Acquired Immunodeficiency Syndrome (or AIDS for short), is probably the best known and most feared STD. AIDS is caused by the Human Immunodeficiency Virus, otherwise known as HIV. The term "Immunodeficiency" common to both names suggests that the effect of HIV is to compromise or impair the function of the immune system; the part of the body that protects the rest of the body from infection. In practice, the HIV virus impairs patient's immune systems, making them vulnerable to infection and disease. When people with AIDS get even simple infections, they become very sick because their immune systems are too weakened to fight these simple infections off. In the absence of medical treatment to strengthen the immune system (described below), AIDS is frequently a lethal disease.
HIV can be passed from one person to another via the sharing of body fluids during sex or through sharing of contaminated needles (used by IV drug users, tattoo artists, etc.). The virus can also be passed from a mother to her newborn baby during the birth process or while breastfeeding.
HIV infection can be silent or symptom-free. Many people who become infected with HIV do not experience symptoms. Some newly infected patients will experience a general illness within six months of their infection. The illness, when it occurs, may resemble the flu with cough, nausea, swollen glands, and general achiness as symptoms. However, in many cases patients will not have symptoms.
After the initial illness, the virus is likely to become dormant, and silent in terms of symptoms, for many years before it reawakens and causes problems. Because of this tenancy towards silent, symptom free infection presentations, it is impossible for people to know if they have HIV without having their blood tested for the virus by a doctor or other health professional.
As governments are eager to prevent the spread of HIV, they often make it easy for people to be tested for HIV. Free and anonymous testing for HIV is available in many communities. Current HIV tests require that a blood sample be taken and tested (newer test formats are under development).
Importantly, it takes several months (up to six months, in fact) for a newly infected person to have enough HIV in their bodies for their infection to show up on a blood test. People who suspect they have been infected, need to wait at least six months after the point of their infection, and then show a negative test in order to feel confident that they do not have the virus.
When people find out they are HIV positive (meaning, having the virus in their bodies), they are often required by law to inform sexual partners, both past and future, of this fact. Such laws vary from state-to-state. The purpose of such laws is to reduce the spread of HIV, which is a worthwhile goal. Whether or not HIV-positive people agree that they should be legally forced to share their virus status with past and future partners, they hopefully can agree that it is the morally right thing to do to help other people avoid infection, or to seek out treatment that will likely save their lives. If you are HIV-positive, we strongly urge you to inform all past and future sexual partners you may have of your virus status, so that they can take steps to minimize their own risk.
The severity of a person's HIV infection is measured by counting the number of T-cells and the amount of virus in that person's blood. The amount of virus in a person's body is called the "viral load". T-cells are a type of "white blood cell" or immune system cell found in the blood and in the lymph nodes. Healthy T-cells attack and destroy invading bacteria and viruses as part of normal immune system functioning. As a persons' HIV viral load rises, T-cells become fewer and farther in between, and therefore less capable of defending the body from outside infection.
Normally, people have a T-cell count between 800 and 1200. HIV infection turns into a case of AIDS when a person's T-cell count falls below 200 or when they experience what is known as ‘an AIDS-defining illness.' AIDS-defining illnesses are certain infections or diseases that mark a patient's transition from viral infection to the AIDS syndrome. Examples of AIDS-defining illnesses include Kaposi's Sarcoma (a type of cancer), certain types of pneumonia, and wasting syndrome (where a person loses a lot of weight and muscle).
Untreated HIV, which leads to AIDS, makes people very sick. AIDS can cause dementia (where a person loses their mental abilities, including memory and attention) and their ability to care for themselves independently. AIDS also causes standard illnesses, such as the flu or colds, which would be minor for most people, to blossom into major life-threatening conditions. In short, when untreated, AIDS can be lethal.
Although HIV infection (and AIDS) is not curable, treatments are available in more developed parts of the world that can substantially reduce the danger posed by HIV, and dramatically lengthen lifespan and quality of life. There are several families of medicines used to treat HIV/AIDS. Though all such medications act to reduce patient's viral load, each family of medicines handles this process differently. Some medicines, called "anti-retroviruses", prevent the virus from replicating and making more virus. Other types of medicine, such as antibiotics, help prevent the infections to which HIV/AIDS patients are susceptible.
The use of condoms and dental dams can reduce the likelihood of passing on HIV during sex. Likewise, not sharing needles is an important precaution for HIV infected people to take. HIV medications reduce the likelihood of passing on the virus by reducing viral load, or the amount of virus in the blood. However, it is still possible to pass on the virus even when a person is getting HIV treatment.
HIV and Pregnancy
Pregnant women can transmit HIV to their newborns during the birth process, or, thereafter, through breastfeeding. It is important that HIV-positive pregnant women discuss their condition with their doctors so that their child has an optimal chance to live HIV-free. Cesarean delivery may be required in some cases, although in some cases medicated patients may have a low enough viral load to permit vaginal birth. In addition medicine given before birth can significantly reduce the risk of transmission. Pregnant women should be tested for HIV. Such testing is usually offered to women during their pre-natal care.
Psychological Impacts
Learning that you are HIV-positive can be devastating. It is important to know that there are many resources available to HIV patients that can help them cope with the stress of being HIV-positive. Doctors, nurses and other health professionals are available to answer questions. Support groups, both live and via the internet, can be a life-saver. Specialized psychotherapy is also available to assist with the psychological transition to living with HIV. Also, family, friends and other forms of community, including tolerant religious groups, are important resources that should not be forgotten.
Finally, it is important to remember that there are good medications to treat HIV, and that when these medicines are taken correctly, a person can live a full, quality life. HIV may always be a dangerous and chronic condition to have, but it is no longer necessarily a "death sentence".
Additional information on HIV and AIDS can be found at the National Institute for Health website here.
