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Name = Acquired immunodeficiency syndrome (AIDS) |
ICD10 = B24 |
ICD9 = |
}}
is a symbol for solidarity with HIV-positive people and those living with AIDS.]]
  Author Marx, J L title=New disease baffles medical community
  Journal Science year=1982 pages=618-621 volume=217 issue=4560 id=



HIV is transmitted through direct contact of a or Vaginal ) Sex ; Blood Transfusion ; contaminated needles; exchange between mother and infant during Pregnancy , Childbirth , or Breastfeeding ; or other exposure to one of the above bodily fluids.

  Author Gao, F, Bailes, E, Robertson, D L, Chen, Y, Rodenburg, C M, Michael, S F, Cummins, L B, Arthur, L O, Peeters, M, Shaw, G M, Sharp, P M and Hahn, B H
  Title Origin of HIV-1 in the Chimpanzee Pan troglodytes troglodytes
  Journal Nature year=1999 pages=436-441 volume=397 issue=6718 id=


  Author UNAIDS publisher= year= 2005
  Url http://wwwunaidsorg/Epi2005/doc/EPIupdate2005_pdf_en/epi-update2005_enpdf
  Title AIDS epidemic update, 2005 accessdate=2006-01-17


  Author UNAIDS publisher= year= 2005
  Url http://wwwunaidsorg/Epi2005/doc/EPIupdate2005_pdf_en/epi-update2005_enpdf
  Title AIDS epidemic update, 2005 accessdate=2006-01-17


  Author Palella, F J Jr, Delaney, K M, Moorman, A C, Loveless, M O, Fuhrer, J, Satten, G A, Aschman and D J, Holmberg, S D
  Title Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection HIV Outpatient Study Investigators
  Journal N Engl J Med year=1998 pages=853-860 volume=338 issue=13 id=




Infection by HIV


of HIV-1 budding from cultured Lymphocyte .]]
AIDS is the most severe manifestation of infection with HIV. HIV is a Retrovirus that primarily infects vital components of the human Immune System such as CD4+ T Cell s, Macrophage s and Dendritic Cell s. It directly and indirectly destroys CD4+ T Cell s. As CD4+ T cells are required for the proper functioning of the immune system, when HIV kills CD4+ T cells so that there are less than 200 CD4+ T cells per µl blood, Cellular Immunity is lost, leading to AIDS. Acute HIV infection progresses over time to clinical latent HIV infection and then to early symptomatic HIV infection and later, to AIDS, which is identified on the basis of the amount of CD4+ T cells in the blood and the presence of certain infections.

  Author Morgan, D, Mahe, C, Mayanja, B, Okongo, J M, Lubega, R and Whitworth, J A
  Title HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries
  Journal AIDS year=2002 pages=597-632 volume=16 issue=4 id=


  Author Clerici, M, Balotta, C, Meroni, L, Ferrario, E, Riva, C, Trabattoni, D, Ridolfo, A, Villa, M, Shearer, GM, Moroni, M and Galli, M
  Title Type 1 cytokine production and low prevalence of viral isolation correlate with long-term non progression in HIV infection
  Journal AIDS Res Hum Retroviruses year=1996 pages=1053-1061 volume=12 issue=11


  Author Morgan, D, Mahe, C, Mayanja, B and Whitworth, J A
  Title Progression to symptomatic disease in people infected with HIV-1 in rural Uganda: prospective cohort study
  Journal BMJ year=2002 pages=193-196 volume=324 issue=7331


  Author Morgan, D, Mahe, C, Mayanja, B, Okongo, J M, Lubega, R and Whitworth, J A
  Title HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries
  Journal AIDS year=2002 pages=597-632 volume=16 issue=4


  Author Gendelman, H E, Phelps, W, Feigenbaum, L, Ostrove, J M, Adachi, A, Howley, P M, Khoury, G, Ginsberg, H S and Martin, M A
  Title Transactivation of the human immunodeficiency virus long terminal repeat sequences by DNA viruses
  Journal Proc Natl Acad Sci U S A year=1986 pages=9759-9763 volume=83 issue=24


  Author Bentwich, Z, Kalinkovich, A and Weisman, Z
  Title Immune activation is a dominant factor in the pathogenesis of African AIDS
  Journal Immunol Today year=1995 pages=187-191 volume=16 issue=4


  Author Tang, J and Kaslow, R A
  Title The impact of host genetics on HIV infection and disease progression in the era of highly active antiretroviral therapy
  Journal AIDS year=2003 pages=S51-S60 volume=17 issue=Suppl 4


  Author Quiñones-Mateu, M E, Mas, A, Lain de Lera, T, Soriano, V, Alcami, J, Lederman, M M and Domingo, E
  Title LTR and tat variability of HIV-1 isolates from patients with divergent rates of disease progression
  Journal Virus Research year=1998 pages=11-20 volume=57 issue=1


