HIV

HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. If HIV is not
treated, it can lead to AIDS (acquired immunodeficiency syndrome ).

There is currently no effective cure. Once people get HIV, they have it for life.

But with proper medical care, HIV can be controlled. People with HIV who get effective HIV
treatment can live long, healthy lives and protect their partners.

South Africa has the highest number of people living with HIV in the world (7.5 million).
Eswatini (formerly known as Swaziland) has the highest prevalence in the world.
Philippines has highest HIV infection growth rate in Asia-Pacific
There were approximately 37.6 million people across the globe with HIV in 2020. Of these, 35.9
million were adults and 1.7 million were children (15 years old below).

ORIGIN OF HIV/AIDS

 HIV crossed from chimpanzees to humans in the 1920s in what is now the
Democratic Republic of Congo. This was probably because of chimps carrying
the Simian Immunodeficiency Virus (SIV), a virus closely related to HIV, being
hunted, and eaten by people living in the area.

 Originated mostly in west and central Africa

 Link between SIV and HIV
 Transmission of HIV-1 and HIV-2
 Spread of HIV from Haiti in 1960 and USA in 1980
 Groups of HIV-1
 Group (M, N, O and P)
 HIV Strains

3 STAGES OF HIV

Stage 1: Acute HIV Infection

 People have a large amount of HIV in their blood. They are very contagious.
 Some people have flu-like symptoms. This is the body’s natural response to infection.
 But some people may not feel sick right away or at all.
 If you have flu-like symptoms and think you may have been exposed to HIV, seek
medical care, and ask for a test to diagnose acute infection.
 Only antigen/antibody tests or nucleic acid tests (NATs) can diagnose acute infection.
Stage 2: Chronic HIV Infection

 This stage is also called asymptomatic HIV infection or clinical latency.

 People may not have any symptoms or get sick during this phase.
 Without taking HIV medicine, this period may last a decade or longer, but some may
progress faster.
 People can transmit HIV in this phase.
 At the end of this phase, the amount of HIV in the blood (called viral load) goes up and
the CD4 cell count goes down. The person may have symptoms as the virus levels
increase in the body, and the person moves into Stage 3.
 People who take HIV medicine as prescribed may never move into Stage 3.

Stage 3: acquired immunodeficiency syndrome (AIDS)

 The most severe phase of HIV infection.

 People with AIDS have such badly damaged immune systems that they get an increasing
number of severe illnesses, called opportunistic infections.
 People receive an AIDS diagnosis when their CD4 cell count drops below 200 cells/mm,
or if they develop certain opportunistic infections.
 People with AIDS can have a high viral load and be very infectious.
 Without treatment, people with AIDS typically survive about three years.

OPPORTUNISTIC INFECTIONS

Opportunistic infections (OIs) are illnesses that occur more frequently and are more severe in people
with HIV. This is because they have damaged immune systems. Opportunistic infections (OIs) are the ff:

 Candidiasis  simplex
Herpes Herpesvirus
simplex
(HSV)virus (HSV)
 Invasive cervical cancer  Histoplasmosis
Histoplasmosis
 Coccidioidomycosis  sarcoma
Kaposi’s Kaposi’s (KS)
sarcoma (KS)
 Cryptococcosis Lymphoma
 Lymphoma
 Cryptosporidiosis (Crypto) Tuberculosis (TB)
 Tuberculosis (TB)
 Cystoisosporiasis Pneumonia
 Pneumonia
 Cytomegalovirus (CMV)
SYMPTOMS

Some people have flu-like symptoms within 2 to 4 weeks after infection (called acute HIV
infection). These symptoms may last for a few days or several weeks. Possible symptoms
include:

Fever,
Chills,
Rash,
Night sweats,
Muscle aches,
Sore throat,
Fatigue,
Swollen lymph nodes, and
Mouth ulcers.

Types of HIV test

The time between when a person may have been exposed to HIV and when a test can
tell for sure whether they have the virus is called the window period. The window
period varies from person to person and depends on the type of test used to detect HIV.

 A nucleic acid test (NAT)can usually tell you if you have HIV infection 10 to 33 days
after an exposure.
 An antigen/antibody test performed by a laboratory on blood from a vein can usually
detect HIV infection 18 to 45 days after an exposure. Antigen/ antibody tests done with
blood from a finger prick can take longer to detect HIV (18 to 90 days after an exposure).
 Antibody tests can take 23 to 90 days to detect HIV infection after an exposure. Most
rapid tests and self-tests are antibody tests. In general, antibody tests that use blood from
a vein can detect HIV sooner after infection than tests done with blood from a finger
prick or with oral fluid.
Treatment

 The treatment for HIV is called antiretroviral therapy (ART). ART involves taking a combination
of HIV medicines (called an HIV treatment regimen) every day. ART is recommended for
everyone who has HIV. People with HIV should start taking HIV medicines as soon as possible.

 The treatment for HIV is called antiretroviral therapy (ART). ART involves taking a combination
of HIV medicines (called an HIV treatment regimen) every day.  ART is a lifelong
commitment.

 ART is recommended for everyone who has HIV. People with HIV should start taking HIV
medicines as soon as possible. ART cannot cure HIV, but HIV medicines help people with HIV live
longer, healthier lives. ART also reduces the risk of HIV transmission.

 A main goal of HIV treatment is to reduce a person’s viral load to an undetectable level.

An undetectable viral load means that the level of HIV in the blood is too low to be detected by
a viral load test. People with HIV who maintain an undetectable viral load have effectively no
risk of transmitting HIV to their HIV-negative partners through sexual intercourse.

