Almost three decades after the recognition of the disease process caused by the Human Immunodeficiency Virus (HIV), many people still do not know about the prevention, diagnosis and treatment of AIDS.
AIDS, also known as the Acquired Immunodeficiency Syndrome, is a disease resulting from damage to a person's immune system by the HIV virus. Specifically, the virus infects and destroys T-helper cells, a group of white blood cells essential to the body's defense against many forms of infection from common microbes.
The first cases of AIDS were recognized by scientists in 1981, while the connection between AIDS and the HIV virus was discovered in 1985. In the early years, many taboos about the illness developed.
The earlier stages of the illness often were not recognized. Treatments were not widely available, and progression to full-blown AIDS and AIDS-related deaths stoked fears about the illness. Because early reports linked the illness to homosexual men, it became permanently linked with this demographic - even though HIV is transmitted commonly by other means including heterosexual intercourse.
The stigma associated with HIV and AIDS has limited prevention efforts, including efforts targeting universal screening, promoted by the Centers for Disease Control and Prevention in recent years. The CDC recommends routine screening for HIV infection because many infected persons are not symptomatic and therefore are unaware of their infection. This results in ongoing spread of the illness, for which many simple preventive measures exist.
So where do we stand now?
Fortunately, in the intervening years since the recognition of AIDS as a new human illness, considerable progress has been made regarding prevention, diagnosis and treatment.
It is well-established that HIV can be transmitted by sexual intercourse, sharing of infected needles among IV drug users, and from mother to child during pregnancy, delivery or breast-feeding. Occupational exposures have been greatly minimized among the health-care community through practice of preventive measures during procedures. The risk of transfusion-associated HIV infection has been all but eliminated through rigorous screening of donated blood products.
Advancements in the diagnosis of HIV infection also are integral to the prevention of spread of the disease. Traditional test techniques for HIV infection have been augmented by approval of rapid testing techniques that permit rapid turnaround of test results.
Presently, the CDC recommends that all U.S. adolescents and adults know their HIV status. Each year in the U.S., approximately 20 million adults are tested for HIV with about 40 percent of the total U.S. adult population having been tested for HIV. However, among more than 1 million U.S. residents living with HIV, the CDC estimates that 1 in 5 do not know they have the disease.
Considerable advancement in the treatment of HIV, including the development of many new effective anti-viral medications, means that many Americans with HIV can survive long-term and symptom-free despite chronic viral infection. Considerable efforts also are under way to develop a vaccine to prevent disease transmission. Until then, knowledge about and avoidance of risk factors as well as recognition of HIV infection among the general population are essential to preventing spread of the illness.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Health Center in Towaoc.