  Author Campbell, G R, Pasquier, E, Watkins, J, Bourgarel-Rey, V, Peyrot, V, Esquieu, D, Barbier, P, de Mareuil, J, Braguer, D, Kaleebu, P, Yirrell, D L and Loret E P
  Title The glutamine-rich region of the HIV-1 Tat protein is involved in T-cell apoptosis
  Journal J Biol Chem year=2004 pages=48197-48204 volume=279 issue=46


  Author Kaleebu P, French N, Mahe C, Yirrell D, Watera C, Lyagoba F, Nakiyingi J, Rutebemberwa A, Morgan D, Weber J, Gilks C, Whitworth J title=Effect of human immunodeficiency virus (HIV) type 1 envelope subtypes A and D on disease progression in a large cohort of HIV-1-positive persons in Uganda journal=J Infect Dis year=2002 pages=1244-1250 volume=185 issue=9




Diagnosis

Since June 18 , 1981 , many definitions have been developed for epidemiological surveillance such as the Bangui Definition and the 1994 Expanded World Health Organization AIDS Case Definition . However, clinical staging of patients was not an intended use for these systems as they are neither sensitive nor specific. In developing countries, the World Health Organization s (WHO) staging system for HIV infection and disease, using clinical and laboratory data, is used and in developed countries, the Centers For Disease Control (CDC) Classification System is used.


WHO Disease Staging System for HIV Infection and Disease

See Also: WHO Disease Staging System for HIV Infection and Disease


  Author World Health Organization
  Title Interim proposal for a WHO staging system for HIV infection and disease
  Journal WHO Wkly Epidem Rec year=1990 pages=221-228 volume=65 issue=29



: ''Stage I:'' HIV disease is asymptomatic and not categorized as AIDS
: ''Stage II:'' include minor mucocutaneous manifestations and recurrent upper respiratory tract infections
: ''Stage III:'' includes unexplained chronic diarrhoea for longer than a month, severe bacterial infections and pulmonary tuberculosis
: ''Stage IV'' includes Toxoplasmosis of the brain, Candidiasis of the oesophagus, trachea, bronchi or lungs and Kaposi's Sarcoma ; these diseases are indicators of AIDS.


CDC Classification System for HIV Infection

See Also: CDC Classification System for HIV Infection


  Cite Web Author CDC publisher=CDC year=1992
  Url http://wwwcdcgov/mmwr/preview/mmwrhtml/00018871htm
  Title 1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults
  Accessdate 2006-02-09




HIV test

See Also: HIV test


Approximately half of those infected with HIV do not know their HIV status until their AIDS diagnosis with a HIV test. The screening of donor blood and blood products used in medicine and medical research is by this test. Typical HIV tests, including the HIV enzyme immunoassay and the Western blot assay, detect HIV antibodies in serum, plasma, oral fluid, dried blood spot or urine of patients. Commercially available tests to detect other HIV antigens, HIV-RNA, and HIV-DNA in order to detect HIV infection prior to the development of detectable antibodies are available. However, for the diagnosis of HIV infection these assays are not specifically approved, but are nonetheless routinely used in developed countries.


Symptoms and Complications


  Author Holmes, C B, Losina, E, Walensky, R P, Yazdanpanah, Y, Freedberg, K A
  Title Review of human immunodeficiency virus type 1-related opportunistic infections in sub-Saharan Africa
  Journal Clin Infect Dis year=2003 pages=656-662 volume=36 issue=5


  Author Guss, D A
  Title The acquired immune deficiency syndrome: an overview for the emergency physician, Part 1
  Journal J Emerg Med year=1994 pages=375-384 volume=12 issue=3


  Author Guss, D A
  Title The acquired immune deficiency syndrome: an overview for the emergency physician, Part 2
  Journal J Emerg Med year=1994 pages=491-497 volume=12 issue=4


  Author Schneider, M F, Gange, S J, Williams, C M, Anastos, K, Greenblatt, R M, Kingsley, L, Detels, R, and Munoz, A
  Title Patterns of the hazard of death after AIDS through the evolution of antiretroviral therapy: 1984-2004
  Journal AIDS year=2005 pages=2009-2018 volume=19 issue=17


  Author Morgan, D, Mahe, C, Mayanja, B, Okongo, J M, Lubega, R and Whitworth, J A
  Title HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries
  Journal AIDS year=2002 pages=597-632 volume=16 issue=4


  Author Lawn, S D
  Title AIDS in Africa: the impact of coinfections on the pathogenesis of HIV-1 infection
  Journal J Infect Dis year=2004 pages=1-12 volume=48 issue=1



