescents are sexually active and therefore at risk.
■ Ignorance about HIV/AIDS is one of the fundamental reasons why young people are vulnerable to HIV infection. Despite the fact that sexual activity begins in adolescence for most people, surveys among young people in more than 60 countries showed that the vast majority could not accurately say how HIV is transmitted. Half the teenage girls in the sub-Saharan African countries surveyed wrongly believe that someone who looks healthy cannot have HIV.
■ Young women are especially vulnerable to HIV. More than twice as many young women as young men are contracting HIV in some developing countries, particularly in sub-Saharan Africa. In a few severely affected African countries, as many as five or six girls are infected for every young man infected. Because of their biology, girls and women are more easily infected by HIV during heterosexual intercourse than men. Older men, who are likely to have had many sexual partners, are having sexual relations with younger women and girls and putting them at risk. The lifelong disadvantages that girls and women face because of discrimination against them – including inadequate education, poor pay and employment prospects, and violence, abuse and exploitation by men – make them particularly vulnerable to unwanted or unsafe sex, both within and outside of marriage. Compounding the risks, females are often denied access to critical knowledge and education about sexuality and sexual health. During civil unrest and armed conflict, young women and girls are even more likely to become the victims of sexual violence.
■ Disadvantaged and ostracized young people are in greatest danger. Young people who inject drugs, are affected by armed conflict, suffer sexual exploitation, are trafficked, are orphans, or who live on the streets or in institutions have even less access to information, skills, services and support than other young people. Boys and young men who have sexual relations with men are very vulnerable because of the multiple disadvantages they face.
UNICEF (2003) explains:
HIV/AIDS is increasingly a problem of the young. Yet young people are also the greatest hope for stopping the epidemic, partly because they are more likely than adults to adopt and maintain safe behaviors. Wherever the spread of HIV/AIDS has slowed or even declined, it is primarily because young men and women have been given the tools and the incentives to protect themselves against infection.
