As of April 2022, it is estimated that 3,745 Delawareans are living with HIV and that 13 to 29-year-olds represent 32% of that total. So it begs the question, how much do you know about HIV and AIDS? Do you know where it came from or how it’s contracted and spread? Or do you know that HIV and AIDS are not the same thing? What about prevention and treatments?
We want to answer all of those questions and more. Because with knowledge comes power. The power to learn and use preventative measures; power to get tested regularly; and the power to #ErasetheSTIgma that has contributed to the spread of this deadly virus. So we ask you again, do you know?
Do you know the history of HIV?
On June 5, 1981, the CDC published an article that reported a rare lung infection in five, previously healthy, gay men. Along with the lung infection, the men were also reported to have other unusual infections, indicative of weakened immune systems. These cases would later be known as the start of the AIDS epidemic in the U.S. By the end of the year, 337 individuals in the U.S. were reported as having severe immune deficiency, 130 of which did not make it.
The AIDS epidemic seemingly came out of nowhere. But it is believed that AIDS has been around since the late 1800’s, when the virus may have jumped from chimpanzees in Central Africa to humans who would hunt them for meat. It then slowly spread across Africa for decades before it is believed to have arrived in other parts of the world.
Do you know that HIV and AIDS are not the same thing?
HIV and AIDS are not interchangeable terms. HIV, or Human Immunodeficiency Virus, is an infection that attacks the body’s immune system. As it weakens your body’s natural defenses, other infections, known as opportunistic infections, begin to also take hold. There is no known cure for HIV, but, due to major advances in treatments, a person can live a long life with HIV (more on this below). However, if left untreated, HIV can lead to AIDS or Acquired Immunodeficiency Syndrome. AIDS is also known as late-stage HIV, or stage-3 HIV. Those previously mentioned opportunistic infections have been left unchecked for too long and essentially ravage the body. Once diagnosed with AIDS, the life expectancy for someone can be as little as 1-3 years depending on when and if treatment is sought.
Do you know the numbers?
Let’s start this one by saying there are A LOT of numbers when it comes to the state of the HIV and AIDS epidemic. Let’s look at some key ones below.
- According to HIV.gov, about 1.2 million Americans currently have HIV and 13% don’t know it and need testing. Globally, per UNAIDS.org, about 37.7 million people currently have HIV and 16% don’t know it and need testing.
- Globally, new HIV infections are down 52% since their peak in 1997 (1.5 million from 3 million, per UNAIDS.org). And in the U.S. alone, new HIV infections are down by more than 66% since the height of the epidemic in the mid-80’s (per the CDC). These impressive numbers are the direct result of advancements in treatments, testing, education, and prevention.
- In the U.S., Black/African Americans represent 13% of the population but make up 40% of HIV infections. In Delaware, Black/African Americans are 57.8% of current HIV infections. Globally, around 5000 women a week, ages 15-24, become infected with HIV. And the risk of acquiring HIV is 25 times higher for gay men and other men who have sex with men. These figures show the range of disparity when it comes to who is impacted the most by HIV. And that disparity is the result of a range of factors like discrimination, stigma, resources, education, even geography.
- There is a global initiative to end the threat of AIDS by 2030. The U.S. has developed its own plan to reduce new HIV infections 75% by 2025 and 90% by 2030, prioritizing the most at-risk populations.
Do you know how HIV is transmitted, prevented, and treated?
Transmission: Like most STIs, HIV is transmitted through infected body fluids such as blood, semen, vaginal and rectal fluids, and even breast milk. It is NOT spread through saliva, sweat, or tears. The transmission of HIV can occur during vaginal and anal sex but is rarely, if ever, transmitted during oral sex. It can occur by sharing needles, syringes, and other injection materials. And it can even be passed from mother to child during pregnancy, birth, and breastfeeding. However, advances in care and treatments have made this occurrence much rarer.
