AIDS: Epidemic Of The Decade Essay, Research Paper

INTRODUCTIONThere is no doubt that AIDS is indeed the epidemic of the decade. Not only are there many supporting facts and data, visiting urban cities and third world countries prove this point. Furthermore, AIDS is not only highly infectious, it is also the first major incurable epidemic throughout this biomedical revolution that mankind is going through. This epidemic might actually be the one that will completely wipeout the third world. Scientists, government agencies and pharmaceutical companies are scrambling to find a cure to this epidemic but in the mean time we have to find a way to deal with it, if possible. As we continue into the next millennium with all sorts of problems facing humanity, the choice with regard to AIDS is simple, evolve or die!

INFECTIVITYThe Human Immunodeficiency Virus (HIV) has two different types of strains. HIV-1 is the North American strain while HIV-2 is the African strain. The only real difference between the two is that HIV-2 has the vpx gene while HIV-1 does not. As you can tell by the name, the virus works by gradually deteriorating the immune system. The virus can infect any cell with CD4 molecules on the cell?s membrane. It seems to specifically destroy or disable the CD4+ T cells. These cells are sometimes called “T helper” cells. They work by signalling other cells to perform their special functions. A normal healthy person usually has a CD4+ T cell count of 800 to 1,200 per cubic millimetre of blood. Once a person?s CD4+ T cell count falls below 200/mm3, a person is diagnosed with Acquired Immunodeficiency Syndrome (AIDS). A person diagnosed with AIDS will usually die of an opportunistic infection, not of HIV/AIDS itself.

HIV is a virus and a virus is basically a microscopic bag of protein filled with a strain of DNA or RNA. To be more specific, HIV has a diameter of approximately 1/10,000 of a millimetre and is spherical in shape (see Figure 1-1). The viral envelope consists of two layers of lipid molecules and contains proteins taken from the host cell. There are 72 copies (on average) of a complex HIV protein called Env. Env is made of three or four molecules of a glycoprotein, gp120, that form a cap and a stem consisting of gp41 molecules that anchor the structure to the surface of the viral envelope. HIV belongs to the class of viruses known as retroviruses. HIV is a retrovirus because its viral core is composed of RNA. Inside the viral core there is a capsid that is made of 2000 copies of a viral protein called p24. This capsid surrounds two strands of HIV RNA, each of which contains nine of the virus? genes. Three of these genes (gag, pol, and env) contain information regarding the manufacture of structural proteins and new virus particles. Three regulatory genes (tat, rev, and nef) and three auxiliary genes (vif, vpr and vpu) contain information regarding the production of proteins that allows HIV to infect a cell, produce new copies of the virus or cause disease. At the end of the HIV RNA strands there is a RNA sequence called long terminal repeat (LTR). The LTR acts as a switch to control the production of new viruses. Proteins from the virus or the host cell trigger the LTR. The core of HIV also contains a protein called p7, the nucleocapsid protein and the three enzymes that carry out later steps in the virus’s life cycle: reverse transcriptase, integrase and protease. The p17 protein called the HIV matrix protein, lies between the viral core and the viral envelope.

In order to continue its life in an evolutionary sense, HIV must do what every virus does, and that is, to float around in the blood stream and wait for a cell that it can infect. In HIV’s case it usually waits around until a cell swallows it up with CD4 molecules on its cell membrane. Once it is swallowed the following occurs (see figure 1-2):

Entry and AttachmentThis is when the virus comes in contact with the host cell?s membrane. Once the two membranes meet, the gp120 binds and fuses with the CD4 molecules on the surface of the host cell?s membrane. During this stage the virus will release its HIV RNA, enzymes and proteins into the host cell.

Reverse TranscriptionIn this stage the HIV RNA converts itself into DNA in the cell?s cytoplasm. This process has no correction mechanism so there is often a high rate of error in the transcription. This leads to an especially high mutation rate of HIV.

IntegrationThe new DNA moves to the nucleus of the cell. In the nucleus of the cell the HIV DNA is spliced with the DNA of the cell with the help of HIV integrase. Once the HIV DNA has been incorporated into the cell?s genes it is called a ?provirus”.

