Acquired Immunodeficiency Syndrome (AIDS), human viral disease that ravages the immune system, undermining the body’s ability to defend itself from infection and disease. Caused by the human immunodeficiency virus (HIV), AIDS leaves an infected person vulnerable to opportunistic infections. Such infections are harmless in healthy people, but in those whose immune systems have been greatly weakened, they can prove fatal. Although there is no cure for AIDS, new drugs are available that can prolong the life spans and improve the quality of life of infected people.
Infection with HIV does not necessarily mean that a person has AIDS. Some people who have HIV infection may not develop any of the clinical illnesses that define the full-blown disease of AIDS for ten years or more. Physicians prefer to use the term AIDS for cases where a person has reached the final, life-threatening stage of HIV infection.
AIDS was first identified in 1981 among homosexual men and intravenous drug users in New York and California. Shortly after its detection in the United States, evidence of AIDS epidemics grew among heterosexual men, women, and children in sub-Saharan Africa. AIDS quickly developed into a worldwide epidemic, affecting virtually every nation. By 2000 an estimated 34.7 million adults and 1.4 million children worldwide were living with HIV infection or AIDS. The World Health Organization (WHO), a specialized agency of the United Nations (UN), estimates that from 1981 to the end of 2000 about 21.8 million people died as a result of AIDS. More than 4.3 million of those who died were children under the age of 15.
AIDS is the final stage of a chronic infection with the human immunodeficiency virus. There are two types of this virus: HIV-1, which is the primary cause of AIDS worldwide, and HIV-2, found mostly in West Africa. On its surface, HIV carries a protein structure that recognizes and binds only with a specific structure found on the outer surface of certain cells. HIV attacks any cell that has this binding structure. However, white blood cells of the immune system known as T cells, which orchestrate a wide variety of disease-fighting mechanisms, are especially vulnerable to HIV attack. Particularly vulnerable are certain T cells known as CD4 cells. When HIV infects a CD4 cell, it commandeers the genetic tools within the cell to manufacture new HIV virus. The newly formed HIV virus then leaves the cell, destroying the CD4 cell in the process. No existing medical treatment can completely eradicate HIV from the body once it has integrated into human cells.
The loss of CD4 cells endangers health because these immune cells help other types of immune cells respond to invading organisms. The average healthy person has over 1,000 CD4 cells per microlitre of blood. In a person infected with HIV, the virus steadily destroys CD4 cells over a period of years, diminishing the cells’ protective ability and weakening the immune system. When the density of CD4 cells drops to 200 cells per microlitre of blood, the infected person becomes vulnerable to any of about 26 opportunistic infections and rare cancers, which take advantage of the weakened immune defenses to cause disease.
Scientists have identified three ways that HIV infections spread: sexual intercourse with an infected person, contact with contaminated blood, and transmission from an infected mother to her child before or during birth or through breastfeeding.
The routes of HIV transmission are well documented by scientists, but health officials continually grapple with the public’s unfounded fears concerning the potential for HIV transmission by other means. HIV differs from other infectious viruses in that it dies quickly if exposed to the environment. No evidence has linked HIV transmission to casual contact with an infected person, such as a handshake, hugging, or kissing, or even sharing dishes or bathroom facilities. Studies have been unable to identify HIV transmission from modes common to other infectious diseases, such as an insect bite or inhaling virus-infected droplets from an infected person’s sneeze or cough.
With a vaccine for AIDS years away and no cure on the horizon, experts believe that the most effective treatment for AIDS is to prevent the occurrence of HIV infection. Health officials focus public education programs on altering risky behaviors linked to HIV transmission, particularly unsafe sexual practices and needle-sharing by intravenous drug users. Safe-sex campaigns sponsored by health clinics, social centers, schools, and churches encourage sexual abstinence or monogamy (sexual relations with only one partner). Education programs instruct about the proper way to use condoms to provide a protective barrier against transmission of HIV during sexual intercourse. Needle-exchange programs, which provide clean needles to drug users, enable intravenous drug abusers to avoid sharing HIV-contaminated needles. Needle-exchange programs have been widely criticized because they seem to condone illicit drug use.
Exercise 1.Answer the questions below:
How much do you know about HIV?
1.HIV infection can be passed on by which of the following means:
a. heterosexual sexual intercourse;
b. homosexual sexual intercourse;
d. using infected injection equipment.
2. Mark the following true (T) or false (F):
a. AIDS and HIV are the same thing.
b. An HIV test will show immediately if someone is infected with HIV.
c. Current treatment can eliminate the HIV infection in some people.
Find out the correct answers from your teacher.
