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HIV/AIDS Overview

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Updated June 15, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

 

What is HIV?

The human immunodeficiency virus (HIV) is a virus that attacks the cells of the immune system. Although infections may show no clinical signs for years, without treatment the virus can reduce the strength of the immune response and leave HIV-positive individuals susceptible to other diseases. HIV itself usually causes few to no symptoms . It is devastating, instead, because it lowers the body's defenses against other diseases. The diseases that take advantage of HIV's effects on the immune system are known as opportunistic infections.

 

The Early History of the HIV Epidemic

HIV first came to public attention in the early 1980s when, on opposite coasts, doctors noticed sudden spikes in the numbers of two rare diseases occurring among gay men. In New York, a group of eight men had been diagnosed with a rare form of cancer known as Kaposi's sarcoma (KS). In both New York and Los Angeles, infections with an unusual type of pneumonia caused by the fungus Pneumocystis carinii (PCP) were also on the rise.

Doctors and scientists, at first, were dumbfounded by the sudden surge in these two diseases. There were many theories early on. Some suspected that they might be related to drug use in the gay community, specifically amyl nitrate ("poppers") or to a particularly dangerous strain of cytomegalovirus.

After about a year of the disease being identified strongly with the gay population, where it was sometimes called "gay-related immunodeficiency" (GRID) or "gay cancer," researchers began to notice that the same syndrome was occurring in other groups of people -- particularly in injection drug users, people from Haiti, and hemophiliacs. Unfortunately, that belated realization had a high cost. Even today, when the vast majority of HIV infections worldwide are heterosexually transmitted, there are many who still think of it as a "gay disease."

 

How is HIV Transmitted?

HIV is transmitted through bodily secretions. It is not transmitted by casual contact. Methods of HIV transmission between adults include sex (oral, vaginal, anal) with an infected partner and sharing needles or syringes with an infected partner. HIV can also be transmitted from a mother to her infant during pregnancy, birth, or breastfeeding. Bodily fluids that contain HIV include:

  • blood
  • semen
  • vaginal secretions
  • breast milk

HIV is also found in saliva and tears, but there have been no documented cases of transmission from either of these sources. Contact with the saliva, sweat, and/or tears of a person infected with HIV does not put you at risk of the disease.

Doctors consider there to be an extremely small risk of HIV transmission from open-mouthed kissing someone who is HIV positive; however, this risk is from the possible presence of blood in the mouth. For this reason, some HIV educators recommend not brushing or flossing your teeth right before kissing, since tooth brushing can cause bleeding. Instead, if you are worried about your breath, use a mouthwash or chew on a piece of gum.

However, this is not something that should cause a great deal of stress since, in the entire history of the HIV/AIDS epidemic, the Centers for Disease Control and Prevention (CDC) have only identified one case of HIV transmission that may be related to open-mouth kissing, and they are not even certain of that one.

 

How is HIV NOT Transmitted?

HIV is not transmitted through casual contact. You can't get it from hugging, shaking hands, sharing food, or even a casual kiss. Because HIV is such a fragile virus, it doesn't live long outside the body. You are therefore also not at risk of the virus if you use public restrooms, drinking fountains, doorknobs or any other public facilities. HIV is a relatively difficult virus to transmit.

 

Who is at Risk Of HIV?

There is no group that is safe from the risk of HIV. HIV transmission can occur in people old and young, gay and straight, white, black, or any other race. If you have unprotected sex, or share needles, you are at risk of HIV infection no matter who you are. Doubtful? According to the CDC, in 2005:

  • There were more new diagnoses of HIV in individuals over 40 than in people under 40, but it was a close call.
  • Though blacks bear a disproportionate burden of HIV in the United States, whites and Hispanics accounted for approximately half of all new HIV diagnoses.
  • Heterosexual sex was responsible for twice as many new HIV cases as injection drug use.
  • Male-to-male sexual transmission was the source of approximately half of new reported HIV infections.
  • Approximately one quarter of all new infections occurred in women.

 

Can HIV Be Prevented?

HIV prevention is a matter of taking proper precautions. Using a condom or other barrier correctly every time you have anal, vaginal, or oral sex, not sharing needles or syringes, and wearing latex gloves whenever you come into contact with blood or other secretions will vastly reduce your risk of becoming infected with HIV. Although proper precautions should always be taken, regular testing is also essential, so that people know their HIV status and can make informed decisions about their HIV risk

Although circumcised men have a reduced risk of HIV compared to uncircumcised men, circumcision is only recommended as an intervention for men who live in areas with a high prevalence of HIV and a low prevalence of condom use. Circumcision does not eliminate the possibility of men contracting HIV from their male or female sexual partners, it only reduces it.

 

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