TranscriptionFor the provirus to create more viruses it must take over the cell?s protein making machinery. This is done with the messenger RNA (mRNA). mRNA is RNA that can be read by the protein making machinery. Transcription is initiated by the tat gene or by cytokines, which are proteins that are involved with the normal regulation of the immune response. Transcription may also by initiated by molecules such as tumour necrosis factor (TNF)-alpha and interleukin (IL)-6 which are secreted at higher levels by the cells of HIV infected people. (www.aegis.com)

TranslationThis is the process of the HIV mRNA taking over the cell?s protein making machinery. Once the HIV mRNA is processed in the cell?s nucleus, it is transported to the cytoplasm of the cell. HIV proteins are very important to this process. For example, a protein encoded by the rev gene allows the mRNA that encodes HIV structural proteins to be transported from the nucleus to the cytoplasm. Without this rev protein structural proteins cannot be made. In the cytoplasm, the HIV mRNA takes over the cell’s protein making machinery and begins to produce long chains of viral proteins and enzymes.

Assembly and BuddingNew HIV core proteins, enzymes and RNA gather just inside the cell’s membrane with viral envelope proteins. An immature virus particle then pinches off from the cell membrane taking with it an envelope that includes both cellular and HIV proteins. During this part of the virus’s “life” it is not infectious because the core is not yet mature. The long chains of proteins and enzymes that form the viral core are then cut into smaller pieces by a viral protein called protease. Once the protease has finished its work the virus is ready to infect another cell.

HIV researchers around the world are currently studying how the HIV virus destroys or disables CD4+ T cells. Many of these researchers think that the mechanisms described below happen simultaneously in an HIV infected person. Recent data suggests that billions of CD4+ T cells can be killed almost everyday, eventually overwhelming the body?s ability to reproduce T cells. Here are some of the ways researchers think that HIV kills or disables CD4+ T cells:

Direct Cell KillingInfected CD4+ T cells may be killed directly when large amounts of virus are produced and bud off from the cell surface, disrupting the cell membrane, or when viral proteins and nucleic acids collect inside the cell, interfering with cellular machinery.(www.aegis.com)

Syncytia FormationInfected cells may also fuse with nearby uninfected cells, forming balloon?like giant cells called syncytia. In test?tube experiments at the National Institute of Allergy and Infectious Diseases (NIAID) and elsewhere, these giant cells have been associated with the death of uninfected cells. The presence of so?called syncytia?inducing variants of HIV has been correlated with rapid disease progression in HIV?infected individuals.(www.aegis.com)

ApoptosisSome scientists believe that when an HIV infected cell has its cellular regulation distorted by HIV proteins it undergoes a programmed self-destruct or aptosis. There are reports that indicate HIV infected persons have a much higher rate of aptosis in both their blood stream and in their lymph nodes. Some scientists report that gp120 alone or bound to gp120 antibodies can give false biochemical signal to uninfected cells causing them to commit suicide. (www.aegis.com)

Innocent BystandersUninfected cells may die in an innocent bystander scenario: HIV particles may bind to the cell surface, giving them the appearance of an infected cell and marking them for destruction by killer T cells. Killer T cells may also mistakenly destroy uninfected CD4+ T cells that have consumed HIV particles and that display HIV fragments on their surfaces. Alternatively, because HIV envelope proteins bear some resemblance to certain molecules that may appear on CD4+ T cells, the body’s immune responses may mistakenly damage such cells as well. (www.aegis.com)

AnergyResearchers have shown in cell cultures that CD4+ T cells can be turned off by a signal from HIV that leaves them unable to respond to further immune stimulation. This inactivated state is known as anergy. (www.aegis.com)

SuperantigensOther investigators have proposed that a molecule known as a superantigen, either made by HIV or an unrelated agent, may stimulate massive quantities of CD4+ T cells at once, rendering them highly susceptible to HIV infection and subsequent cell death. (www.aegis.com)

Damage to Precursor CellsStudies suggest that HIV also destroys precursor cells that mature to have special immune functions, as well as the parts of the bone marrow and the thymus needed for the development of such cells. These organs probably lose the ability to regenerate, further compounding the suppression of the immune system. (www.aegis.com)

