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HIV/AIDS INFECTION: A THREATHENING

VIRAL DISEASE

By

Raymond G. Cervantes

John Rey Hesita

March, 2010

Mr. Armando Torrente

Professor

OUTLINE

I. Introduction-------------------------------------------------------------------------------------------1

A. Background of the Research-------------------------------------------------------------------------1

B. Statement of the Problem------------------------------------------------------------------ ----------3

C. Importance of the Paper------------------------------------------------------------------------------3

D. Definition of Terms ----------------------------------------------------------------------------------3

II. Body----------------------------------------------------------------------------------------------------5

A.Modes of Transmission of HIV/Aids (Direct Factors) ----------------------------------------5

1.Sexual Transmission-----------------------------------------------------------------------------------5

2,Mother to Child Transmission------------------------------------------------------------------------5

3.Transmission via Fomites-----------------------------------------------------------------------------5

4. Needles--------------------------------------------------------------------------------------------------5

5. Blood Traces--------------------------------------------------------------------------------------------6

6. Routine Medical Care---------------------------------------------------------------------------------6

B. Modes of Transmission of HIV/Aids (Indirect Factors)-------------------------------------7

1. Poverty--------------------------------------------------------------------------------------------------7

2.Civil war and Prostitution---------------------------------------------------------------------------8

3. Migration------------------------------------------------------------------------------------------------9

4. Role of Education------------------------------------------------------------------------------------10

C. Ways HIV/AIDS not transmitted-------------------------------------------- ------------------13

D. Solutions----------------------------------------------------------------------------------------------14

III. Conclusions-----------------------------------------------------------------------------------------15

IV. Bibliography---------------------------------------------------------------- -----------------------17

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I. INTRODUCTION

A. Background of the Research

The HIV/AIDS pandemic has caused 12 millions only in Africa excluding the arising

victims in the whole world. Unfortunately, the numbers are still increasing. Nowadays, two

strains of HIV have been identified. HIV-1 which is predominant in the United States and

Europe, and HIV-2 presents mostly in Africa. The CDC stigmatizes that most infection by

the HIV are caused by unprotected sexual contact with an infected person. In Sub Saharan

Africa, the HIV transmission by contact with objects containing blood products is facilitated

and remains high because of lack of adequate screening techniques, poverty and the lack of

education. The problem of war in Africa constitutes the main barrrier to the continent econo-

mical development. War leads to poverty and poverty is followed by prostitution. This inter-

action is a viscious cycle that should be take in consideration to resolve the problem of

AIDS in the Sub-Sahara as the origin of this viral disease. Studies are focused mainly on HIV

-1 in detriment to HIV-2.Despite the fact that antiretrovial drugs are availabl in developed

countries, it was and is still rare in Africa. Research should be impartial and exend on both

types of virus.

This study will focus on the HIV/AIDS INFECTION IN AFRICA as the origin of this

viral disease. Regrettably, the Sub- Saharan Africa is the most affected region from the

impact of the HIV virus. Indeed, according to Foster and Williamson, "Of the 49.7 million

HIV infections that had occurred worldwide, 72% were in sub-Saharan Africa ". Preoccupied

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by this alarming situation, this research will focus on the reasons why HIV/ AIDS is predo-

minant in Sub- Sahara Africa , the impact of the virus on the socioeconomic status of the

population. And also, some solutions will be enumerated to decrease the prevalence and inci-

dence of AIDS in developing countries.

B. Statement of the Problem

This research paper aims to answer the following questions:

1. What is HIV/Aids?

2. Where did it originate?

3. Who could be the possible victims?

4. What are the reasons that make HIV/Aids epidemic and a continuous disaster?

5. What should be done to resolve this problem?

C. Importance of the Paper

This research paper will supplement information to may people about HIV/Aids.

This will answer the questions of many people about this threatening viral disease as one of

the world’s most alarming global issue. This paper will provide new data about the topic, and this will also serve as bases for those students, recently conducting their research.

