AIDS Update 2014

Preface

Introduction: Histories of Global Pandemics, AIDS, Its Place in History, Overview of HIV/AIDS, International AIDS Conferences, and Means of Remembering—the AIDS Quilt, Candlelight Memorial, and World AIDS Day

How Much Do You Really Know about HIV/AIDS?
Three Words Echo Around the World: AIDS Crisis Worsens!
History of Global Pandemics and Epidemics
Fear, Ignorance, and Condemnation: Who Is to Blame?
Imagine a World without AIDS
Overview of HIV/AIDS
HIV/AIDS: A Unique Disease
HIV/AIDS: A Cause of Death
Another Anniversary
Other Anniversaries
International AIDS Conferences
Means of Remembering: Uncommon Threads
The 29th Candlelight Memorial
Walking to Change the Course of the HIV/AIDS Epidemic—United States
Bicycle Riding and Other Social Events to Change the Course of the HIV/AIDS Epidemic—United States
The AIDS Olympics
World AIDS Day: An International Day of Coordinated Action: A Time to Recharge and Reconnect
The Future
National AIDS Hotlines
Useful Internet Addresses
International Statistics
Acquired Immune Deficiency Syndrome (AIDS)

1.AIDS: Defining the Disease and Finding Its Cause

The New Millennium
AIDS: A Disease or a Syndrome?
First Reaction to AIDS: Denial
What Causes AIDS?
The Centers for Disease Control and Prevention Reports
Discovery of What Causes AIDS
Defining the Illness: AIDS and Surveillance
Summary
Review Questions

2. What Causes AIDS: Origin of the AIDS Virus

The Cause of AIDS: The Human Immunodeficiency Virus (HIV)
HIV Does Not Cause AIDS: Dissidents and Their Cults: A Minority Point of View
News Flash 2010—Leading HIV/AIDS Dissident Cleared of Misconduct Following Complaints Made after He and Others Published a 2009 Paper Arguing That There Is “As Yet No Proof That HIV Causes AIDS”
Dissidents’ Websites (AIDS Doesn’t Exist or HIV Isn’t the Cause)
Summary of HIV/AIDS Dissidents’ Viewpoints
Evidence That HIV Causes AIDS
Origin of HIV: The AIDS Virus
Summary on the Origin of HIV
Summary
Review Questions

3. Biological Characteristics of HIV

Viruses Need a Host Cell in Order to Replicate
Viruses Are Parasites
Viruses Specific to Cell Type
What Are CD4 Cells
How Do Human T4 or CD4+ Lymphocytes Relate to HIV Infection and AIDS?
Description of HIV; How It Attaches to a Host Cell and Buds Out of the Cell
HIV Fitness
The HIV Life Cycle
Understanding How HIV Works
How HIV Escapes the Infected Cell
Distinct Genotypes (Subtypes/Clades) of HIV-1 Worldwide Based on ENV and GAG Proteins
Unless Specified, the Information on HIV in this Book Relates only to HIV-1 Group M
Summary
Review Questions

4. Anti-HIV Therapy

Better Drugs, Better Technologies, and Lingering Problems
Antiretroviral Therapy or ART
The Good News About Antiretroviral Therapy (ART)
Antiretroviral Therapy (ART) Drugs with FDA Approval
The HIV Medicine Chest: ART Drugs Receiving FDA Approval
Use of Non-Nucleoside Analog Reverse Transcriptase Inhibitors
FDA-Approved Protease Inhibitors
Entry Inhibitors and Problems
Integrase Inhibitors
Development and Selection of HIV Drug-Resistant Mutants
Development of HIV Drug Resistance to Protease Inhibitors
How Combination or Combined Drug Therapy Can Reduce the Chance of HIV Drug Resistance
Viral Load: Its Relationship to HIV Disease and AIDS
Medical Complications Associated with Antiretroviral Therapies (ART)
Summary
Caution
Disclaimer
Some HIV/AIDS Therapy Information Hotlines
Review Questions

5. The Immunology of HIV Disease/AIDS

The Immune System
Human Lymphocytes: T Cells and B Cells
Why CD4+ Cells Are Important in HIV Infection—What It Means
The CD4+ Cell Count—Why It Matters
Antibodies and HIV Disease
HIV Eradication Currently Not Possible Because of Infection of Latent Resting CD4+ Cells and Immunologic Memory Cells
Immune System Dysfunction
Original Antigenic Sin
The Search for Additional Receptors (Coreceptors) to CD4: Fusin or CXCKR-4 (R-4)
CCKR-5 (R-5) Receptor
Emergence of HIV Strains that Vary in Their Lethal Abilities
In Search of Genetic Resistance to HIV Infection
T4 Cell Depletion and Immune Suppression
Impact of T4 Cell Depletion
Role of Monocytes and Macrophages in HIV Infection
Where Do T4 or CD4+ Cells Become HIV Infected?
Summary
Review Questions

