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Chapter 2: What is HIV/AIDS?

Think HIV & AIDS have nothing to do with you? Think again. In 2002, there were 42 million people living with HIV/AIDS. Over 11 million of those were between 15 and 24. Most of them don't know they carry the HIV virus. This epidemic won't go away by itself and there is no cure, but we can do something about it.

Protect yourself. Get informed. Spread the word. (http://www.staying-alive.org/en/index.jhtml)

HIV/AIDS is a world-wide tragedy. During the last decades of the 20th century, it has become the most significant health threat for young people all over the world.

Fact is, this is a pandemic – which means an epidemic which spreads over the entire planet. (www.biorap.org/aids_student (“Facts around the world”))

And it’s here to stay. Do not drop your guard, not for a single moment.

Check the statistics:
HIV and AIDS is a global emergency claiming over 8,000 lives every day.

In fact, 5 people die of AIDS every minute. (http://www.areyouhivprejudiced.org/facts/)

Over 40 million people world-wide are living with HIV/AIDS.

5 million people got infected by HIV in 2003

3 million people died of HIV in 2003 (http://www.sidaction.org/pages/etat_monde.htm)

Around half of the people who acquire HIV become infected before they turn 25 and typically die of the life-threatening illnesses called AIDS before their 35th birthday. This age factor makes AIDS uniquely threatening to children. By the end of 2001, the epidemic has left behind a cumulative total of 14 million AIDS orphans, defined as those having lost one or both parents to AIDS before reaching the age of 15.

In 2003, an estimated 700,000 children aged 14 or younger became infected with HIV. Over 90% were babies born to HIV-positive women, who acquired the virus at birth or through their mother's breast milk.” (from www.avert.org/statindx.htm.)

“Think HIV is not a big deal where you live? Wrong. HIV/AIDS is a worldwide epidemic. The numbers will surprise you.”
(http://www.staying-alive.org/en/knowfacts_02.jhtml)


Check the statistics for your particular part of the world on www.avert.org/statindx.htm – the information is arranged per continent – and specific stats relating for instance to children or to the epidemic in high-income countries.

i. The virus, the disease... the facts!

What exactly is HIV and AIDS? We know it’s a virus – HIV – that causes a disease – AIDS – for which no cure has yet been found. But what does it look like, and what does it do?

Here are some of the questions that you probably – like most of us – ask yourself:

• What exactly is HIV?
HIV stands for Human Immunodeficiency Virus (for details of its structure, see www.avert.org/virus.htm ), in other words it is a virus that attacks your immune system – your body’s defence mechanism against disease. way)

• How does HIV affect your body?

Among the human cells that the virus attacks is a lymphocyte type called helper T-cells. These cells help direct many of the activities of the immune system. Over many years, HIV causes a dramatic drop in the number of helper T-cells in the blood.

When enough of the helper T-cells are destroyed, the immune system becomes weak, and people develop AIDS. Because their immune systems are weak, they may get many diseases such as pneumonia and cancer.

Scientists are trying to understand exactly how HIV harms helper T-Cells. When they do, that will give us a powerful weapon against AIDS. (http://www.biorap.org/br4immune.html)

See www.avert.org/hivstages.htm for a description of the various stages of HIV infection, and the symptoms you’re likely to recognise at each stage.

• What is AIDS – and what does it do to your body?

AIDS stands for Acquired Immune Deficiency Syndrome. It's caused by the virus called HIV (…). Being HIV-positive is not the same as having AIDS; it means that antibodies for the virus have been detected in the bloodstream. Though it's a life-threatening illness, many HIV-positive people don't get sick for years. However, they can still spread the virus (…)

An HIV-positive person gets diagnosed as having AIDS when their immune system is so weak that the level of infection fighting cells (known as CD-4+ or T-helper cells) drops below 200, or when a person develops one or more opportunistic infections (OIs). OIs are infections that take advantage of weak immune system and can be fatal. (http://www.staying-alive.org/en/knowfacts_01.jhtml )

• What is the treatment?