Note: Although you may still hear the term AIDS (Acquired Immune Deficiency Syndrome) it is no longer used widely by doctors. They prefer to talk of ‘late stage’ or 'advanced HIV infection’. Before effective treatments, someone with HIV almost certainty developed AIDS. This is no longer the case.
Exercise 2. Answer these questions with a partner. Then read the information below to find the answers:
1. Which area of the world is most affected by HIV?
2. Is there a cure for HIV?
3. Are more men or more women affected by HIV?
4. Which age group is most affected by HIV?
1. HIV in the world
There were 33.4 million people infected with HIV around the world in 1999: 22.5 million in sub-Saharan Africa, 6.7 million in South and South-east Asia, 1.4 million in Latin America and 0.2 million in the USA. There are about 9,000 new infections each day – 90% of these in developing countries. More than l4 million people have already died of the disease, including 2.5 million in 1998.
Although there is no actual cure, drugs are now available which suppress the progress of HIV infection and many sufferers can live relatively long and healthy lives. For most people with HIV, however, recent advances in treatment will have little impact. The high cost of developing and producing new drugs and the lack of available money for healthcare in many countries make it unlikely that new treatments will ever be widely available in the developing world.
3. Who is most affected?
Throughout the world, roughly equal numbers of men and women are infected. But HIV mostly affects young adults and people in early middle age. These are the people who raise the children, support the elderly and build a country’s economy. The loss of such people has had and will continue to have a serious effect on the economies of some countries particularly in some areas of Africa.
4. Stopping the epidemic
We could slow down the worldwide HIV epidemic if everyone had good information about preventing infection, along with support from society to help them act on this information. Furthermore, each new generation of gay men needs to be made aware of the risks of HIV.
Sometimes, for religious, cultural or economic reasons it can be difficult for people to use condoms and protect themselves and their partners. A woman who is economically dependent on a man may find it impossible to ask for safer sex. Women are most commonly infected through unprotected sex with their husbands or long term partners. Some governments do not accept that HIV is a problem for them at all. A few national leaders even deny that some behaviour happens, such as sex between men or drug injecting. This can make it particularly difficult for people in those countries to be aware of and avoid the risks. We must continue to fight prejudice and increase understanding. Together we can make a difference.
Adapted from ‘Understanding HIV infection and AIDS’,
Terrence Higgins Trust
Exercise 2.1.Read the text again more carefully and answer these questions:
l. Why do most people not receive new treatments for HIV?
2. How does the spread of HIV affect a country's economy?
3. What would help to slow down the spread of HIV infection?
4. What factors can be unhelpful in preventing the spread of HIV?
Discuss the following questions in pairs or small groups:
5. What is done in your country to help prevent the spread of HIV?
6. Do you think more could be done? If so, what?
7. What is the attitude of most people towards HIV sufferers?
8. How could the large drug companies do more to help?
Exercise 2.2.Read through the text again and find the verbs which go with the following nouns and noun phrases. The first one has been done for you.
1. make little impact (paragraph 2)
2. __________ new drugs (2)
3. __________ new drugs (2)
4. __________ a serious effect on (3)
5. __________ infection (4)
6. __________ aware of the risks (4)
7. __________ the risks (5)
8. __________ prejudice (5)
9. __________ understanding(5 )
10. _________ a difference( 5)
Now match the adverbs on the left with the adjectives on the right:
11. widely a. dependent on
12. roughly b. difficult
13. economically c. equal numbers
14. most commonly d. available
15. particularly e. infected
Exercise 2.3.Complete the summary below with the correct form of words from the previous exercise:
Although research scientists have (1) . . . . and (2) . . . . many new drugs to fight the HIV infection, at the moment these treatments are only widely (3) . . . . in developed countries. In developing countries efforts to (4) . . . . infection rest on (5) . . . . understanding of the disease and encouraging people to (6) . . . . the risks of unprotected sex. The number of deaths among young people has, in some countries (7) . . . . a serious effect on the national economy. It is vital therefore to continue to (8) . . . . prejudice and continue to (9) . . . . people aware of the risks of HIV infection.
Exercise 3.Discuss these questions in pairs:
l. Do you know anyone with HIV?
2. If a friend of yours or a member of your family was infected with HIV, would you treat them differently from the way you do now?
How far do you agree or disagree with the following?
1. HIV started because of homosexuality.
2. Too much money is spent on research into HIV. Cancer research is more important.
3. Developed countries only care about their own HIV infected population. They are doing nothing to help the developing world.
4. lt is irresponsible of the Roman Catholic church to say that people should not use condoms.