Everyone knows the safer sex 'rules and regulations', but the fact that the number of women being infected world-wide with the HIV virus now equals that of men is proof that, while people may be listening, they are still not paying attention. The number of infected men, women and children is constantly on the increase and we should be asking ourselves 'why?'
The 13th Annual World AIDS Day which will take place on 1st December 2000
hopes to raise awareness and alert young people, especially those under
25 to, amongst other things, the fact that 16,000 people become infected
with the virus each day - approximately 6 people per minute. It's about
blowing the myths out of the water and making AIDS a subject which can be
talked about openly. It's not about assigning blame or denying responsibility,
it's about giving people hope, it's about stopping a deadly epidemic. "Working
with people under 25 is perhaps the best hope we have today of bringing
the epidemic under control," comments Dr. Piot, Executive Director
of the Joint United Nations Programme on HIV/AIDS (UNAIDS). He continues,
"All over the world, children and young people continue to be in the
line of the virus, and we have to ask ourselves why. A big part of the answer
is that adults spend too much time telling young people what to do without
listening to what they need: affection, close bonds with adults, and education
about healthy sexuality. In addition, we must speak out and loudly challenge
the violence, poverty and discrimination that create huge reservoirs of
HIV risk in young lives."
According to the World Health Organisation there are over 33.4 million people
living around the world with HIV/AIDS - a 10% rise in new infections. Over
95% of these cases live in the developing world and 95% of AIDS deaths have
occurred in the same region. Women aged 15 and above represent 43% of the
number infected placing women in the highest risk category.
Originally called GRID (Gay-Related Immune Disease) its name was changed
when it emerged that the virus did not only affect gay men. In 1982 the
Wall Street Journal published an article detailing reports of exactly who
the disease affected. It emerged that both men and women (regardless of
sexual orientation) new-born babies, intravenous drug users and haemophiliacs
had all been infected. What was once regarded by many as God's curse on
gay people had now revealed itself for what it really was - a disease which
attacks indiscriminately. Haemophiliacs had been celebrating the success
of a product called 'Factor VIII' only to discover that it was in fact killing
them. As blood transfusions became a routine part of medical practice, blood
was being distributed world-wide with minimal screening in place. In order
to produce the coagulant, which was the active ingredient in Factor VIII,
blood from thousands of individual donors had to be combined. Factor VIII
was then distributed across the globe to haemophiliacs, putting them in
the 'firing line' of this 'new' infection.
I say 'new' because until recently it had been assumed that HIV was a disease
which first emerged in the late 1970s, early 1980s. It has since been discovered
that a plasma sample taken from an adult male living in what is now the
Democratic Republic of Congo is the first known case of HIV - the sample
was taken in 1959. For forty years HIV has been allowed to grow silently.
It is unclear why there has been such a dramatic increase in the number
of infections, perhaps the virus mutated in some way to make it more virulent.
What is clear is that it has been around for longer than the general public
is aware, begging the question, 'why didn't someone do something in 1959?'.
Perhaps the technician who was looking at the sample didn't know, or didn't
want to know, what he/she was looking at. Whatever the reason, millions
of people across the globe are now paying the ultimate price. It is also
a mystery where the virus first emerged (the case in 1959 being the first
KNOWN case), but it has been in the bodily fluids of humans for far longer
than anyone ever dared imagine and it is widely assumed that sub-Sahara
Africa is the birthplace of AIDS. What is certain is that HIV/AIDS has emerged
and it is destroying everything in its path. Assumptions about the virus
and its origin are on offer from medical experts if you care to listen.
It's all mostly speculation, linking it to the simian virus SIV (Simian
Immundeficiency Virus) which has been found in certain types of chimpanzees
in Africa. Where it came from is no longer an issue, the virus has developed
and mutated so much, that even if the original source could be confirmed,
its use would be limited, if, any use at all. The theories of conspiracy
and of a genetically engineered disease are little more than paranoid ramblings
by people with little better to do. It was scientifically impossible to
engineer a disease like HIV in 1959. It has developed naturally, unaided
by humans.
HIV, the virus which it is now acknowledged leads to AIDS, attacks the immune
system in humans, restricting and eventually blocking altogether the body's
ability to fend off disease. When contracted, HIV can lie dormant in a person's
bodily fluids for up to ten years (in some rare cases longer) before developing
into AIDS. Because the person's immune system is impaired, they are more
likely to succumb to rare illnesses and cancers on top of 'ordinary' diseases.