There are many HIV medicines available for HIV treatment regimens. The HIV medicines are
grouped into seven drug classes according to how they fight HIV.
A group of drugs that share common properties, including a similar mechanism of action,
chemical structure, or approved use. Approved antiretroviral (ARV) HIV drugs are divided into
seven drug classes based on how each drug interferes with the HIV life cycle. These seven
classes include the nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse
transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), fusion inhibitors, CCR5
antagonists, post-attachment inhibitors, and integrase strand transfer inhibitors (INSTIs).
The choice of an HIV treatment regimen depends on a person's individual needs. When
choosing an HIV treatment regimen, people with HIV and their health care providers consider
many factors, including possible side effects of HIV medicines and potential drug interactions.
HIV/AIDS PREVENTION

 Use condoms
 Get tested
 Be monogamous
 Limit your number of sexual partners
 Get vaccinated
 Do not abuse alcohol or drugs
 Never share injection drug equipment

RELATED PROBLEMS ASSOCIATED HIV/AIDS

STIGMA AND DISCRIMINATION

 There is a cyclical relationship between stigma and HIV; people who experience stigma
and discrimination are marginalized and made more vulnerable to HIV, while those
living with HIV are more vulnerable to experiencing stigma and discrimination.
 Myths and misinformation increase the stigma and discrimination surrounding HIV and
AIDS.
 Roughly one in eight people living with HIV is being denied health services because of
stigma and discrimination.
 Adopting a human rights approach to HIV and AIDS is in the best interests of public
health and is key to eradicating stigma and discrimination.

 UNAIDS and the World Health Organization (WHO) cites fear of stigma and
discrimination as the main reason why people are reluctant to get tested, disclose their
HIV status, and take antiretroviral drugs (ARVs).

 One study found that participants who reported high levels of stigma were over four
times more likely to report poor access to care. This contributes to the expansion of the
global HIV epidemic and a higher number of AIDS-related deaths.

Forms of HIV stigma and discrimination

HIV and AIDS-related stigma can lead to discrimination, for example, when people living with
HIV are prohibited from travelling, using healthcare facilities, or seeking employment.

 Self-stigma/internalized stigma

Self-stigma, or internalized stigma, has an equally damaging effect on the mental wellbeing of
people living with HIV or from key affected populations. This fear of discrimination breaks down
confidence to seek help and medical care.
  Governmental stigma

A country’s discriminatory laws, rules and policies regarding HIV can alienate and exclude
people living with HIV, reinforcing the stigma surrounding HIV and AIDS. In 2014, 64% of
countries reporting to UNAIDS had some form of legislation in place to protect people living
with HIV from discrimination. While, conversely, 72 countries have HIV-specific laws that
prosecute people living with HIV for a range of offences.
 Healthcare stigma

Healthcare professionals can medically assist someone infected or affected by HIV and provide
life-saving information on how to prevent it. However, HIV-related discrimination in healthcare
remains an issue and is particularly prevalent in some countries. It can take many forms,
including mandatory HIV testing without consent or appropriate counselling. Health providers
may minimize contact with, or care of, patients living with HIV, delay or deny treatment,
demand additional payment for services and isolate people living with HIV from other patients.

Ending HIV stigma and discrimination

In March 2016, UNAIDS and WHO’s Global Health Workforce Alliance launched the Agenda for
Zero Discrimination in Healthcare. This works towards a world where everyone, everywhere,
can receive the healthcare they need with no discrimination, in line with The UN Political
Declaration on Ending AIDS. Zero discrimination is also at the heart of the UNAIDS vision, and
one of the targets of its Fast-Track response. This focuses on addressing discrimination in
healthcare, workplace, and education settings.

HIV/AIDS GLOSSARY

CD4 - In molecular biology, CD4 (cluster of differentiation 4) is a glycoprotein that serves as a

co-receptor for the T-cell receptor (TCR). A CD4 count is a blood test to check the amount of
CD4 cells in the body. CD4 cells are a type of white blood cell. They play a key role in the
immune system. They alert other immune cells to the presence of infections such as bacteria
and other viruses in the body. CD4 cells are also a subset of immune cells called T cells.
 CD4 count Meaning

500–1,600 cells/mm3 Most people without HIV have this level.

250–500 cells/mm3 The immune system is compromised, and one reason could be HIV.

Under 200 cells/mm3 A doctor will diagnose AIDS.

WINDOW PERIOD - The time period that starts when a person becomes infected with the
human immunodeficiency virus (HIV) and ends when the body makes enough antibodies
against the virus or HIV DNA or RNA to be found with an HIV test.

VIRAL LOAD - A high viral load is generally considered about 100,000 copies, but you could
have 1 million or more. The virus is at work making copies of itself, and the disease may
progress quickly. A lower HIV viral load is below 10,000 copies.

VERTICAL TRANSMISSION – a transmission of HIV from mother to child

ANALYSIS: WHAT ARE THE IMPACTS OF GLOBAL HEALTH ISSUES?

 economic costs of infectious diseases.

 reduced profitability and decreased foreign investment

 increase government’s debt.

 serious effect on the economic growth of some poor countries.

 make households property exhausted, indebted, and reduce their essential

consumption.

ANALYSIS: PURPOSE OF GLOBAL HEALTH

Global health plays an increasingly crucial role in both global security and the security of the
country’s population. As the world and its economies become increasingly globalized, including
extensive international travel and commerce, it is necessary to think about health in a global
context.

ANALYSIS: IMPORTANCE OF GLOBAL HEALTH

Global health initiatives were established to tackle increasing global health threats, reduce
disparities within communities and between nations and contribute to a world where people
live healthier, safer, and longer lives.