HIV and AIDS are related, but they are not the same. HIV is a virus that infects and damages the immune system, making it harder to fight off infections and diseases. AIDS is the most advanced stage of HIV infection when the immune system is severely compromised and vulnerable to life-threatening conditions. In this article, we will explain the causes, symptoms, treatment, and prevention of HIV and AIDS, and why it is important to understand them.
HIV: Human Immunodeficiency Virus
HIV stands for human immunodeficiency virus. It is a type of retrovirus that targets and destroys a specific type of immune cell called CD4 cell or T cell. These cells are essential for coordinating the immune response and protecting the body from various pathogens. When HIV infects and kills these cells, the immune system becomes weaker and less able to defend itself.
HIV is transmitted through certain body fluids that contain the virus, such as blood, semen, vaginal fluid, breast milk, and rectal fluid. The most common ways that HIV is spread are:
Sexual transmission: Having unprotected sex (vaginal, anal, or oral) with someone who has HIV, especially if there are sores, cuts, or inflammation in the genitals or mouth.
Blood transmission: Sharing needles, syringes, or other equipment that has been used by someone who has HIV, or receiving a blood transfusion or organ transplant from someone who has HIV (this is very rare in countries where blood and organs are screened for HIV).
Mother-to-child transmission: Passing HIV from a pregnant woman to her baby during pregnancy, delivery, or breastfeeding.
Needle sharing: Using needles or syringes that have been used by someone who has HIV, or getting a tattoo, piercing, or injection with unsterilized equipment that has been used by someone who has HIV.
Some factors that can increase the risk of getting HIV are:
Having multiple sexual partners or having sex with someone who has multiple partners
Having another sexually transmitted infection (STI) that can cause sores or inflammation in the genitals or mouth
Having a low level of circumcision (for men)
Having a history of sexual abuse or violence
Living in a region or community where HIV is prevalent
Using drugs or alcohol that can impair judgment or reduce condom use
AIDS: Acquired Immunodeficiency Syndrome
AIDS stands for acquired immunodeficiency syndrome. It is the most advanced stage of HIV infection when the immune system is severely damaged and unable to fight off infections and diseases that normally would not cause harm. AIDS is diagnosed when a person with HIV has either:
A CD4 cell count below 200 cells per cubic millimeter of blood (the normal range is 500 to 1,600 cells per cubic millimeter)
An opportunistic infection or cancer that is rare or severe in people who do not have HIV
An opportunistic infection is an infection that takes advantage of a weakened immune system and causes serious illness. Some of the common opportunistic infections associated with AIDS are:
Pneumocystis jirovecii pneumonia (PCP), is a fungal infection that affects the lungs
Tuberculosis (TB), is a bacterial infection that affects the lungs and other organs
Cryptococcal meningitis, a fungal infection that affects the brain and spinal cord
Toxoplasmosis is a parasitic infection that affects the brain and other organs
Cytomegalovirus (CMV), is a viral infection that affects the eyes and other organs
Kaposi’s sarcoma is a type of cancer that causes purple or brown lesions on the skin and mucous membranes
Non-Hodgkin’s lymphoma, a type of cancer that affects the lymph nodes and other organs
Cervical cancer is a type of cancer that affects the cervix (the lower part of the uterus)
Symptoms of HIV and AIDS
The symptoms of HIV and AIDS vary depending on the stage of infection and the individual’s immune system. Some people may not experience any symptoms for years after being infected, while others may have signs and symptoms that are similar to other illnesses. Therefore, the only way to know for sure if one has HIV is to get tested.
Early symptoms of HIV infection
In the first few weeks after being infected with HIV, some people may have an acute retroviral syndrome (ARS), which is a flu-like illness that can include fever, headache, rash, sore throat, swollen lymph nodes, and muscle and joint pain. However, not everyone who has HIV will have ARS, and some people may have mild or no symptoms at all. ARS usually lasts for a few days to a few weeks and then subsides. However, this does not mean that the virus is gone. HIV remains in the body and continues to damage the immune system.