6. Opportunistic Infections and Cancers Associated with HIV Disease/AIDS

What Is an Opportunistic Disease?
The Prevalence of Opportunistic Diseases
Opportunistic Infections in HIV-Infected People
TB: The Leading Cause of Death Among HIV-Positive People Worldwide
Cancer or Malignancy in HIV/AIDS Patients
Disclaimer
Summary
Review Questions

7. A Profile of Biological Indicators for HIV Disease, Progression to AIDS, and Hope

The Prediction
What Is Known and What Is Missing from Our Understanding of HIV/AIDS: The New Crisis
HIV Disease Defined
Stages of HIV Disease (Without Drug Therapy)
HIV Disease Without Symptoms, with Symptoms, and AIDS
Production of HIV-Specific Antibodies
Prognostic Biological Markers (Biomarkers) Related to AIDS Progression
HIV Infection of the Central Nervous System (CNS)
Neuropathies (Nerve Tissue Damage) in HIV Disease/AIDS Patients
Finally, A Renewed Hope for the Future of Those Who Are HIV Infected
Summary
Review Questions

8. Epidemiology and Transmission of the Human Immunodeficiency Virus

Epidemic/Epidemiology
We Must Stop HIV Transmission Now! But How?
Epidemiology of HIV Infection
Transmission of Two Strains of HIV (HIV-1/HIV-2)
The Ten Most Common Fears in the U.S.A. Associated with HIV Transmission—10 Being the Least and 1 Being the Most Feared
Is HIV Transmitted by Insects?
HIV Transmission
HIV Transmission in Family/Household Settings
Noncasual Transmission
Gay Men Putting Themselves at High Risk for HIV Infection
The Biological Factor
CDC HIV Transmission Risk, June 2012
Injection-Drug Users and HIV Transmission
United States: Heterosexual Injection-Drug Use (IDU)
Injection-Drug Use and HIV Infections in Other Countries
Other Means of HIV Transmission
Influence of Sexually Transmitted Diseases (STDs) on HIV Transmission and Vice Versa
Pediatric Transmission
National AIDS Resources
Summary
Challenge Your Assumptions about the HIV Infected
Review Questions

9. Preventing the Transmission of HIV

The AIDS Generation: “I Knew Everything about It, and I Still Got It!”
Prevention, Not Treatment, Is the Least Expensive and Most Effective Way to Reduce the Spread of HIV/AIDS. However, When Faced with Discrimination, Stigma, Alienation, and Marginalization, People Will Not Disclose Their Risk Factors, Use Condoms, Get Tested for HIV, Seek Treatment, or Talk Openly about HIV/AIDS.
Primary Goal of Prevention
Global Prevention
Antiretroviral Drugs Have an Impact on Prevention, But We Can’t Treat Our Way Out of This Pandemic
Advancing HIV Prevention: New Strategies for a Changing Epidemic
Preventing the Transmission of HIV
Sexual Risk Taking Depends on Sexual Activity
New Rules to an Old Game: Promoting Safer Sex—Nobody Has a Body to Die For!
The Male Condom
The Female Condom or Femidom (Vaginal Pouch)
An Alternative to Condoms: Vaginal Microbicides (Mi-cro-ba-cides) and Circumcision (Cir-cum-ci-sion)
The CAPRISA 004 Study Results
Circumcision and the Prevention of HIV Transmission
Injection-Drug Use (IDU) and HIV Transmission: The Twin Epidemics
HIV Prevention for Injection-Drug Users
Prevention of Blood and Blood Product HIV Transmission
Infection Control Procedures
Sexual Partner Notification: Disclosure
The U.S. Federal Government Has Now Adopted Partner Notification as Its Cornerstone in Its Effort to Help Control the Spread of HIV
Vaccines
The First Human Vaccine: The Impact of Vaccines on Infectious Diseases
The Journey Toward an HIV/AIDS Vaccine Now in Its 31st Year (1983–2014)
HIV Vaccine Development and Its Role in Prevention
How These Two Neutralizing Antibodies Work
Types of Experimental HIV Vaccines
DNA Vaccine
Problems in the Search for HIV Vaccine
September 2009—News Broken That a Partially Effective HIV Vaccine Was Found!
Summary
Five Ways You Can Help Prevent HIV/AIDS
Review Questions

