A  I  D  S
INTRODUCTION:

"It is estimated that by the end of 20th century there were 40 million people infected with HIV all over the world and India has been leading with highest number of cases (ranging from 10-20 million). We may not be infected but will definitely be affected indirectly by it. Hence it is a duty of every citizen of India to have detailed knowledge about this disease".

Due to lack of knowledge about AIDS people have fear in their mind against the victims of this disease. Because of fear of social boycott, AIDS patients and their relatives hide their HIV status. Many doctors (due to fear of getting infection) also refuse to treat these patients. There is danger of AIDS for everybody and only thing that can save us is to be completely informed.

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New law to fight HIV discrimination
Friday, May 26, 2006 
NEW DELHI: The Centre is set to bring in a comprehensive legislation to prevent discrimination against HIV-positive persons in all spheres of public life, including the private sector. 

Drafted by the Union health ministry in consultation with experts and affected persons, the proposed HIV/AIDS Bill 2006 to be introduced in the Monsoon session of Parliament is the first specific legal measure to prohibit discrimination against HIV-positive persons, especially in jobs, education, healthcare, travel and insurance. 

Though India has a national AIDS prevention and control policy, it does not have the status of law and is not enforceable in court. For instance, a person claiming to have lost her job because she is HIV-positive cannot necessarily seek redress in court on the basis of the policy. 

"The Bill aims to address several gaps in the existing laws and policies," health secretary P K Hota said. 

"The most important are the anti-discrimination provisions which will apply to the private sector also." 
 

What is AIDS? What causes AIDS? 

AIDS stands for Acquired Immune Deficiency Syndrome. 

An HIV-positive person receives an AIDS diagnosis after developing one of the CDC-defined AIDS indicator illnesses. An HIV-positive person can also receive an AIDS diagnosis on the basis of certain blood tests (CD4 counts) and may not have experienced any serious illnesses. A positive HIV test does not mean that a person has AIDS. A diagnosis of AIDS is made by a physician according to the CDC AIDS Case Definition. 

Over time, infection with HIV (Human Immunodeficiency Virus) can weaken the immune system to the point that the system has difficulty fighting off certain infections. These types of infections are known as opportunistic infections. Many of the infections that cause problems or that can be life-threatening for people with AIDS are usually controlled by a healthy immune system. The immune system of a person with AIDS has weakened to the point that medical intervention may be necessary to prevent or treat serious illness

What are the Symptoms of AIDS? 

There are no common symptoms for individuals diagnosed with AIDS. When immune system damage is more severe, people may experience opportunistic infections (called opportunistic because they are caused by organisms which cannot induce disease in people with normal immune systems, but take the "opportunity" to flourish in people with HIV). Most of these more severe infections, diseases and symptoms fall under the Centers for Disease Control's definition of full-blown "AIDS." The median time to receive an AIDS diagnosis among those infected with HIV is 7-10 years
 

What is the Difference Between HIV and AIDS? 

HIV is the virus that causes AIDS.

H - Human: because this virus can only infect human beings.
I - Immuno-deficiency: because the effect of the virus is to create a deficiency, a failure to work properly, within the body's immune system.
V - Virus: because this organism is a virus, which means one of its characteristics is that it is incapable of reproducing by itself. It reproduces by taking over the machinery of the human cell.

A - Acquired: because it's a condition one must acquire or get infected with; not something transmitted through the genes
I - Immune: because it affects the body's immune system, the part of the body which usually works to fight off germs such as bacteria and viruses
D - Deficiency: because it makes the immune system deficient (makes it not work properly)
S - Syndrome: because someone with AIDS may experience a wide range of different diseases and opportunistic infections.

Can I get HIV from oral sex? 

There is considerable debate within the HIV/AIDS prevention community regarding the risk of transmission of HIV through oral sex. What is currently known is that there is some risk associated with performing oral sex without protection; (there have been a few documented cases of HIV transmission through oral sex). While no one knows exactly what that risk is, cumulative evidence indicates that the risk is less than that of unprotected anal or vaginal sex. The risk from receiving oral sex, for both a man and a woman, is considered to be very low. 

Currently, risk reduction options when performing oral sex on a man (fellatio) include the use of latex condoms, but also include withdrawal before ejaculation without a condom (avoiding semen in the mouth) and/or refraining from this activity when cuts or sores are present in the mouth. 