At the moment, AIDS has a 100% mortality rate. The first virus to be isolated
was HIV1, a minuscule particle (1/10,000mm) which comprises numerous variants
classified into two groups. It consists of a protein coat which encapsulates
the RNA molecule and carries the genetic code for the virus. The core is
covered by an envelope which is composed of proteins and lipids. A second
virus has also been discovered and isolated by the Institut Pasteur and
at the Hôpital Claude Bernard in Paris from an area in West Africa.
It is called HIV2 and is less virulent than HIV1, but leads to the same
outcome - AIDS. HIV2 is not always detected by the serological tests used
for HIV1 but specific tests for HIV2 are now available.
HIV is extremely clever in the way that it works. The body's cells act like
miniature computers, communicating their codes in two languages - RNA (ribonucleic
acid) and DNA (deoxyribonucleic acid). In order to infect cells, the AIDS
virus must insert its genetic code, composed of RNA into the genetic code
of the CD4 lymphocytes (the co-ordinator of the immune system) which is
formed by DNA. RNA and DNA are incompatible so the virus transforms its
RNA code into DNA using a special enzyme, reverse transcriptase. Once the
virus has implanted its code into the code of the CD4 lymphocyte, it is
able to replicate at the expense of lymphocyte before destroying the cell
and impairing the immune system. The AIDS virus also infects other white
cells, the macrophages.
Between three weeks and six months 20-30% of infected subjects may develop
non-specific symptoms of a viral infection. Others experience no symptoms
at all. People infected with the virus start to produce antibodies against
HIV which are detected by a serological test between three weeks and six
months after the initial infection. The patient is then referred to as being
seropositive. During the second phase of infection some patients may develop
clinical symptoms and signs. Between several months and ten years after
infection about 20% of people will develop persistent clinical manifestations
including:
" Persistent increase (more than three months) in the volume if lymph
nodes in several parts of the body.
" Weight loss of more than 10% of the body weight
" Fever.
" Night sweats.
" Sever forms of Herpes (viral infection causing painful vesicles on
the skin).
" Persistent and abundant diarrhoea.
During the ten years following infection 60% of seropositive patients will
develop major signs and are considered to be suffering from AIDS. AIDS is
responsible for three groups of symptoms:
" Opportunistic infections which affect the lungs, producing a persistent
cough with a fever, the gastrointestinal tract leading to chronic diarrhoea
( 10 to 15 stools per day for a period of more than one month) and eating
difficulties, and finally the brain causing paralysis, visual disturbances,
meningitis and abnormal mental manifestations. The skin may develop cutaneous
herpes.
" Certain cancers, such as Kaposi's sarcoma, which is the cancer most
frequently associated with AIDS. It presents itself in the form of blue
or brown cutaneous plaques or nodules. These lesions are not only on the
skin but also in the lymph nodes, lungs and virtually all of the viscrea.
The risk of developing lymphoma (tumours of the lymph nodes) is also increased
by 100 times.
" Other manifestations as HIV acts directly on the central nervous
system inducing neurological lesions.
There's more to living with HIV/AIDS than just being careful sexually and
taking some pills every day. Studies have shown that 75-90% of sufferers
use alternative 'medicines' - homeopathy, massage, acupuncture, herbs and
vitamin supplements. When a person falls victim to HIV their bodies need
an increase in minerals and vitamins as staying healthy is imperative to
increase the time before the onset of AIDS. Deciding whether or not to take
supplements, and in what amounts, are important decisions which have to
be taken with care - too much of a good thing can, as we all know, be not
so good. Long-term studies have shown that it is well worth taking one multivitamin
and mineral supplement every day, ensuring that each supplement contains
one or two times the daily-recommended dose (RDA). People with HIV have
also been recorded as having deficiencies in vitamins A, E, B6, B12 and
zinc. Vitamins accomplish mighty tasks, many of which are still only being
discovered in the fight against HIV. Doses of Vitamin A above 9,000mcg in
men and 7,500mcg in women can be toxic, Vitamin E doses should be kept to
below 800mg per day, as amounts above this can cause adverse effects. Minerals
are natural elements that the body requires to perform various functions
and help keep the immune system healthy. Minerals such as zinc, selenium
and iron are receiving a lot of praise for the various roles they play in
fighting HIV. Selenium works alongside Vitamin E in slowing the progress
of HIV. The recommended daily allowance is 55mcg with levels becoming toxic
at 1000mcg.
