HIV/AIDS: Need We Say More? (Yes)

The spectrum that is HIV/AIDS is ubiquitous even amongst sexually transmitted diseases. It has scary statistics beside it, such as the global populace living with the disease, numbering at anywhere about 36 to 38 million people. It does not help that the storied history of HIV infection consists mostly of caution tales against misconceptions, folk remedies and stigmatization.

For a pandemic of such staggering breadth, the amount of general knowledge regarding it is surprisingly narrow. The esoteric details of the infection are widely known, the causative agent, a virus – the Human Immunodeficiency Virus and its strains are regularly invoked in popular media. The ways to acquire the infection are widely trumpeted as well – be it sexual contact, significant exposure to body fluids or mother-to-child.

Startlingly however, few people would be able to accurately instruct one in how life proceeds after infection. India hosts the third largest population of people living with HIV/AIDS, and it would be prudent to discover the challenges they face in day to day life.

Because, essentially, contracting HIV is not the end of the road. Relatively few of the people who contract HIV develop full-blown AIDS, and the period in between can range from two weeks to twenty whole years or more. The spectrum of HIV/AIDS is a chronic condition, which means that, with treatment and prudence in life, it is possible to live nearly unimpeded by the existence of an HIV infection.

Living with HIV – The key word is living, rather than HIV.

The first part is to seek help. Therapeutic intervention can increase longevity as well as quality of life.

A note here on the natural history of HIV/AIDS; a few weeks after infection, an acute stage develops. Fifty to ninety percent of infected individuals show flu-like symptoms, which are difficult to diagnose as HIV infection, for an average of a month or so.

The virus then silently progresses over a latent period, when no outward signs are visible. During this period, the virus infects and reduces the number of CD4+ T cells. These cells are important in maintaining the immune conditions of the body. As they decrease, other organisms which could have been fought off take hold and cause infections.

The final stage of the spectrum is when the T cells are virtually non-existent, which means that opportunistic infections become rather deadly. Pneumocystis pneumonia, Tuberculosis, esophagitis, diarrhoea, neurological and psychiatric disorders are among the commonly associated infections.

Further, since other viruses which promote the formation of tumors are facilitated, Kaposi’s sarcoma, B-cell lymphoma as well as invasive cervical cancers are so well associated with AIDS that they are considered to be the definitive diagnostic criteria to determine AIDS in a HIV infected person.

Therapeutic intervention in the form of antiretrovirals and the ilk early in the course of the HIV infection restricts the amount of damage it can do to the immunity, and a person can stay non-progressing from the latent stage of the disease.

The second and important bit, is to tell people, to build support and acceptance around oneself. The timing of the conversation is important as well. It does not do to isolate oneself just because of the presence of this infection. Dating, and marriage are both completely possible, simply with a little extra care. It is important to discuss the condition with the partner.

Sexual life may proceed unimpeded with care. Pre-infection prophylaxis for the partner, combined with the therapeutic antiretroviral therapy can drop the chance of infection by a great extent.

A certain degree of care must be maintained in day to day life while living with HIV infection. The immune system is slightly frail, and it must be supported wherever possible. Foodborne illnesses can be easily avoided by proper eating habits, and with a slight supplementation to boost the immune system.

Now, to move on to consider the paradoxically more esoteric and well-known aspects of HIV/AIDS.
The transmission of HIV infection occurs, as mentioned, primarily by three methods.

Sexual contact is the most common one. It can be prevented by practicing safe sex and taking appropriate measures specific to HIV infection as considered before. The viral load, that is, the amount of virus present in the body is an important factor in the risk of transmission, which can be lowered by ART. Having another STD simultaneously also increases the chance of infection.

Amongst body fluids, blood is the most common agent of transfer. In places where screening of blood before transfusion is not appropriately done, HIV infection is concurrently high. Similarly, this is the cause for transfer of infection via needles that may have been used by infected individuals which may occur during drug abuse or tattooing, etc.

There is no risk of acquiring HIV if exposed to feces, nasal secretions, saliva, sputum, sweat, tears, urine, or vomit unless these are contaminated with blood. Also, mosquitoes cannot transfer the infection from one person to another.

Those are a lot of words strung together, but they bear thinking upon. They imply that living with a person infected with HIV does not mean that you cannot share your things or your life with them, that you cannot touch, hug or reassure them, and it definitely does not mean that you cannot help wipe away their tears and hopefully bring a smile to their face.

HIV can be transmitted from mother to child during pregnancy, during delivery, or through breast milk resulting in infection in the baby. Appropriate measures taken against it however, can decrease the chances significantly.

The diagnosis of HIV infection is based on laboratory testing for antibodies against the virus, or if in an early stage, by detecting the genetic material of the virus itself. The latter is somewhat expensive and restricted however.

The spectrum of HIV/AIDS is further staged depending on the extent of immune suppression due to the infection by evidence of clinical signs and is primarily of interest to the treating physicians to determine the course of action and prognosis.

Speaking of which, the prognosis of HIV/AIDS is highly variable, however it has become largely a long-term disease rather than an acutely fatal one. With appropriate measures and a healthy outlook on life, a high quality of life is very probable.

Misconceptions about HIV/AIDS, unfortunately, are still widely prevalent. However, the excellent programmes initiated by the governments of the world is seeking to remedy this.

The origins of the spectrum of HIV/AIDS was murky due to the stigma associated with STDs, as well as the tendency to generalize such diseases to a certain way of life, and then ostracize those choices, which is notionally absurd. Rather, it does well to try and understand the reality of the situation and work together for a healthier future. We only fear the unknown, and all that is needed to do, is talk.

Delve deeper into our series on STD Awareness.

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