1,514,868,940 visitors served.

forum mailing list For webmasters

AIDS

Most serious of all the sexually transmitted diseases (STDs). It is caused by the retrovirus human immunodeficiency virus (HIV), and is transmitted in body fluids, such as blood, saliva, semen, and vaginal secretions. AIDS is the world's most deadly STD and the fourth leading global cause of death. Unlike other diseases, which typically claim most lives among young children and the elderly, AIDS particularly hits those of working age. This has resulted in huge demographic changes in the countries most severely affected by AIDS, causing widespread social and economic hardship.

Diagnosis of AIDS

The HIV virus destroys the immune system, leaving the victim vulnerable to diseases that would not otherwise develop. Diagnosis of AIDS is based on the appearance of rare tumours or infections in people unexpected to suffer from such illness. Pneumocystis carinii pneumonia, for instance, normally seen only in the malnourished or those whose immune systems have been deliberately suppressed, is common among AIDS victims and is for them a leading cause of death.

Treatment

In the West, the time-lag between infection with HIV and the development of AIDS seems to be about ten years. However, it is far more rapid in developing countries, where roughly 50% of AIDS victims die within three years. There is no cure for the disease. In 1995 it was discovered that using a recently developed AIDS drug called 3TC in conjunction with zidovudine (formerly AZT) reduced levels of virus in the blood by ten times. In the West, the use of a three-drug cocktail has had dramatic effects, suppressing levels of the virus to a point where infected people can lead normal lives, although the drugs can have unpleasant side effects. In Africa, triple therapy drug treatment is not widely used because it is so expensive. Drugs companies have reduced the cost of medication, but the price still takes into account the costs of research and development for new drugs. However, in April 2001 pharmaceutical companies dropped their court case against the South African government over the provision of cheaper generic drugs for AIDS.

Research has found that the HIV virus has begun to mutate to become resistant to the current drug cocktail. Studies in 1999 on 11,990 HIV patients in the USA found more than one-quarter to be resistant to all three classes of HIV drugs. Likewise, in the UK, 30% of new HIV infections in 2000 were found to be caused by viruses that are resistant to at least one of the currently available treatment drugs.

Worldwide statistics

Estimates published by the World Health Organization (WHO) and the Joint United Nations programme on HIV/AIDS (UNAIDS) put the number of adults living with the HIV virus globally at the end of 2003 to be 37 million. A further 2.5 million children are also thought to be infected with the virus. During 2003, 3 million people died from HIV/AIDS and another 5 million are thought to have become infected with HIV. Around 95% of the people infected with HIV live in the developing world.

The AIDS virus is thought to have originated in Africa, where the disease is most widespread. In the USA, where there were more than a quarter of a million reported AIDS cases by the beginning of 1994, there is a worrying link with tuberculosis, a disease undergoing a marked resurgence, particularly in inner city areas.

Young, poor American women are being infected with the AIDS virus at a higher rate than men of the same age, according to a study result released in August 1998 by the Centers for Disease Control and Prevention (CDC). The infection rate among women 16–21 years old was 50% higher than for men of that age. The highest rate was among black women, with 5 out of every 1,000 infected with HIV. The rate for black men was 3.2 per 1,000. Rates were nearly equal for white men and women, with 0.8 per 1,000 men and 0.7 per 1,000 for women. African Americans are eight times more likely than whites to have HIV and AIDS, and Hispanics are four times as likely.

In December 2002, the CDC published a report breaking down the HIV/AIDS statistics into racial groups. They found that of the 384,906 reported cases of people infected with HIV, 46% were white, 34% were black, and 18% were Hispanics. Less than 2% belonged to the Asian and Pacific Islander communities and less than 1% was found in American Indian and Alaskan Native populations. During 2002 35,247 new cases of HIV infection were diagnosed in the USA and by the end of 2002 there were 384,906 people living with HIV.

Sub-Saharan Africa The area worst affected by AIDS is the African continent south of the Sahara Desert. The social and economic effect of the disease is enormous. Ten million of the 26.6 million living with HIV in sub-Saharan Africa in 2003 were 15–24 years of age; an estimated 11 million children have been orphaned by AIDS, and, with household income falling, many are forced into the workplace at an early age. The education sector has been disrupted, with, in Côte d'Ivoire, for example, 70% of the deaths of teachers now occurring as a result of AIDS. The health sector is also in crisis, with rising deaths among hospital workers, and in some states, 50–80% of urban hospital beds being occupied by AIDS patients. AIDS accounted for the deaths of 2.3 million people in the region in 2003.

In June 2000, a UN report predicted that in the worst affected countries in the region, a third of all 15-year-olds would die of AIDS. It was thought that by 2010 life expectancy in Botswana would fall to 29 years (17 years lower than the current level), as a direct result of AIDS; the life-expectancy figure for neighbouring Zimbabwe and Namibia was predicted to be 33 years, and in South Africa 35 years.

