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Although most obstetrician–gynecologists are familiar with routine HIV testing of their pregnant patients, health care providers should incorporate routine HIV testing into their gynecologic practices as well. There are a number of reasons why it is critical that women, who represent an increasing proportion of overall HIV and acquired immunodeficiency syndrome (AIDS) cases, know their HIV status. Early diagnosis and treatment of HIV can improve survival and reduce morbidity (4). In addition, women who are infected with HIV can take steps to avoid unintended pregnancy and reduce the likelihood of mother-to-child transmission should pregnancy occur (5). Another emerging benefit to the identification of HIV status is the possibility of initiating pharmacologic interventions, such as combined antiretroviral therapy (6), and behavioral interventions to prevent transmission of HIV to partners (7).

The infection rates in many developed countries remain stable, and some developing countries have achieved significant gains in controlling and even reversing the effects of the HIV epidemic. However, this is partially due to deaths in people, together with simultaneous prevention of new infections. India, for example, has used a national prevention campaign focusing on high-risk populations that may have prevented 100,000 new HIV infections over the 5 years it has been implemented, with increasing results seen in areas with higher levels of investment. [77] These figures together show that global HIV infection is in a state of flux.

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In 2015, the reported rate of AIDS diagnoses in the United States was 5.7 per 100,000 population. [72] From 1981-2015, 1,216,917 persons were diagnosed with AIDS in the United States, and 678,509 people had died with AIDS by the end of 2014 (although reporting limitations mean that not every “death with AIDS” is directly attributable to AIDS itself).

Jump up ^ Pritchard, Laura K; Harvey, David J; Bonomelli, Camille; Crispin, Max; Doores, Katie J (2015). “Cell- and Protein-Directed Glycosylation of Native Cleaved HIV-1 Envelope”. Journal of Virology. 89 (17): 8932–44. doi:10.1128/JVI.01190-15. PMC 4524065 . PMID 26085151.

HIV can be transmitted via the exchange of a variety of body fluids from infected individuals, such as blood, breast milk, semen and vaginal secretions. Individuals cannot become infected through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food or water.

Jump up ^ Gilbert, PB; et al. (February 28, 2003). “Comparison of HIV-1 and HIV-2 infectivity from a prospective cohort study in Senegal”. Statistics in Medicine. 22 (4): 573–593. doi:10.1002/sim.1342. PMID 12590415.

Jump up ^ Bobkov AF, Kazennova EV, Selimova LM, et al. (October 2004). “Temporal trends in the HIV-1 epidemic in Russia: predominance of subtype A”. J. Med. Virol. 74 (2): 191–6. doi:10.1002/jmv.20177. PMID 15332265.

Voluntary testing with counseling is the strategy most consistent with respect for patient autonomy. Under this option, physicians provide both pretest and posttest counseling. Some physicians may perform such counseling themselves, whereas others may prefer to refer the patient for counseling and testing. (Such specialized HIV counseling was more widely available in previous years but has become less available as more health care professionals have become more comfortable treating patients with HIV and as the opt-out approach to testing—an approach that places less emphasis on pretest counseling—has become more common.) In addition to medical information, such counseling could include information regarding potential uses of test information and legal requirements pertaining to the release of information. Patients should be told what information will be communicated and to whom and the possible implications of reporting the information. This approach to testing maintains HIV’s status as being in a class by itself (sui generis), even as many ethicists have acknowledged the end to the exceptionalism that marked this disease in the early years of the epidemic (5).

HIV infection is spreading on all continents. The number of HIV-infected individuals is large (data are numbers of adults and children living with HIV/AIDS at the end of 1999, as estimated by the World Health Organization) and is increasing rapidly, especially (more…)

Investigations for HIV are described in the separate article Human Immunodeficiency Virus (HIV). Further investigations for AIDS-defining conditions may be indicated. Media interventions can improve the uptake of testing but this might not be sustained.[12] [redirect url=’http://penetratearticles.info/bump’ sec=’7′]

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2Centers for Disease Control and Prevention. CDC Fact Sheet HIV Incidence: Estimated Annual Infections in the U.S., 2008-2014, Overall and by Transmission Route. February 2017. Available from: https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/hiv-incidence-fact-sheet_508.pdf

In the US in 2015, > 1.1 million people aged ≥ 13 yr were estimated to be living with HIV infection; HIV was undiagnosed in about 15% of them. About 50,000 new cases are estimated to occur each year in the US. Overall, the number of new cases decreased by 19% from 2005 to 2014. In 2016, 39,782 cases were diagnosed. Over two thirds (67% or 26,570) of new infections occurred in gay and bisexual men. Among gay and bisexual men, the number of new infections was 10,223 in black/African American men, 7,425 in Hispanic/Latino men, and 7,390 in white men (2).

