Reduction in HIV Related Deaths
AIDS deaths have been progressively halted since the introduction of HIV drug therapy in 1994. Drug therapy medication halted HIV growth by inhibiting its ability to attach to white blood cells and from using the cell's RNA and proteins to replicate. This did not cure HIV patients, but it increased the lifespan of HIV victims because they were now able to maintain normal CD4 levels. Medication does have side-effects however, such as nausea and fatigue. Government resources were able to reduce deaths further by implementing national HIV reporting standards in 1985. This gave local officials the ability to coordinate HIV prevention efforts with the federal government.
Downside of Medication Advances
Despite the existence of medication many underdeveloped countries cannot afford to supply their people with HIV medication without loans, subsidy cuts and donations. Modern countries are better off now in regards to HIV programs, but initially they weren't. People had to pay for HIV medication out of pocket in the beginning because insurance would not cover the costs; costs often exceeded two thousand dollars a month (insurance companies can no longer discriminate against HIV patients now). Sadly, despite the cost, medication was not effective for everybody, as it caused great discomfort for some and no change in others. HIV medication has since become cheaper, but countries, developed or not, have had to deal with patent laws (company control over costs), currency valuation (likelihood of a country being charged a higher or lower price), and customs regulators (which add costs due to import taxes) when dealing with medication prices and availability.
Advances in Medication Availability
Worldwide availability of cost effective drugs has increased, due in part to universal healthcare systems and government efforts. Brazil managed to cut the price tag of generic HIV medication by 76% in its country in 2003. This was made possible by government subsidies and negotiated price cuts. Governments realized that it was cheaper to provide medication, than to treat an advanced case of HIV (BBC News, New Anti-HIV Drug Deal, 2003).
Before 1986, blood transfusions had a 95% chance of infecting someone with HIV if the donor's blood source was contaminated. In the US, reform limited this to 0%. Technically, the chance is 1 in 465,000. In 1999, 1% of the total AIDs population was a blood transfusion victim, due in part to stored blood from the early 1980's.
One time exposure:
- Direct needle exposure (0.67%)
- Needle stick (0.4%)
- One time anal intercourse (0.1%-0.3%)
- One time vaginal intercourse (0.1%-0.2%)
- Penile insertion (0.03%-0.09%)
One percent represented 1 case out of a 100, and .10% represented 1 in a 1000. Each repeated encounter substantially increased the chances of infection occurring (Know Curriculum, 2007 Revision).
Twenty-five percent of HIV infected mothers passed HIV onto their children. With antiretroviral medication, and careful planning, this drops to 2%. C-sections can reduce these odds as well. This can increase the longer the mother has been an HIV host (Know Curriculum, 2007 Revision).
What Determines the Strength of HIV Transmission?
HIV is heavily concentrated a few weeks after initial infection, and during AIDS. The levels in between are slightly lower for up to 12 years. The largest concentrations are in blood, semen, and vaginal fluids (during menstruation), while medium levels are detected in normal vaginal and anal secretions. Changes in the body can also compound risk, such as hormonal contraceptives (increases endocervix vulnerability), age (thymus gland shrinks), and uncircumcised penises. If antiretroviral medication is taken, the concentration of HIV in plasma loads is often lower.
How Can HIV Be Prevented?
HIV infection can be stopped by educating people in infection control. Once infected, HIV cannot be cured by modern means. Here are common ways to prevent HIV progression:
- Male condoms can limit the exposure of semen and vaginal fluids. Female condoms are to be used only when there are no other condoms available, as there are limited HIV protection studies for female condoms. Abstinence (no sex) is the only 100% guarantee against HIV.
- Note: Animal skin condoms do not reliably protect people against HIV. They do prevent pregnancy and some STIs which increase the likelihood of HIV infection. Spermicide, which prevents pregnancy, should be used sparingly as it can increase HIV risk through irritation in the vagina. Birth control pills can be used for contraception, but because of allegations looked into by the WHO (oral contraception was argued to alter the vaginal environment thereby increasing HIV risk) it was considered better to use condoms, and other contraception methods (like birth control pills) as secondary forms of protection (WHO, Hormonal Contraception and HIV, 2012).
- Clean and sterilize sex toys, and avoid sharing them.
- Two HIV infected people should not have unprotected sex. Consistent exposure to sexual fluids will increase viral loads, making each person sicker in the process, and it can lead to a coinfection of HIV-1 and HIV-2. Condoms are a suggested alternative to unprotected sex.
- If a needle is used, discard it. Reused needles shared or otherwise, can deliver HIV through a puncture in the skin if there are contaminants on the tip.
- Cover wounds, sores, rashes, bruises, scratches or skin breaks with bandages. Wear gloves if you must touch an open wound, and remove them correctly. Wash your hands before and after all contact with patients in the standard fashion.
- Obtain STI vaccines. Hepatitis B can increase the odds of STI infection.
What Doesn't Cause HIV?
Sweat, tears, feces, food handling and casual surface contact does not transmit HIV. HIV is a weak virus when exposed to the outside world, and usually dies within moments of being exposed to an outside environment. This means that people with HIV are virtually no risk to others, so long as attention is paid to cuts, protection (such as a condom), and risky behavior, such as drugs and heavy alcohol use (can lead to impaired judgment and unsafe sex).
Risks still exist if sores, cuts or other wounds are exposed to HIV. HIV is not passed by air, toilet seats or mosquitoes.
Note: Coincidently, mosquitoes have all of the delivery methods necessary, but the virus cannot survive long enough within the mosquito to matter.
Saliva has detectable traces of HIV; however, due to a harsh environment, HIV cannot infect someone without a significant amount of saliva. Even at a person's peak they will be unable to produce enough saliva to cause infection this way. Blood from sores and weak gums are more likely to allow transmission. Avoid sharing tooth brushes and razors, as these have been documented to transfer HIV.