  Author Clerici, M, Balotta, C, Meroni, L, Ferrario, E, Riva, C, Trabattoni, D, Ridolfo, A, Villa, M, Shearer, GM, Moroni, M and Galli, M
  Title Type 1 cytokine production and low prevalence of viral isolation correlate with long-term non progression in HIV infection
  Journal AIDS Res Hum Retroviruses year=1996 pages=1053-1061 volume=12 issue=11


  Author Morgan, D, Mahe, C, Mayanja, B and Whitworth, J A
  Title Progression to symptomatic disease in people infected with HIV-1 in rural Uganda: prospective cohort study
  Journal BMJ year=2002 pages=193-196 volume=324 issue=7331


  Author Tang, J and Kaslow, R A
  Title The impact of host genetics on HIV infection and disease progression in the era of highly active antiretroviral therapy
  Journal AIDS year=2003 pages=S51-S60 volume=17 issue=Suppl 4


  Author Morgan, D, Mahe, C, Mayanja, B, Okongo, J M, Lubega, R and Whitworth, J A
  Title HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries
  Journal AIDS year=2002 pages=597-632 volume=16 issue=4


  Author Lawn, S D
  Title AIDS in Africa: the impact of coinfections on the pathogenesis of HIV-1 infection
  Journal J Infect Dis year=2004 pages=1-12 volume=48 issue=1


  Author Campbell, G R, Pasquier, E, Watkins, J, Bourgarel-Rey, V, Peyrot, V, Esquieu, D, Barbier, P, de Mareuil, J, Braguer, D, Kaleebu, P, Yirrell, D L and Loret E P
  Title The glutamine-rich region of the HIV-1 Tat protein is involved in T-cell apoptosis
  Journal J Biol Chem year=2004 pages=48197-48204 volume=279 issue=46


  Author Campbell, G R, Watkins, J D, Esquieu, D, Pasquier, E, Loret, E P and Spector, S A
  Title The C terminus of HIV-1 Tat modulates the extent of CD178-mediated apoptosis of T cells
  Journal J Biol Chem year=2005 pages=38376-39382 volume=280 issue=46


  Author Senkaali, D, Muwonge, R, Morgan, D, Yirrell, D, Whitworth, J and Kaleebu, P
  Title The relationship between HIV type 1 disease progression and V3 serotype in a rural Ugandan cohort
  Journal AIDS Res Hum Retroviruses year=2005 pages=932-937 volume=20 issue=9




Major pulmonary illnesses

  Author Feldman, C
  Title Pneumonia associated with HIV infection
  Journal Curr Opin Infect Dis year=2005 pages=165-170 volume=18 issue=2


  Author Decker, C F and Lazarus, A
  Title Tuberculosis and HIV infection How to safely treat both disorders concurrently
  Journal Postgrad Med year=2000 pages=57-60, 65-68 volume=108 issue=2




Major gastro-intestinal illnesses

  Author Zaidi, S A and Cervia, J S
  Title Diagnosis and management of infectious esophagitis associated with human immunodeficiency virus infection
  Journal J Int Assoc Physicians AIDS Care (Chic Ill) year=2002 pages=53-62 volume=1 issue=2


  Author Guerrant, R L, Hughes, J M, Lima, N L, Crane, J
  Title Diarrhea in developed and developing countries: magnitude, special settings, and etiologies
  Journal Rev Infect Dis year=1990 pages=S41-S50 volume=12 issue=Suppl 1




Major neurological illnesses

  Author Luft, B J and Chua, A
  Title Central Nervous System Toxoplasmosis in HIV Pathogenesis, Diagnosis, and Therapy
  Journal Curr Infect Dis Rep year=2000 pages=358-362 volume=2 issue=4


  Author Sadler, M and Nelson, M R
  Title Progressive multifocal leukoencephalopathy in HIV
  Journal Int J STD AIDS year=1997 pages=351-357 volume=8 issue=6


  Author Gray, F, Adle-Biassette, H, Chrétien, F, Lorin de la Grandmaison, G, Force, G, Keohane, C
  Title Neuropathology and neurodegeneration in human immunodeficiency virus infection Pathogenesis of HIV-induced lesions of the brain, correlations with HIV-associated disorders and modifications according to treatments
  Journal Clin Neuropathol year=2001 pages=146-155 volume=20 issue=4


  Author Grant, I, Sacktor, H, and McArthur, J
  Year 2005
  Title The Neurology of AIDS
  Chapter HIV neurocognitive disorders
  Chapterurl http://wwwhnrcucsdedu/publications_pdf/2005grant1pdf
  Editor H E Gendelman, I Grant, I Everall, S A Lipton, and S Swindells (ed)
  Edition 2nd
  Pages 357-373
  Publisher Oxford University Press
  Location London, UK
  Id ISBN 0198526105


  Author Satishchandra, P, Nalini, A, Gourie-Devi, M, Khanna, N, Santosh, V, Ravi, V, Desai, A, Chandramuki, A, Jayakumar, P N, and Shankar, S K
  Title Profile of neurologic disorders associated with HIV/AIDS from Bangalore, south India (1989-96)
  Journal Indian J Med Res year=2000 pages=14-23 volume=11 issue=


  Author Wadia, R S, Pujari, S N, Kothari, S, Udhar, M, Kulkarni, S, Bhagat, S, and Nanivadekar, A
  Title Neurological manifestations of HIV disease
  Journal J Assoc Physicians India year=2001 pages=343-348 volume=49 issue=




Major HIV-associated malignancies

  Author Boshoff, C and Weiss, R
  Title AIDS-related malignancies
  Journal Nat Rev Cancer year=2002 pages=373-382 volume=2 issue=5


  Author Yarchoan, R, Tosatom G and Littlem R F
  Title Therapy insight: AIDS-related malignancies - the influence of antiviral therapy on pathogenesis and management
  Journal Nat Clin Pract Oncol year=2005 pages=406-415 volume=2 issue=8




Other opportunistic infections

  Author Skoulidis, F, Morgan, M S, and MacLeod, K M
  Title Penicillium marneffei: a pathogen on our doorstep
  Journal J R Soc Med year=2004 pages=394-396 volume=97 issue=2




Transmission and prevention

|- bgcolor="#efefef"
| style="width: 100px"|Exposure Route
| style="width: 150px"|Estimated infections per 10,000 exposures to an infected source
|-
  Cite Journal Author Donegan, E, Stuart, M, Niland, J C, Sacks, H S, Azen, S P, Dietrich, S L, Faucett, C, Fletcher, M A, Kleinman, S H, Operskalski, E A, et al title=Infection with human immunodeficiency virus type 1 (HIV-1) among recipients of antibody-positive blood donations journal=Ann Intern Med year=1990 pages=733-739 volume=113 issue=10


|-
  Cite Journal Author Coovadia, H title=Antiretroviral agents&mdashhow best to protect infants from HIV and save their mothers from AIDS journal=N Engl J Med year=2004 pages=289-292 volume=351 issue=3 id=


|-
  Cite Journal Author Kaplan, E H and Heimer, R title=HIV incidence among New Haven needle exchange participants: updated estimates from syringe tracking and testing data journal=J Acquir Immune Defic Syndr Hum Retrovirol year=1995 pages=175-176 volume=10 issue=2


|-
  Cite Journal Author European Study Group on Heterosexual Transmission of HIV title=Comparison of female to male and male to female transmission of HIV in 563 stable couples journal=BMJ year=1992 pages=809-813 volume=304 issue=6830 id=


  Cite Journal Author Varghese, B, Maher, J E, Peterman, T A, Branson, B M and Steketee, R W title=Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use journal=Sex Transm Dis year=2002 pages=38-43 volume=29 issue=1 id=


|-
  Cite Journal Author Bell, D M title=Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview journal=Am J Med year=1997 pages=9-15 volume=102 issue=5B id=


|-
  Cite Journal Author European Study Group on Heterosexual Transmission of HIV title=Comparison of female to male and male to female transmission of HIV in 563 stable couples journal=BMJ year=1992 pages=809-813 volume=304 issue=6830 id=


  Cite Journal Author Varghese, B, Maher, J E, Peterman, T A, Branson, B M and Steketee, R W title=Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use journal=Sex Transm Dis year=2002 pages=38-43 volume=29 issue=1 id=


  Cite Journal Author Leynaert, B, Downs, A M and de Vincenzi, I title=Heterosexual transmission of human immunodeficiency virus: variability of infectivity throughout the course of infection European Study Group on Heterosexual Transmission of HIV journal=Am J Epidemiol year=1998 pages=88-96 volume=148 issue=1 id=


|-
  Cite Journal Author European Study Group on Heterosexual Transmission of HIV title=Comparison of female to male and male to female transmission of HIV in 563 stable couples journal=BMJ year=1992 pages=809-813 volume=304 issue=6830 id=


  Cite Journal Author Varghese, B, Maher, J E, Peterman, T A, Branson, B M and Steketee, R W title=Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use journal=Sex Transm Dis year=2002 pages=38-43 volume=29 issue=1 id=


|-
  Cite Journal Author European Study Group on Heterosexual Transmission of HIV title=Comparison of female to male and male to female transmission of HIV in 563 stable couples journal=BMJ year=1992 pages=809-813 volume=304 issue=6830 id=


  Cite Journal Author Varghese, B, Maher, J E, Peterman, T A, Branson, B M and Steketee, R W title=Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use journal=Sex Transm Dis year=2002 pages=38-43 volume=29 issue=1 id=


|-
  Cite Journal Author Varghese, B, Maher, J E, Peterman, T A, Branson, B M and Steketee, R W title=Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use journal=Sex Transm Dis year=2002 pages=38-43 volume=29 issue=1 id=


|-
  Cite Journal Author Varghese, B, Maher, J E, Peterman, T A, Branson, B M and Steketee, R W title=Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use journal=Sex Transm Dis year=2002 pages=38-43 volume=29 issue=1 id=


|- bgcolor="#efefef"

The three main transmission routes of HIV are sexual contact, exposure to infected body fluids or tissues and from mother to foetus or child during perinatal period. It is possible to find HIV in the Saliva , Tears and Urine of infected individuals, but due to the low concentration of virus in these biological liquids, the risk is negligible.