These particular vitamins and minerals can be found in the following produce:
Beta-Carotene (Vitamin A) - Carrots, apricots, carrot juice, spinach, broccoli,
and mango.
Vitamin C - Citrus fruits, red/green peppers, cabbage, strawberries, brussel
sprouts, mango, potato, kiwi fruit, broccoli, cauliflower and fortified
cereals.
Vitamin E - Wheat germ oil, safflower oil, mayonnaise, wheat germ, fortified
cereals, breads, almonds, avocado, and whole grains.
Selenium - Brazil nuts, seafood, eggs, organ meats (liver), chicken, cereals
and breads, lean meats, beans, and whole grains.
In the past two-three years the number of AIDS deaths have fallen dramatically
due mainly to the three major types of drugs used in antiviral therapy.
They are:
1. Nucleoside Analog Reverse Transcriptase Inhibitors (a.k.a. Nukes)
2. Non-nucleoside Reverse Transcriptase Inhibitors (NNRT's)
3. Protease Inhibitors (PI's)
The problem with these drugs is that the virus mutates around them and the
drugs eventually become ineffective.
By means of blocking the replication of the virus, antiretroviral drugs
such as AZT, ddI, ddC, 3TC, D4T, and antiproteases help slow down the development
of AIDS and are often prescribed in combination. None of these treatments
can ensure the complete and definitive eradication of the virus but basic
and clinical research is on the right track. It is not possible to speak
of a cure at this moment in time but modern treatments substantially prolong
the survival of patients.
AIDS is a serious illness, but remember, so were tuberculosis, typhoid and
influenza until a treatment was discovered. Research is very active and
a breakthrough could occur at any moment. Hopes have been high for the development
of a successful AIDS vaccine. These hopes have taken a severe battering
with the discovery that people infected with a weakened form of the HIV
virus, more than 17 years ago, have begun to develop the symptoms of AIDS.
The form of the virus which they were infected with lacked the 'nef' gene
which helps the virus evade the body's immune system. While scientists had
hoped the strain of the virus would prove harmless, it has developed into
a very expensive mistake. Scientists are still confident of developing a
vaccine, although they are aware of the dangers now more than ever. The
danger lies in using live attenuated viral strains as there is a risk of
the virulence returning in these strains. A vaccine could be produced from
one or several viral proteins, which are capable of inducing the formation
of antibodies which neutralise the virus without any risk of the virus itself
developing. The theory appears simple, but in practice it is a long complicated
procedure. The predominant viral strain for each population would have to
be identified (in the US and Western Europe one strain accounts for 80%
of all strains detected) but there is a multiplicity of strains throughout
the rest of the world and Africa in particular. The major stumbling block
is the fact that there is no animal on which to test the vaccine. The animal
model, the macaque, is not sensitive to HIV1, and only the chimpanzee can
be infected with the virus but it does not develop AIDS. The horrifying
part of developing a vaccine for HIV is that it is a virus. If you think
of the common cold, it is also a virus and there is still no cure for it,
only medicines to ease the symptoms. But, as any doctor will tell you, prevention
is better than a cure.
What can you do to prevent the spread of HIV/AIDS?
PREVENTION
" ALWAYS practice safer sex - use a condom, even if the person you
are with assures you they are not infected. The only way to be 100% sure
is to see your partner's test results for yourself.
" Do not touch someone else's open wounds or blood without wearing
surgical gloves.
" If you are using intravenous drugs, use a sterile needle and syringe
every time.
" Insist that anyone touching you where they are going to come into
contact with your bodily fluids (blood, semen, vaginal fluid) - i.e. doctors,
nurses, dentists, tattoists, piercer's etc - take the proper precautions.
You CANNOT catch HIV/AIDS from the following:
" Kissing
" Touching/holding hands/shaking hands/hugging
" Toilet seats
" Sharing cutlery
" Food
" Cups/glasses
" Swimming pool
" Public telephone
" Donating blood
" Everyday contacts do not transmit the virus.