Advanced symptoms and complications associated with AIDS
As HIV progresses and the immune system becomes weaker, the person may develop more severe and persistent symptoms, such as weight loss, chronic diarrhea, night sweats, oral thrush, shingles, and recurrent infections. These symptoms indicate that the person has a low CD4 cell count and a high viral load, and is at risk of developing AIDS. AIDS is the most advanced stage of HIV infection when the immune system is severely damaged and unable to fight off opportunistic infections and cancers that normally would not cause harm. Some of the common opportunistic infections and cancers associated with AIDS are Pneumocystis jirovecii pneumonia (PCP), tuberculosis (TB), cryptococcal meningitis, toxoplasmosis, cytomegalovirus (CMV), Kaposi’s sarcoma, non-Hodgkin’s lymphoma, and cervical cancer. These conditions can cause serious complications and death if not treated promptly and effectively.
Diagnosis of HIV and AIDS
The diagnosis of HIV and AIDS is based on testing for the presence of HIV antibodies, antigens, or genetic material in the blood or other body fluids. There are different types of tests available, such as rapid tests, laboratory tests, and home tests, that can detect HIV at different stages of infection and with different levels of accuracy and reliability.
Testing methods
The most common testing method for HIV is the antibody test, which looks for the presence of antibodies that the body produces in response to HIV infection. Antibodies are proteins that help the immune system fight off foreign invaders, such as viruses and bacteria. However, it can take several weeks to months for the body to produce enough antibodies to be detected by the test. This period is called the window period, and it varies from person to person and from test to test. During the window period, a person can have a negative test result, but still be infected and infectious.
To reduce the window period and increase the accuracy of the test, some tests also look for the presence of antigens, which are parts of the virus that trigger the immune response. Antigens can be detected sooner than antibodies, usually within a few weeks after infection. These tests are called combination tests or fourth-generation tests, and they are the recommended standard of care in most settings.
Another testing method for HIV is the nucleic acid test (NAT), which looks for the presence of HIV genetic material, or RNA, in the blood. RNA is the genetic code that the virus uses to replicate itself. NAT can detect HIV as early as 10 days after infection, and it is the most sensitive and specific test available. However, it is also the most expensive and complex test, and it is not widely available or accessible in many settings.
Importance of early detection
Early detection of HIV is important for several reasons. First, it can help the person to start treatment as soon as possible, which can improve their health outcomes and reduce the risk of transmitting the virus to others. Second, it can help the person access care and support services, such as counseling, education, and social assistance, that can help them cope with the emotional and practical challenges of living with HIV. Third, it can help the person to prevent or treat opportunistic infections and cancers, that can cause serious complications and death if left untreated.
Linkage to care and support services
Linkage to care and support services is the process of connecting people who have been diagnosed with HIV to the appropriate medical and non-medical services that can help them manage their condition and improve their quality of life. Linkage to care and support services can include:
Referral to a health care provider who can prescribe and monitor antiretroviral therapy (ART), the main treatment for HIV
Referral to a laboratory or clinic where the person can get regular tests to check their CD4 cell count, viral load, and other indicators of their health status
Referral to a pharmacy or dispensary where the person can get their antiretroviral drugs and other medications that they may need
Referral to a counselor or therapist who can provide emotional and psychological support and help the person cope with the stigma and discrimination that they may face
Referral to an educator or peer educator who can provide information and guidance on how to prevent or reduce the risk of transmitting HIV to others, and how to protect themselves from other sexually transmitted infections (STIs) and unwanted pregnancies
Referral to a social worker or case manager who can help the person access social and legal services, such as housing, food, transportation, employment, education, and human rights protection
Linkage to care and support services is essential for ensuring that people who have been diagnosed with HIV can access the services that they need and deserve and that they can adhere to their treatment and care plan. Linkage to care and support services can also help to reduce the gap between diagnosis and treatment, which can improve the health outcomes and survival rates of people living with HIV.