10. Prevalence of HIV Infections, AIDS Cases, and Deaths among Select Groups in the United States and in Other Countries

A Word about HIV/AIDS Data
Year 2014
Formula for Estimating HIV Infections
Behavioral Risk Groups and Statistical Evaluation
Aging with HIV/AIDS: The Hidden Side of This Crisis in the United States
September 18: Annual National HIV/AIDS Aging Awareness Day
Estimates of AIDS Cases and HIV Infection
Shape of the HIV Pandemic: United States
Estimates of Deaths and Years of Potential Life Lost Due to AIDS in the United State
s
Selected Nations/Countries Have Different Epidemics. Each Faces Its Own Reality
Fast Facts
Canada’s Estimated HIV/AIDS Cases through 2013: Population about 34,310,000
Mexico’s Estimated HIV/AIDS Cases through 2013: Population about 115 Million
United Kingdom’s (UK) Estimated HIV/AIDS Data through 2013: Population about 63 Million
Global Prevalence and Impact of HIV/AIDS
Connected but Separate: Each Country a Different Reality, Different Countries, Similar Questions, but Different Answers, Different Epidemics
Workforce—South Africa: Some Examples
Education: Teachers and Students—South Africa and Some Countries in Southern Africa
Other HIV/AIDS Time Bombs in Asia: India, China, and Russia
Summary
CDC Releases Atlas Tool to Map, Chart U.S. HIV/AIDS Surveillance Data (January 2012)
Review Questions

11. Prevalence of HIV Infection and AIDS Cases among Women and Children

Women and HIV/AIDS
HIV/AIDS Is Defining the Lives of Many Millions of Women
Female Vulnerability to HIV
Every Day a Tragedy
Triple Jeopardy
Annual International Women’s Day—March 8
Women: AIDS and HIV Infections Worldwide
Asia-Pacific Region, Over Six Million HIV Positive
Women: HIV-Positive and AIDS Cases—United States
Childbearing Women: Worldwide
Internet Resources
Pediatric HIV-Positive and AIDS Cases—United States: A Fight We Can Win!
Orphaned Children Due to HIV Infection and AIDS
The Phenomenon of AIDS Orphans
Update 2013 on American Women and Breastfeeding—American Academy of Pediatrics
Summary
Review Questions

12. Prevalence of HIV Infection and AIDS among Young Adults, Ages 13 to 24

Global HIV Infections in Young Adults
Addressing the AIDS Pandemic among Young Adults: Know-Protect-Talk
How Large Is the Young Adult Population in the United States?
HIV/AIDS Won’t Affect Us!
Estimate of HIV-Infected and AIDS Cases among Young Adults in the United States, Globally
When Will Routine Testing for Human Immunodeficiency Virus Infection Be the Routine for Adolescents/Young Adults?
Summary
Internet
Other Useful Sources
Review Questions

13. Testing for Human Immunodeficiency Virus

Determining the Presence of Antibody Produced When HIV Is Present
Requests for HIV Testing
Reasons for HIV Testing: I Know, I Took the Test
Laboratory Methods for Detecting HIV
ELISA HIV Antibody Test
Western Blot Assay
New ELISA Antibody Antigen and RNA Detection Procedures Reveal Early Versus Late HIV Infection
Rapid Test Results for HIV Testing
FDA Approves Home-Collection HIV Antibody Test Kit
Some Screening and Confirmatory Antigen-Detection Tests for HIV
Deciding Who Should Get an HIV Test and When
Why Is HIV Test Information Necessary?
Immigration and Travel Ban into the United States Is Lifted
Testing, Privacy, Competency, and Informed Consent
Summary
Review Questions

14. AIDS and Society: Knowledge, Attitudes, and Behavior

HIV/AIDS Is a Story in Our Lifetime
The New Millennium and HIV/AIDS
HIV/AIDS Is an Unusual Social Disease
Discrimination and Stigma vs. Compassion and Support
HIV/AIDS Is Here to Stay
AIDS Comes to the United States
Blame Someone, Deja Vu
Fear: Panic and Hysteria over the Spread of HIV/AIDS in the United States
Whom Is the General Public to Believe?
AIDS Education and Behavior: Dissipating Fear with Education
The Character of Society
Dealing with Discrimination: The Americans with Disabilities Act
Update
Federal and Private Sector Financing: Creation of an AIDS Industry
U.S. Government Believes HIV/AIDS Is a Threat to National Security
Global HIV/AIDS Funding for Underdeveloped Nations
Unspent Global Funds?
Forms of U.S. Monetary Assistance for HIV/AIDS
Summary
Review Questions

Answers to Review Questions
Glossary
References
Index