Table of Contents

 

 

 

 

About the Author

 

 

A Quarter Century of AIDS and Counting: A Humanitarian Crisis

 

 

AIDS UPDATE 2010

 

 

Preface

 

Introduction

Histories of Global Pandemics, AIDS, Its Place in History, Overview of HIV/AIDS, International AIDS Conferences and Means of Remembering—the AIDS Quilt, Candlelight Memorial, and World AIDS Day

 

 

Three Words Echo around the World: AIDS Crisis Worsens!

 

 

History of Global Pandemics and Epidemics

 

 

Fear, Ignorance, and Condemnation: Who Is to Blame?

 

 

Imagine a World without AIDS

 

 

Overview of HIV/AIDS

 

 

AIDS: A Unique Disease

 

 

AIDS: A Cause of Death

 

 

Another Anniversary

 

 

Other Anniversaries

 

 

International AIDS Conferences

 

 

Means of Remembering

 

 

The 27th Candlelight Memorial

 

 

Walking to Change the Course of the HIV/AIDS Epidemic—United States

 

 

Bicycle Riding to Change the Course of the HIV/AIDS Epidemic—United States

 

 

World AIDS Day: An International Day of Coordinated Action: A Time to Recharge and Reconnect

 

 

The Future

 

 

National AIDS Hotlines

 

 

Useful Internet Addresses

 

1

AIDS: Defining the Disease and Finding its Cause

 

 

The New Millennium

 

 

AIDS: A Disease or a Syndrome?

 

 

First Reaction to AIDS: Denial

 

 

What Causes AIDS?

 

 

The Centers for Disease Control and Prevention Reports

 

 

Discovery of What Causes AIDS

 

 

Defining the Illness: AIDS and Surveillance

 

 

Summary

 

 

Review Questions

 

2

What Causes AIDS: Origin of the AIDS Virus

 

 

The Cause of AIDS: The Human Immunodeficiency Virus (HIV)

 

 

HIV Does Not Cause AIDS: Dissidents and Their Cults: A Minority Point of View

 

 

News Flash 2010—Leading HIV/AIDS Dissident Cleared of Misconduct Following Complaints Made After He and Others

 

 

Published a 2009 Paper Arguing That There Is “As Yet No Proof That HIV Causes AIDS”

 

 

Dissidents (AIDS Doesn’t Exist or HIV Isn’t the Cause)

 

 

Summary of HIV/AIDS Dissidents’ Viewpoints

 

 

Evidence that HIV Causes AIDS

 

 

Origin of HIV: The AIDS Virus

 

 

Summary on the Origin of HIV

 

 

Summary

 

 

Review Questions

 

3

Biological Characteristics of HIV

 

 

Viruses Need a Host Cell in Order to Replicate

 

 

Viruses Are Parasites

 

 

Viruses Specific to Cell Type

 

 

How Do Human T4 or CD4+ Lymphocytes Relate to HIV Infection and AIDS?

 

 

Description of HIV; How It Attaches to a Host Cell and Buds Out of the Cell

 

 

HIV Fitness

 

 

The HIV Life Cycle

 

 

Understanding How HIV Works

 

 

How HIV Escapes the Infected Cell

 

 

Distinct Genotypes (Subtypes/Clades) of HIV-1 Worldwide Based on ENV and GAG Proteins

 

 

Summary

 

 

Review Questions

 

4

Anti-HIV Therapy

 

 

Better Drugs, Better Technologies, and Lingering Problems

 

 

Anti-HIV Therapy

 

 

The Good News About ART

 

 

Antiretroviral Therapy (ART) Drugs with FDA Approval

 

 

The HIV Medicine Chest: ART Drugs Receiving FDA Approval

 

 

FDA-Approved Nucleoside/Non-Nucleoside Analog Reverse Transcriptase Inhibitors, Protease Inhibitors, Integrase Inhibitors,

 

 

Entry Inhibitors, and Maturation Inhibitors

 

 

Use of Non-Nucleoside Analog Reverse Transcriptase Inhibitors

 

 

FDA-Approved Protease Inhibitors

 

 

Entry Inhibitors and Problems

 

 

Integrase Inhibitors

 

 

Development and Selection of HIV Drug-Resistant Mutants

 

 

Development of HIV Drug Resistance to Protease Inhibitors

 

 

How Combination Drug Therapy Can Reduce the Chance of HIV Drug Resistance

 

 

Viral Load: Its Relationship to HIV Disease and AIDS

 

 

Medical Complications Associated with Anti-HIV Drug Therapies (ART)

 

 

Update 2010

 

 

Summary

 

 

Disclaimer

 

 

Some AIDS Therapy Information Hotlines

 

 

Review Questions

 

5

The Immunology of HIV Disease/AIDS

 

 

The Immune System

 

 

Human Lymphocytes: T Cells and B Cells

 

 

Why CD4+ Cells Are Important in HIV Infection—What It Means

 

 

The CD4+ Cell Count—Why It Matters

 

 