Treatment of HIV and AIDS
The treatment of HIV and AIDS is based on the use of antiretroviral therapy (ART), which is a combination of drugs that prevent the virus from multiplying and damaging the immune system. ART can reduce the viral load to undetectable levels, which means that the person cannot transmit HIV to others. ART can also improve the CD4 cell count and reduce the risk of opportunistic infections and AIDS-related complications. ART must be taken every day for life and requires regular monitoring and testing.
Antiretroviral therapy (ART)
Mechanism of action
Antiretroviral therapy (ART) works by blocking different stages of the HIV life cycle, which is the process by which the virus infects, replicates, and spreads in the body. The HIV life cycle consists of the following steps:
Attachment: The virus attaches to the surface of a CD4 cell and fuses with its membrane
Entry: The virus releases its genetic material, or RNA, into the CD4 cell
Reverse transcription: The virus uses an enzyme called reverse transcriptase to convert its RNA into DNA
Integration: The virus uses another enzyme called integrase to insert its DNA into the DNA of the CD4 cell
Transcription: The virus uses the CD4 cell’s machinery to make copies of its RNA and proteins
Assembly: The virus assembles its RNA and proteins into new viral particles
Budding: The virus buds off from the CD4 cell, releasing new viral particles that can infect other cells
ART consists of different classes of drugs that target different steps of the HIV life cycle, such as:
Nucleoside reverse transcriptase inhibitors (NRTIs), which block the reverse transcription step
Non-nucleoside reverse transcriptase inhibitors (NNRTIs), which also block the reverse transcription step
Protease inhibitors (PIs), which block the assembly step
Integrase strand transfer inhibitors (INSTIs), which block the integration step
Entry inhibitors, which block the attachment or entry step
Fusion inhibitors, which also block the attachment or entry step
ART usually involves taking a combination of three or more drugs from different classes, to prevent the virus from developing resistance to any single drug. The choice of drugs depends on various factors, such as the person’s health status, viral load, CD4 cell count, drug resistance, side effects, drug interactions, and preferences.
Types of antiretroviral drugs
There are many types of antiretroviral drugs available, and new ones are being developed and tested. Some of the most commonly used antiretroviral drugs are:
These drugs are often combined into fixed-dose combinations or single-tablet regimens, which can simplify the treatment and reduce the pill burden. Some examples of these combinations are :
Atripla (EFV + FTC + TDF)
Biktarvy (BIC + FTC + TAF)
Complera (RPV + FTC + TDF)
Dovato (DTG + 3TC)
Genvoya (EVG + COBI + FTC + TAF)
Juluca (DTG + RPV)
Odefsey (RPV + FTC + TAF)
Stribild (EVG + COBI + FTC + TDF)
Triumeq (DTG + ABC + 3TC)
Truvada (FTC + TDF or TAF)
Management of opportunistic infections
In addition to antiretroviral therapy, people with HIV and AIDS may also need to take other medications to prevent or treat opportunistic infections and cancers that can cause serious complications and death. These medications may include antibiotics, antifungals, antiparasitics, antivirals, and anticancer drugs, depending on the type and severity of the condition.
Some of the common medications used to prevent or treat opportunistic infections and cancers are :
Trimethoprim-sulfamethoxazole (TMP-SMX), also known as Bactrim or Septra, for PCP, toxoplasmosis, and bacterial infections
Isoniazid (INH), rifampin (RIF), and ethambutol (EMB) for tuberculosis
Fluconazole (FLU), amphotericin B (AMB), and flucytosine (5-FC) for cryptococcal meningitis and other fungal infections
Ganciclovir (GCV), foscarnet (FOS), and cidofovir (CDV) for cytomegalovirus
Doxorubicin (DOX), paclitaxel (PAC), and bleomycin (BLE) for Kaposi’s sarcoma
Rituximab (RIT), cyclophosphamide (CYP), and vincristine (VIN) for non-Hodgkin’s lymphoma
Cisplatin (CIS), carboplatin (CAR), and 5-fluorouracil (5-FU) for cervical cancer
Importance of adherence to treatment
Adherence to treatment is the degree to which a person follows their prescribed treatment and care plan, such as taking their medications as directed, attending their appointments, and following their recommendations. Adherence to treatment is crucial for ensuring the effectiveness and safety of antiretroviral therapy and other medications, as well as for improving the health outcomes and survival rates of people living with HIV and AIDS.