In 2002, the Department of Health in South Africa estimated the total number of HIV-positive South Africans to be 5.3 million, of which 91,270 were babies who had become infected by mother to child transmission.

South and Southeast Asia The trends of HIV infection in South and Southeast Asia are also alarming, with the epidemic spreading as fast as it did a decade ago in sub-Saharan Africa. In 2003 the UN estimated that there were 7.4 million people infected with HIV, 96% of whom were adults. In Cambodia, approximately 170,000 people were living with HIV. By the end of 2003, there were a total of 670,000 HIV cases in Thailand and 500,000 in Myanmar. In India in 2001 there were an estimated 3,970,000 adults and 170,000 children living with HIV.

Latin America and the Caribbean In Latin America, AIDS is increasingly occurring among women and adolescents. The future course of the epidemic in the region depends greatly on the rate at which the virus spreads in Brazil, which has more AIDS cases than any other country outside Africa, India, and the USA. By 2003, 1.5 million people in Latin America were infected with HIV, including 610,000 in Brazil and 130,000 in Argentina. The estimated number of deaths from AIDS in Latin America in 2002 was 60,000. In the Caribbean, 440,000 were HIV-positive by the end of 2002, chiefly in Haiti (250,000) and the Dominican Republic (130,000). In terms of the proportion of the population which is infected, the Caribbean was, behind Africa, the second worst affected part of the world. The total number of AIDS-related deaths in the Caribbean in 2002 was 42,000.

Middle East and North Africa In 2003, a joint UNAID and WHO report estimated that there were around 600,000 persons infected with HIV in the Middle East and North Africa. The report estimated that 55,000 people had become infected with HIV that year and that 45,000 people died of AIDS-related diseases.

Eastern Europe By the end of 2002, approximately 300,200 persons were reported as HIV-positive in the 15 countries of the former USSR, with the rate of HIV infection increasing rapidly.

Throughout Eastern Europe, the period 2000–01 saw a sharp increase in infections, especially among intravenous drug users. However, in 2002 the number of new diagnoses fell for the first time due to a steady decline in the number of drug-injection cases. A total of 64,222 new HIV-positive cases were reported in 2002.

By 2004, the Baltic States had one of the highest rates of HIV infection in the world and a spreading AIDS epidemic.

North America In 1993, AIDS for the first time became the USA's leading cause of death among all people aged between 25 and 44. In October 1999, official statistics showed that deaths due to AIDS had declined to such an extent in 1998 that the disease was now no longer one of the 15 most significant causes of death in the USA. In December 2002, around 364,900 people were living with HIV.

Western Europe In December 2003, WHO estimated that 165,454 persons were infected with HIV in Western Europe, with a total of 14,439 new cases being reported in 2002. However, these figures underestimate the scale of the disease, as Spain, France, and Italy did not have national HIV reporting systems when the reports were compiled.

The Pacific An HIV epidemic developed in Papua New Guinea, and by January 2000, this island of about 4 million people had an estimated 5,200 adults (0.2% of the adult population) living with HIV, overtaking Australia as the country with the highest number of HIV cases per head of population in the Pacific region.

China In 2001, a UNAIDS report estimated there were 850,000 adults and children in China who were HIV-positive. The report estimated that there were 30,000 AIDS-related deaths in that year in China.

Cheaper AIDS drugs Facing a public outcry in April 2001, 38 drug companies abandoned their legal challenge to a South African law that sought to provide access to cheaper AIDS treatment by permitting the manufacture of generic drugs. In June, the USA halted its attempt to stop Brazil overriding patents on AIDS drugs, and on 26 July dropped its complaint to the World Trade Organization over a law Brazil used to keep down the costs of AIDS drugs, which required the drug giants who sold their products in the country to manufacture the products there as well.

In April 2004, a consortium of public health groups and large funding agencies announced the expansion of a programme set up in 2003 to provide and distribute AIDS drugs at a very high discount to 100 developing countries where these drugs would normally be too expensive for sufferers of the disease to be able to buy. The 2003 programme originally only targeted 16 developing countries. The major partners in the consortium were the World Health Organization; the World Bank; the Global Fund to fight AIDS, Tuberculosis, and Malaria; UNICEF; and the Clinton Foundation. This initiative was partly an attempt to help meet WHO's target for increasing access to antiretroviral drugs in poor countries from the current level of 200,000 victims to 3 million people by 2005.

acquired immune deficiency syndrome AZT Gallo, Robert Charles gene shears hearing aid

HIV immunocompromised Jay, Margaret Ann Kaposi's sarcoma Krim, Mathilde

Montagnier, Luc National AIDS Trust opportunistic infection Pneumocystis carinii protease

retrovirus Shilts, Randy Martin South Africa zidovudine More results