D. Definitions

HIV stands for Human Immune-Deficiency Virus. It is a member of the family Retroviridae. Retroviridae maintain their genetic information in the form of ribonucleic acid (RNA). HIV was first discovered by Professor Luc Montagnier in collaboration with

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Professor Gallo in 1983. Infection by the virus is responsible for AIDS which means Acquired Immune Deficiency Syndrome. AIDS is not a disease but as its name suggested a syndrome, meaning a group of signs (objective) and symptoms (subjective) with a common cause. Nowadays, two strains of HIV have been identified. HIV-1 which is predominant in the United States and Europe, and HIV-2 presents mostly in Africa.The AIDS stage is the last stage of infection characterized by a group of diseases called opportunist infections including in most cases Kaposi’s sarcoma, Histoplasmosis,Pneumocystis Carinii Pneumonia, tuberculosis that target the efficiency of the immune system. Tuberculosis constitutes the major threat for infected people in the Sub-Sahara. AIDS still increase the number of orphans in Africa. In the context of HIV/AIDS, an orphan is defined as a child whose either one or both parents have died before he/she gets to the age of 15 years. In consequence of this loneliness, they become vulnerable and their chances to success in live are reduced. Therefore, it becomes primordial to analyze the interaction between the social economic status of the population in the Sub-Sahara and AIDS in one part, and in the other hand AIDS as the cause of poverty.

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THREE-DIMENSIONAL STRUCTURE OF THE VIRUS

The following picture from molecular expressions (2005) represents the structure of the HIV virus. This picture exhibits specific characteristics of the virus such as the presence of envelope and a reverse transcriptase enzyme. In fact, these features of the HIV virus increase its resistance factor and constitute a barrier (exactly the reverse transcriptase) in the discovery of vaccine, and treatment to improve the life expectancy of people infected by the HIV virus.

As a retrovirus, HIV is capable of using an enzyme called reverse transcriptase which transcribes double stranded DNA from RNA and integrate the host cell genome. The virus attacks specific cells in the body: the T4 cells; macrophage cells; smooth muscle cells (arterial walls); dendritic cells which are antigenic presenting cells, lymph nodes HIV infection targets major systems in the body.

More than 25 years have passed since the first case of AIDS was reported and still the epidemic is uncontrollable mostly in poor areas such as in Africa sub-Saharan.

*Thesis Statement: HIV/AIDS is a slow and irreversible killer that constitutes a global health issue affecting the lives of many people.

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II. BODY

A.MODES OF TRANSMISSION OF HIV/AIDS (DIRECT FACTORS)

What are the reasons that make the HIV/AIDS epidemic in and a continuous disaster?

According to the Centers for Disease Control and Prevention (What is HIV?) the risks factors associated with the HIV infection require direct contact from one individual to another via body fluids specifically blood, semen, vaginal secretions, and breast milk.

Additionally, the CDC stigmatizes that most infections by the HIV virus are caused by unprotected sexual contact with an infected person. Moreover, people who do not have sex with one partner or engage in serial monogamy, anal intercourse, and those who have sex with people in advanced stage of infection, or people who have a Sexual Transmitted Disease are considered at higher risks of being contaminated by the HIV virus. Transmission can be passive and occur via an infected mother to a fetus during birth process or breastfeeding. However, antiretroviral can be used to attenuate the transmission from mother to child.

Another of the transmission of HIV is via fomites exposure (contaminated blood or blood products) which includes mainly sharing syringe or needle with an infected person. Currently, the mode of transmission via contaminated objects is very low compare to other mode of transmission. This decrease is due to the introduction in the 1980s of blood products screening. Another transmission is through needles, the sharing of needles among people who practice intravenous (IV) drug abuse is the second most common path by which HIV travels from person to person. Programs that allow the exchange of used needles for sterile

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ones have reduced the spread of blood-borne illness in other countries. Such programs are not favored in the United States, however, because of fears of encouraging drug abuse. So little blood is needed to pass on the virus that even being scratched by an infected needle can transmit AIDS. Unsterilized needles used for purpose are dangerous, including the needles of acupuncture, tattooing, ear or body piercing, and electrolysis (the removal of hair by electricity using needle. Another is, by blood traces. Only traces of whole cells are needed to convey the virus from person to person. Semen commonly carries HIV, but so can blood—the amount you see sometimes when brushing your teeth, for example. Passing this tiny amount of blood to a partner through intense, open-mouth kissing could possibly pass on the virus. Ordinary kissing poses little danger, especially in people with healthy mouths.