Some of the benefits of adherence to treatment are :
Reducing the viral load to undetectable levels means that the person cannot transmit HIV to others and has a lower risk of developing AIDS and opportunistic infections
Improving the CD4 cell count and the immune system function means that the person can fight off infections and diseases better and has a higher quality of life
Preventing or delaying the development of drug resistance, which means that the person can continue to use the same drugs and has more options for treatment in the future
Reducing the risk of side effects and drug interactions, which means that the person can tolerate the drugs better and has fewer complications
Some of the factors that can affect adherence to treatment are :
The complexity and cost of the treatment regimen, such as the number of pills, the dosing frequency, the food and water requirements, and the availability and affordability of the drugs
The side effects and drug interactions of the treatment regimen, such as nausea, vomiting, diarrhea, headache, rash, fatigue, insomnia, and mood changes
The personal and social factors of the person, such as their knowledge, beliefs, attitudes, motivation, self-efficacy, and support system
The environmental and structural factors of the person, such as their access to health care, transportation, housing, food, employment, education, and human rights protection
To improve adherence to treatment, it is important to address these factors and to provide the person with the necessary information, guidance, support, and resources that they need and deserve. Some of the strategies that can help improve adherence to treatment are :
Choosing a treatment regimen that suits the person’s needs, preferences, and lifestyle, and that is simple, effective, and affordable
Educating the person about the benefits and risks of the treatment regimen, and how to take the drugs correctly and safely
Providing the person with reminders, alarms, pill boxes, calendars, or other tools that can help them remember and track their medication intake
Encouraging the person to involve their family, friends, partners, or peers in their treatment and care plan, and to seek their support and assistance
Linking the person to care and support services, such as counseling, education, and social assistance, can help them cope with the emotional and practical challenges of living with HIV and AIDS
Empowering the person to take an active role in their treatment and care plan, and to communicate with their health care provider and other service providers about their concerns and needs
Prevention of HIV
The prevention of HIV is the best way to reduce the spread and impact of the virus and to protect oneself and others from infection and disease. There are various methods and strategies that can help prevent HIV transmission, such as safe sex practices, needle exchange programs, prevention of mother-to-child transmission, pre-exposure prophylaxis, and education and awareness programs.
Safe sex practices
Safe sex practices are behaviors that can reduce the risk of getting or passing HIV and other STIs through sexual contact, such as vaginal, anal, or oral sex. Safe sex practices include :
Using condoms correctly and consistently every time one has sex, regardless of the type of sex or the partner’s HIV status
Using lubricants that are water-based or silicone-based, and that do not contain oil, spermicide, or nonoxynol-9, which can damage the condom or the mucous membranes
Limiting the number of sexual partners or having a mutually monogamous relationship with a partner who has tested negative for HIV and other STIs
Getting tested for HIV and other STIs regularly and before starting a new sexual relationship, and sharing the test results with the partner
Seeking treatment and notifying the partner if one has or suspects to have an STI, and avoiding sex until the infection is cured
Avoiding alcohol and drugs that can impair judgment or reduce condom use
Needle exchange programs
Needle exchange programs are services that provide sterile needles, syringes, and other injection equipment to people who inject drugs, and that collect and dispose of used ones safely. Needle exchange programs aim to prevent the transmission of HIV and other blood-borne infections, such as hepatitis B and C, among people who inject drugs, and to reduce the harm associated with drug use. Needle exchange programs also offer other services, such as counseling, education, testing, treatment, and referral to health and social services.
