December 1 is World AIDS Day, and the entire month is dedicated to AIDS awareness. The first cases of AIDS in the United States were reported in June 1981. Since then, nearly 700,000 people have died from AIDS-related infections in the U.S., and there are about 35,000 new infections each year (KFF, 2021). Many people born in the middle- to late-1980s grew up learning about HIV/AIDS. We learned the stigma around infections, the stereotypes about the groups most affected, and any sexual education that wasn’t strictly “abstinence only” emphasized safe, protected sex.
For those of us who have lived with the knowledge of this disease our entire lives and who are lucky enough to have grown up in countries where people have access to high quality medical care and education, this is a virus that lurks in the background. It’s another sexually transmitted infection we must be careful to avoid, so we take precautions to prevent it. And although we know it’s something we don’t want to catch, we are starting to see it’s no longer a death sentence. Because of this, we may wonder why we should even have a month to recognize something that, while dangerous, has little impact on our daily lives.
But this is not the reality of many other countries still grappling with HIV/AIDS. In 2020, there were 37.7 million people globally living with HIV, and 680,000 people died from complications from the virus (UNAIDS, 2021). December is a time to recognize that while more affluent countries have come a long way fighting this virus, HIV/AIDS is still a worldwide health problem that does not have a cure.
HIV vs. AIDS
While you may hear these terms used almost interchangeably, HIV and AIDS are different. Human immunodeficiency virus (HIV) is the virus that causes the condition acquired immunodeficiency syndrome (AIDS). Ellis (2014) explains that HIV becomes AIDS when HIV progresses to stage three, at which point it causes serious harm to the immune system; however, it is possible to have HIV and never develop AIDS. Even if AIDS never develops, HIV never actually goes away.
Transmission and Impact
HIV spreads via contaminated blood, semen, and vaginal secretions entering your bloodstream. Having sexual intercourse without a condom or sharing needles places you at a higher risk of getting HIV. Mothers who have HIV can also pass the virus to children during childbirth and breastfeeding. HIV does not spread through ordinary activity such as touching, kissing, or breathing. HIV destroys your T-cells, which are an important part of your immune system. Fewer T-cells means your body is less able to fight infections (if you need a refresher on T-cells and immunity, read my blog post about understanding immunity). The Mayo Clinic (2021) further describes HIV’s transmission and impact on your body, including common infections people can develop as HIV progresses to AIDS.
HIV is still a problem in many areas of the world because it often impacts marginalized communities or people living in poverty. These groups may be unable or unlikely to receive adequate medical attention, including testing, and education regarding preventive measures (World Health Organization, 2021). However, the virus is also problematic because of its mutations and its ability to evade a vaccine. There have been a handful of large, phase three clinical trials and smaller trials for vaccines, but none have been successful. Desrosiers (2021) goes into greater detail about the characteristics that make HIV able to mutate and so easily evade vaccines. Researchers haven’t given up hope of having a vaccine, though, and some are investigating the use of mRNA vaccines against HIV. Radcliffe (2021) provides information about early research using Moderna’s mRNA technology. Currently, the treatment for HIV is antiretroviral therapy (NIH Office of AIDS Research, 2021).
You can reduce your risk of contracting HIV by using a condom when you have sex, having fewer sexual partners, not injecting drugs, and treating any sexually transmitted infections. You should also get tested regularly if you engage in risky behavior or believe you were exposed. If you do not have HIV but are at high risk for contracting it, you can also consider a pre-exposure prophylaxis (PrEP) antiretroviral therapy regimen. Finally, if you are in an emergency situation that could put you at risk of HIV (for example, a condom breaks or you are accidentally stuck with a needle), you may have a post-exposure prophylaxis (PEP) antiretroviral therapy regime. The U.S. National Library of Medicine (2021) has more information about HIV prevention.
You can learn more about HIV/AIDS at the following websites.