How is HIV different than AIDS? An HIV primer


This year marks 35 years since AIDS was first recognized by the CDC. News of the highly-fatal AIDS epidemic was initially met with profound concern, panic and confusion. Still today, there are plenty of misconceptions about what HIV and AIDS are, and who is affected.  In honor of World AIDS Day, we’ll provide an abbreviated history of the discovery of HIV and AIDS, discuss how they’re different, and talk about how you can get tested for FREE!

AIDS and HIV: A super-duper brief history

In 1981, the Centers for Disease Control and Prevention (CDC) received several reports of a rare cancer, typical only among those with severely compromised immune systems and the elderly, among young gay men. Suspecting that there may be other factors at-play, the CDC began an investigation. At this stage of the epidemic, there was no identifiable cause and no single name for the phenomenon. Various organizations referred to it with different names, among them “gay-related immune deficiency” (GRID).  As the epidemic spread, it became clear that several groups were affected, including injection drug users, hemophiliacs and Haitians.  The CDC proposed using a unifying name for the condition, as there was mounting evidence that it was not limited to the gay community. In 1982, with over 400 cases reported globally, the CDC proposed the term “Acquired Immune Deficiency Syndrome” or (AIDS). Around the same time, cases of mother-to-child transmissions of AIDS were reported, and a child who had received blood transfusions also appeared to have developed AIDS. Cases of AIDS among women who have sex with men were recorded. All of these cases provided evidence that an infectious agent was likely responsible for AIDS, and suggested several possible routes of transmission: through blood, breast milk, and sexual activity. In 1986, at least five years after AIDS cases were initially reported, the name for the virus that causes AIDS was born: “Human Immunodeficiency Virus”, or HIV.

AIDS vs. HIV?

The history of AIDS and HIV helps clarify how and why they’re different. Contrary to the widespread belief, HIV is not a disease. It is a virus – but a pretty serious one. Our bodies are able to fight off other viruses like the common cold, but for some reason, we just can’t rid our bodies of HIV. Our immune system is comprised of various types of cells, each having special roles to fight off infections. HIV attacks one such cell, the CD4 cell. The higher your CD4 cell count, the stronger your immune system is and the better you are at fighting infections. HIV attacks our CD4 cells by entering them and becoming part of their life cycle. Think of…mind control. When HIV takes over a CD4 cell, it no longer thinks it is a CD4 cell. When the CD4 cell (with its brain taken over by the virus) tells itself to ‘replicate,’ HIV replicates. This leads to an increase in HIV, a decrease in CD4, and a compromised immune system. If the CD4 cell count drops significantly, an individual has AIDS, or Acquired Immune Deficiency Syndrome.

https://i1.wp.com/aids.gov/images/aids-infographics/what-is-hiv-aids-2.jpg

Image from http://aids.gov

AIDS refers to a syndrome, meaning the presence of clinical features or phenomena (example:  weakened immune system). HIV is a necessary but not sufficient cause of AIDS. In other words, HIV infection always precedes AIDS, but HIV doesn’t always develop into AIDS. HIV can be detected with a variety of tests that identify either HIV itself or circulating HIV antibodies. AIDS diagnosis is more complicated, and requires the presence of certain signs and symptoms, such as decreased white blood cell count and certain  AIDS-defining illnesses.

Who gets HIV?
Given that HIV can be transmitted through sex, contaminated sharp instruments or breastfeeding, almost all individuals are at risk. HIV transcends geographic, socioeconomic, political, racial, and gender boundaries. Some individuals have a higher risk than others depending on how often they are exposed to the following four fluids that transmit HIV: blood, vaginal fluid, semen and breast milk.

A person’s sexual network (a group of people one individual is connected to through sexual contact), which may be influenced by race, socioeconomic status, and sexual orientation, may also influence his/her/zir risk for contracting HIV. Think of it in terms of probability. Let’s say Person A is an African American man who has sex with other men, and Person B is a White man who does not have sex with other men. Person A has a smaller number of potential sexual partners than Person B. In other words, Person A has a smaller sexual network. In terms of numbers, this means that if someone in Person A’s network becomes infected with HIV, he has a higher chance of also becoming infected even if he engages in the exact same level of “risky sexual behavior” as Person B.

HIV Prevention and Treatment
The key to prevention is education. With a lack of education about the truth, millions of individuals become infected because they believe HIV can’t impact them. In reality, specific communities have higher infection rates due to historical inequitable access to care and modern institutions that keep these communities at a lower socioeconomic status which maintains unequal access to care. Treatments for HIV exist, but are expensive.

Other than breaking down myths (which the Center for Aids Research is excellent at doing!), everyone needs to understand risks of sexual transmission BEFORE they put themselves in high-risk situations. The four fluids of HIV transmission (do you remember what they are? Blood, vaginal secretions, semen, and breast milk) along with education on proper condom use help prevent the spread of sexually transmitted infections and diseases -and (bonus!) unintended pregnancy. Everyone who has sex should get tested once a year or before embarking on a new sexual encounter, whichever comes first. Testing should be a regular part of healthy relationships.

HIV Testing

In honor of World AIDS Day, Student Wellness is hosting a FREE, walk-in HIV testing event in the Carolina Union from 10AM-4:45PM on December 1st (TODAY!). Please see our event page for more information. Additionally, at UNC Campus Health Services, we offer a rapid oral test (results available in about 20 minutes), and a blood test available every weekday. More information about HIV testing at UNC is available on the Campus Health webpage; for more information about making an HIV appointment with Student Wellness call 919.962.9355.

 

This post was compiled and updated based on two previous Healthy Heels blog posts, one written by Diana Sanchez, a PhD student in Public Health Epidemiology in 2012 and the other written by Jani Radhakrishnan, a MPH and City and Regional Planning Master’s Student. Both writers served as graduate student staff with wellness at UNC. 

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