Prevention of mother-to-child transmission
Prevention of mother-to-child transmission (PMTCT) is a set of interventions that aim to prevent the transmission of HIV from a pregnant woman to her baby during pregnancy, delivery, or breastfeeding. PMTCT can reduce the risk of transmission from 15-45% to less than 5%. PMTCT includes :
Testing the woman for HIV as early as possible in pregnancy, and offering her antiretroviral therapy if she is positive
Providing the woman with antiretroviral drugs during pregnancy and labor, and giving the baby antiretroviral drugs for the first few weeks of life
Delivering the baby by cesarean section if the woman has a high viral load or other complications
Avoiding breastfeeding if possible, and using formula or other safe alternatives, or using antiretroviral drugs if breastfeeding is the only option
Testing the baby for HIV at birth and at regular intervals until the final diagnosis is confirmed
Pre-exposure prophylaxis (PrEP)
Pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by people who do not have HIV, but who are at high risk of getting it, to prevent infection. PrEP involves taking a daily pill that contains two antiretroviral drugs, tenofovir, and emtricitabine, which can block the virus from establishing itself in the body.
PrEP can reduce the risk of getting HIV by up to 92% if taken correctly and consistently. PrEP is recommended for people who are at high risk of HIV exposure, such as those who have multiple or unknown sexual partners, who have sex with someone who has HIV, who inject drugs, or who live in areas where HIV is prevalent. PrEP must be prescribed by a healthcare provider, and it requires regular testing and monitoring. PrEP is not a substitute for other prevention methods, such as condoms, needle exchange, and PMTCT, but a complementary strategy that can provide additional protection.
Education and awareness programs
Education and awareness programs are initiatives that aim to provide accurate and comprehensive information about HIV and AIDS and to raise awareness and understanding of the virus and the disease among the general public and specific populations. Education and awareness programs can help prevent HIV transmission by :
Dispelling myths and misconceptions about HIV and AIDS, such as how the virus is spread and who can get it
Promoting safe and responsible behaviors, such as condom use, needle exchange, and testing
Reducing stigma and discrimination against people living with HIV and AIDS, and encouraging respect and support for their rights and dignity
Empowering people to make informed and healthy decisions about their sexual and reproductive health and well-being
Mobilizing resources and partnerships to support the prevention, treatment, and care of HIV and AIDS
Education and awareness programs can take various forms and approaches, such as mass media campaigns, school-based curricula, community-based workshops, peer education, and advocacy. Education and awareness programs can target different audiences and groups, such as youth, women, men who have sex with men, sex workers, people who inject drugs, and healthcare workers. Education and awareness programs can also address different topics and issues, such as HIV transmission, testing, treatment, prevention, stigma, discrimination, human rights, and gender equality.
Global Impact of HIV/AIDS
HIV/AIDS is one of the most serious public health challenges in the world, affecting millions of people and causing significant social and economic consequences. Despite the progress made in the past decades, HIV and AIDS remain a major threat to global health and development, especially in low- and middle-income countries and among key populations. HIV and AIDS also pose a challenge to human rights and dignity, as people living with or affected by the disease face stigma and discrimination in various settings.
Statistics and prevalence
According to the latest statistics from UNAIDS, approximately 39 million people were living with HIV globally in 2022, of whom 37.5 million were adults and 1.5 million were children under 15 years old. More than two-thirds of the people living with HIV were in sub-Saharan Africa, followed by Asia and the Pacific, Latin America and the Caribbean, Eastern Europe and Central Asia, the Middle East and North Africa, and Western and Central Europe and North America. Women and girls accounted for 53% of all people living with HIV globally.
In 2022, there were an estimated 1.3 million new HIV infections globally, marking a 38% decline since 2010 and a 59% decline since the peak in 1995. However, some regions and countries reported increasing trends in new infections, such as Eastern Europe and Central Asia, the Middle East and North Africa, and some parts of Asia and the Pacific. Key populations, such as men who have sex with men, sex workers, people who inject drugs, transgender people, and prisoners, and their sexual partners, accounted for 65% of all new HIV infections globally.