Researchers have found that it takes about 10 years for the symptoms of AIDS to appear in a HIV infected person. However, it has also been observed that there can be a wide variation in disease progression. Approximately 10 percent of HIV?infected people in these studies have progressed to AIDS within the first two to three years following infection, while 5 to 10 percent of individuals in the studies have stable CD4+ T cell counts and no symptoms even after 12 or more years. Factors such as age or genetic differences among individuals, the level of virulence of an individual strain of virus, and co?infection with other microbes may influence the rate and severity of disease progression. (www.aegis.com)

During the early parts of the HIV infection the virus will infect a large number of T-cells and replicate rapidly. During this phase the virus seeds itself into many different organs of the body, including the lymphatic system, brain, kidneys, skin, and intestines. The person?s blood during this time is very infectious. By the end of this phase, the person?s CD4+ t cell count is decreased by 20 to 40 percent. Scientists don’t know if the T cells are killed or if they “retreat” to the lymphatic organs in preparation for an immune response. Two to four weeks after exposure to the virus, the majority of infected people (70 %) experience flu-like symptoms as the body fights the virus with a massive immune response. During this immune response the body will fight back with killer T cells (CD8 + T cells) and B-cell produced antibodies, which dramatically reduce the HIV levels in the blood stream. A person?s CD4+ T cell count may rebound up to80 or 90 percent of its original.

One reason why HIV is so unique is that for some reason it survives this purge. Some scientists believe that the body?s best soldiers (killer T cells) simply tire themselves out and allow some of the virus to escape and multiply slowly. The killer T cells also stay in the blood stream and ignore the virus stuck in the lymphatic system. More scientists now believe that HIV hides in special parts of the lymphatic system called follicular dendritic cells (FDCs). FDCs are located in the hot spots of the immune activity called germinal centres. FDCs act as a sort of flypaper trapping invading pathogens (including HIV) and hold them until B cells come along to initiate an immune response. Close behind these B cells, CD4+ T cells come to help kill the invaders. When the CD4+ T cells try to help to clean out the FDCs the HIV in the FDCs infects them in large numbers. (AIDS and the Arrows of Pestilence, Charles F. Clark) Over the years even if there is almost no sign of HIV in the blood stream the virus accumulates in the germinal centres. During the time while HIV is accumulating the person may feel no symptoms of HIV from anywhere between two to twelve years. Eventually the virus will kill most of the T cells in the body and a person will get AIDS.

The majority of scientists believe that HIV causes AIDS but there are some scientists that don’t believe this. For example, Peter Duesberg thinks that AIDS is an infectious disease and not a result of HIV. His main point is that HIV is not cytocidal (does not directly kill cells) however HIV is cytocidal because it does directly kill CD4+ T cells, as described above. Duesberg?s second major point is that the body can generate most of the lost T cells. In reality, the virus uses the T cells as hosts so whenever the body reproduces more T cells, the virus has more hosts to infect. Therefore more viruses will be produced and will eventually overwhelm the body?s ability to make more. His third point is that there is no Simian (monkey) model for AIDS. Many however, believe that HIV is a direct “sibling” to SIV (Simian Immunodeficiency Virus). Monkeys die from SIV the same way humans die from HIV. So there is a simian version of AIDS. His final theory is that the drug AZT causes AIDS. This is very hard to believe because AZT works by interrupting the reverse transcription of RNA to DNA, which results in HIV not affecting the immune system.

HIV is very different than any other disease in human history because it specifically attacks the immune system allowing the body to die from an opportunistic infection that is usually too weak to cause death on its own. It is also interesting because it is the first disease that has been discovered during the biomedical revolution that is both highly contagious and has no cure.

TransmissionHIV can be spread in many ways. The main ways that HIV spreads are:

through sexual intercourse with an infected partner

by using recreational drugs intravenously with a syringe that has been used by someone with the virus(http://www.avert.org)

Injecting drug use continues to play an important role in HIV-1 transmission in developed countries, but sexual transmission is responsible for the recent rapid expansion of the epidemic in Asia, India, and the Indian subcontinent. Sexual transmission among homosexual males is still a significant part of epidemic spread in the United States and Europe, but now most experts estimate that homosexual males account for fewer than 50% of new infections in the United States. (Holmberg SD) In the most populous regions of the world, sexual transmission among heterosexuals is the dominant mode of spread.