When performing oral sex on a woman (cunnilingus), moisture barriers such as a dam (sheet of latex), a cut-open and flattened condom, or household plastic wrap can reduce the risk of exposure to vaginal secretions and/or blood. 

 

Can I get HIV from kissing? 

Casual contact through closed-mouth or "social" kissing is not a risk for transmission of HIV. Because of the potential for contact with blood during "French" or open-mouth, wet kissing, CDC recommends against engaging in this activity with a person known to be infected. However, the risk of acquiring HIV during open-mouth kissing is believed to be very low. CDC has investigated only one case of HIV infection that may be attributed to contact with blood during open-mouth kissing. In this case both partners had extensive dental problems including gingivitis (inflammation of the gums). It is likely that there was blood present in both partners' mouths making direct blood to blood contact a possibility. 
 

Can I get HIV from casual contact (shaking hands, hugging, using a toilet, drinking from the same glass, or the sneezing and coughing of an infected person)? 

No. HIV is not transmitted by day to day contact in the home, the workplace, schools, or social settings. HIV is not transmitted through shaking hands, hugging or a casual kiss. You cannot become infected from a toilet seat, a drinking fountain, a doorknob, dishes, drinking glasses, food, or pets. 

HIV is a fragile virus that does not live long outside the body. HIV is not an airborne or food borne virus. HIV is present in the blood, semen or vaginal secretions of an infected person and can be transmitted through unprotected vaginal, oral or anal sex or through sharing injection drug needles. 

Can a woman give HIV to a man during vaginal intercourse? 

Yes. If the woman is infected, HIV is present in vaginal and cervical secretions (the wetness in a woman's vagina) and can enter the penis through the urethra (the hole at the tip) or through cuts or abrasions on the skin of the penis. The presence of other STDs can increase the risk of transmission. The correct and consistent use of a latex condom or female condom can reduce the risk of transmitting HIV during vaginal intercourse. 
 

How long does it take for HIV to cause AIDS? 

Currently, the average time between HIV infection and the appearance of signs that could lead to an AIDS diagnosis is 8-11 years. This time varies greatly from person to person and can depend on many factors including a person's health status and behaviors. Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS. As with other diseases, early detection offers more options for treatment and preventative health care. 

What's the connection between HIV and other sexually transmitted diseases? 

Having a sexually transmitted disease (STD) can increase a person's risk of becoming infected with HIV, whether or not that STD causes lesions or breaks in the skin. If the STD infection causes irritation of the skin, breaks or sores may make it easier for HIV to enter the body during sexual contact. Even an STD that causes no breaks or sores can stimulate an immune response in the genital area that can make HIV transmission more likely. 
 

Where did HIV come from? 

The most recent presentation on the origin of HIV was presented at the 6th Conference on Retroviruses and Opportunitistic Infections (Chicago, January 1999). At that conference, research was presented that suggested that HIV had "crossed over" into the human population from a particular species of chimpanzee, probably through blood contact that occurred during hunting and field dressing of the animals. The CDC states that the findings presented at this conference provide the strongest evidence to date that HIV-1 originated in non-human primates. The research findings were featured in the February 4,1999 issue of the journal, Nature. 

We know that the virus has existed in the United States, Haiti and Africa since at least 1977-1978. In 1979, rare types of pneumonia, cancer and other illnesses were being reported by doctors in Los Angeles and New York. The common thread was that these conditions were not usually found in persons with healthy immune systems. 

In 1982 the Centers for Disease Control and Prevention (CDC) officially named the condition AIDS (Acquired Immune Deficiency Syndrome). In 1984 the virus responsible for weakening the immune system was identified as HIV (Human Immunodeficiency Virus).
 

How many people have HIV and AIDS? 

Worldwide: UNAIDS estimates that as of December 2000, there were an estimated 36.1 million people living with HIV/AIDS (34.7 million adults and 1.4 million children under 15). Since the epidemic began, an estimated 21.8 million people have died of AIDS (17.5 million adults and 4.3 million children under 15). 

An estimated 5.3 million new HIV infections occurred in 2000. During 2000, HIV- and AIDS-associated illnesses caused deaths of an estimated 3 million people, including 500,000 children under the age of 15. 

