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Aids and Contemporary Society: Politics, Policies and Pathophysiology
A virus is a microorganism which invades living organisms and replicates inside their bodies, producing diseases. Beyond this limited physiological meaning, there are multiple levels of social and cultural meanings which are attached to the virus by humans. The Human Immunodeficiency Virus — fearsomely known as HIV virus, which causes a progressive failure of the immune system leading to opportunistic infections and ultimately death — has produced great social and moral consternation in the last two decades. In this article, we turn our attention to three aspects of the disease caused by the HIV virus: pathophysiology, government response to the pandemic and societal reaction to the disease.
Pathophysiology: the virus and its mode of transmission
HIV virus is a retrovirus which is transmitted through human body fluids like blood, semen, vaginal fluid, breast milk etc. It affects the immune system of our body, destroying the CD4+ T cells of our body. There are two strains of the virus, which are currently known:
- HIV-1 which was originally discovered and known throughout the world
- HIV-2, the less virulent of the two varieties which is mainly restricted to West Africa
There are a lot of misconceptions regarding HIV and AIDS. It should be kept in mind that HIV is the virus, which when present inside the body, produces a disease spectrum, the final level of which is called AIDS or Acquired Immunodeficiency Syndrome. In totality the disease has 5 stages, as recognized by WHO.
- Initial stage is called the stage of infection and is asymptomatic in nature.
- The next stage is called the primary stage which is also asymptomatic with T cell count greater than 500 per cubic mm of blood.
- In the next stage, mucacutenous infections along with respiratory tract diseases might occur.
- In stage four, there may be chronic diarrhea with bacterial infections like tuberculosis.
- The final stage is called AIDS which is characterized by toxoplasmosis of brain, Kaposi’s sarcoma, yeast infections etc.
Another area of misconception is about how the virus spreads. The virus cannot be indirectly transmitted. It needs the warmth of human body fluids. As such, kissing, hugging or dining with an infected person does not entail a transmission of the virus. It can, however, be transmitted through sexual contact, use of intravenous injections and from mother to the child. Sexual transmission may either be between persons of different sex or persons of the same sex. Intravenous drug users are also highly susceptible to HIV.
Clinical testing is the only way we can be aware about the presence of the virus. Most people infected with HIV develop antibodies within three to twelve weeks of initial infection. Positive results can only be obtained after 12 weeks have passed.
As of 2014, HIV virus has produced no vaccine. Treatment of AIDS consists of high active antiretroviral treatment (HAART) which incorporates a cocktail of various classes of anti-retroviral drugs. Prevention is the only way to tackle the epidemic and condom (only the latex variety) is the best way to prevent the disease.
Societal and Cultural Responses
The society at large associates certain diseases with certain marginalized groups of people; and HIV/AIDS is no different. Although medically it can be transmitted in either male to male or male to female or female to male sexual interactions, the male homosexual community has been deeply ostracized in contemporary United States of America. Gay men in USA have been targeted by church, state and society alike for being the principal vectors of HIV infection.
Apart from the social and cultural stigma, AIDS seriously affects the economy as well. Sub Saharan Africa, which has the highest rates of infection, has seen reduced adult mortality rate and depleted adult population between 18 to 49 years of age. Since this chunk of population is also the most productive chunk, large scale infection of the epidemic leads to a huge burden on the economy
Ever since its identification in 1981 in the United States of America, the disease has been a subject of widespread public discussion and governmental scrutiny. For years the association of the disease with sexual promiscuity and immorality among gay men meant that there was a delayed response from the governments to prevent future transmission and manage the present victims. Today, governments across the world run various public awareness campaigns to counter the pandemic. The church on the other hand insists that abstinence from sex is the only way to prevent the disease.
HIV Drugs and research have improved tremendously in recent years. Most of the popular anti-retroviral drugs have lost their patents. This means that companies can produce cheaper and generic varieties of the drug. In high income countries, people on HAART treatment can expect normal life expectancy. There is, however, no vaccine for HIV. A clinical trial of HIV vaccine RV144 was tried with some positive results. Similarly, when disabled HIV virus was inserted into the body of the Emma Whitehead in Pennsylvania who was suffering from cancer, it produced positive results. However, we are still far away from an effective cure.
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