Sexual contact

  Cite Journal Author Rothenberg, R B, Scarlett, M, del Rio, C, Reznik, D and O'Daniels, C
  Title Oral transmission of HIV journal=AIDS year=1998 pages=2095-2105 volume=12 issue=16



  Author Laga, M, Nzila, N, Goeman, J
  Title The interrelationship of sexually transmitted diseases and HIV infection: implications for the control of both epidemics in Africa
  Journal AIDS year=1991 pages=S55-S63 volume=5 issue=Suppl 1


  Author Laga, M, Nzila, N, Goeman, J
  Title The interrelationship of sexually transmitted diseases and HIV infection: implications for the control of both epidemics in Africa
  Journal AIDS year=1991 pages=S55-S63 volume=5 issue=Suppl 1


  Author Tovanabutra, S, Robison, V, Wongtrakul, J, Sennum, S, Suriyanon, V, Kingkeow, D, Kawichai, S, Tanan, P, Duerr, A and Nelson, K E
  Title Male viral load and heterosexual transmission of HIV-1 subtype E in northern Thailand
  Journal J Acquir Immune Defic Syndr year=2002 pages=275-283 volume=29 issue=3


  Author Sagar, M, Lavreys, L, Baeten, J M, Richardson, B A, Mandaliya, K, Ndinya-Achola, J O, Kreiss, J K, and Overbaugh, J
  Title Identification of modifiable factors that affect the genetic diversity of the transmitted HIV-1 population
  Journal AIDS year=2004 pages=615-619 volume=18 issue=4


  Author Lavreys, L, Baeten, J M, Martin, H L Jr, Overbaugh, J, Mandaliya, K, Ndinya-Achola, J, and Kreiss, J K
  Title Hormonal contraception and risk of HIV-1 acquisition: results of a 10-year prospective study
  Journal AIDS year=2004 pages=695-697 volume=18 issue=4



  Author Cayley, W E Jr
  Title Effectiveness of condoms in reducing heterosexual transmission of HIV
  Journal Am Fam Physician year=2004 pages=1268-1269 volume=70 issue=7


Promoting condom use, however, has often proved controversial and difficult. Many religious groups, most visibly the Catholic Church , have opposed the use of condoms on religious grounds, and have sometimes seen condom promotion as an affront to the promotion of marriage, monogamy and sexual morality. As of April 2006 however, the Catholic Church for the first time relaxed its stance on the use of contraception, citing it as "the lesser of two evils" and that it may be acceptable to use if the prevention of disease is considered. Other religious groups, such as the Scottish Episcopalians , have argued that preventing HIV infection is a moral task in itself and that condoms are therefore acceptable or even praiseworthy from a religious point of view.

  Author Durex publisher= year=
  Url http://wwwdurexcom/cm/assets/SexEdDownloads/Module_5_condomsdoc
  Title Module 5/Guidelines for Educators
  Accessdate 2006-04-17


'' The Female Condom '' is an alternative to the male condom and is made from Polyurethane , which allows it to be used in the presence of oil-based lubricants. They are larger than male condoms and have a stiffened ring-shaped opening, and are designed to be inserted into the vagina. The female condom contains an inner ring which keeps the condom in place inside the vagina—inserting the female condom requires squeezing this ring.

  Author WHO publisher= year= 2003
  Url http://wwwwprowhoint/media_centre/fact_sheets/fs_200308_Condomshtm
  Title Condom Facts and Figures
  Accessdate 2006-01-17


The United States government and health organizations both endorse the ''ABC Approach'' to lower the risk of acquiring AIDS during sex:

: Abstinence or delay of sexual activity, especially for youth,
: Being faithful, especially for those in committed relationships,
: Condom use, for those who engage in risky behaviour.