Virus is also transmittable through Routine Medical Care. A few years ago a story of a young woman who was infected with HIV by her dentist was cause for great concern. It

appeared that she had contracted the virus during a routine dental procedure. As the case

unfolded however, evidence seemed to indicate that her infection may not have been accidental. No one may ever know the truth, but this case helped to bring national attention to the importance of sanitation. The best protection against acquiring any infection from the office of a health-care provider is to notice whether the provider uses precautions such as those listed in the margin. If you find the health-care provider who doesn’t leave right away, and report the problem to your parents or the school nurse.However, in Sub Saharan Africa, the HIV transmission by contact with objects containing blood products is facilitated and remains high because of the lack of adequate screening techniques, the lack of education, and poverty.

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B. MODES OF TRANSMISSION OF HIV/AIDS (INDIRECT FACTORS)

1. Poverty

Consequently, to comprehend the sizeable spread of HIV/AIDS among the Sub-Saharan population, careful attention should be paid to specific risk factors (indirect factors) associated with Africa history were poverty and civil

war have always dominated the socioeconomic life of the population.

This map from the United Nations stressed the geographical diversity in the repartition of infected people in Africa. When analyzing the number of infected people in each countires, it becomes clear that the spread of HIV in africa varies in each region. This fact raises important question that should be answered to undertsand the reasons of the high incidence of HIV infection in the Sub Sahara region in order to preconize some solutions. Indeed, factors such as poverty, cultural norms, religion, urbanization, and war influenced the African society, and play a major role in the increase of prevalence of HIV/AIDS in the Sub Sahara.

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2. Civil war and Prostitution

The problem of war in Africa constitutes the main barrrier to the continent economical development. War does not build but destroys. Thereupon, it creates a situation of instabilitty that displays population from on place to another for safety. Moreover, poverty increasea as well as the number of refugees. War leads to poverty and poverty is followed by prostitution. To illustrate these interaction, the Norvegian Journal of Geography (The hiv/aids epidemic) states that «Recent civil wars in West Africa have ssen the deployment of peacekeeping operations. Sexual exploitation is frequently an element of persecution, particularly for refugee women». Hence, this situation provoked by political divergence first begin at a micro level to reach a huge spectrum where population become refugees and sometimes forced into prostitution in others countries. Sexual intercourse with

occassional partners plays a major role in the spread of AIDS mainly in poor countries where access to education or adequate protection are not available.

Without doubt, the impacts on the receiving countries become dramatical and sometimes uncontrollable as seing in the case of the Ivory Coast. For instance, to illustrate the impact of indirects factors in the extend of HIV epidemic between Sub-Sahran countries, comparaison could be made between the number of infected people in Ivory Coast (510, 000) and the number infected people in Senegal (44,000), a neighboring country. Senegal has less infected population because it has a better political stability ,and less immigrants because less economical opportunities (UNAIDS, 2006).

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3. Migration

Migration principally in West Africa countries is favorized by the Economic Community of West African States’ (ECOWAS) protocol of free movement of goods and services (Musibau, 2006). It becomes easier for population to settle in the country of their choice without strict control. Because of this reason, the Ivory Coast considered as a properious and hospitalitary country had a growing population from 6,700,000 in 1975 to 16,310,500 in 2000 (Atlapedia, 2006) with 40 percent of the population from neighboring countries looking for a better life or safety. This situation has been amplified with the politcal, ethnic and religious contradiction that dominates the country since 1999 (CNN, 2000).

Following the same pattern of migration, caused by urbanization during the 1980s, the number of infected population from HIV increased considerably in Cameroon from 0.5% in 1987 to 11% in 2000(UNAIDS, 2006).This raises an important point which is the education factor. In fact, the unavailability of adequate information and the lack of education have contributed to the rapid and uncontrolable spread of the virus among poor communities.

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4. The Role of Education

Additionally, most of Africans did not have access to education in the 1980’s. People did not want to hear about the epidemic, they did not feel concern about it. They sheilded their faces and prefered say that they were dying from malaria. Because of some cultural and religious beliefs some considered AIDS as a punishment from God, and people were afraid to get tested. A positive test could automatically mean rejection from family members and friends. It was an embarrassing situation, for a family to have her son or daughter dying from AIDS. AIDS was considered as a ‘western invention’ that had nothing to do with African people. In the Ivory Coast, AIDS (SIDA in French) had a different definitions among which “Syndrome Invente pour Decourager Les Amoureux’’ that can be translated in English as “Syndrom Invented to Discourage Lovers”. However, in the 1995, African population started to realize that many people were dying in the same way. A Father died, followed by