Prevention: According to the CDC, 80% of HIV transmission is due to unprotected sex. So when it comes to prevention, as a broken record would say: condoms, condoms, condoms, CONDOMS! You can also choose less risky sexual behaviors like oral sex or opt to not have sex altogether. You can choose to take PrEP (pre-exposure prophylaxis) if you know you might be exposed to HIV. And for those times when things don’t go as planned, there is PEP (post-exposure prophylaxis). NEVER share needles or syringes. And if you do have HIV, seek treatment and you will be less likely to transmit HIV (but you still must practice safe sex). And finally, make testing a priority in your sexual health routine and the likelihood of transmiting HIV will greatly decrease.
Treatment: Receiving a positive diagnosis for HIV can seem unbearable if not life-ending. But, while HIV is not curable, it is no longer a death sentence. HIV is treatable to the point that many who are infected can move to an HIV-negative status meaning the level of the virus in the blood is so low it’s undetectable and therefore less transmissible (you still must practice safe sex and other prevention measures). But to get there you have to get tested, seek care, take the prescribed treatments, and practice some self-love.
The first treatment for HIV came in 1986 with azidothymidine (AZT), now called zidovudine, an antiretroviral drug that was moderately effective at prolonging life-expectancy but also at preventing mother-to-child transmission during pregnancy. Several advances continued through the nineties, including a ground-breaking treatment in 1996, known as HAART or highly active antiretroviral treatment, that resulted in a 47% decline in AIDS-related deaths. Treatment for HIV is now referred to as ART, antiretroviral treatment. Testing also improved in the 90’s and into the early 00’s contributing to more people getting diagnosed early put onto treatment plans. All of this advancement in therapies, testing, and the latest introduction of PrEP in 2012, is bringing us closer to a zero-transmission future.
Do you know the myths and stigma surrounding HIV?
We’ve covered a lot about HIV and AIDS, but it doesn’t hurt to mention some of the common myths and stigmas that also contribute to the spread of the virus. One of the most common myths still around is that touching, kissing, sharing a toilet, or eating the same food as an infected person can cause you to contract HIV. FALSE! As we mentioned above, HIV is only contracted via infected bodily fluids such as blood, semen, vaginal and anal fluids, and breast milk.
Another big myth that was rampant during the beginning of the epidemic and still lingers is that HIV and AIDS is a “gay” disease that only affects the LGBTQIA+ population. Let’s be clear: HIV does NOT discriminate. Regardless of your gender, race, sexual orientation, age, ethnicity, or where you live, you can contract HIV. However, your risk for contraction can be higher based on such things as your personal behaviors (like drug-use or unprotected sex) or if you already have an STI. And societal factors can also increase your risk such as lack of access to healthcare and testing.
These myths contribute to the stigma associated with HIV, AIDS, and STIs. That stigma not only affects the emotional and mental health of those who are infected, but it also leads to discrimintation which creates barriers to the stop of the spread of HIV. There is no other choice but educate ourselves, be open to conversation, and work to #ErasetheSTIgma.
Do you know the future of HIV?
HIV currently has no cure so the only way to end it is to stop the transmission of it. As mentioned before, there is a global initiative to end the transmission of HIV by 2030. This initiative was started by UNAIDS, a United Nations entity, created in 1996 to lead the way of global response to the AIDS epidemic. The report released by UNAIDS, Fast-Track: ending the AIDS epidemic by 2030, outlines a “fast-track” approach to the epidemic that would mean 28 million new HIV infections and 21 million AIDS-related deaths would be avoided by 2030. To meet this goal, targets have been set for the years leading up to 2030. The end targets are to reach 95% of people living with HIV knowing their HIV status; 95% of people who know their HIV-positive status on treatment; and 95% of people on treatment with suppressed viral loads. There is also a target of reducing new HIV infections by about 90% to 200,000 in 2030, and zero discrimination. Along with this AIDS response, UNAIDS has 17 Sustainable Development Goals, such as ending poverty, ending hunger, ending gender inequality to name a few, as a core principle behind ending the epidemic and “leaving no one behind”. They state, “The AIDS epidemic cannot be ended without the needs of people living with and affected by HIV, and the determinants of health and vulnerability, being addressed.”
The global mission to end HIV transmission seems huge, but is necessary. And it will take everyone contributing in some way–from practicing safe sex each and every time to being willing to listen and empathise with someone who is infected to #ErasetheSTIgma.
For even more information on HIV and AIDS, checkout these resources: