HIV/AIDS is one of the most serious global epidemics. HIV/AIDS was first known in the 1980s, during which there was also a surge in HIV/AIDS cases and deaths. However, it is highly likely that HIV has been around longer than this. Due to the aggressive nature of HIV/AIDS, it took decades to develop a treatment and scientists are still in the process of developing a vaccine (HIV.gov, 2019). Today, HIV/AIDS continues to be a major public health problem throughout the world, affecting men, women, and children. In this research paper, I will define HIV/AIDS, how it is transmitted, screened, and treated. I will also tackle the current challenges faced by governments and organizations in fighting HIV/AIDS.
The Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS)
HIV or Human Immunodeficiency Virus is one of the most common sexually transmitted diseases that attacks T cells that help fight infections in the body (HIV.gov, 2020a). This virus, thus, makes the infected person vulnerable to other viruses and various chronic diseases. There are two types of HIV—HIV-1 and HIV-2. HIV-1 is the most common strain all over the world, while HIV-2 is more common in West Africa, but has begun to appear in the US, Europe, and India as well (Robert, et al.). These two strains are genetically different, with HIV-2 being harder to transmit, taking longer to exhibit symptoms, slower to progress, and being less responsive to medication. If left untreated, both strains of HIV can progress to AIDS. HIV has three stages:
- Stage 1 – acute stage
The acute stage is the first two to four weeks after transmission, during which the virus multiplies at a rapid rate. Symptoms of acute HIV infection includes rash; fever; chills; headache; fatigue; sore throat; night sweats; loss of appetite; ulcers in the mouth, esophagus, or genitals; swollen lymph nodes muscle aches; and diarrhea (HIV.gov, 2020c). Acute HIV stage is often left undetected because it is often mistaken as a temporary illness and may be resolved after the body develops antibodies.
- Stage 2 – Chronic HIV / Clinical Latency
After the first few weeks, HIV continues to multiply in the body, causing more severe symptoms. Coughing or breathing difficulties, weight loss, diarrhea, fatigue, high fever may occur in varying severity. However, some individuals may not exhibit symptoms. (HIV.gov, 2020c) This case is called clinical latency. This stage of HIV may last for ten years before progressing to the final stage.
- Stage 3 - AIDS
AIDS or Acquired Immune Deficiency Syndrome is the late stage of HIV infection. HIV progresses to AIDS when the body’s immune system becomes severely damaged. AIDS is a fatal disease—people who develop AIDS typically survive for 3 years with treatment; without treatment, the survival rate is at 1 year (HIV.gov, 2020c). Symptoms of AIDS include persistent high fevers; severe chills and night sweats; white spots in the mouth; genital or anal sores; severe fatigue; rashes; coughing and breathing problems; significant weight loss; persistent headaches; memory problems; and pneumonia.
The human body is not capable of fighting off or eliminating HIV. Once it is contracted, the virus stays in the body for life. Once a totally fatal disease, HIV is no longer fatal. With regular antiretroviral treatment (ART) and medications, an individual may stay in the latent stage or stage 2 (HIV.gov, 2020c). Regular and proper ART may lead to undetectable traces of HIV and practically no risk of transmission. Treatment of HIV/AIDS is thus crucial in preventing the spread of the virus and in reducing HIV/AIDS fatality.
Transmission of HIV
As mentioned earlier, HIV is a sexually transmitted disease, which means that it is transmitted through bodily fluids like blood, semen, vaginal fluid, rectal fluid, as well as breast milk. It cannot be transmitted through other means like through air, water, or casual contact with an individual living with HIV.
Vaginal and anal sex are two of the most common ways of transmitting HIV. Sharing syringes and needles, sharing tattoo equipment, and exposure to bodily fluids of someone living with HIV are also ways HIV is transmitted. The issue of drug abuse and HIV/AIDS are tightly interrelated. HIV may also be transmitted by the mother to its baby during pregnancy, labor, or delivery, as well as through breastfeeding and premastication.
HIV symptoms take some time to manifest, if they manifest at all. Thus, HIV screening is the only way to ascertain one’s HIV status. To further drive the point, awareness of one’s HIV status is imperative in treatment, protecting oneself from possible infection, and protecting others to prevent the further spread of the virus. The Center for Disease Control and Prevention or CDC (2015) recommends getting screened at least once for everyone aged 13 to 64. However, annual testing is recommended for those with the following risk factors:
- Men who has had sex with another man
- Individuals who have had multiple sex partners
- Individuals who have exchanged sex for money or others
- Individuals who had been diagnosed with another sexually transmitted disease
- Individuals who have used injected drugs and shared needles
- Individuals who has had sex with someone who has HIV or whose sexual history is unknown (CDC, 2015)
HIV Screening involves multiple types of tests that will check the presence of HIV in your blood or bodily fluids. The first two screening tests are antibody test and antigen/antibody test (HIV.gov, 2020c). The antibody test is the most common type of HIV screening method. Instead of the virus, this test looks for antibodies that the body makes when HIV is present. The second most common HIV test is the antigen/antibody test, which looks for part of the virus or the antigen in the blood (HIV.gov, 2020c). This test can tell if there is HIV within 2 to 6 weeks of exposure. The FDA has also approved HIV test kits that can be used at home.