mother, and after younger children; and in some cases second or third wife. It was the beginning of a painful reality. The life expectancy dropped ranging between 33 to 58 Nevertheless, the majority of the population still refused to get testing. In the population perspective, having HIV is positively correlated to death not only by opportunist diseases, but also by depression and stress. This is because no cure has been found yet and access to medication to treat opportunists infections were questionable. Despite, the fact that medication (antiretrovial drugs) are available in developed countries, it was and is still rare in Africa.The following data shows the number of people going throught on AIDS treatment in 2005 in some African countries.

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|Countries |Estimated number needed |Estimated number on treatment |Treatment coverage |
| |treatment | | |
|Kenya |253,831 |38,000 |16% |
|South Africa |837,000 |104,600 |12% |
|Ethiopia |211,000 |16,400 |8% |
|Mozambique |199,000 |10,657 |5% |
|Zimbabwe |295,000 |15,000 |5% |
|D.R Congo |167,000 |5,327 |3% |
|Nigeria |538,000 |15,000 |2% |
|Tanzania |263,000 |8,300 |3% |

As it appears on this sheet, access to medications is limited in Sub-Saharan Africa. This problem interacts with the issue of testing (making testing decisions difficult). In addition to the fact that AIDS update stress infection HIV- 2 (predominant in Africa) develops slowly before reaching the AIDS stage in contrast to HIV-1, increases the risks of being infected by a partner who ignore his health status (Stine, 2005). This becomes a perpetual cycle that seems hard to remediate when taking in consideration the previous factors specific to the Sub –Saharan Africa that contribute to the rapid evolution of infection by the HIV virus.

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Furthermore, “most research are done on HIV -1 (mostly found in western population) in detriment to HIV -2 in Sub- Saharan Africa. Money that is needed to invest in Africa to control the HIV/AIDS epidemic or on researches represented a fraction of the money that is invest in the War on Irak (trillions of dollars). To illustrate the cost of the war in Iraq, Bryan Bender, the Washington Bureau chief for Jane’s defense and former Pentagon reporter claims in Budget office analysis that the war in Iraq could cost a trillion with “more than $ 500 billion on the day-to day combat operation”. As presented by Brian, the daily investment on the war in Iraq is enormous when only little is needed to to give hope to HIV/ AIDS patients in developing countries. When comparing the spending on war to this estimation from the Harvard Faculty Consensus “cost of treatment for the 1-3 million HIV infected Africans would be $1,100 – 3.3 billion /year;this range includes drugs, testing, directly observed therapy, clinical support and research”, it become obvious that more could be done to give hope to affected families in the Sub- Sahara. The analysis of these numbers is in contrast to the human rights. The Sub-Saharan African countries suffer from this imbalance, and play the passive role instead of being active. The shocking reality is they do not have the necessary resources to engage in research. They still depends on international help. As the result of this

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dependence, the number of infected people increase at an incredible rate. This graph from UNAIDS website shows a slow evolution of people living with the HIV/AIDS in the Sub-Sahara from 1980 – 1990. Then in the 1990s the number of cases doubled from 10 million to almost 30 million in 2001. “Over 42 million people are living with HIV/AIDS, and 74 percent of these infected people live in sub-Saharan Africa. An estimated one million people are currently living with HIV in the United States, with approximately 40,000 new infections occurring each year” (Until there is a cure). These numbers demonstrate that effort to reduce the epidemic should be specific and oriented toward campaign to sibilize the population, socioeconomic problems and access to treatment. Access to medication and poverty are key components of solution.

C. WAYS HIV/AIDS IS NOT TRANSMITTED

➢ Causal contact * Hugging or lightly kissing an HIV-infected person.

➢ Mosquitoes or other biting insects * Swimming with an HIV-infected person.

➢ Eating food prepared by HIV-infected people

➢ Blood donation

➢ Vaccination using sterilized needles

➢ Contact with unbroken, healthy skin

➢ Contact with tears, saliva, or sweat from an HIV-infected person

➢ Touching shared objects, including towels

➢ Wearing clothes of an HIV-infected person

➢ Using a toilet used previously by an HIV-infected person.