The other less common modes of transmission of the HIV virus are:

blood transfusions

blood products

mother to baby transmission

infection in the health-care setting

Blood TransfusionsSome people have been infected through a transfusion of infected blood. But in most countries all the blood used for transfusions is now tested for HIV. In these countries where the blood has been tested, infection through a blood transfusion is now extremely rare. (www.aeges.com)

Blood ProductsBlood products, such as those used by people with Hemophilia, are now heat treated to make them safe.

Mother to Baby TransmissionThe virus can be transmitted to the child from the mother before or during the delivery of the newborn. The other mother to child transmission case is through the breast milk that he/she is fed in the early stages of the child’s life.(www.westnet.com)

Infection in the Health-Care SettingSome health-care workers have become infected with HIV by being stuck with needles containing HIV-infected blood. Even fewer have become infected by HIV-infected blood getting into the health-care worker’s bloodstream through an open cut or splashes into a mucous membrane (e.g. eyes or the inside of the nose).

There have only been two documented instances of patients becoming infected by a health-care worker.

Duration of EpidemicThe duration of HIV has been known to stay with the infected individual all of their life because there is no known cure for it. Other illnesses such, as the cold or flu, have been cured over time, because the body is still well enough that the body’s white blood cells can fight it off. However, with HIV, the infected cells attack the white blood cells and destroy them, rendering the body helpless and unable to fight off other illnesses, which would not have affected the body normally. The problem also lies in the fact that HIV, once in the body, does not go for an “all-out attack”. It hides in major reservoirs such as the lymph nodes and stays there; sending out infected cells a little at a time. When the HIV virus has infected enough cells, then the cells attack the body’s defenses and destroy them. Because HIV is a smart virus, it does these accomplishments in astounding ways, which are listed below.

First of all, HIV produces about ten billion copies of itself every day, while the body can only replace about a billion of the white blood cells every day. Second, HIV hides a large percentage of its “army” in reservoirs, and seldom brings them out. Third, a person can have HIV for as long as several years without even knowing they have it, and then HIV suddenly emerges and hits them, killing them in weeks or even days.

There are no cures, but in the future, the human species may adapt to the HIV virus and so it would no longer be an epidemic, but just something that can be cured over time, like the flu or cold.

Sub-Saharan Africa22 500 000South & Southeast Asia6 700 000Latin America1 400 000North America890 000East Asia and Pacific560 000Western Europe500 000Caribbean330 000Eastern Europe and Central Asia270 000North Africa and Middle East210 000Australia and New Zealand12 000TOTAL33 400 000Management – Treatment and Side Effects, ImmunizationMany drugs are used to fight off HIV. Some of these treatments disrupt the RNA of the HIV-infected cells, preventing them from making more HIV cells; others find and kill off the infected cells. Doctors believe that taking at least three drugs at a time will increase the drug efficiency and lower the risk of getting any more severe symptoms. They believe this because if you take just one drug, then HIV has a chance of resisting the drug after a while. However, if you take more than one drug, it takes longer for the HIV virus to adapt to the medication. When you take three, it takes even longer, so the risk is decreased.

It also helps when the drugs that are being taken have no similar side effects. For example, AZT was one of the first drugs that were found to slow down the rush of HIV. But, it also has some side effects that include headaches and stomach aches. However, these go away after several weeks.

But what about the more severe side effects? Well, for starters, there’s Abacavir. Abacavir is a drug that is potentially powerful, but causes hypersensitivity to about three percent of the patients. This symptom usually starts anywhere from about several days to four weeks after the drug has been used. Stopping the drug use and never taking it again can solve this problem. It can also cause fever, nausea, and malaise. Others, such as Adefovir, can cause vomiting and nausea, and Indinavir may cause stomach aches, generalized discomfort and kidney stones.

Doctors must be careful when prescribing several drugs for HIV, because if some of the side effects are the same, then that increases the risk of that symptom. Part of the responsibility also lies in the patient. The patient must be diligent in administering the drugs to themselves, and if they miss taking the drugs for a day, then they should stop because then there is a possibility that the HIV virus has had a chance to adapt and that drug(s) is no longer effective.