In 2022, there were 630,000 AIDS-related deaths globally, representing a 54% decline since 2010 and a 74% decline since the peak in 2004. However, some regions and countries experienced rising mortality rates, such as Eastern Europe and Central Asia, the Middle East and North Africa, and some parts of Asia and the Pacific. AIDS-related illnesses remain the leading cause of death among women of reproductive age and among adolescents in sub-Saharan Africa.
Social and economic consequences
HIV/AIDS has profound social and economic impacts on individuals, families, communities, and countries. HIV/AIDS can affect the health, education, employment, income, and social protection of people living with or affected by the disease, and can increase their vulnerability to poverty, hunger, and inequality. HIV/AIDS can also reduce the productivity, growth, and development potential of affected countries, and can strain their health systems, public services, and social fabric. HIV/AIDS can also exacerbate existing conflicts, crises, and humanitarian emergencies, and can undermine the efforts to achieve the Sustainable Development Goals.
According to the World Bank3, HIV and AIDS can reduce the gross domestic product (GDP) per capita growth rate by 0.5 to 1.2 percentage points in countries with high prevalence rates. HIV/AIDS can also reduce the labor force by 10 to 30% in the most affected countries and can increase the health expenditure by 2 to 6% of GDP. HIV and AIDS can also harm education, as it can reduce the enrollment, attendance, and completion rates of children and adolescents, especially girls and orphans. HIV and AIDS can also have a detrimental effect on food security and nutrition, as it can reduce the agricultural output, income, and access to food of affected households.
Stigma and discrimination
Stigma and discrimination are among the main barriers to the prevention, treatment, and care of HIV/AIDS. Stigma is the negative attitude or judgment that people have towards people living with or affected by HIV/AIDS, based on fear, ignorance, prejudice, or moral judgment. Discrimination is the unfair or unequal treatment or exclusion that people living with or affected by HIV and AIDS face in various settings, such as health care, education, employment, housing, and legal systems. Stigma and discrimination can violate the human rights and dignity of people living with or affected by HIV and AIDS and can affect their access to services, opportunities, and justice. Stigma and discrimination can also fuel the spread of the epidemic, as they can discourage people from seeking testing, treatment, and support, and from disclosing their status to their partners, family, and friends.
According to UNAIDS, more than half of the people living with HIV globally reported experiencing some form of stigma or discrimination in 2022. In some countries, more than 80% of the people living with HIV reported facing stigma or discrimination in healthcare settings, such as being denied or delayed services, being verbally or physically abused, or being segregated or isolated. In some countries, more than 60% of the people living with HIV reported facing stigma or discrimination in employment settings, such as being fired, refused, or harassed because of their status. In some countries, more than 40% of the people living with HIV reported facing stigma or discrimination in education settings, such as being expelled, suspended, or bullied because of their status. In some countries, more than 20% of the people living with HIV reported facing stigma or discrimination in legal settings, such as being arrested, prosecuted, or imprisoned because of their status.
Challenges and Future Perspectives
Despite the remarkable progress made in the past decades, HIV/AIDS remains a formidable challenge that requires sustained and concerted efforts from all stakeholders. There are still many gaps and obstacles that need to be addressed and overcome, such as stigma and discrimination, access to treatment and prevention, and ongoing research and development. Some new opportunities and innovations can offer hope and solutions, such as long-acting therapies, pre-exposure prophylaxis, and functional cures.
Stigma associated with HIV/AIDS
Stigma associated with HIV/AIDS is one of the most pervasive and persistent challenges that hamper the response to the epidemic. Stigma not only affects the lives and well-being of people living with or affected by HIV/AIDS, but also undermines the effectiveness and efficiency of the interventions and services that aim to prevent, treat, and care for the disease. Stigma also fuels the transmission of the virus, as it creates a climate of fear, silence, and denial that prevents people from seeking information, testing, treatment, and support. Therefore, addressing stigma is essential for ending the AIDS epidemic by 2030.
To combat stigma, various strategies and approaches have been developed and implemented, such as awareness raising, education, advocacy, empowerment, and legal reform. These strategies aim to challenge and change the negative attitudes and behaviors that people have towards people living with or affected by HIV and AIDS and to promote and protect their human rights and dignity. These strategies also aim to involve and engage people living with or affected by HIV and AIDS as active agents and partners in the response to the epidemic and to empower them to speak out and claim their rights and entitlements.