  Author Human Rights Watch publisher=Human Rights Watch year=2002
  Url http://wwwhrworg/reports/2002/usa0902/USA0902-04htm
  Title Ignorance only: HIV/AIDS, Human rights and federally funded abstinence-only programs in the United States Texas: A case study
  Accessdate 2006-03-28


: Condom use, for those who engage in risky behaviour.
: Needles, use clean ones
: Negotiating skills; negotiating safer sex with a partner and empowering women to make smart choices

  Author The Economist publisher= year=2005
  Url http://wwweconomistcom/opinion/displayStorycfmstory_id=4223619
  Title Too much morality, too little sense
  Accessdate 2006-03-28


  Author WHO publisher= year=2005
  Url http://wwwwhoint/mediacentre/news/releases/2005/pr32/en/
  Title UNAIDS statement on South African trial findings regarding male circumcision and HIV
  Accessdate 2006-03-28


  Author Various publisher=Kaisernetworkorg year=2005
  Url http://wwwkaisernetworkorg/daily_reports/rep_indexcfmDR_ID=31199
  Title Repeated Use of Unsterilized Blades in Ritual Circumcision Might Contribute to HIV Spread in S Africa, Doctors Say
  Accessdate 2006-03-28




Exposure to infected body fluids

  Author Fan, H year = 2005
  Title AIDS: science and society chapter = chapterurl =
  Editor Fan, H, Conner, R F and Villarreal, L P eds
  Edition 4th pages =
  Publisher Jones and Bartlett Publishers
  Location Boston, MA
  Id ISBN 076370086X


  Author WHO publisher= year= 2003
  Url http://64233179104/searchq=cache:adH68_6JGG8J:tokyousembassygov//e/p/tp-20030317a3html+site:tokyousembassygov+HIV+healthcare+injection&hl=en&gl=us&ct=clnk&cd=1
  Title WHO, UNAIDS Reaffirm HIV as a Sexually Transmitted Disease
  Accessdate 2006-01-17


  Author Physicians for Human Rights publisher=Partners in Health year=2003
  Url http://wwwphrusaorg/campaigns/aids/who_031303html
  Title HIV Transmission in the Medical Setting: A White Paper by Physicians for Human Rights accessdate=2006-03-01


  Author United Nations General Assembly publisher= year=2001
  Url http://wwwunorg/ga/aids/coverage/FinalDeclarationHIVAIDShtml
  Title Declaration of Commitment on HIV/AIDS ''Global Crisis — Global Action''
  Accessdate 2006-03-01



  Author WHO publisher= year= 2001
  Url http://wwwwhoint/inf-pr-2000/en/pr2000-25html
  Title Blood safetyfor too few
  Accessdate 2006-01-17


Medical workers who follow Universal Precautions or body substance isolation such as wearing latex gloves when giving injections and washing the hands frequently can help prevent infection of HIV.

All AIDS-prevention organizations advise drug-users not to share needles and other material required to prepare and take drugs (including syringes, cotton balls, the spoons, water for diluting the drug, straws, crack pipes etc). It is important that people use new or properly sterilized needles for each injection. Information on cleaning needles using bleach is available from health care and addiction professionals and from Needle Exchange s. In some developed countries, clean needles are available free in some cities, at needle exchanges or Safe Injection Site s. Additionally, many nations have decriminalized needle possession and made it possible to buy injection equipment from pharmacists without a prescription.


Mother to Child Transmission (MTCT)

  Cite Journal Author Coovadia, H journal=N Engl J Med year=2004 pages=289-292 volume=351 issue=3 id=



  Author Sperling, R S, Shapirom D E, Coombsm R W, Todd, J A, Herman, S A, McSherry, G D, O'Sullivan, M J, Van Dyke, R B, Jimenez, E, Rouzioux, C, Flynn, P M and Sullivan, J L
  Title Maternal viral load, zidovudine treatment, and the risk of transmission of human immunodeficiency virus type 1 from mother to infant
  Journal N Engl J Med year=1996 pages=1621-1629 volume=335 issue=22


  Author UNAIDS publisher= year= 2005
  Url http://wwwunaidsorg/Epi2005/doc/EPIupdate2005_pdf_en/epi-update2005_enpdf
  Title AIDS epidemic update, 2005
  Accessdate 2006-01-17



  Author Dias, S F, Matos, M G and Goncalves, A C
  Title Preventing HIV transmission in adolescents: an analysis of the Portuguese data from the Health Behaviour School-aged Children study and focus groups
  Journal Eur J Public Health year=2005 pages=300-304 volume=15 issue=3



Treatment

  Author Schneider, M F, Gange, S J, Williams, C M, Anastos, K, Greenblatt, R M, Kingsley, L, Detels, R, and Munoz, A
  Title Patterns of the hazard of death after AIDS through the evolution of antiretroviral therapy: 1984-2004
  Journal AIDS year=2005 pages=2009-2018 volume=19 issue=17


  Author Morgan, D, Mahe, C, Mayanja, B, Okongo, J M, Lubega, R and Whitworth, J A
  Title HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries
  Journal AIDS year=2002 pages=597-632 volume=16 issue=4 id=