There's no cure for HIV/AIDS, but there are treatment options to help people with AIDS live longer, healthier lives. (http://www.staying-alive.org/en/knowfacts_01.jhtml ) www.iwannaknow.org/glossary.index.html (all the terminology you’ve wondered about)


ii. So where do this virus and disease come from and how do they develop?

We hear and read so much about HIV and AIDS that it’s sometimes difficult to seperate reality from rumours. Lots of ligitimate questions worry us, like:

• How does one get infected?
• Can I get AIDS from kissing/shaking hands/masturbating/looking after someone with AIDS/having someone sneeze on me who has AIDS/drink from the same cup?
• Will I automatically get sick if I get infected?

Again, a useful site is http://www.staying-alive.org/en/knowfacts_01.jhtml:

“You don't get HIV from a kiss or a sneeze, but you could be at risk. Learn how it's transmitted so you can protect yourself the right way.

HIV is transmitted through an exchange of certain body fluids - blood, vaginal secretions, semen and breast milk. Because HIV lives in these fluids in high concentrations, most people are infected through:

- Unprotected sex (vaginal, anal or oral) with an infected person.
- Sharing drug needles, syringes (shooting drugs) tattooing or piercing needles with an infected person.
- Pregnancy, childbirth or breast feeding when the mother is HIV positive.

HIV must get into your blood stream to infect you. That means if you're having sex and any of your partner's blood, semen (including pre-cum), or vaginal secretions come in contact with a tiny tear in the lining of your vagina, anus or mouth, even invisible ones, you are at risk of being infected.

Here's how you don't get infected with HIV: kissing, hugging, touching, sneezing, coughing, playing sports, sharing eating utensils, drinking from the same cup, or sharing a bathroom with a person who is infected with HIV. There are no documented cases of transmission through saliva, sweat or tears. Mosquitoes, fleas and other insects don't transmit HIV either.”


(You’ll notice that, in the case of unprotected sex or sharing drug needles, you can only get it from someone who is infected by HIV. Note too, however, that most HIV-carriers do not know that they are infected…)

Also see http://www.avert.org/trans.htm on “how you can and can’t be infected by HIV”.

But how can I then avoid getting HIV/AIDS?
Though HIV-infection and AIDS are incurable, there are many things you can do to avoid getting it in the first place, such as avoiding unprotected sex or sharing any form of needles (drugs, piercing, etc.), even with someone you know fairly well. Remember, even they might not know that they are infected with HIV. The following sites provide useful information on prevention:

www.avert.org/hivprevention.htm gives detailed information on: prevention and sex (condoms etc.), prevention when you’re using drugs, prevention for health-care workers, and much more.

http://www.staying-alive.org/en/knowfacts_06.jhtml explains that you can either have no sex – which would make you 100% safe – or if you do decide to have sex, what you can do to make it much safer for you and your partner. (This site is also available in Spanish and in French.)

Sadly enough, people who have already been there, might know best how it could have been avoided in the first place. In http://www.youthhiv.org/health/safersex/how.cfm, HIV-positive teenagers give advice on safe sex, also how to avoid infecting your partner if you are the one who has HIV.

iii. What if I’ve got it?
Why and when should I be worried?
And how, why and where do I undergo an HIV test?
How do these tests work?
(see http://www.mysistahs.org/features/hiv/nhtdindex.htm) These are some of the questions you may be asking if you think you’ve done anything risky. Most countries have places you can go for free, anonymous or confidential testing. Find out for instance from:
your local hospital,
family-planning clinic,
doctor,
HIV/AIDS help-line if one is available in your area,
or if you don’t know any of these, an adult you trust, for instance a teacher.

These tests may differ from country to country, so it’s best to find out exactly how it works where you live. The important thing is, if you have any doubts, do it immediately.