Antibodies and HIV Disease

 

 

Cellular MicroRNAs Contribute to HIV Latency in Resting Primary CD4+ T Cells

 

 

Immune System Dysfunction

 

 

Original Antigenic Sin

 

 

The Search for Additional Receptors (Coreceptors) to CD4: Fusin or CXCKR-4 (R-4)

 

 

CCKR-5 (R-5) Receptor

 

 

Emergence of HIV Strains That Vary in Their Lethal Abilities

 

 

In Search of Genetic Resistance to HIV Infection

 

 

T4 Cell Depletion and Immune Suppression

 

 

Impact of T4 Cell Depletion

 

 

Role of Monocytes and Macrophages in HIV Infection

 

 

Where DO T4 or CD4+ Cells Become HIV Infected?

 

 

Summary

 

 

Review Questions

 

6

Opportunistic Infections and Cancers Associated with HIV Disease/AIDS

 

 

What is an Opportunistic Disease?

 

 

The Prevalence of Opportunistic Diseases

 

 

Opportunistic Infections in HIV-Infected People

 

 

TB: The Leading Cause of Death among HIV-Positive People Worldwide

 

 

Cancer or Malignancy in HIV/AIDS Patients

 

 

Disclaimer

 

 

Summary

 

 

Review Questions

 

7

A Profile of Biological Indicators for HIV Disease and Progression to AIDS

 

 

What Is Known and What Is Missing from Our Understanding of HIV/AIDS

 

 

HIV Disease Defined

 

 

Stages of HIV Disease (without Drug Therapy)

 

 

HIV Disease without Symptoms, with Symptoms, and AIDS

 

 

Production of HIV-Specific Antibodies

 

 

Prognostic Biological Markers Related to AIDS Progression

 

 

HIV Infection of the Central Nervous System (CNS)

 

 

Neuropathies (Nerve Tissue Damage) in HIV Disease/AIDS Patients

 

 

Pediatric Clinical Signs and Symptoms

 

 

Summary

 

 

Review Questions

 

8

Epidemiology and Transmission of the Human Immunodeficiency Virus

 

 

Epidemic/Epidemiology

 

 

We Must Stop HIV Transmission Now!

 

 

Epidemiology of HIV Infection

 

 

Transmission of Two Strains of HIV (HIV-1/HIV-2)

 

 

IS HIV Transmitted by Insects?

 

 

HIV Transmission

 

 

HIV Transmission in Family/Household Settings

 

 

Noncasual Transmission

 

 

Gay Men Putting Themselves at High Risk for HIV Infection

 

 

The Biological Factor

 

 

Injection-Drug Users and HIV Transmission

 

 

United States: Heterosexual Injection-Drug Use (IDU)

 

 

Injection-Drug Use and HIV Infections in Other Countries

 

 

Other Means of HIV Transmission

 

 

Influence of Sexually Transmitted Diseases (STDs) on HIV Transmission and Vice-Versa

 

 

Pediatric Transmission

 

 

Conclusion

 

 

National AIDS Resources

 

 

Summary

 

 

Challenge Your Assumptions about the HIV Infected

 

 

Review Questions

 

9

Preventing the Transmission of HIV

 

 

The AIDS Generation: “I Knew Everything about It, and I Still Got It!”

 

 

Prevention, Not Treatment, Is the Least Expensive and Most Effective Way to Reduce the Spread of HIV/AIDS

 

 

Global Prevention

 

 

Antiretroviral Drugs Have and Impact on Prevention, But We Can’t Treat Our Way Out of This Pandemic

 

 

Advancing HIV Prevention: New Strategies for a Changing Epidemic

 

 

Preventing the Transmission of HIV

 

 

Sexual Risk Taking Depends on Sexual Activity

 

 

New Rules to an Old Game: Promoting Safer Sex—Nobody Has a Body to Die For!

 

 

The Male Condom

 

 

The Female Condom or Femidom (Vaginal Pouch)

 

 

An Alternative to Condoms: Vaginal Microbicides (MI-CRO-BA-CIDES) and Circumcision

 

 

Update 2010—The CAPRISA 004 Study Results

 

 

Circumcision and the Prevention of HIV Transmission

 

 

Injection-Drug Use (IDU) and HIV Transmission: The Twin Epidemics

 

 

HIV Prevention for Injection-Drug Users

 

 

Prevention of Blood and Blood Product HIV Transmission

 

 

Infection Control Procedures

 

 

Sexual Partner Notification: Disclosure

 

 

The U.S. Federal Government Has Now Adopted Partner Notification as Its Cornerstone in Its Effort to Help Control the Spread of HIV

 

 

The First Human Vaccine: The Impact of Vaccines on Infectious Diseases

 

 

HIV Vaccine Development and Its Role in Prevention

 

 

How These Two Neutralizing Antibodies Work

 

 

Types of Experimental HIV Vaccines

 

 

DNA Vaccine

 

 

Problems in the Search for HIV Vaccine

 

 

September 2009—News Broken that a Partially Effective HIV Vaccine Was Found!

