UNIVERSITY OF THE WITWATERSRAND, JOHANNESBURG

Basics of HIV and AIDS

What is AIDS?

First identified in the 1980s, Acquired Immunodeficiency Syndrome (AIDS) is a disease caused by the Human Immunodeficiency Virus (HIV). HIV uses cells of the immune system to replicate and spread, and through this process weakens a person’s immune system over time. With prolonged infection, a person’s immune system may be weakened until their bodies are unable to defend itself from common infections. The individual is then said to have AIDS. Without treatment or delaying treatment may further compromise a person’s health and could eventually lead to death. 

The Impact of HIV and AIDS

HIV and AIDS as a global pandemic has a distinct statistical concentration in sub-Saharan Africa, with South Africa having the highest prevalence rates. In describing the HIV climate of South Africa, Shisana, et al (2005) estimates that of approximately 32.6 million people over the age of 15 years; 16.5% are HIV positive, equaling an approximate number of 5.4 million people. It is further estimated that approximately 1000 people die from HIV related illnesses daily in South Africa. \

HIV and AIDS is not just a medical concern but also raises other concerns relating to the perpetuation of poverty, the lack of access to adequate treatment and care, economic and labour impacts, infringements of human rights and dignity, inadequate institutional support, poor health care structures, discrimination and stigma, etc.

Progression of HIV Infection

Initial infection:

Initial infection is characterized by a high viral load but because the body has not produced antibodies against it, it is not detectable. A person infected with HIV can test negative and it is at this stage when they are most infectious. Once the immune system produces antibodies against HIV, the virus can be detected and the person has seroconverted. The period from infection to seroconversion is called the window period which on average is said to be approximately three (3) months. 

Asymptomatic stage:

As the immune system produces antibodies the viral load will drop. A person will be HIV positive but will not exhibit any symptoms of the disease. People can remain asymptomatic for a number of years, depending on a range of factors. At this stage, even though the person does not have any symptoms, tests can still detect the virus and they can still infect other people. A person receiving treatment can remain infected for many more years without getting sick.

Symptomatic stage (AIDS):

Without any intervention however, the virus will eventually overwhelm the immune system and viral load will increase dramatically. The body is also unable to replenish T-cells. At this stage, an HIV positive person becomes more susceptible to opportunistic infections. These include TB, pneumonia and hepatitis. With increased exposure to infections, the individual will progress to full blown AIDS. Despite being in this stage a person on treatment may improve in health so that symptoms are no longer present. TransmissionHIV is transmitted by unprotected penetrative sexual contact with an infected person and intravenous contact with blood of infected person, most commonly by sharing needles and/or syringes (primarily for drug injection), or, less commonly (and now very rarely in countries where blood is screened for HIV antibodies), through transfusions of infected blood or blood clotting factors. Babies born to HIV-infected women may become infected before or during birth or through breast-feeding after birth.For more information on transmission of HIV and a better understanding of risk download the Risk Robot.

Prevention: the ABCs

  • Delay the age of sexual debut or abstain from sexual intercourse where possible. 
  • Be faithful to the sexual partner whom you are with and as far as possible avoiding multiple concurrent sexual partners.
  • Condoms should be used during sexual intercourse, and where possible less risky sexual practices should be engaged in including masturbation.
  • Where possible an HIV positive mother should preferably not breastfeed her infant. Exposure to blood should be avoided as far as possible.
  • Should you think that you may have had a risk exposure consult with a medical practitioner before 72hours after exposure to get onto the post-exposure-prophylaxis. 

Download: Risk Robot

Treatment

The range of treatment which is presently available and the access we have to it through public health care, is increasingly improving. Treatment allows an infected person to live a far more healthier and productive life and increases the lifespan of individuals living with HIV. Treatment is most effective, when complimented with a positive attitude toward living with HIV, accessing treatment and care as early as possible and adherence to medication. Read more …