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Describe HIV to me in one minute. Go! Now tell me what the AIDS acronym stands for. What about the difference between the two labels?
Did you stumble? Or maybe second guess your answer? Many people do when it comes to discussing HIV and AIDS. But that’s why I’m writing this, to help clear the air on something I find most people have vague knowledge about. By the end of this article, you’ll know way more about this virus than ever before.
December 1st is World AIDS Day, and this year marks its 25th anniversary. Yup, that’s right, World AIDS Day has been observed since 1988, only a year prior to my birth. The continuing theme this year will be the concept of “Getting to Zero,” a strategy designed by United Nation’s program called UNAIDS. “Getting to Zero” means: zero new HIV infections, zero AIDS-related deaths, and zero discrimination. The latter being a big issue in Canada.
How do we, as global citizens – no, as a fellow human beings– fight this virus and its stigmas? The first and main step is to get educated. Most people fear HIV/AIDS because they don’t fully understand it.
Let’s start with the basics. Everybody has an immune system made up of various cells; it’s what helps us live and fight off sicknesses like the common cold. One of the key groups of these cells is called “CD4+ T-helper cells.”
Yeah, that’s a mouthful, so we’ll just call them CD4 cells for short. These CD4 cells are vital for identifying and killing unwanted invaders like viruses and bacteria. How does HIV and AIDS relate to any of this? If we look at the actual acronyms, it literally tells us what each of them is. HIV stands for Human Immunodeficiency Virus, which is the virus that infects – you guessed it – humans! This nasty virus is different than your average bad guy because it attacks our vital CD4 cells directly. It can not only kill them, but HIV implants their genetic information into our CD4 cells, forcing them to produce even more HIV particles. I think of it as our body’s soldiers being overrun with zombies, and as they’re bitten, they join the dark side and the zombies multiply.
Someone who has HIV is considered as being HIV-positive, whereas someone without the virus is considered HIV-negative. Also, once infected with HIV, there’s a possibility of showing symptoms such as fever, enlarged lymph nodes, diarrhea, and weight loss, to name a few. Sometimes only one happens, and sometimes no symptoms arise at all. The only way to identify HIV is by having a blood test done, since these symptoms are similar to every other infection known to man.
Once HIV has taken over the majority of our immune system, which can take ten years on average, AIDS comes in. It stands for Acquired ImmunoDeficiency Syndrome, which means we have acquired certain syndromes that typically occur once our body’s army has been reduced to only a few soldiers. Remember that common cold? We no longer have the resources or strength to fight off everyday parasites, so they take over our body, and we die. Therefore, AIDS is generally the last stages of life after HIV has obliterated our CD4 cells.
If our goal is to reduce HIV infections, we’ll need to understand how it’s transferred and who can get it. I asked various individuals how they thought HIV could get from host to host. A lot of them were correct, but a lot of them were also misinformed. This misinformation is what spreads ignorance or anxiety, both of which are dangerous when trying to confront a global pandemic.
HIV does not discriminate; it can infect anyone regardless of your sex, your age, your ethnicity, your orientation, even your religion. However, we do know that once outside the human body, HIV is actually a very fragile virus and doesn’t survive. So, here’s how it is NOT transmitted: coughing or sneezing; saliva or snot; sweat or tears; urine or feces; or vomit. That means HIV does NOT fester on doorknobs or countertops like influenza does. You can NOT become infected by touching someone’s hand or skin, NOR by kissing, NOR by sharing utensils, NOR by using the same toilet seat, NOR exercise equipment, NOR swimming pools, and definitely NOT from mosquitoes or any bugs.
Then how is it transferred? Well, let’s be clear that HIV does not materialize from nowhere; it has to be passed from someone who is already infected. And we’ve got five fluids that can transmit HIV – count them – five bodily fluids: blood, semen, vaginal, rectal (not feces), and breast milk. That means the virus can spread via sharing needles, by infected blood transfusions or organ transplants, by giving birth and infecting the baby, or by having unprotected sex. Sharing needles generally encompasses those who take drugs intravenously, but it also means every needle at clinics around the world needs to be sterile and not reused between patients.
Contaminated blood and organs can happen, mainly because the donor didn’t know they had HIV. Granted, in Canada and developed countries, we’ve been screening donations since 1985, but that doesn’t mean a bad batch couldn’t slip through. Anything’s possible, and I say this not to scare you, but so you realize HIV victims never deserve their fate. Moreover, for those who are born with HIV from their mothers.
When it comes to sex, there’s no telling how often you need to be exposed to someone with HIV in order to contract the virus. There are many variables involved, so you could become infected with just one random act, or you could have safe sex with the same HIV-positive partner for months or years before an accident occurs, if at all. Wait…someone can have safe sex with an HIV-positive person without getting infected? Yes, yes they can, but first, some quick history.
HIV/AIDS is considered a modern pandemic; modern because researchers have estimated its existence to be around since the early 1900s. There are many theories about how it came to be and how it evolved. It’s proposed that HIV began to mutate and take a foothold in humanity during the European colonization of Africa. It’s thought that a strain of HIV, called SIV, lived inside chimps and various monkeys that were often killed and prepared for meat. Generally, if SIV got into the butcher’s blood, his immune system would fight it off no problem. However, it’s theorized that with the expansion of industrialization, vaccines, and prostitution, the SIV virus was able to quickly evolve as it was passed around. Vaccination needles back then weren’t sterilized between patients, and because of the colonial cities, prostitution increased significantly. Syphilis was also rampant during the same time, creating genital ulcers, as we now know, easily allows HIV access into the bloodstream.
