Ending the Stigma With AIDS Awareness

Since 1988, World AIDS Day has been observed annually on 1st December with the primary objective of shedding light on HIV and AIDS while honouring the lives affected by this ongoing global epidemic. As we strive for a world without new HIV infections, it is crucial to emphasize the transformative power of education. By dispelling myths, combating misinformation, and fostering understanding, we can dismantle the barriers that perpetuate stigma and discrimination.

First, let’s go through the glossary of the acronyms used.

AIDS: Acquired immunodeficiency syndrome A chronic, potentially life-threatening condition caused by HIV.

HIV: Human immunodeficiency virus A virus that attacks the body's immune system. If HIV is not treated, it can lead to AIDS.

Next, we look at the numbers:

39 million people globally were living with HIV in 2022 1.3 million people became newly infected with HIV in 2022 630 000 people died from HIV-related illnesses in 2022

The relationship between HIV and AIDS

HIV is a virus that attacks a specific type of white blood cell that has the CD4 receptor protein on its surface. These cells are also known as “helper T cells” and they play a crucial role in the body's immune response as they help fight infections by triggering the immune system to destroy viruses, bacteria, and other germs that may make you ill. Over time, HIV can destroy so many CD4 cells that the body loses its capability to fight off infections and diseases effectively. If left untreated, HIV infections can progress to AIDS. AIDS is the final and most severe stage of HIV infection. This is when the immune system is severely damaged and becomes vulnerable to opportunistic infections including certain cancers that a healthy immune system would normally be able to fight off.

The progression from HIV to AIDS typically occurs over several years and can vary from person to person. The two criterias for the diagnosis of AIDS is as follow:

1)  < 200 CD4 cells per cubic millimetre of blood

2) Suffers from opportunistic infections that are common in people who have weakened immune systems (e.g. pneumonia, herpes infection, tuberculosis)

Understanding HIV

Transmission

HIV is primarily transmitted through direct contact with certain bodily fluids of an infected person. There are multiple routes of transmission such as:

• Sexual contact: HIV is spread most commonly through sexual intercourse with an infected partner. The virus enters the body through the lining of the vagina, vulva, penis, rectum, or mouth during sexual activity.

• Blood contamination: Sharing needles or syringes is a high-risk behaviour that can lead to HIV transmission if the equipment has been used by an infected person.

• Mother to infant: HIV can be spread to babies during childbirth or through breastfeeding, by mothers infected by the virus.

Myths and misconceptions

Stages of HIV Infection

HIV infection progresses through several stages, each characterised by specific features. It is important to note that the timeline for progression through these stages can vary from person to person. The stages of HIV infection are described as follows:

1. Acute HIV Infection:

• This is the initial stage that occurs within the first few weeks after exposure to the virus.

• Many people experience flu-like symptoms, such as fever, fatigue, swollen lymph nodes, sore throat, and a rash.

• The virus is highly contagious during this stage, as the concentration of the virus in the blood is usually very high.

2. Chronic HIV Infection:

• After the acute stage, the virus enters a stage of clinical latency, also known as chronic HIV infection or asymptomatic HIV infection.

• During this phase, the virus continues to replicate at lower levels, and there may be few or no symptoms.

• Clinical latency can last for an average of 8 to 10 years or longer, but antiretroviral therapy can significantly prolong this period.

3. Symptomatic HIV Infection

• As the immune system becomes more compromised, symptoms may start to appear.

• Common symptoms may include persistent fever, fatigue, weight loss, diarrhoea, and other opportunistic infections.

• This stage is an indication that the immune system is significantly damaged, and without treatment, it may progress to AIDS.

4. Acquired Immunodeficiency Syndrome (AIDS)

• AIDS is the final and most advanced stage of HIV infection.

• By definition, AIDS is diagnosed when the immune system is severely damaged, and the individual has a CD4 cell count below a certain threshold or has specific opportunistic infections or cancers.

• AIDS is characterised by a high risk of life-threatening infections and cancers.

Screening

Rapid HIV tests are now widely available and it produces very quick results within 20 minutes. Here are some key situations and scenarios when HIV testing is recommended:

• Before starting a new sexual relationship

  If you are entering into a new sexual relationship or considering becoming sexually active, it's advisable for both partners to undergo HIV testing. Knowing your partner's HIV status and sharing your own helps make informed decisions about protection and prevention.

• Pregnancy and prenatal care

  Pregnant individuals should be tested for HIV as part of routine prenatal care. Early detection allows for appropriate medical interventions to prevent mother-to-child transmission.

• After a possible exposure

  If you have engaged in unprotected sex or shared needles or other injection equipment with someone whose HIV status is unknown or who may be at a higher risk, it's advisable to get tested. 

• Following a potential needlestick or occupational exposure

  Healthcare workers or individuals who may have experienced needlestick injuries or other occupational exposures to potentially infected blood or body fluids should seek immediate testing.

• Symptoms of acute HIV infection

  If you experience symptoms suggestive of acute HIV infection, such as fever, fatigue, swollen lymph nodes, sore throat, or a rash, it's crucial to seek testing. Early detection during the acute stage is important for timely intervention.

Treatment

Currently, there is no cure for HIV or AIDS. Once you have the infection, it is not possible for your body to get rid of it completely. However, there are many medications that can reduce HIV viral load to an undetectable level and prevent complications. These medications are called antiretroviral therapy (ART). ART involves taking a combination of HIV medicines every day.

In summary, regular testing for HIV plays a pivotal role in individual health, public health, and efforts to control the spread of the virus. Early detection and timely intervention not only benefits those living with HIV but also contributes to broader global efforts to eliminate new HIV infections and improve health outcomes among HIV-positive individuals.