In the United States: According to the Centers for Disease Control and Prevention (CDC), there are between 800,000 and 900,000 people living with HIV. Through December 2000, a total of 774,467 cases of AIDS have been reported to the CDC; of this number, 448,060 persons (representing 58% of cases) have died
 

How can I tell if I'm infected with HIV? 

The only way to determine whether you are infected is to be tested for HIV infection. You can't rely on symptoms to know whether or not you are infected with HIV. Many people who are infected with HIV don't have any symptoms at all for many years. 

Similarly, you can't rely on symptoms to establish that a person has AIDS. The symptoms associated with AIDS are similar to the symptoms of many other diseases. AIDS is a diagnosis made by a doctor based on specific criteria established by the Centers for Disease Control and Prevention (CDC). 


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What are the Symptoms of HIV? 

Primary HIV infection is the first stage of HIV disease, when the virus first establishes itself in the body. Some researchers use the term acute HIV infection to describe the period of time between when a person is first infected with HIV and when antibodies against the virus are produced by the body (usually 6- 12 weeks). 

Some people newly infected with HIV will experience some "flu-like" symptoms. These symptoms, which usually last no more than a few days, might include fevers, chills, night sweats and rashes (not cold-like symptoms). Other people either do not experience "acute infection," or have symptoms so mild that they may not notice them.

Given the general character of the symptoms of acute infection, they can easily have causes other than HIV, such as a flu infection. For example, if you had some risk for HIV a few days ago and are now experiencing flu-like symptoms, it might be possible that HIV is responsible for the symptoms, but it is also possible that you have some other viral infection
 

How is HIV Transmitted? 

HIV can be transmitted from an infected person to another through: 

Blood (including menstrual blood) 
Semen 
Vaginal secretions 
Breast milk 
Blood contains the highest concentration of the virus, followed by semen, followed by vaginal fluids, followed by breast milk.
* Activities That Allow HIV Transmission 

Unprotected sexual contact 
Direct blood contact, including injection drug needles, blood transfusions, accidents in health care settings or certain blood products 
Mother to baby (before or during birth, or through breast milk) 
Sexual intercourse (vaginal and anal): In the genitals and the rectum, HIV may infect the mucous membranes directly or enter through cuts and sores caused during intercourse (many of which would be unnoticed). Vaginal and anal intercourse is a high-risk practice.

Oral sex (mouth-penis, mouth-vagina): The mouth is an inhospitable environment for HIV (in semen, vaginal fluid or blood), meaning the risk of HIV transmission through the throat, gums, and oral membranes is lower than through vaginal or anal membranes. There are however, documented cases where HIV was transmitted orally, so we can't say that getting HIV-infected semen, vaginal fluid or blood in the mouth is without risk. However, oral sex is considered a low risk practice.

Sharing injection needles: An injection needle can pass blood directly from one person's bloodstream to another. It is a very efficient way to transmit a blood-borne virus. Sharing needles is considered a high-risk practice.

Mother to Child: It is possible for an HIV-infected mother to pass the virus directly before or during birth, or through breast milk. Breast milk contains HIV, and while small amounts of breast milk do not pose significant threat of infection to adults, it is a viable means of transmission to infants.

The following "bodily fluids" are NOT infectious: 
Saliva 
Tears 
Sweat 
Feces 
Urine 

How effective are latex condoms in preventing HIV? 

Several studies have demonstrated that latex condoms are highly effective in preventing HIV transmission when used correctly and consistently. These studies looked at uninfected people considered to be at very high risk of infection because they were involved in sexual relationships with HIV-infected persons. The studies found that even with repeated sexual contact, 98-100% of those people who used latex condoms consistently and correctly remained uninfected. 
 

What if I test HIV positive? 

If you test positive, the sooner you take steps to protect your health, the better. Early medical treatment, a healthy lifestyle and a positive attitude can help you stay well. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. It is important to know that a positive HIV test should always be confirmed, to be sure that it is a true positive. If your test result is positive, there are a number of important steps you can take immediately to protect your health: 

See a doctor, even if you don't feel sick. Try to find a doctor who has experience treating HIV. There are now many new drugs to treat HIV infection. There are important tests, immunizations and drug treatments that can help you maintain good health. It is never too early to start thinking about treatment possibilities. 
Have a tuberculosis (TB) test done. You may be infected with TB and not know it. Undetected TB can cause serious illness. TB can be treated successfully if detected early. 
Recreational drugs, alcoholic beverages and smoking can weaken your immune system. There are programs available to help you stop. 