Follow-up tests, however, are required to confirm the positive result and to verify the type of HIV contracted. To accomplish this, the follow-up test must be a blood test. There are three types of follow-up tests: Antibody differentiation test, which tells if the patient contracted HIV-1 or HIV-2; HIV -1 nucleic acid amplification test (NAAT), which verifies the presence of HIV in the blood as early as the first two weeks after infection; and the indirect immunoflourescence assay, which tests for antibodies (HIV.gov, 2020c). Another follow-up test is the viral load test, which measures the number of HIV copies are present in a milliliter of blood. This test is useful for doctors as it informs them of how much damage has been done by the virus or whether the treatment is working.
HIV screening plays a significant role in preventing another HIV/AIDS epidemic. By getting tested, people living with HIV/AIDS, not only get access to treatment that prevents the progress of HIV to AIDS, it also helps them protect others from contracting the virus from them.
Current Public Health Challenges
The 1980s was characterized by the HIV/AIDS epidemic, during which thousands of lives were lost (HIV.gov, 2019). A combination of limited knowledge and the US government’s lack of action, HIV/AIDS uncontrollably spread. HIV/AIDS became a public problem for the whole world. Eventually, a stigma was developed and people living with HIV/AIDS became a kind of lepers as minorities and the LGBT community were the most affected. It was not until the 2000s that the US government, as well as the United Nations, made an effort to develop treatment and raise awareness on HIV/AIDS.
Despite continuous effort since the 2000s, the HIV/AIDS continues to be a public health problem throughout the world. 1.7 million individuals all over the world were diagnosed with HIV in 2019 (HIV.gov, 2020b). Although this shows a 23% decline in new HIV infections since 2010, the number of new cases remains significant (HIV.gov, 2020b). As already mentioned, treatment of HIV/AIDS is no longer an issue. In its place are issues on access to tests and treatment, and mother-to-child transmission.
In 2019, only 81% of the global population were aware of their HIV status (HIV.gov, 2020b). There have been efforts to make testing and awareness more accessible all over the world. However, various cultural and practical issues bar people from getting tested. Conservative social traditions in the MENA region, for instance, prevent women from accessing reproductive health services, including HIV screening (Robert, et al.). Another barrier is the stigma. The view of HIV/AIDS as a punishment for the LBGT community and sexually promiscuous individuals is quite universal. Such attitudes lead many at-risk individuals to avoid getting an HIV screening.
This issue regarding stigma is related to the other issues in a domino effect. Since a significant part of the population does not get tested, individuals with HIV may not be able to tap into the treatment made available by governments and NGOs. Consequently, individuals with HIV run the risk of infecting even more people, including, in the cases of pregnant women, infants.
In this essay, I have described HIV/AIDS, how it is transmitted, its symptoms, treatment, and the current challenges the public health sector and governments face in the endeavor to eliminate the said disease. HIV/AIDS started as a fatal illness that took millions of lives but has now become a manageable disease through regular treatment. Despite these, however, the spread of HIV/AIDS has not improved and many continue to be unaware of their HIV status. This is partly due to inaccessibility of HIV/AIDS screening as a result of the rising poverty rates in the western world. and the stigma associated with HIV/AIDS. There had been great progress in the handling of HIV/AIDS, but more work is still needed to fully curb HIV/AIDS.
Center for Disease Control and Prevention. (2015, June 4). HIV infection: Detection, counseling, and referral. https://www.cdc.gov/std/tg2015/hiv.htm
HIV.gov. (2019) A timeline of HIV and AIDS. HIV.gov. https://www.hiv.gov/hiv-basics/overview/history/hiv-and-aids-timeline
HIV.gov. (2020, June 5). What are HIV and AIDS? https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids
HIV.gov. (2020, July 7). Global HIV/AIDS overview. https://www.hiv.gov/federal-response/pepfar-global-aids/global-hiv-aids-overview
HIV.gov. (2020, September 28). HIV overview. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/stages-hiv-infection
Robert, R.H., et al. (2009, July). Gender and care: Access to HIV testing, care, and treatment. Journal of Acquired Immune Deficiency Syndrome, 51(p S106-110). doi: 10.1097/QAI.0b013e3181aafd66