Other drugs, such as protease, are categories rather than individual drugs. Other categories include Ribonucleotide Reductase Inhibitors, such as Hydroxyurea, or Hydrea. Although Hydrea is the only drug that works this way, but there are other drugs like this under development; Protease Inhibitors, like Ritonavir, work by targeting the protease enzyme of the virus, which is essential for HIV to assemble copies of itself. Nucleotide Reverse Transcriptase Inhibitors, Non-Nucleoside Reverse Transcriptase Inhibitors, and Nucleoside Analog Reverse Transcriptase Inhibitors are other examples of drug categories and how they work.

Brand NameGeneric NameFirm NameApproval Date Retrovir capsulesZidovudine, AZTGlaxo, WellcomeMar. 19, 87 Retrovir syrupZidovudine, AZTGlaxo, WellcomeSept. 28, 89 Retrovir InjectionZidovudine, AZTGlaxo, WellcomeFeb. 2, 90 VidexDidanosine, ddlBristol Myers-SquibbOct. 9, 91 HividZalcitabine, ddcHoffman-La RocheJune 19, 1992 ZeritStavudine, d4tBristol Myers-SquibbJune 24, 1994 Epivirlamivudine, 3TCGlaxo, WellcomeNov. 17, 1995 InvirasesaquinavirHoffmann-La RocheDec. 6, 1995 NorvirritonavirAbbott LaboratoriesMar. 1, 1996 CrixivanindinavirMerck & Co., Inc.Mar. 13, 1996 ViramunenevirapineBoehringer Ingelheim Pharmaceuticals, Inc.June 21, 1996 ViraceptnelfinavirAgouron PharmaceuticalsMar. 14, 1997 RescriptordelavirdinePharmacia & UpjohnApril 4, 1997 Combivirzidovudine & lamivudineGlaxo WellcomeSept. 26, 1997 FortovasesaquinavirHoffmann-La RocheNov. 7, 1997 SustivaefavirenzDuPont PharmaceuticalsSept. 17, 1998 ZiagenabacavirGlaxo WellcomeDec. 17, 1998 AgeneraseamprevanirGlaxo WellcomeApril 15, 1999Drug ResistanceIn 1996, optimism about HIV treatment had people wondering if AIDS was over. Yet late in 1997, reports of widespread drug failure began to appear. Several media reports that followed the disappointing research findings all but eulogized people living with HIV-again. (Aug. 7, 97 edition of San Francisco’s Bay Area Reporter)

While the problem of HIV drug resistance may be overcome or prevented by better use of available agents, many experts state that the best hope for overcoming the virus are better drugs- that is, drugs that are active against resistant HIV. However, the recent news suggests that existing pharmaceutical company development programs are not finding these drugs. In a few years, will we be filled with drugs that work against “wild type” (non-resistant) virus, only to find that those viruses no longer exist in people, but only in test tubes? (tpan.com)

All of the currently approved antiretroviral therapies (AZT, ddI, ddC, d4T) interfere with viral reverse transcription of HIV (an enzyme that is capable of copying RNA into DNA therefore being an important step of the life cycle of HIV) and are thus able to slow viral replication. However the usefulness of these therapies is often short-lived because their antiviral capability diminishes over time. As these drugs are not able to completely suppress viral replication, resistance develops and ultimately limits their usefulness. Eventually, resistance may render a drug completely ineffective. (projinf.org)(www.aegis.com)

HISTORY AND GEOGRAPHICAL PATTERNSNobody knows exactly when the HIV retrovirus popped up in history. Most believe that it mutated from the Simian Immunodeficiency Virus (SIV), and this theory is quite possible for HIV-2 from Africa, where there are a lot of monkeys, but not so likely for HIV-1 from the United States where there are not so many monkeys. According to many scientists the minimum time HIV could have mutated from SIV is approximately forty years, but it is also possible it could have existed since the beginning of time (History of AIDS, Mirko D. Grmek). There are other scientists that have put the age of HIV at 140-160 years old (Paul M. Sharp, and Wen-Hsung Li), while the calculations of S. Yokoyama indicate that HIV has existed for at least 280 years.