AIDS became noticed in America around the 1960s, after HIV had enough time to brew and spread under our radar. Illnesses that our regular immune system would otherwise defeat were actually killing people, such as pneumonia. By the 1980s, it had appeared to be an epidemic in the gay community and as their HIV progressed into AIDS, a lot of individuals became co-infected with Kaposi’s sarcoma – a skin disease that creates dark lesions often associated with AIDS victims. In fact, America’s Centre for Disease Control started calling AIDS the “4H disease” which stood for: homosexuals, Haitians, heroin users, and hemophiliacs. Like, way to single out minorities and further their discrimination, eh? Thank God by 1982, the name was switched to AIDS. Celebrities like Rock Hudson, Liberace, and Freddie Mercury were plastered in the headlines when they died of AIDS-related illnesses. By the time I was born in 1989, there were well over 80,000 cases of AIDS in the United States alone.
It’s not all bad news, though. As HIV and AIDS escalated throughout the world, scientists were studying the hell out of it. By 1996, that’s only seventeen years ago, a giant step forward happened. Drugs were invented that could actually give victims a fighting chance against HIV. The drugs go by the name of HAART, Highly Active AntiRetroviral Therapy. Based on stats from Public Health Canada, there were 1,827 AIDS cases reported in 1993, but after the introduction of HAART, the number of reported AIDS cases in 2011 went down to a mere 151. Fantastic! Canadian scientists are even trying to invent a functional vaccine that’s undergoing trials.
No, it’s not a cure, but HAART is something outstanding that we are still implementing today in 2013. The drugs assist our immune systems in reducing the viral load of HIV, to undetectable levels in most cases, allowing for CD4 cells to repopulate. As our CD4 cells repopulate, we can begin to function almost normally again, defending against pneumonias, influenzas, and rare diseases that are common in AIDS victims. That means HIV/AIDS is no longer a death sentence as it once was. Instead of the expected ten-year lifespan, HIV-positive people can now live a nearly normal life without dying from AIDS-related illnesses. However, until a cure is made, they will have to take a daily dose of HAART every day of their lives, and will need to consistently monitor HIV levels. Thankfully in Canada, our healthcare covers the majority of the costs for HAART. One month’s dose, which is only thirty pills, can cost over $1,300 or more. You can imagine the lack of access to the drugs simply due to the prices.
Now that you know the basics about HIV and AIDS, it’s time to give you some numbers to try and understand the depth of this pandemic. Are you ready? There are 35.3 million people living with HIV around the world as of 2012. That’s roughly equivalent to Canada’s total population, if not more! But how many HIV victims actually live in Canada? The latest data from Public Health Canada was for 2011; there were 71,300 HIV-positive
Canadians, with 3,175 of them being new infections just that year alone. Assuming the Canadian infection rate increased by that number each year, there would be roughly 77,650 victims as of 2013. That works out to approximately 1 in every 500 Canadians being infected with HIV. Think about that for a moment. The World Health Organization, a branch of United Nations, states that nearly 1 in every 20 adults are living with HIV in the Sub-Saharan region of Africa – which means all African countries that lie below the Sahara Desert. Globally, over 900 children become infected with HIV every day.
Within developed countries, such as Canada, there are still negative stigmas associated with having HIV. Mainly due to lack of education, there are ideas that HIV-positive people got the virus due to their lifestyles. Whether people are gay, bisexual, straight, drug users, escorts, have lots of sexual partners, have one sexual partner, or what have you, we’re all susceptible to the virus. And that’s all it is: a virus. We don’t need to give HIV any more power than it already has. In fact, because of fear of rejection and abandonment, a vast majority of HIV-positive people in our society today do not reach out for the support and help they need. There are even cases of people getting fired from their jobs because they were discovered as being HIV-positive.
Do we need to backtrack to the five fluids? Because if you’re not having sex at work or not making blood pacts with coworkers, there is no risk of ever getting HIV from a positive employee. The same goes with strangers who might be positive, or hanging out with your positive friends. Even in the most obscene scenario, like getting sprayed with infected blood, the infected blood would have to find its way into your own bloodstream through an open wound. Even if you had an open cut, then there are the variables of the infected blood’s viral load, the amount of blood, the exposure to the air, etcetera, etcetera. What I’m trying to say is, you needn’t be afraid of working with HIV-positive people, talking to them, or being friends with them. We need to eradicate the discrimination associated with HIV and AIDS and “Get to Zero.” It’s not their fault they got HIV any more than it’s your fault you got influenza or chickenpox.
This year for World AIDS Day, get tested. Know your status. Early diagnosis results in better treatment and a better life. It’s as simple as going to your local health unit and getting a Rapid Point-of-Care HIV test, where they simply prick your finger and get results within minutes.
What you need to do is be HIV-aware. This includes knowing your own HIV status. If you are sexually active, it’s best to get tested once a year, if not more frequently based on healthcare advice. Of the Canadians who are infected, it’s estimated that 25% of them do not even know it. That’s a huge amount of infections waiting to spread from ignorance alone! If you have questions, visit www.catie.ca for more information.