  Author Department Of Health And Human Services publisher=
  Year January, 2005
  Url http://wwwhabhrsagov/tools/HIVpocketguide05/PktGARTtableshtm
  Title A Pocket Guide to Adult HIV/AIDS Treatment January 2005 edition
  Accessdate 2006-01-17


  Author Wood, E, Hogg, R S, Yip, B, Harrigan, P R, O'Shaughnessy, M V and Montaner, J S
  Title Is there a baseline CD4 cell count that precludes a survival response to modern antiretroviral therapy
  Journal AIDS year=2003 pages=711-720 volume=17 issue=5


  Author Chene, G, Sterne, J A, May, M, Costagliola, D, Ledergerber, B, Phillips, A N, Dabis, F, Lundgren, J, D'Arminio Monforte, A, de Wolf, F, Hogg, R, Reiss, P, Justice, A, Leport, C, Staszewski, S, Gill, J, Fatkenheuer, G, Egger, M E and the Antiretroviral Therapy Cohort Collaboration
  Title Prognostic importance of initial response in HIV-1 infected patients starting potent antiretroviral therapy: analysis of prospective studies
  Journal Lancet year=2003 pages=679-686 volume=362 issue=9385



  Author Department Of Health And Human Services Working Group on Antiretroviral Therapy and Medical Management of HIV-Infected Children
  Publisher year= November 3 , 2005
  Url http://wwwaidsinfonihgov/ContentFiles/PediatricGuidelines_PDApdf
  Title Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection
  Accessdate 2006-01-17


  Author Department Of Health And Human Services Panel on Clinical Practices for Treatment of HIV Infection
  Publisher year= October 6 , 2005
  Url http://aidsinfonihgov/ContentFiles/AdultandAdolescentGLpdf
  Title Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents
  Accessdate 2006-01-17



  Author Montessori, V, Press, N, Harris, M, Akagi, L, Montaner, J S
  Title Adverse effects of antiretroviral therapy for HIV infection
  Journal CMAJ year=2004 pages=229-238 volume=170 issue=2 id=


  Author Saitoh, A, Hull, A D, Franklin, P and Spector, S A
  Title Myelomeningocele in an infant with intrauterine exposure to efavirenz
  Journal J Perinatol year=2005 pages=555-556 volume=25 issue=8


  Author Dybul, M, Fauci, A S, Bartlett, J G, Kaplan, J E, Pau, A K Panel on Clinical Practices for Treatment of HIV
  Title Guidelines for using antiretroviral agents among HIV-infected adults and adolescents
  Journal Ann Intern Med year=2002 pages=381-433 volume=137 issue=5 Pt 2


  Author Becker, S, Dezii, C M, Burtcel, B, Kawabata, H and Hodder, S
  Title Young HIV-infected adults are at greater risk for medication nonadherence
  Journal MedGenMed year=2002 pages=21 volume=4 issue=3 id=



A number of studies have shown that measures to prevent opportunistic infections can be beneficial when treating patients with HIV infection or AIDS. Vaccination against hepatitis A and B is advised for patients who are not infected with these viruses and are at risk of getting infected. In addition, AIDS patients should receive vaccination against Streptococcus Pneumoniae and should receive yearly vaccination against Influenza Virus . Patients with substantial immunosuppression are generally advised to receive prophylactic therapy for Pneumocystis Jiroveci Pneumonia (PCP), and many patients may benefit from prophylactic therapy for Toxoplasmosis and Cryptococcus meningitis.

  Author Saltmarsh, S
  Title Voodoo or valid Alternative therapies benefit those living with HIV
  Journal Positively Aware year=2005 pages=46 volume=3 issue=16
  Id url=http://wwwtpancom/publications/pa/may_jun_05/voodooshtml


  Author Saltmarsh, S
  Title Voodoo or valid Alternative therapies benefit those living with HIV
  Journal Positively Aware year=2005 pages=46 volume=3 issue=16
  Id url=http://wwwtpancom/publications/pa/may_jun_05/voodooshtml


  Author Mills, E, Wu, P and Ernst, E
  Title Complementary therapies for the treatment of HIV: in search of the evidence
  Journal Int J STD AIDS year=2005 pages=395-403 volume=16 issue=6




Epidemiology

See Also: AIDS pandemic



  Author UNAIDS publisher= year= 2005
  Url http://wwwunaidsorg/Epi2005/doc/EPIupdate2005_pdf_en/epi-update2005_enpdf
  Title AIDS epidemic update, 2005
  Accessdate 2006-01-17


  Author UNAIDS publisher= year= 2005
  Url http://wwwunaidsorg/Epi2005/doc/EPIupdate2005_pdf_en/epi-update2005_enpdf
  Title AIDS epidemic update, 2005
  Accessdate 2006-01-17