Access to treatment and prevention
Access to treatment and prevention is another key challenge that needs to be addressed and improved, as there are still millions of people who do not have access to the life-saving and life-changing services that they need and deserve. According to UNAIDS, in 2022, only 76% of the people living with HIV globally were receiving antiretroviral therapy, which means that 9.2 million people were still in need of treatment. Moreover, only 71% of the people on treatment had achieved viral suppression, which means that 8.6 million people were still at risk of transmitting the virus and developing AIDS-related illnesses. Furthermore, only 23% of the people at risk of HIV infection had access to pre-exposure prophylaxis, which means that 77% of the people at risk were still unprotected.
To improve access to treatment and prevention, various efforts and initiatives have been undertaken and supported, such as increasing the availability and affordability of antiretroviral drugs and other commodities, expanding the coverage and quality of health care and community-based services, strengthening the health systems and human resources, reducing the financial and structural barriers, and enhancing the demand and uptake of services. These efforts and initiatives aim to ensure that everyone who needs treatment and prevention can access them without delay, discrimination, or difficulty and that they can benefit from them without fear, stigma, or harm.
Ongoing research and development
Ongoing research and development is another crucial challenge and opportunity that can shape the future of HIV/AIDS. Research and development can generate new knowledge and evidence that can inform and improve the policies and practices that guide the response to the epidemic. Research and development can also produce new tools and technologies that can enhance and expand the options and outcomes for treatment and prevention. Research and development can also explore new possibilities and potentials that can offer hope and solutions for a functional cure.
To advance research and development, various areas and priorities have been identified and pursued, such as improving the efficacy, safety, and durability of antiretroviral drugs and regimens, developing long-acting and injectable therapies that can simplify and optimize the delivery and adherence of treatment, and prevention, discovering and testing vaccines and microbicides that can induce and confer immunity and protection against HIV infection, investigating and evaluating gene and cell therapies that can modify and manipulate the immune system and the virus, and understanding and exploiting the mechanisms and factors that can enable and achieve a functional cure.
Conclusion
HIV/AIDS is a complex and dynamic disease that has caused immense suffering and loss but also inspired remarkable resilience and solidarity. Over the past four decades, the world has witnessed the evolution and revolution of HIV/AIDS, from a deadly and mysterious syndrome to a manageable and preventable condition. The world has also witnessed the mobilization and collaboration of various actors and sectors, from governments and organizations to communities and individuals, in the fight against HIV/AIDS. The world has also witnessed the innovation and discovery of new tools and technologies that can enhance and expand the options and outcomes for treatment and prevention. The world has also witnessed the exploration and experimentation of new possibilities and potentials that can offer hope and solutions for a functional cure.
However, the fight against HIV/AIDS is not over yet, and there are still many gaps and obstacles that need to be addressed and overcome, such as stigma and discrimination, access to treatment and prevention, and ongoing research and development. Some new challenges and threats need to be anticipated and prevented, such as emerging variants, drug resistance, and complacency. Therefore, it is important to maintain and increase the awareness and prevention of HIV/AIDS and to support and sustain the research and development of HIV/AIDS. It is also important to respect and protect the human rights and dignity of people living with or affected by HIV/AIDS and to empower and engage them as active agents and partners in the response to the epidemic. By doing so, we can end the AIDS epidemic by 2030, and make HIV/AIDS a thing of the past.
FAQ
What is HIV and what is AIDS?
HIV is a virus that attacks the body’s immune system and damages the cells that help fight infections and diseases. AIDS is a condition that develops when the immune system is severely weakened by HIV and the body is vulnerable to opportunistic infections and cancers.
How is HIV transmitted?
HIV is transmitted through contact with the blood, semen, vaginal fluid, or breast milk of an infected person. The most common ways of getting HIV are through unprotected sex (anal or vaginal) without a condom, sharing drug-injecting equipment, or from mother to child during pregnancy, childbirth, or breastfeeding.