How long after a possible exposure should I be tested for HIV?? 

The time it takes for a person who has been infected with HIV to seroconvert (test positive) for HIV antibodies is commonly called the "Window Period."

The California Office of AIDS, published in 1998, says about the window period: "When a person is infected with the HIV virus, statistics show that 95-97% (perhaps higher) of all infected individuals develop antibodies within 12 weeks (3-months)." 

The National CDC has said that in some rare cases, it may take up to six months for one to seroconvert (test positive). At this point the results would be 99.9% accurate. 

* What does this mean for you? 

The three-month window period is normal for approximately 95% of the population. If you feel any anxiety about relying on the 3-month result, by all means you should have another test at 6 months. 


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When do you know for sure that you are not infected with HIV? 

The tests commonly used to determine HIV infection actually look for antibodies produced by the body to fight HIV. According to the Centers for Disease Control and Prevention (CDC), most people will develop detectable antibodies within 3 months after infection. In rare cases, it can take up to six months. Therefore, the CDC recommends testing at 6 months after the last possible exposure. (unprotected vaginal, anal or oral sex or sharing injecting drug needles). It would be extremely rare to take longer than six months to develop detectable antibodies. It is important, during the six months between exposure and the 6-month test, to protect yourself and others from further exposures to HIV. The CDC National AIDS Hotline can provide more information and referrals to testing sites in your area. 
 

What is the difference between an Anonymous and a Confidential Test? 

Anonymous and Confidential use the same testing method. The only difference is one does not have your name attached to the results.

Anonymous antibody testing is available at Anonymous Test Sites in most California counties. Anonymous testing means that absolutely no one has access to your test results since your name is never recorded at the test site.

Confidential antibody testing means that you and the health care provider know your results, which may be recorded in your medical file.
 

Which test should I have done: Anonymous or Confidential? 

It is recommended that one have an anonymous test. The results will only be known to you and will not appear on any records. 

Some reasons that one would need a confidential test would be: a result is required for immigration purposes or for some international travel visas; a pregnant woman who is clearly at risk might choose to be tested through her doctor, rather than anonymously, since the result is of key importance to the course of her medical care. 

I have heard there are many different types of HIV tests. How do I know which one I should take? 

The combination of an Eliza/Western Blot HIV Antibody Test is the accepted testing method for HIV infection. This combination test is looking for the antibodies that develop to fight the HIV virus. There are two ways to conduct this test. Either through a blood draw or through the "Orasure" method (a sample of oral mucus obtained with a specially treated cotton pad that is placed between the cheek and lower gum for two minutes). Both forms, by blood draw or orally, have the same accuracy with their results.

Other tests that you will hear about are Viral Load tests. These tests are used by physicians to monitor their patients who have already tested positive for HIV antibodies. Viral Load tests are very costly and should not be used to determine if one is HIV positive.
 

What do test results mean?

A positive result means:

You are HIV-positive (carrying the virus that causes AIDS). 
You can infect others and should try to implement precautions to prevent doing so. 
A negative result means: 
No antibodies were found in your blood at this time. 
A negative result does NOT mean: 
You are not infected with HIV (if you are still in the window period). 
You are immune to AIDS. 
You have a resistance to infection. 
You will never get AIDS. 

If I test positive, does that mean that I will die? 

Testing positive for HIV means that you now carry the virus that causes AIDS. It does not mean that you have AIDS, nor does it mean that you will die. Although there is no cure for AIDS, many opportunistic infections that make people sick can be controlled, prevented or eliminated. This has substantially increased the longevity and quality of life for people living with AIDS.
 

If I test HIV negative does that mean that my partner is HIV negative also? 

No. Your HIV test result reveals only your HIV status. Your negative test result does not tell you about the HIV status of your partner(s). HIV is not necessarily transmitted every time there is an exposure. 

No one's test result can be used to determine another person's HIV status. 
 

Is there anything I can do to stay healthy? 

The short answer is yes. There are things that you can do to stay healthy.