Although the virus may have existed for hundreds or thousands years it first manifested itself among homosexuals in the United States and Western Europe around 1978 but the cases were so few that nobody really noticed anything abnormal. Here is a chronological history of important events in the history of HIV and AIDS:

1981It took until 1981 for it to become noticed in the national Untied States. In the beginning a related disease, Kaposi?s sarcoma, seemed to only affected homosexuals and because of this it was nick named ?gay cancer?, or GRID (Gay Related Immune Deficiency). Soon afterwards, it because apparent that IV drug users were also affected by the virus.

1982 The term AIDS was first used.

1983HIV was first isolated by Dr. Luc Montagnier of the French Institute Pasteur but it took the Americans (Dr. Robert Gallo of the U.S. National Institutes of Health) another year to isolate the virus even though they had patients with the virus a year longer.

1984A young French Canadian flight attendant named Gaetan Dugas was identified as patient zero for HIV-1.

1985The first international conference on AIDS was held in Atlanta, and the first HIV antibody test was approved by the Food and Drug Administration (FDA – USA). The death of Rock Hudson in 1985 greatly changed the way the public looked at HIV and AIDS.

1987AZT was first legalized in the United States in 1987. It was also during this year that the US would not allow any HIV positive immigrants or travellers to enter the country. Canada started screening blood.

1988The United States finally banned discrimination against federal workers with HIV.

1993 The CDC revised its definition of AIDS to include a list of opportunistic infections. Magic Johnson told the world he had HIV in 1993 thus helping the world deal with the fact that anyone could get HIV. Arthur Ashe also died in 1993, which finally allowed the public to see that anyone could be infected with HIV. The death toll in the US rose drastically to 43,465 in 1993 (compared to 128 deaths in 1981). Since the discovery of the virus the world death toll has reached about 6,400,00 and the number of people infected with the virus had risen to 22,000,000, the majority of both statistics are from sub-Saharan Africa.

As mentioned above, most of the HIV/AIDS casualties have been in sub-Saharan Africa. HIV began its reign of terror in Africa between the years of 1983-1985. For a long while sub-Saharan Africa denied that the HIV/AIDS epidemic was going on in their country because they were worried about being judged on the same level of druggies and homosexuals in the West. It got to a point where the African people made such jokes as to create a false acronym for AIDS that stood for An Imaginary Discourager of Sex. After this, the rate of HIV infection consistently rose. Today, seven out of every ten adults newly infected with the disease are from sub-Saharan Africa. Nine out of every ten people under fifteen infected with HIV are from Africa. Eighty-three percent of all AIDS casualties are from this region, and at least ninety-five percent of all AIDS orphans are from Africa, yet only one-tenth of the world?s population live in sub-Saharan Africa. The most interesting thing about Africa is that HIV/AIDS is much more prevalent in the literate sections of Africa than in the less literate parts. (UN AIDS report 1998)

HIV/AIDS will be a very interesting epidemic to watch because either the human race will adapt to it (like every other major disease so far) or will be wiped out by it. The worst part about HIV is, it might very well wipe out the Third World before the human race can adapt to it or before we can come up with a resistance, other than the condom, that_is_cheap_enough_for_the_third_world.

Social and Economical InfluenceSociety plays a very important role on epidemics such as AIDS and HIV because mankind is the main source of transmission for the HIV virus. People?s influences are positive and negative towards the epidemic.

The positive influence on AIDS helps spread the awareness of the disease and helps people better understand how to prevent the epidemic. Condom distributions and needle exchange programs in the U.S. and Canada proved to have spread awareness and have helped people be careful of what they do. Although programs like these have been criticized for encouraging kids to engage in sexual behaviour and to have promoted drug abuse, these programs have gained popularity and will remain in schools and community centers.

AIDS and HIV victims face discrimination almost everyday. This is mainly because the transmission of HIV is well known and some people believe that it can be prevented. Even young children with HIV have been discriminated against. Many laws had to be inducted by the United States government in order to let them go to school. Currently in the U.S., AIDS victims fall under the American Disabilities Act which makes it illegal to discriminate against them for jobs, housing and other social benefits.