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D.SOLUTIONS

“HIV is actually an umbrella for two genetically distinct types of virus HIV-1 and HIV-2. embraces three genetically distinct groups .As stated previously, this book is about HIV-1 or HIV”. This passage illustrates the fact that researchers and studies are focus mainly on HIV -1. Indeed, it disavantages the Sub Saharan Africa countries whose population still struggle with the HIV-2 and do not possess large pharmaceutical industries to improve their conditions. Consequently, research should be impartial and exend on both types of virus. Peter Piot, who is the executive director of the joint United Nations Program recognizes that “this epidemic won’t be under control in any country until it is brought under control everywhere. This idea should be source of inspiration for researchers and anyone involved in the fight against HIV/AIDS pandemic. In this world dominated by globalization (immigration increases everyday, people travel from one place to another so diseases), it appears that only healing a small fraction of the infected population is not a strict measure to eradicate the disease. This measure is contradictory to the United Nations (UN) statement about human rights which emphasis equality between human beings.

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III.CONCLUSIONS

• HIV/AIDS is a slow and irreversible killer that constitutes a global health issue. “HIV is actually an umbrella for two genetically distinct types of virus HIV-1 and HIV-2. embraces three genetically distinct groups.

• HIV/Aids started in africa and continue to threaten the whole world.

• Its impacts on the population in Sub-Saharan Africa constitute a tragedy for

communities. HIV/AIDS affects active population and reduces the work force.

The HIV/AIDS pandemic has caused 12 millions only in Africa excluding the

arising victims in the whole world.

• Poverty, civil war, education, and no access to antiretroviral drugs account for

this continuous growth of infection.Other reasons are those indirect and direct

factors that also account for the growth of this disease.

• The positive and interactive correlation between poverty and HIV/AIDS, indicates that poverty and education should be targeting to resolve the tragedy that destroy families, villages and nations. Consequently, It becomes primordial to invest money on research to avoid a perpetual transmission of the virus worlwide.

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IV. BIBLIOGRAPHY

“Aids patients”. Retrieved August 10, 2007 from http://www.nigeriamasterweb.com

Africa’s orphan crisis: two model of care. (2007). Aids care.19 (3).p 326-329.

Bauman, R. (2004) Microbiology pathogenic RNA viruses. p 718. San Francisco Pearson Benjamin Cummings.

Foster, G. and Williamson, J. (2000). A review of current literature of the impact of HIV/AIDS on children in sub-Sahara. UNAIDS Geneva.
“History of AIDS and the HIV Virus”. (2007). Retrieved August 10, 2007 from http://www.aidsarchive.com

“Harvard faculty consensus”. (n.d).Retrieved August 15, 2007 from http://www.scn.org

Maps of Africa. Ancient astronomy of Africa. (n.d). Retrieved August 05, 2007 from http://hej3.as.utexas.edu

Molecular expressions. (2005). Structure and function of cells and virus. Retrieved august 06, 2007 from http://www.micro.magnet.fsu.edu

Musibau. (2006). Trade policy reform: regional integration and expert performance in the ECOWAS sub- region. Retrieved August 10, 2007 from https://www.gtap.agecon.purdue.edu

National aids control the hiv/aids.(2000).Cameroon

Peter Piot. (2005). Update on aids. San Franscisco. Daryl Fox. Pearson Education. p 13
Stine, G. (2005). Aids update. San Franscisco. Daryl Fox. Pearson Education.

Watstein, S. (1998).The aids dictionary. (1998). New York. p 1297.

Longe J. (2006).The gale encyclopedia of medicine.3rd Edition.Volume 2. Farmington Hills

The hiv/aids epidemic in sub – saharan Africa . (2005). Homogeneity or heterogeneity. Norwegian Journal of Geography. Oslo. Volume 59, p14-29
The Merk manual of diagnosis and therapy. (2006). 18th Edition. Merk Research Laboratories. West Point.

The ugandan experience.1999. Forgotten children: The Legacy of poverty and aids in Africa. Retrieved July 28,2007 from www.ithaca.edu

UNAIDS/WHO .(2006). Report on the global AIDS epidemic. Accessed August 05, 2007 from http://www.avert.org

Until there is a cure. (n.d). Retrieved13, 2007 from http://www.until.org

What is HIV? (2006). Center for Disease Control and Prevention. Accessed August 07, 2007 from http://www.cdc.gov