 

 

Summary

 

 

Review Questions

 

10

Prevalence of HIV Infections, AIDS Cases, and Deaths among Select Groups in the United States and in Other Countries

 

 

A Word about HIV/AIDS Data

 

 

Year 2011

 

 

Formula for Estimating HIV Infections

 

 

Behavioral Risk Groups and Statistical Evaluation

 

 

September 18: Annual National HIV/AIDS Aging Awareness Day

 

 

Estimates of AIDS Cases and HIV Infection

 

 

Newly Infected

 

 

Shape of the HIV Pandemic: United States

 

 

Estimates of Deaths and Years of Potential Life Lost Due to AIDS in the United States

 

 

Selected Nations/Countries Have Different Epidemics. Each Faces Its Own Reality

 

 

Canada’s Estimated HIV/AIDS Cases through 2009: Population 110 Million

 

 

United Kingdom’s (UK) Estimated HIV/AIDS Cases through 2009: Population 61 Million

 

 

Global Prevalence and Impact of HIV/AIDS

 

 

Connected but Separate: Each Country a Different Reality, Different Countries, Similar Questions, but Different Answers,

 

 

Different Epidemics

 

 

Workforce—South Africa: Some Examples

 

 

Education: Teachers and Students—South Africa and Some Countries in Southern Africa

 

 

Other HIV/AIDS Time Bombs in Asia: India, China, and Russia

 

 

Summary

 

 

Review Questions

 

11

Prevalence of HIV Infection and AIDS Cases among Women and Children

 

 

HIV/AIDS Is Defining the Lives of Millions of Women

 

 

Female Vulnerability to HIV

 

 

Every Day a Tragedy

 

 

Triple Jeopardy

 

 

Annual International Women’s Day—March 8

 

 

Women: AIDS and HIV Infections Worldwide

 

 

Asia-Pacific Region, Over Five Million HIV Positive: 2010

 

 

Women: HIV-Positive and AIDS Cases—United States

 

 

Childbearing Women: Worldwide

 

 

Internet Resources

 

 

Pediatric HIV-Positive and AIDS Cases—United States: A Fight We Can Win!

 

 

Orphaned Children Due to HIV Infection and AIDS

 

 

The Phenomenon of AIDS Orphans

 

 

Summary

 

 

Review Questions

 

12

Prevalence of HIV Infection and AIDS among Young Adults, Ages 13 to 24

 

 

Global HIV Infections in Young Adults

 

 

Addressing the AIDS Pandemic among Young Adults

 

 

How Large Is the Young Adult Population in the United States?

 

 

HIV/AIDS Won’t Affect Us!

 

 

Estimate of HIV-Infected and AIDS Cases among Young Adults in the United States, Globally

 

 

Summary

 

 

Internet

 

 

Other Useful Sources

 

 

Review Questions

 

13

Testing for Human Immunodeficiency Virus

 

 

Determining the Presence of Antibody Produced When HIV Is Present

 

 

Requests for HIV Testing

 

 

Reasons for HIV Testing: I Know, I Took the Test

 

 

Laboratory Methods for Detecting HIV

 

 

ELISA HIV Antibody Test

 

 

Western Blot Assay

 

 

New ELISA Antibody Testing and Viral Load Procedures Reveal Early Versus Late HIV Infection

 

 

Rapid Result HIV Testing

 

 

FDA Approves Home HIV Antibody Test Kit

 

 

Some Screening and Confirmatory Antigen-Detection Tests for HIV

 

 

Deciding Who Should Get an HIV Test and When

 

 

Why Is HIV Test Information Necessary?

 

 

Immigration and Travel Ban into the United States Is Lifted

 

 

Testing, Privacy, Competency, and Informed Consent

 

 

Summary

 

 

Review Questions

 

14

AIDS and Society: Knowledge, Attitudes, and Behavior

 

 

HIV/AIDS Is a Story in Our Lifetime

 

 

The New Millennium and HIV/AIDS

 

 

HIV/AIDS Is an Unusual Social Disease

 

 

Discrimination vs. Compassion and Support

 

 

HIV/AIDS Is Here to Stay

 

 

AIDS Comes to the United States

 

 

Blame Someone, Déjà Vu

 

 

Fear: Panic and Hysteria over the Spread of HIV/AIDS in the United States

 

 

Whom Is the General Public to Believe?

 

 

AIDS Education and Behavior: Dissipating Fear with Education

 

 

The Character of Society

 

 

Dealing with Discrimination: The Americans with Disabilities Act

 

 

Federal and Private Sector Financing: Creation of an AIDS Industry

 

 

U.S. Government Believes HIV/AIDS Is a Threat to National Security

 

 

Global HIV/AIDS Funding for Underdeveloped Nations

 

 

Forms of U.S. Monetary Assistance for HIV/AIDS

 

 

Summary

 

 

Review Questions

 

 

Answers to Review Questions

 

 

Glossary

 

 

References

 

 

Index