Since celebrities play a very important role on society, when a notable person gets a highly recognized disease, the community is in shock because the attitudes of people are ?it could never happen to me!? So when a rich and famous person gets HIV, it hits the community hard because superstars seem untouchable and invincible, if people like that can get AIDS, then anyone can.

Many community organizations have been set up to help victims and to spread the awareness of the epidemic. Based especially in urban areas, organizations such and Inform and Act-Up were formed to help victims of AIDS and HIV by providing information. These establishments have helped victims cope with the financial and emotional problems of AIDS. ?On Saturday, May 31st, 300 hundred AIDS activists from New York, Philadelphia and Cleveland protested and participated in a giant die-in inside the Jacob Javits Convention Center, site of the POZ Life Expo, a major AIDS trade show and exposition travelling the United States.?(http://www.actupny.org) These demonstrations were to encourage pharmaceutical companies to release medicines that are being tested so that current HIV/AIDS victims have a chance at life.

Associations like these have a problem with funding, without money it?s very difficult to help victims and it?s up to the government and people to help fund these very helpful organizations.

Friends and families made a very famous memorial to AIDS victims; the AIDS Memorial Quilt (see Figure 8-2) has traveled around the world to spread awareness of AIDS and to raise money. Each panel is dedicated to a victim that has died from AIDS. The AIDS Quilt makes up one of many memorials to victims of the epidemic.

The economical issues facing AIDS and HIV could be the deciding objective in finding a cure or not. It?s all about money! With more money, pharmaceutical companies have a better chance of finding a cure. They can experiment with all sorts of things with more cash.

The most reported cases of AIDS are in the third world countries with a very poor economy, countries South Africa can not financially support victims of AIDS and HIV because they do not have enough money. (See figure 8-4) On top of that, lack of jobs results in prostitution and sometimes drug abuse, which will spread the HIV virus faster. The more victims of AIDS, the more the country has to spend and this will further decline the economy.

In Western and European countries where the funding for health care is high, the chance of getting AIDS is less. Also, the funding for people with AIDS is greater. (see figure 8-4) With better economy in these countries, more money can be put into developing a cure for this epidemic. Many international organizations have helped raise money to find a cure for AIDS, although none have been successful, the need for a cure is more needed than ever and the fight will continue.

Attitudes and Values Associated with HIV/AIDSHIV/AIDS has changed quite a few values in society. One type of bias given to AIDS is the one given by religious fanatics. This is the one that God sent HIV/AIDS to punish those who do not live by God’s laws; for example, homosexuals, drug users and all those bad and evil. Lots of people used to, and still believe, that only homosexuals, IV drug users, and third world country inhabitants get HIV/AIDS. In other words, only the ?undesirables? could get HIV so when they cried for help few of the rich Caucasian people cared. Only when HIV/AIDS started breaking out in North America did people start caring. Only then did things like the Tour de Cure, and Fashions Cures pop up. Even now most of these fund raising events mention nothing about the ones suffering in the Third World.

HIV has changed the public’s attitude towards “free love”. Some people believe that if someone is infected with HIV/AIDS, they lead a life style of “free love” and unprotected sex. People also stereotype all homosexuals as being infected with HIV. Many people believe that if you are gay, you automatically have HIV. Homosexuals have just the same chance of getting HIV as the people who have this bias. Being homosexual does not increase your chance of contracting HIV/AIDS. This bias is given to IV drug users as well. The risk is highest for IV drug users that share needles. People believe that everybody that has HIV is gay, an IV druggie, or some ?undesirable?. It took the diagnoses of famous people such as Arthur Ashe, Magic Johnson, and Rock Hudson to make people believe that any group of people could get it.

Millions of people around the world contracted HIV/AIDS incidentally though medical treatment. Some people in Africa received HIV because of the practice of re using syringes in hospitals and doctor’s offices (for malaria vaccinations). The people that received HIV from tainted blood during blood transfusions sure don’t believe that only dirty, “undesirables” can get HIV. Another bias associated with the disease is that the person that has it is unclean, dirty and one that ?sleeps” around. Generally this is not true. Once again the people who received tainted blood from the Red Cross were generally lead low risk lifestyles. HIV/AIDS has changed the whole concept of donating blood and blood transfusions. It used to be that people would walk into a blood clinic and give some blood, but now people are given paperwork to fill out, questionnaires to answer, and their blood is screened. These changes have drastically reduced the chances of giving HIV/AIDS to an otherwise, healthy person.

