What Is HIV/AIDS?
Acquired immunodeficiency syndrome (AIDS) is an older term for the symptoms and illness caused by infection with the human immunodeficiency virus (HIV). In the past, doctors referred to AIDS or "full-blown AIDS" as a separate and more serious phase of the infection. With modern treatments, HIV disease is managed as a long-term illness, and the use of "AIDS" to refer to a separate phase is no longer necessary. Therefore, HIV is now referred to as HIV disease or HIV/AIDS. HIV infects many cells in the body, but the most important ones that cause medical illness are the cells of the immune system.
What Causes HIV/AIDS?
HIV may cause a brief illness and rash during the very early phase of infection, and it may mimic many common virus infections like the common cold, influenza, or even mononucleosis. More often, early infection causes no symptoms, and the person infected is not aware. As HIV infects more and more immune cells over time, the immune cells start to decline and the person is not able to fight off infections. The lower the immune cells drop, the more and more unusual infections begin to occur. Eventually, the person seeks medical care, and HIV infection is often diagnosed at this point in HIV disease.
Research has also suggested that long-term infection with HIV causes long-term inflammation that may lead to conditions such as heart disease, diabetes, stroke, and more; these conditions are found to occur at younger ages in those infected with HIV than in those who are not. Current health guidelines recommend HIV testing for all teens and adults who are sexually active or are exposed to blood and body fluid products. This is recommended at least once in a lifetime, each time a woman is pregnant, and more frequently if the person has risk factors for becoming infected with HIV.
By discovering HIV infection early, effective treatment can be offered to improve the long-term effectiveness of the treatments, prevent babies from being born with HIV or acquiring it from breastfeeding, prevent spread of infection to others, and reduce inflammation-related conditions like diabetes that may reduce quality of life and life span. Early detection of HIV infection also alerts doctors to screen for other diseases that are acquired in the same ways as HIV and may affect health.
What Is the History and Treatment of HIV/AIDS?
The syndrome caused by HIV was first recognized in the U.S. in the late 1970s. Research has confirmed that HIV evolved from a very similar virus, simian immunodeficiency virus, found in chimpanzees in West Africa. HIV is felt to have mutated and jumped to humans when chimpanzees were hunted for meat. This may have occurred as early as the 1800s, and HIV has slowly spread across the world, spreading faster with globalization and travel in recent times (since the 1980s).
In the late 1980s, the first drug treatment with azidothymidine (AZT) or retrovir, became available for treatment of HIV.
In the mid-1990s, antiretroviral therapy as a combination treatment of HIV infection with at least three medications revolutionized the management of this disease. The disease is much more easily controlled with antiretroviral therapy, and progression to advanced stages is now much less common. Today, HIV/AIDS is treatable by several combinations of medications, in some cases, with one combination pill a day.
What was once considered a "death sentence" is now a treatable chronic illness, much like diabetes or heart disease, as long as the person infected does not miss medication doses and keeps up with medical monitoring and recommendations. People on effective combination treatment for HIV may lead relatively normal and productive lives.
Who Is at Risk for HIV/AIDS and Should be Tested?
- HIV transmission requires contact of the HIV-infected person's blood or genital fluids with the blood or genital fluids of an uninfected person, so anyone who has sex without barrier protection (like condoms) from genital membranes and secretions can get HIV. In fact, national guidelines recommend that providers in all health-care settings test for HIV at least once as a routine part of medical care for all patients between ages 13 to 64.
- Perinatal transmission can occur. A mother infected with HIV may transmit HIV to her unborn baby before or during birth, or afterward in breast milk. Any woman who is pregnant, planning to become pregnant, or might accidentally become pregnant should be tested.
- Anyone who has oral sex, genital sex, or anal sex without condoms (rubbers), especially with multiple partners, men who have sex with men, or in exchange for drugs or money
- Anyone who shares injected drugs (including narcotics and steroids) or equipment such as needles and syringes
- Anyone who has been diagnosed with another sexually transmitted infectious diseases, such as syphilis or gonorrhea
- Anyone who has been sexually assaulted or forced into having sex
- Anyone who has been diagnosed with tuberculosis (TB) or hepatitis
- HIV virus cannot be transmitted by routine activities, such as sharing eating or drinking utensils, sharing towels or a bathroom, or living together.
- Common-sense precautions include not using the same razor, which may be contaminated with blood. HIV virus cannot be transmitted by contact of healthy skin with saliva, urine, or feces.