AIDS (acquired immune deficiency syndrome) was first recognized in North America in the early 1980s. It is caused by a virus known as HIV (human immunodeficiency virus). HIV infection has become a worldwide epidemic. The World Health Organization estimates that since its discovery, it has caused over 40 million deaths worldwide, and approximately 38 million people are living with AIDS. It is estimated that around 63,000 people live with HIV in Canada, and of these people, about 10% have not received a diagnosis.
HIV is more common among certain populations, such as men who have sex with men, and people who inject illicit drugs. The infection is also more common among socially disadvantaged communities.
The virus can be found in the blood, semen, vaginal fluid, and breast milk of infected people. HIV is also found in saliva, sweat, and tears, though not in high enough amounts to transmit the virus to another person. HIV does not transmit through sneezing, shaking hands, or from toilet seats or mosquito bites.
The 2 most common ways to be infected with HIV in North America are through unprotected sex and sharing needles. HIV may be transmitted through unprotected vaginal, anal, or oral sex. Although the risk of infection is lower with oral sex, it is still important to use protection during oral sex, such as a dental dam (a piece of latex to cover the vagina during oral sex) or a condom. HIV can also be passed on through perinatal infection, where mothers who have HIV are at risk of giving the disease to the baby during birth. The risk of perinatal infection is declining with new treatments. Breast-feeding by an infected mother can also transmit HIV.
Once HIV enters the bloodstream, it takes over cells vital to the immune response, known as CD4+ lymphocytes. The virus then inserts its own genes into the cell, turning it into a miniature factory that produces more copies of the virus. Slowly, the amount of virus in the blood goes up and the number of healthy CD4+ cells goes down. The destruction of CD4+ cells interferes with the body’s ability to fight off infections, cancers, and other diseases.
HIV is usually treated with HAART (highly active antiretroviral therapy), a potent combination of anti-HIV medications. HAART will not cure HIV, but it can reduce the amount of virus in the blood, improve the immune system, and slow the progression of the disease. At least three medications are used together. Using multiple medications that work in different ways helps prevent the virus from becoming resistant to the treatment. The risk of resistance increases when fewer medications are used, when too low a dose is taken, or when a medication is stopped, even if this only happens for a short period of time.
It is very important to take HIV medications exactly as prescribed. If you miss a dose, take less medication than you need, or take doses at the wrong time, the medication will not work as well. Timing the medications around your meals and daily routine can be difficult. However, both the number and tolerability of HIV medications have increased considerably over the past 5 years. Many are now available as "co-formulated" products where 2, 3, or even 4 separate medications are combined in a single pill, which is taken once daily. Your doctor or pharmacist can help you fit the medications into your day. They may also recommend that you use a beeper or a special medication container to keep track of doses.
Once people develop AIDS, they may take a range of antibiotic, antiviral, and antifungal medications that other people only take for a short time while they are sick. These medications help fight off opportunistic infections. As a person’s immune system begins to recover after beginning HAART, the doctor will discontinue many of these medications. People with "wasting syndrome" may be offered various treatments according to the cause of significant weight loss. Agents such as growth hormone, anabolic steroids, and appetite stimulants are examples of medications that have been used to treat this condition.
There is a great deal of research on new treatments for HIV. Treatment information changes quickly. To keep up-to-date, talk to your doctor or pharmacist. You can also contact CATIE (the Canadian AIDS Treatment Information Exchange) for free, current, and confidential treatment information. You can reach CATIE by phone (1-800-263-1638) or on the Internet (www.catie.ca). You can also check with your provincial Ministry of Health for information on provincial and local programs.
Anyone can become infected with HIV. Fortunately, it can be prevented. The main ways to prevent HIV infection are:
You may also consider pre-exposure prophylaxis (PrEP), where a person who is HIV negative takes a daily dose of an HIV medication to prevent infection.
Unless you are in a mutually monogamous relationship (neither of you is having sex with anyone else), and you are sure neither of you is HIV-positive, make sure to use a condom every time you have sex. In some cases, couples where one partner is infected may decide to risk infection of the other partner, especially if they are trying to get pregnant. If this is the case, talk to your doctor. Control of the HIV infection in the partner with HIV, combined with PrEP for the uninfected partner, can dramatically lower the risk of passing the infection to the child or to the uninfected partner. If you think you’ve been exposed to HIV within the last 72 hours, ask your doctor or pharmacist about post-exposure prophylaxis (PEP) as soon as possible.
Your choice of sexual partner is important, since condoms do sometimes break or leak. You may know that you practice safe sex and that you haven’t used dirty needles, but you must also know that your sexual partners and all their other partners do the same. Sharing needles is very dangerous – it carries a high risk of getting HIV.
People with other sexually transmitted infections (STIs) such as herpes are much more likely to contract HIV during sex, probably because of tiny breaks in their skin or vaginal lining. Keeping free of other STIs will help reduce your risk of HIV infection, but this alone will not protect you from infection. That’s why it is important to use condoms.
If you have HIV and become pregnant, tell your doctor. The risk of infecting an infant during birth has been reduced dramatically through the use of medication and caesarean section when appropriate.
All material copyright MediResource Inc. 1996 – 2025. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/HIVAIDS
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