According to http://www.youthhiv.org/health/hiv/test.cfm, you may decide to have a test if you:

• are starting a new relationship and have decided to get tested together
• had sexual intercourse (vaginal, oral, or anal) without a condom
• learned that a partner was not monogamous
• have been sexually assaulted
• had a condom break
• shared needles or syringes to inject drugs (including steroids) or for body piercing, tattooing, or any other reason
• had multiple sexual partners
• found out that a partner has shared needles
• learned that a past or current partner is HIV-positive
• discovered that a partner has been exposed to HIV
• had a recent diagnosis of another sexually transmitted disease (STD)
• are pregnant.

The following links also give some general information on HIV testing and how it works:

www.avert.org/testing.htm(it explains that there are three main types of HIV tests; it also gives the reasons why you might want to have a test, and explains what the test involves; home testing is not advised; there’s also a personal account of someone who went for a test...)
www.staying-alive.org/en/index.jhtml (“Find help”: hotlines for counselling and where to get tested in various countries – alphabetical country list. It does warn that the country list is by no means complete, and asks you to email them information if you know of help lines in your own area.)
http://www.mysistahs.org/features/hiv/nhtdindex.htm (Explains why you might want to be tested, and features interviews and stories from young people who got tested (see “Risha’s story”). Also explains how testing works, for instance the difference between “confidential” and “anonymous testing”, etc. (read “Tracey’s interview”), plus “the basics” – facts on HIV testing.)
www.teenwire.org/gnTeens.html/teenAdvice.html (getting tested: why, who, how, anonymous/confidential, what if I’m positive/negative?, etc.)
www.iwannaknow.org/basics2/hiv_aids.html (interestingly enough, there is a 3-month delay period in most countries (meaning that you can only tell whether you were infected 3 months after the actual date), whereas this period is 6 months in USA! This would mean that, if you had a new sexual partner, you should protect yourself during sex for at least the first 3 months of your relationship (or 6 months in the USA), and then both have an HIV test before you even consider unprotected sex.)
What if I’m positive? What if I’m negative?
(See also chapter V: Living with HIV/AIDS)

So you’ve had your test, and you’ve got the result. This is the moment of truth: either you are positive, in which case you will need to receive a lot of medical and emotional counselling, treatment and advice on how to avoid getting sick or giving the virus to other people. Or you are negative, which is one of the greatest second chances you’ll ever have in life, and which means you must now be more careful than ever.

Look at the following sites for advice:

www.avert.org/positive.htm (learning you are positive: who should you tell? What about your current and previous partners? Can you still have children?)
www.sxetc.org (testing and treatment; telling your partner if you’re positive)
www.youthhiv.org/health/hiv/test.cfm (what to do if you’re positive, and what to do if you’re negative)

Imagine:
• what the virus would look like if you could actually see it: Let your imagination run wild and make a visual or sound picture of the monster.
• the super, ultra-defence mechanism that would stop the monster from getting in…
• your very own HIV/AIDS-prevention-campaign poster, complete with logo and slogan, visual, body copy…
• how you’d react if you discovered your best friend – or you – was infected

Available resources for this topic (some samples):

Images:

Movies:
The Life Cycle of HIV
(by Dr. Jose Assouline, a neurobiologist and AIDS researcher at the University of Iowa College of Medicine)




Download the full video clip
(4.23Mb, 45 sec)

Anaglyphic (red-blue) movie of HIV protease-inhibitor complex
(by Yue-Ling Wong)
Note: You need a pair of red-blue glasses (red on the left-eye and blue on the right-eye) to view this stereo movie. You can see it rotating in 3D! It shows a rotating HIV protease-inhibitor complex in ribbon and sticks representations (x-ray crystallographic data obtained from Brookhaven Protein Data Bank).




Download the full video clip
(318kb, 2 sec)

Unfolding of the DNA binding domain of HIV intergrase
(by Vijay Pande and Stanford University)
HIV uses proteins to insert its genetic code into our DNA. The DNA binding domain of HIV integrase (below) is the protein which HIV uses to grab onto our DNA such that it can then connect its genetic code into ours.
This movie shows a single trajectory of the unfolding of this protein under extreme denaturing conditions.




Download the full video clip
(2.46MB, 8 sec)


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