  Author UNAIDS publisher= year= 2005
  Url http://wwwunaidsorg/Epi2005/doc/EPIupdate2005_pdf_en/epi-update2005_enpdf
  Title AIDS epidemic update, 2005
  Accessdate 2006-01-17


  Author World Bank publisher= year=2005
  Url http://wwwworldbankorg/oed/aids/main_reporthtml
  Title Evaluating the World Bank's Assistance for Fighting the HIV/AIDS Epidemic
  Accessdate 2006-01-17


  Author CDC
  Title US HIV and AIDS cases reported through December 1996
  Journal HIV/AIDS Surveillance Report year=1996 pages=1-40 volume=8 issue=2 url=http://wwwcdcgov/hiv/stats/hivsur82pdf


In the 35 African nations with the highest prevalence, average Life Expectancy is 48.3 years—6.5 years less than it would be without the disease. For the eleven countries in Africa with prevalence rates above 13%, life expectancy is 47.7 years—11.0 years less than would be expected without HIV/AIDS.

In Africa, the number of MTCT and the prevalence of AIDS is beginning to reverse decades of steady progress in child survival. Countries, such as Uganda are attempting to curb the MTCT epidemic by offering VCT (voluntary counselling and testing), PMTCT (prevention of mother-to-child tranmission) and ANC (ante-natal care) services, which include the distribution of antiretroviral therapy.


Economic impact


  Author UNAIDS publisher= year= 2005
  Url http://wwwunaidsorg/Epi2005/doc/EPIupdate2005_pdf_en/epi-update2005_enpdf
  Title AIDS epidemic update, 2005
  Accessdate 2006-01-17


Without proper nutrition, health care and medicine that is available in developed countries, large numbers of people in these countries are progressing to AIDS. They will not only be unable to work, but will also require significant medical care. The forecast is that this will likely cause a collapse of economies and societies in the region. In some heavily infected areas, the epidemic has left behind many orphans cared for by elderly grandparents.

  Author Greener, R
  Year 2002
  Title State of The Art: AIDS and Economics
  Chapter AIDS and macroeconomic impact
  Chapterurl http://wwwiaenorg/library/statepidemic/chapter7pdf
  Editor S, Forsyth (ed)
  Pages 49-55
  Publisher IAEN


  Author Greener, R
  Year 2002
  Title State of The Art: AIDS and Economics
  Chapter AIDS and macroeconomic impact
  Chapterurl http://wwwiaenorg/library/statepidemic/chapter7pdf
  Editor S, Forsyth (ed)
  Pages 49-55
  Publisher IAEN



  Author Bollinger, L and Stover, J publisher=iaen year=1999
  Url http://wwwiaenorg/impact/stovbollpdf
  Title The Economic Impact of AIDS accessdate=2006-03-28


  Author Over, M
  Title The macroeconomic impact of AIDS in Sub-Saharan Africa, Population and Human Resources Department
  Journal The World Bank year=1992


  Author Bonnel, R
  Title HIV/AIDS and Economic Growth: A Global Perspective
  Journal S A J Economics year=2000 pages=820-855 volume=68 issue=5


  Author Greener, R
  Year 2002
  Title State of The Art: AIDS and Economics
  Chapter AIDS and macroeconomic impact
  Chapterurl http://wwwiaenorg/library/statepidemic/chapter7pdf
  Editor S, Forsyth (ed)
  Pages 49-55
  Publisher IAEN


  Author Bell, C, Gersbach, H and Devarajan, S publisher=eldis year= 2003
  Url http://wwweldisorg/static/DOC12805htm
  Title The long-run economic costs of AIDS: theory and an application to South Africa
  Accessdate 2006-03-28



Many governments in sub-Saharan Africa denied that there was a problem for years, and are only now starting to work towards solutions. Underfunding is a problem in all areas of HIV prevention when compared to even conservative estimates of the problems.


Stigma

AIDS stigma exists around the world in a variety of ways, including ostracism, rejection, discrimination and avoidance of HIV infected people; compulsory HIV testing without prior consent or protection of confidentiality; violence against HIV infected individuals or people who are perceived to be infected with HIV; and the quarantine of HIV infected individuals.

AIDS stigma has been further divided into the following three categories:

  Author Herek, G M and Capitanio, J P publisher=Am Behav, Scientist year=1999
  Url http://psychologyucdavisedu/rainbow/html/abs99_sppdf
  Title AIDS Stigma and sexual prejudice
  Accessdate 2006-03-27


  Author Herek, G M and Capitanio, J P publisher=Am Behav, Scientist year=1999
  Url http://psychologyucdavisedu/rainbow/html/abs99_sppdf
  Title AIDS Stigma and sexual prejudice
  Accessdate 2006-03-27


  Author Snyder M, Omoto AM, Crain AL
  Title Punished for their good deeds: st