AIDS is a chronic, life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging or destroying cells of the body immune system, HIV interferes with the body’s ability to effectively fight off viruses, bacteria and fungi that cause disease. This makes more susceptible to certain types of cancers and to opportunistic infections your body would normally resist.
The virus and the infection itself are known as HIV. The term Aids (acquired immunodeficiency syndrome) is used to mean the later stages of HIV infection. Thus, the terms HIV infection and Aids refer to different stages of the same disease.
In the more than two decades since the first reports of the disease, Aids has become a global epidemic. The latest statistics on the world epidemic of Aids and HIV were published by UNAIDS/WHO in December 2004. The report stated that total number of cases estimates about 39.4 million in which adult population is 37.2 million and children up to 15 years about 2.2 million. More than 6,000 people become infected with HIV every day around the world. An estimated 950,000 Americans are currently living with HIV/Aids.
It has become very important for us to understand what HIV is and how the virus is transmitted
Despite some progress against Aids, most experts agree that the epidemic is still in its early stages. Because it seems unlikely that a vaccine will be found soon, hopes for stemming the infection appear to lie for now in education, prevention and treatment.
In industrialized nations, improved treatments have reduced serious complications of the disease and helped prolong life. That is not the case in the developing world, where large numbers of infected people don’t have access to adequate treatment.
The symptoms of HIV and Aids vary, depending on the phase of infection. When first infected with HIV, there are no symptoms at all, although it’s more common to develop a brief flu-like illness two to six weeks after becoming infected. Because the symptoms of an initial infection which may include fever, headache, sore throat, swollen lymph glands and rash are similar to those of other diseases.
Even if someone doesn’t have symptoms, he may still be able to transmit the virus to others. Once the virus enters into the body, the immune system also comes under attack. The virus multiplies in the lymph nodes and slowly begins to destroy helper T cells (CD4 lymphocytes) the white blood cells that coordinate with the entire immune system.
Someone may remain symptom-free for eight or nine years or more. But the virus continues to multiply and destroy immune cells. Tests are likely to show a sharp decline in the number of these cells in the blood. Eventually, you may develop mild infections or chronic symptoms such as swollen lymph nodes often one of the first signs of HIV infection, diarrhoea, weight loss, fever and cough and shortness of breath.
During the last phase of HIV which occurs approximately 10 or more years after the initial infection, more serious symptoms may begin to appear, and the infection may then meet the official definition of Aids. In 1993 the Centres for Disease Control and Prevention (CDC) redefined Aids to mean the presence of HIV infection as shown by a positive HIV-antibody test plus at least one of the following:
The development of an opportunistic infection, an infection that occurs when the immune system is impaired such as Pneumocystis carinii pneumonia (PCP).
A CD4 lymphocyte count of 200 or less, a normal count ranges from 600 to 1,000.
By the time Aids develops, the immune system has been severely damaged, making susceptible to opportunistic infections.
The signs and symptoms of some of these infections may include:
Soaking night sweats, shaking chills or fever higher than 100 F for several weeks. Dry cough and shortness of breath, chronic diarrhoea, persistent white spots or unusual lesions on your tongue or in your mouth, headaches, blurred and distorted vision, and weight loss.
If somebody infected with HIV, also more likely to develop certain cancers, especially Kaposi’s sarcoma, cervical cancer and lymphoma.
Symptoms of HIV in children: Children who are HIV-positive often fail to gain weight or grow normally. As the disease progresses, they may have difficulty in walking or delayed mental development. In addition to being susceptible to the same opportunistic infections that adults are, children may also have severe forms of common childhood illnesses such as ear infections (otitis media), pneumonia and tonsillitis.
Situation in Pakistan: The first case of Aids in a Pakistani citizen was reported in 1987 in Lahore. During the late 1980s and 1990s, it became evident that an increasing number of Pakistanis, mostly men, were becoming infected with HIV while living or travelling abroad. Upon their return to Pakistan, some of these men subsequently infected their wives who, in some cases, passed along the infection to their children. During the 1990s, cases of HIV and Aids began to appear among groups such as commercial sex workers (CSWs), drug abusers and jail inmates. The increased rates of infection among these groups are assumed to have facilitated, at least to some extent, a further dissemination of HIV into the general population. There were 2,832 documented HIV cases till March 2005 in Pakistan.
The UNAIDS estimates the actual number to be around 80,000 (range 24,000-150,000). Of these 65 per cent are due to heterosexual transmission, 19 per cent to blood borne transmission and four per cent to injection drug abuse.
According to the UNDP, the estimated HIV prevalence remains low at about 0.06 per cent of the population. Cases have been reported from all provinces, but they appear to have been confined mainly to people engaged in high-risk behaviour. Most of the infected persons belong to the 20 to 49 years age group. Until 1993, most infections were detected among foreigners and in Pakistani citizens returning from abroad. Though heterosexual route is the most common, infection through contaminated blood and blood products and through IDU is also prevalent. Most observers believe that the number of reported cases represents only the “tip of the iceberg”, and that the number of actual cases may be far greater than official reports suggest.
