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HIV (human immunodeficiency virus) is a retrovirus that infects the body’s immune system. This destroys and impairs its function. As the infection progresses, the immune system becomes weaker, and the person becomes more susceptible to infections. Globally, approximately 33.4 million people are living with HIV. Moreover, close to 2.7 million new people are infected each year. The most advanced stage of HIV infection is known as AIDS (acquired immunodeficiency syndrome). When HIV is left untreated, it can take up to 10-15 years for an HIV-infected person to develop into AIDS. AIDS is a major global burden to society with approximately 2 million people dying of AIDS each year.
The major routes of HIV transmission include: unprotected sexual intercourse (anal or vaginal), blood transfusion, needle sharing and mother-infant transmission during pregnancy, childbirth or breastfeeding.
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Fact 1: The HIV virus infects cells of the immune system
HIV is composed of both RNA and DNA elements. Therefore, it has the ability to both directly infect human cells, as well as utilize the cell’s components to replicate the HIV structure. The immune system is primarily comprised of two major cell types: B-cells and T-cells (helper and cytotoxic subtypes). T-cells are affected by this virus, which leads to a constant battle between HIV replication efforts and immune system ability to reproduce T-cell. HIV attacks helper T-cells immediately upon infection. This leads to the gradual deterioration of the immune system. Moreover, HIV attacks and kills all new T-cells that the body produces to counter the effects of the virus. This battle between T-cells and HIV continues for approximately 10 years until the body is no longer capable of producing T-cells and the body succumbs to weak viral and bacterial infections. Once this has occurred, the condition is commonly known as AIDS.
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Fact 2: The prevalence of HIV is highest in developing countries
Approximately 7 out of 10 HIV-related deaths in 2008 were in Sub-Saharan Africa. Moreover, this region also has over two-thirds of all global adult HIV cases and over 90% of new HIV infections amongst children. This elevated death toll may stem from a reduced affordability of modern and effective HIV treatments or these treatments are inaccessible. For wealthier people in industrialized countries, there is a better chance to afford the very expensive treatments that are available. In addition the spread of HIV or AIDS is also largely a result of poverty because many of these countries are not educated about the risks of HIV and protective agents such as condoms are not readily available.
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Fact 3: HIV cannot survive for very long outside of the body
HIV is not readily passed from one person to another. The reason for this is that the HIV virus cannot survive for long periods of time outside of the body. This is why HIV cannot be transmitted to another person via casual or everyday encounters such as hand shaking, kissing or hugging. While, sweat, tears, vomit, feces and urine contain small amounts of HIV, no cases of HIV infections due to any of these biological fluids have been reported.
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Fact 4: HIV can be transmitted via oral sex
While there have been reports of HIV transmission via oral sex, the risk of oral transmission is much less than that of anal or vaginal sex. Since the majority of sexually active individuals practice oral sex in addition to other forms of sex, it is very difficult to make a direct link between oral sex and HIV transmission. Certain factors such as oral ulcers, bleeding gums, genital sores and/or the presence of another STD or STI can increase the risk of oral HIV transmission.
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Fact 5: STIs can increase the risk of HIV infection
Scientific studies have clearly indentified a link between the presence of genital ulcer diseases and other STIs in facilitating sexual HIV transmission. In both men and women STIs can boost HIV shedding in the genital tract. This amplifies HIV infectiousness. STIs can also increases HIV susceptibility by recruiting T-cells to the genital tract. Additionally, STIs can disrupt mucosal barriers that can act as a protective barrier to HIV infection.
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Fact 6: Drug users are at an increased risk of HIV infection
Drug use is a major factor in the spread of HIV infection. The main reason for this is that shared needles used by drug users can carry HIV. It is also important to note that drug abuse by any route (not just injection) can alter an individual’s judgment leading to unsafe sexual practices. Drug abuse and addiction can also affect a person's overall health, which can increase susceptibility to HIV infection and the progression of AIDS.
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Fact 7: Women are at an increased risk of HIV infection
The unequal social status of women, primarily in developing countries, places them at an increased risk for contracting HIV. In support of this notion, the HIV infection rate among women have been on the rise compared to men in the Caribbean and Latin America. There are many physiological and cultural factors that influence women’s increased risk of HIV infection. These include:
- A reduced accessibility to information about HIV prevention
- Reduced ability to negotiate safe sexual encounters
- Reduced access to treatment for HIV/ AIDS
- Gender norms (women are supposed to be unknowledgeable about sex)
- Women seeking information about safe sex are considered promiscuous or adulterous
- High importance on virginity leads to young unmarried women engaging in high-risk behaviors such as anal sex to maintain their virginity
- Women are physiologically 2 to 4 times more susceptible to HIV infection
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Fact 8: Gay and bisexual men are at increased risk of HIV infection
Homosexual and bisexual men are the only HIV risk group in the U.S. in which the annual number of new HIV infections is increasing. Moreover, homosexual men accounted for than half of all new cases of HIV infections in 2008. Since the beginning of the AIDS epidemic, approximately 300,000 homosexual males have died in the U.S. alone. It is important to note that until today no confirmed cases of female-to-female sexual HIV transmission has yet to be reported. However, since vaginal secretions and menstrual blood are potentially highly infectious, oral or vaginal exposure to these secretions may lead to an HIV infection. There are many factors that contribute to this elevated risk of HIV in the homosexual population. These include:
- Underestimation of personal risk
- Social and economic factors, including homophobia, stigma, and lack of access to healthcare
- Substance abuse (the homosexual population has elevated levels of drug use)
- Higher-risk sexual behaviors (anal sex)
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Fact 9: Mothers can transmit HIV to their child
Mother-child HIV transmission during pregnancy, labor, delivery or breastfeeding is known as perinatal transmission. While mothers with HIV are at risk of transmitting the virus to their child, treatments (zidovudine) have significantly reduced this risk. However, even with this treatment, between 100 and 200 children in the U.S. are perinatally infected each year. Many of these infections involve women who were not tested early enough in pregnancy or who did not receive any treatments.
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Fact 10: HIV patients taking antiretroviral therapy can still infect others
Antiretrovirals have been shown to be very effective in lower blood HIV levels, even to an unreadable level. However, even if very low levels of detectable HIV is present in blood, the virus is not totally eradicated and others can still be infected. Many antiretrovirals do not penetrate the genitals very well and thus only reduce blood HIV levels and not genital. This means that there still are high levels of HIV in both semen and vaginal fluids. Therefore, it is very important that condoms are still used by patients even if their antiretroviral treatments are effective.
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World Health Organization - http://www.who.int/topics/hiv_aids/en/
Center for Disease Control and Prevention - http://www.cdc.gov/hiv/resources/factsheets/
Pan American Health Organization - www.paho.org/English/ad/ge/GenderandHIVFactSheetI.pdf
Global Health Reporting - http://www.globalhealthreporting.org/printallfaq.asp?id=29
National Institute of Drug Abuse - http://hiv.drugabuse.gov/english/learn/abuse.html