Emotional support may be very important for HIV-positive people because it breaks the isolation and provides a safe way of sharing both feelings and practical information.

Medical Care: Once you find a doctor or clinic, your main objective is to get an evaluation of your general health and immune function.

Many doctors do the following: 

Administer lab tests to evaluate your immune system. 
Determine if you have other diseases that might become problematic in the future, including syphilis, TB, hepatitis-B, and toxoplasmosis. 
If you are already infected with one or more of these other illnesses, there may be treatments or prophylaxis available to prevent it from becoming more serious or recurring in the future. If you're not already infected, doctors may be able to prevent future infection by:

Administering vaccines. Many HIV positive people get a hepatitis-B vaccine and bacterial pneumonia vaccines, since contracting these diseases could be dangerous for immune suppressed people. 
Prescribing antiviral treatments and protease inhibitors when tests show immune system impairment. 
Scheduling regular checkups. Checkups may be scheduled every three to six months. Some people need more frequent check-ups, particularly when they are starting new antiviral drugs. 

HIV is present to variable degrees in the blood and genital secretions of virtually all individuals infected with HIV, regardless of whether or not they have symptoms. The spread of HIV can occur when these secretions come in contact with tissues such as those lining the vagina, anal area, mouth, or eyes (the mucus membranes), or with a break in the skin, such as from a cut or puncture by a needle. The most common ways in which HIV is spreading throughout the world include sexual contact, sharing needles, and by transmission from infected mothers to their newborns during pregnancy, labor (the delivery process), or breastfeeding. (See the section below on treatment during pregnancy for a discussion on reducing the risk of transmission to the newborn.)

Sexual transmission of HIV has been described from men to men, men to women, women to men, and women to women through vaginal, anal, and oral sex. The best way to avoid sexual transmission is abstinence from sex until it is certain that both partners in a monogamous relationship are not HIV-infected. Because the HIV antibody test can take up to six months to turn positive after infection occurs, both partners would need to test negative six months after their last potential exposure to HIV. If abstinence is out of the question, the next best method is the use of latex barriers. This involves placing a condom on the penis as soon as an erection is achieved in order to avoid exposure to pre-ejaculatory and ejaculatory fluids that contain infectious HIV. For oral sex, condoms should be used for fellatio (oral contact with the penis) and latex barriers (dental dams) for cunnilingus (oral contact with the vaginal area). A dental dam is any piece of latex that prevents vaginal secretions from coming in direct contact with the mouth. Although such dams occasionally can be purchased, they are most often created by cutting a square piece of latex from a condom.

The spread of HIV by exposure to infected blood usually results from sharing needles, as in those used for illicit drugs. HIV also can be spread by sharing needles for anabolic steroids to increase muscle, tattooing, and body piercing. To prevent the spread of HIV, as well as other diseases including hepatitis, needles should never be shared. At the beginning of the HIV epidemic, many individuals acquired HIV infection from blood transfusions or blood products, such as those used for hemophiliacs. Currently, however, because blood is tested for both antibodies to HIV and the actual virus before transfusion, the risk of acquiring HIV from a blood transfusion in the United States is extremely small and is considered insignificant.

In 1981, homosexual men with symptoms of a disease that now are considered typical of the acquired immunodeficiency syndrome (AIDS) were first described in Los Angeles and New York. The men had an unusual type of lung infection (pneumonia) called Pneumocystis carinii (now known as Pneumocystis jiroveci) pneumonia (PCP) and rare skin tumors called Kaposi's sarcomas. The patients were noted to have a severe reduction in a type of cell in the blood that is an important part of the immune system, called CD4 cells. These cells, often referred to as CD4 T cells, help the body fight infections. Shortly thereafter, this disease was recognized throughout the United States, Western Europe, and Africa. In 1983, researchers in the United States and France described the virus that causes AIDS, now known as the human immunodeficiency virus (HIV) and belonging to the group of viruses called retroviruses. In 1985, a blood test became available that measures antibodies to HIV that are the body's immune response to the HIV. This blood test remains the best method for diagnosing HIV infection. Recently, tests have become available to look for these same antibodies in blood and saliva, some providing results within 20 minutes of testing.

(Source: Centers for Disease Control - CDC)
(Source: San Francisco AIDS Foundation)
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