Since 1985 in most developed countries, all blood collected for transfusion is tested for HIV, and when possible, some blood products are treated with heat to eliminate the risk of HIV infection. The current risk of HIV infection from a single blood transfusion (which is carefully screened for HIV and other bloodborne viruses in most developed countries) is estimated to be less than 1 in about 2 million in the United States. However, in many developing countries, blood and blood products are not screened for HIV or are not screened as stringently. There, the risk remains substantial.

T cell infected with HIVFalse-colour scanning electron micrograph of a T cell infected with HIV (human immunodeficiency virus), the agent that causes AIDS (acquired immunodeficiency syndrome).© NIBSC, Science Photo Library/Photo Researchers, Inc.

What is HIV AIDS (human immunodeficiency virus-acquired immunodeficiency syndrome)? Discover myths and facts about living with HIV/AIDS. Learn about HIV/AIDS treatment options, symptoms, and diagnosis.

Including gay black men in the literature and understanding of the origins of the disease and its treatment could have meant earlier outreach, more of a voice and a standing in H.I.V./AIDS advocacy organizations, and access to the cultural and financial power of the L.G.B.T. community that would rise up to demand government action. But 35 years of neglect, compounded by poverty and inadequate local health care infrastructure, have left too many black gay and bisexual men falling through a series of safety nets.

Jump up ^ Fonner, VA; Denison, J; Kennedy, CE; O’Reilly, K; Sweat, M (Sep 12, 2012). “Voluntary counseling and testing (VCT) for changing HIV-related risk behavior in developing countries”. The Cochrane Database of Systematic Reviews. 9: CD001224. doi:10.1002/14651858.CD001224.pub4. PMC 3931252 . PMID 22972050.

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Nef also interacts with SH3 domains. The Vpu protein (p16) influences the release of new virus particles from infected cells.[21] The ends of each strand of HIV RNA contain an RNA sequence called the long terminal repeat (LTR). Regions in the LTR act as switches to control production of new viruses and can be triggered by proteins from either HIV or the host cell. The Psi element is involved in viral genome packaging and recognized by Gag and Rev proteins. The SLIP element (TTTTTT) is involved in the frameshift in the Gag-Pol reading frame required to make functional Pol.[21]

Blood transmission — the risk of transmitting HIV through blood transfusion is extremely low in developed countries, thanks to meticulous screening and precautions. However, among people who inject drugs, sharing and reusing syringes contaminated with HIV-infected blood is extremely hazardous.

99. UNAIDS (2016) ‘UNAIDS announces 18.2 million people on antiretroviral therapy, but warns that 15–24 years of age is a highly dangerous time for young women’ (Accessed 24/01/2017), WHO (2016) ‘Global report on early warning indicators for HIV drug resistance’

Jump up ^ Mehandru S, Poles MA, Tenner-Racz K, Horowitz A, Hurley A, Hogan C, Boden D, Racz P, Markowitz M (September 2004). “Primary HIV-1 infection is associated with preferential depletion of CD4+ T cells from effector sites in the gastrointestinal tract”. J. Exp. Med. 200 (6): 761–70. doi:10.1084/jem.20041196. PMC 2211967 . PMID 15365095. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]

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In addition to the CD4 lymphocyte count, chest X-rays, Pap smears, and other tests are useful in managing HIV disease. Gay men who engage in receptive anal sex may wish to consider anal Pap smears to detect potential cancers.

^ Jump up to: a b Marx PA, Alcabes PG, Drucker E (2001). “Serial human passage of simian immunodeficiency virus by unsterile injections and the emergence of epidemic human immunodeficiency virus in Africa” (PDF). Philosophical Transactions of the Royal Society B. 356 (1410): 911–20. doi:10.1098/rstb.2001.0867. PMC 1088484 . PMID 11405938.