In 1988, shortly after the diagnosis of the first HIV/Aids cases in the country, the Ministry of Health of the Government of Pakistan established the National Aids Control Programme (NACP), based at Pakistan’s National Institute of Health. Despite budgetary limitations, the NACP has played an important role in the creation of awareness about HIV/Aids in Pakistan through an extensive general public awareness campaign. This effort has included the publication of educational materials, many different types of workshops and educational events, and an electronic media campaign.
Risk factors: HIV crosses all cultures, national borders and religions. No one is immune, and the virus continues to spread among all segments of the human population at a rapid rate.
Low-income factor: It is a major development concern in Pakistan, and may be an important facilitating factor in the further spread of HIV infection in the country. While estimates vary, recent documentation suggests that poverty is undeniably on the rise in Pakistan. It is important to note that the poor suffer not just limitations in income; they also lack basic facilities and amenities, which allow for a full and meaningful existence such limitations also increase the likelihood that those who are most vulnerable are the least able to protect themselves from HIV infection, and, once infected, are the least able to gain access to the health and social support that they need.
Gender discrimination: May also play a facilitating role in the further spread of HIV/Aids in Pakistan. Pakistani women in general have lower socio-economic status, less mobility and less decision-making power than do men, all of which contributes to their HIV vulnerability. In educational enrolment, the female literacy rate in Pakistan is much lower than that of males. Thus, while illiteracy presents an obstacle for HIV/Aids prevention efforts in general, it is much harder to reach women than men with information about how they can protect themselves from HIV infection. In situations where their decision-making power is restricted, it is unlikely that all women are equipped with the skills necessary to negotiate with their partners for safer sexual practices.
Blood and their products transfusion: The collection and transfusion of blood and blood products, the use and re-use of unsterilized medical instruments (especially needles and syringes) and the generally low level of attention to standard infection control procedures are important potential avenues for the spread of HIV in Pakistan. Unsafe blood transfusion practices and poor infection control are likely to make a significant contribution to the further rapid spread of HIV/Aids among the general population.
Commercial sex workers: Some individuals and groups of people are especially vulnerable to HIV/Aids due to their social status. For instance, the social and economic disadvantages experienced by women in Pakistan sometimes results in their involvement in livelihood strategies, which enhance their vulnerability to HIV and other STIs. Female commercial sex workers (CSWs) and female migrant workers are often exploited and abused, and have little recourse due to their low social status and limitations in legal protection. Nearly 70 per cent of the HIV transmission is through the sexual route.
Sexually transmitted infections (STIs): Men and women alike are often unaware of the differences between reproductive and sexual “health” and reproductive and sexual “disease”.
Personal awareness and knowledge of reproductive health issues is limited and also due to their limited access to effective reproductive health services. They often seek care from traditional healers (hakims) or from one of the many unregulated “sex clinics” in the informal health sector. Health care professionals generally believe, however, that the incidence of STIs in Pakistan may be increasing due to the relatively widespread presence of risk behaviours.
Injecting drug users (IDUs): IDUs are at a high risk of acquiring HIV and other blood borne infections because they often resort to unsafe practices such as needle and syringe sharing. Although smoking and inhalation are still the most frequent forms of drug abuse in Pakistan, injecting drug use is thought to be increasingly common, especially in the large urban areas of the country.
Sexual behaviour: While there is little documentation about the extent to which men engage in sexual activity with other men (MSM) in Pakistan, the limited evidence available suggests that such activity does occur throughout the country. Anecdotal evidence indicates that sexual activity between men occurs relatively frequently in hostels and jails; additionally, research suggests that sex between men is often practised among long distance truck drivers. Finally, there is a small but highly mobile population of transvestites, transsexuals and eunuchs known as the hijra, who are known to engage in unsafe sexual practices.
Prevention: There’s no vaccine to prevent HIV infection yet and no cure for Aids. But it’s possible to protect yourself and others from infection. That means educating yourself about HIV and avoiding any behaviour that allows HIV-infected fluids like blood, semen, vaginal secretions and breast milk into your body.
Educate yourself and others. Make sure you understand what HIV is and how the virus is transmitted. Just as important, teach your children about HIV.
Know the HIV status of any sexual partner. Don’t engage in unprotected sex unless you’re absolutely certain your partner isn’t infected with HIV.
Always avoid multiple sex partners.
Use a clean needle and disposable syringe.
Be cautious about blood products:
The blood should be well screened for HIV/Aids.
Avoid tattooing with out sterilization of needles.
Always demand sterilized instruments at barber’s shop and during dental procedures.
AIDS is a chronic, life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging or destroying cells of the body immune system, HIV interferes with the body’s ability to effectively fight off viruses, bacteria and fungi that cause disease. This makes more susceptible to certain types of cancers and to opportunistic infections your body would normally resist.