What are the symptoms of HIV infection?
Most people have no symptoms or just a mild flu-like illness when they are first infected with HIV. This is called the seroconversion illness and it usually occurs around 10 to 14 days after infection. Some of the symptoms may include fever, fatigue, headache, sore muscles and joints, sore throat, swollen lymph glands, or rash. After the initial illness, people with HIV may have no symptoms for many years, but the virus remains in the body and continues to damage the immune system.
How is HIV diagnosed?
HIV is diagnosed by testing a sample of blood or saliva for the presence of antibodies or antigens to the virus. Antibodies are proteins that the body produces to fight the virus, while antigens are parts of the virus itself. There is a period, called the window period, between exposure to HIV and the appearance of antibodies or antigens in the blood or saliva. The window period can vary from a few weeks to a few months, depending on the type of test and the individual’s immune response. During the window period, a person can have a negative test result but still be infected and able to transmit the virus to others.
How is HIV treated?
There is no cure for HIV infection, but it can be treated with antiretroviral drugs, which stop the virus from replicating in the body. Antiretroviral therapy (ART) consists of taking a combination of drugs, usually three or more, every day for life. ART can reduce the amount of virus in the blood (viral load) to very low levels, which helps the immune system to recover and prevents the development of AIDS. ART also reduces the risk of transmitting the virus to others.
What are the side effects of antiretroviral drugs?
Antiretroviral drugs can have different side effects depending on the type of drug, the dose, and the individual’s reaction. Some of the common side effects are nausea, vomiting, diarrhea, headache, fatigue, rash, or changes in appetite or weight. Some of the serious side effects are liver damage, kidney damage, bone loss, high cholesterol, diabetes, or allergic reactions. It is important to monitor the side effects and report any changes to the health care provider. Sometimes, the side effects can be managed by changing the dose, switching to a different drug, or taking other medications to relieve the symptoms.
How can HIV infection be prevented?
The best way to prevent HIV infection is to avoid exposure to the virus. This can be done by practicing safer sex, using condoms correctly and consistently, limiting the number of sexual partners, and getting tested regularly. It is also important to avoid sharing drug-injecting equipment, tattooing or piercing equipment, or any other items that may have blood on them. People who are at high risk of HIV infection can also take a daily pill called pre-exposure prophylaxis (PrEP), which can reduce the chance of getting HIV if exposed to the virus. PrEP must be prescribed by a healthcare provider and taken as directed.
What is the life expectancy of a person with HIV?
The life expectancy of a person with HIV depends on many factors, such as the age at diagnosis, the stage of infection, the access to treatment, the adherence to medication, the presence of other health conditions, and the quality of care. With effective ART, people with HIV can live as long as people without HIV. However, people with HIV may still face challenges such as stigma, discrimination, mental health issues, or aging-related complications. Therefore, it is important to have regular check-ups, follow a healthy lifestyle, and seek support from family, friends, or community groups.
Is there a vaccine for HIV?
There is currently no effective vaccine for HIV, although many scientists are working to find one. Several vaccine candidates have been tested in clinical trials, but none of them have shown enough protection against the virus. One of the challenges is that HIV is a highly variable virus that can mutate and evade the immune system. Another challenge is that there is no natural immunity to HIV, meaning that people who are infected do not clear the virus from their bodies and do not develop protective antibodies. Therefore, developing a vaccine that can induce a strong and durable immune response against HIV is a complex and difficult task.
What are the statistics of HIV and AIDS?
According to the World Health Organization (WHO), about 38 million people were living with HIV worldwide at the end of 2019. Of these, 25.4 million were accessing ART. There were 1.7 million new HIV infections and 690,000 AIDS-related deaths in 2019. The majority of people living with HIV (67%) were in the African region, followed by the Americas (13%), South-East Asia (9%), Europe (6%), Eastern Mediterranean (3%), and Western Pacific (2%). The global target is to end the AIDS epidemic as a public health threat by 2030.
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