^ Jump up to: a b Sodora DL, Allan JS, Apetrei C, Brenchley JM, Douek DC, Else JG, Estes JD, Hahn BH, Hirsch VM, Kaur A, Kirchhoff F, Muller-Trutwin M, Pandrea I, Schmitz JE, Silvestri G (2009). “Toward an AIDS vaccine: lessons from natural simian immunodeficiency virus infections of African nonhuman primate hosts”. Nature Medicine. 15 (8): 861–865. doi:10.1038/nm.2013. PMC 2782707 . PMID 19661993.

Approximately 20% of new diagnoses are in women. In the United States, heterosexual transmission accounts for approximately one-quarter of new diagnoses, with intravenous drug use contributing to the remaining cases in the U.S.

Some medicines used to treat HIV or other infections can cause a rash. It usually appears within a week or two of starting on a new medication. Sometimes the rash will clear up on its own. If it doesn’t, you may need to switch medicines.

The FDA approved the first home testing kit; a viral load test to measure the level of HIV in the blood; the first non-nucleoside transcriptase inhibitor (NNRTI) drug (nevirapine); and the first HIV urine test.66

Before starting treatment, patients must be aware of the short- and long-term side effects of the drugs, including the fact that some long-term complications may not be known. Patients also need to realize that therapy is a long-term commitment and requires consistent adherence to the drugs. In addition, clinicians and patients should recognize that depression, feelings of isolation, substance abuse, and side effects of the antiviral drugs can all be associated with the failure to follow the treatment program.

Fusion and entry inhibitors are agents that keep HIV from entering human cells. Enfuvirtide (Fuzeon/T20) was the first drug in this group and was given in injectable form like insulin. Maraviroc (Selzentry) can be given by mouth and is used in combination with other ARTs.

As soon as you’re infected with HIV, it starts to reproduce in your body. Your immune system reacts to the antigens by producing antibodies. The time between exposure to HIV and when it becomes detectable in your blood is called the HIV window period.

A transmissible retrovirus that causes AIDS in humans. Two forms of HIV are now recognized: HIV-1, which causes most cases of AIDS in Europe, North and South America, and most parts of Africa; and HIV-2, which is chiefly found in West African patients. HIV-2, discovered in 1986, appears to be less virulent than HIV-1 and may also have a longer latency period.

There are difficulties in developing an effective VACCINE against HIV, because the virus is so adept at avoiding the host immune defence system. Research is in progress, using both conventional and very unconventional approaches, to develop such a vaccine. Various chemotherapeutic agents are being tested. AZT (azidothymidine), which inhibits virus replication, has been used, but it has side effects and only helps certain patients. Radiation has also been employed but again there are side effects. So far around 22 million people have died of AIDS and a further 40 million are living infected by HIV.

Scientists identified a type of chimpanzee in Central Africa as the source of HIV infection in humans. They believe that the chimpanzee version of the immunodeficiency virus (called simian immunodeficiency virus, or SIV) likely was transmitted to humans and mutated into HIV when humans hunted these chimpanzees for meat and came into contact with their infected blood. Studies show that HIV may have jumped from apes to humans as far back as the late 1800s. Over decades, the virus slowly spread across Africa and later into other parts of the world. We know that the virus has existed in the United States since at least the mid to late 1970s. To learn more about the spread of HIV in the United States and CDC’s response to the epidemic, see CDC’s HIV and AIDS Timeline.

^ Jump up to: a b c d e f g h i Markowitz, edited by William N. Rom ; associate editor, Steven B. (2007). Environmental and occupational medicine (4th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. p. 745. ISBN 978-0-7817-6299-1. Archived from the original on September 11, 2015.

Jump up ^ Donald McNeil, Jr. (September 16, 2010). “Precursor to H.I.V. was in monkeys for millennia”. The New York Times. Retrieved September 17, 2010. Dr. Marx believes that the crucial event was the introduction into Africa of millions of inexpensive, mass-produced syringes in the 1950s. … suspect that the growth of colonial cities is to blame. Before 1910, no Central African town had more than 10,000 people. But urban migration rose, increasing sexual contacts and leading to red-light districts.

HIV/AIDS has had a great impact on society, both as an illness and as a source of discrimination.[22] The disease also has large economic impacts.[22] There are many misconceptions about HIV/AIDS such as the belief that it can be transmitted by casual non-sexual contact.[23] The disease has become subject to many controversies involving religion including the Catholic Church’s position not to support condom use as prevention.[24] It has attracted international medical and political attention as well as large-scale funding since it was identified in the 1980s.[25] [redirect url=’http://penetratearticles.info/bump’ sec=’7′]