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HIV / AIDS Prevention – researchers first detected the human immunodeficiency VIRUS (HIV) that causes acquired immunodeficiency syndrome (AIDS) in the early 1980s. New HIV/AIDS infections peaked about a decade later and have since slowly but steadily declined to reach a point over the past decade of holding relatively steady in the United States at about 40,000 a year. Advances in treatment, however, have resulted in increasing numbers of people living with HIV. Though this marks an exciting milestone in the fight against HIV/AIDS, it also means the risk for INFECTIONis growing because more people are already infected. As well, health experts worry that improved treatment regimens that can forestall the transition from an HIV-positive status to AIDS may encourage complacency about HIV protection. AIDS remains ultimately fatal, and preventing infection remains the only cure. Though medical treatments can delay the disease’s progression, there are as yet no treatments that can eradicate the virus. Research continues to search for both a cure and a VACCINE.
Prevention efforts target two dimensions of HIV/AIDS infection, halting the spread of infection and early diagnosis and treatment for those who become infected. Because of the long period of time during which a person can be infected and not know it, health experts view early diagnosis as a preventive measure; because most people, once diagnosed as HIV-positive, will take the recommended precautions to prevent spreading the virus to others. People who do not know they have HIV often do not feel the need to take significant precautions. A special focus area is preventing perinatal infection, in which an HIV-positive woman passes the virus to her unborn child.
Preventing New Infections
A person gets HIV/AIDS from close and regular contact with the body fluids, such as BLOOD and SEMEN, of another person who already has the virus. Abstinence is the only certain way to prevent infection via sexual activity with a partner. Barrier methods to prevent the body fluids of one person from contact with the mucous tissues of the other person during sex are the most effective approaches to reduce the risk for transmitting HIV. Consistent use of latex condoms during sex (anal, vaginal, and oral intercourse) significantly reduces the risk of passing HIV from the infected partner to the noninfected partner. People who inject drugs and share needles and paraphernalia can spread HIV through blood-to-blood contact. Breast milk can also transmit the virus from mother to infant. The average length of time from infection to symptoms is about 10 years, during which time the person may not know he or she has HIV and can spread the infection to others.
In 1994 HIV/AIDS experts issued a recommendation to test high-risk pregnant women for HIV and to offer those with positive tests treatment with zidovudine (AZT), which slows the rate at which the virus replicates. This allows the infant’s IMMUNE SYSTEM to develop sufficiently to produce resistance against HIV and stave off infection. The result was a two thirds reduction in the number of infants born with HIV between 1994 and 1997. Since then, HIV/AIDS programs have made a concerted effort to extend HIV testing and AZT treatment to all pregnant women with the hope that congenital HIV infections will decline even further. Many health-care providers believe HIV testing should be among the routine screenings pregnant women undergo.
Early Diagnosis and Prevention
Nearly a million Americans live with HIV/AIDS yet about 250,000 of them—one in four—do not know they do. The virus can exist in the body for decades without progressing to the disease condition of AIDS. During this time, however, the virus remains active and can spread to other people. By the time symptoms begin to manifest, an important window of therapeutic opportunity has closed. Treatment can still contain the progression of disease for years, but symptoms progress and will increasingly diminish QUALITY OF LIFE.
In 2004 the US Food and Drug Administration (FDA) approved the first rapid test to detect HIV-1 antibodies in a fingerstick blood sample. HIV-1 is the form of the virus that causes nearly all AIDS infections in the United States. More extensive and precise blood tests then confirm positive results. The US Centers for Disease Control and Prevention (CDC) and other health organizations recommend HIV testing become part of the ROUTINE MEDICAL EXAMINATION to facilitate early diagnosis.
Key Measures for Preventing HIV/AIDS
- sexual abstinence
- when sexually active, latex condom use during every act of sexual intercourse unless in a longstanding monogamous relationship in which both partners have tested negative for HIV
- avoiding injectable drugs
- regular testing for all people who are sexually active
- frequent testing for people who engage in high-risk sexual behaviors (multiple sex partners, unprotected sex) or who use injectable drugs
- early intervention and monitoring for people who are HIVpositive, to start treatment at the most opportune times and to encourage preventive behaviors
See also OCCUPATIONAL HEALTH AND SAFETY; SEXUALLY TRANSMITTED DISEASES (STDS).