Another attitude that needs to be dispelled is the one that people with HIV/AIDS are weak, bedridden and waiting for death. This myth is not true. For example, Magic Johnson came back to play basketball for a season, and Eduardo Esidio, one of the leading scorers in the Peru Premier soccer league, continues to play soccer. He was the first soccer player to be diagnosed with HIV. Another myth is that if someone is diagnosed as HIV+, they automatically have AIDS. Many people that are diagnosed with HIV do not even develop AIDS.

HIV has certainly changed the way in which we look at medical treatment. It is mandatory for all health professionals to wear sterile latex gloves when treating patients. Even sports officials now wear sterile gloves in case there is an injury. Despite the tremendous advances we have made in understanding HIV/AIDS, many people still treat its victims as undesirables.

Effect on Individual and Society (Role of Public Health)AIDS/HIV has a huge impact on society because society is the host and transmitter of the disease. In order to prevent the fast spreading HIV virus, there would have to be drastic changes in peoples? sexual behaviour. (Folks & Butera, AIDS) Since this is not possible, we have to explore different methods of prevention.

The knowledge that an epidemic like AIDS exists causes a lot of people to be careful. More people are using condoms these days and people are more careful than before with sharing needles but this just isn?t enough. Society needs to understand that this is big! They need to know that only they can stop the spreading of this disease. This is where anti-aids organizations and Public Health play an important role.Public health objectives, with regard to AIDS, are to slow the spreading of HIV, make people aware of the disease and to help infected people.

The main source of funding for public health is through the government, which usually runs the organization. In the case with AIDS, public health makes people aware of the disease by holding many campaigns, especially trying to attract teenagers to promote condom use. They also put out public service announcements aimed at adults and, again, teenagers to keep them well educated about the silent killers at this present time. Public health also helps AIDS/HIV victims with all sorts of problems from helping them cope to financial. Not only does this government organization help society, it also works with companies to help find a cure.

The impact AIDS/HIV has on people is phenomenal. It causes people to be more careful about who they?re sexual partners are and also causes people to wake up and see that there isn?t complete sexual bliss. Knowing that AIDS exists could keep a lot of men from seeing prostitutes. This could have a chain reaction, which will lead to no hookers on the streets, but we all know that there would have to be jobs for this to happen and in third world countries, this is not possible.

Furthermore, the knowledge of the existence of HIV motivates people to be cleaner. It forces people to keep toilets and kitchens clean. Outbreaks of all the diseases over the century have changed the attitudes of people towards cleanliness, especially in third world countries.

All we, as a society, can hope for now is that the government, commercial companies and health departments will come up with a cure for it soon or the epidemic of the decade will cause major human destruction all over the world.

Bibliography:AIDS and the Arrows of Pestilence, Charles F. Clark, Fulcrum publishing, Golden, Colorado, 1994

Sexually Transmitted Diseases, Alan E. Nourse M.D., Franklin Watts publishing, 1992

History of AIDS, Mirko D. Gremk, Princeton University Press, Princeton New Jersey, 1990

The Gift of Death, Andre Picard, HarperCollins Publishing, Toronto Ontario, 1995

Infectious AIDS Have We Been Misled? Peter H. Duesberg, North Atlantic Books, Berkley California,1995

http://hivinsite.ucsf.edu. University of California, San Francisco AIDS Program

UN AIDS global report 1998. UN AIDS Joint United Nations Program on HIV/AIDS

AIDS epidemic update: December 1998. UN AIDS Joint United Nations Program on HIV/AIDS

UN AIDS Africa Report 1998. UN AIDS Joint United Nations Program on HIV/AIDS

AIDS, Folks, Thomas and Butera, Salvatore, Microsoft Encarta Encyclopedia 1997

Holmberg SD. The Estimated Prevalence and Incidence of HIV in 96 large US Metropolitan areas, Am J Public Health 1996

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