HIV/AIDS IN NORTHERN IRELAND
HIV/AIDS is something that few people have felt at risk from in Northern
Ireland. It is this 'it couldn't happen to me' mentality which is costing
people their homes, their jobs and their lives. Although the number of infected
people in Northern Ireland is substantially lower than in the remainder
of the United Kingdom, it is on the increase and a person only needs to
come in contact with the virus once to be infected. HIV/AIDS doesn't get
stopped at customs, so you may think you are not at risk at home, but think
carefully about what you get up to on that foreign holiday. Patient Zero,
a Canadian flight attendant named Gaetan Dugas, is reported to be partly
responsible for the wide spread of HIV/AIDS. Several early cases of AIDS
have been analysed to show that infected individuals had came into either
direct or indirect contact with Dugas.
HIV/AIDS is among us now. To think otherwise is nothing short of stupidity.
In December 1997 the number of people suffering from HIV in Northern Ireland
was 217, of whom 100 have AIDS. This number has increased gradually since
then. A number of people who had left Northern Ireland for many different
reasons are now returning to their family and friends after discovering
the terrifying news that they are HIV positive. B.C. AIDS Homelink, a confidential
direct-line telephone service working within the Social Work department
of the Royal Group of Hospitals in Belfast, specialise in helping people
return to the country and all the complications they might encounter. There
are no personal implications or hidden agendas attached to seeking help
or advice through B.C. AIDS Homelink, it is a totally confidential service,
offered free of charge. But if attitudes are as ignorant towards AIDS in
Northern Ireland as to make people afraid to admit that they have the disease,
why come home?
John, a former resident of Northern Ireland, spoke frankly with a social
worker from B.C. AIDS Homelink about why he felt he should return. "In
a way the decision was made for me," he begins. " I was living
illegally abroad and could not afford the medical treatment which I was
beginning to need." John left originally to live with his eldest sister
after both his parents died, making him an orphan at a very early age. Was
he worried about the prospect of returning home? "I suppose I was worried
about how I would fit in with members of my family who still lived here
but I hadn't seen in many years. They were bound to wonder why I had decided
to return at this point in time. Would they accept me if I gave them a truthful
answer or would I be totally rejected? Even if they accepted me, would I
be able to get a job and, more to the point, would I feel able to work?
My biggest fear was giving up everything I had known to face the unknown.
I felt isolated, confused and alone." Despite the negative attitudes
which are rife across this very small country, the medical staff who deal
directly with HIV/AIDS patients in Northern Ireland couldn't be praised
enough for the way they handle the most difficult of situations. "I
was seen (on my return) by a consultant at the clinic who was very reassuring
and spent a lot of time putting me at ease. We discussed my health situation,
how I was coping with this, my family, and returning home. He explained
how the clinic worked and introduced me to the Social Worker and the Health
Advisor. It was reassuring not to get the reaction I was dreading, the reaction
I might get when I declared I was HIV+ve. Everyone was very concerned and
supportive."
So why do people with HIV/AIDS suffer abuse when others suffering from terminal
illnesses such as cancer receive sympathy from all quarters? Ignorance.
Plain and simple. Despite numerous, expensive campaigns by the World Health
Organisation and Governments around the world, HIV/AIDS is still seen by
the majority in Northern Ireland as a 'gay' disease. Maybe, just maybe,
by reading this article, your attitude has changed, if only slightly. Maybe,
should you happen to meet someone who is afflicted with this life destroying
disease, you might extend a hand of support, as opposed to ignorant words
of cold comfort.
The fight will continue, against HIV, against AIDS, against the multi-drug
resistance strains of both and against the ignorance, which is as responsible
for the millions of deaths as the disease, itself. If you think you can
do nothing to help - think again. Listen, learn, live. What could be simpler?
May we extend our sincerest thanks to both The Terrance Higgins Trust and
B.C. AIDS Homelink for their help in compiling this article and wish them
every success in their battle against AIDS.
Useful Contact Numbers:
Terrence Higgins Trust
52-54 Grays Inn Road
London
WC1X 8JU
Tel: 0171 831 0330
B.C. AIDS Homelink
Level 5 Outpatient centre
Royal Victoria Hospital
Grosvenor Road
Belfast
BT12 6BA
Tel: 01232 439888
Body Positive Northern Ireland
Tel: 01232 235515
AIDS Helpline Northern Ireland
Tel: 0800 137437