Circumcision in Sub-Saharan Africa “reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months”. Due to these studies, both the World Health Organization and UNAIDS recommended male circumcision as a method of preventing female-to-male HIV transmission in 2007 in areas with a high rates of HIV. However, whether it protects against male-to-female transmission is disputed, and whether it is of benefit in developed countries and among men who have sex with men is undetermined. The International Antiviral Society, however, does recommend for all sexually active heterosexual males and that it be discussed as an option with men who have sex with men. Some experts fear that a lower perception of vulnerability among circumcised men may cause more sexual risk-taking behavior, thus negating its preventive effects.
Keith Boykin, a former Clinton White House aide, became so incensed by the down-low hysteria that he wrote a 2005 best-selling book, “Beyond the Down Low: Sex, Lies and Denial in Black America.” “Because the whole down-low story was doing a disservice to the black gay community and creating a racially troubling narrative that black men who have sex with men were villains, I felt I had to step in and correct the record,” said Boykin, a CNN commentator who teaches at Columbia University’s Institute for Research in African-American Studies. “I think the near-decade-long obsession with the down low diverted our attention into what was really a side issue.”
Lambert-Niclot S, Tubiana R, Beaudoux C, et al. Detection of HIV-1 RNA in seminal plasma samples from treated patients with undetectable HIV-1 RNA in blood plasma on a 2002-2011 survey. AIDS. 2012 May 15. 26(8):971-5. [Medline].
Over time, three potential strategies for HIV testing have been considered by public health and public policy officials: 1) universal testing with patient notification and right of refusal, also called “opt-out” testing; 2) voluntary testing with pretest counseling regarding risks and benefits, also called “opt-in” testing; and 3) mandatory testing with no right of refusal. In order to understand their ethical merits, each is considered briefly in the sections that follow. Increasingly, national organizations and federal agencies have recommended opt-out testing in preference to other strategies.
hypermobility syndrome; joint hypermobility syndrome disordered collagen (types 1 and 3) structure, with associated decreased tensile strength of skin/structural tissues; characterized by generalized joint hypermobility, easy bruising, impaired healing, increasing incidence of joint/soft-tissue pain, joint dislocation and osteoarthritis; a presenting feature of benign familial joint hypermobility syndrome (BFJHS) (see Table 3), Ehlers-Danlos syndrome, Marfan syndrome and osteogenesis imperfecta
HIV infection is commonly diagnosed by blood tests. Testing for HIV is usually a two-step process. First, a screening test is done. If that test is positive, a second test (Western blot) is done to confirm the result.
ABSTRACT: Because human immunodeficiency virus (HIV) infection often is detected through prenatal and sexually transmitted disease testing, an obstetrician–gynecologist may be the first health professional to provide care for a woman infected with HIV. Universal testing with patient notification and right of refusal (“opt-out” testing) is recommended by most national organizations and federal agencies. Although opt-out and “opt-in” testing (but not mandatory testing) are both ethically acceptable, the former approach may identify more women who are eligible for therapy and may have public health advantages. It is unethical for an obstetrician–gynecologist to refuse to accept a patient or to refuse to continue providing health care for a patient solely because she is, or is thought to be, seropositive for HIV. Health care professionals who are infected with HIV should adhere to the fundamental professional obligation to avoid harm to patients. Physicians who believe that they have been at significant risk of being infected should be tested voluntarily for HIV.
^ 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. Archived (PDF) from the original on September 17, 2013.
A severe immunological disorder caused by the retrovirus HIV, resulting in a defect in cell-mediated immunity that is manifested by increased susceptibility to opportunistic infections and to certain rare cancers, especially Kaposi’s sarcoma. It is transmitted primarily by exposure to infected body fluids, especially blood and semen.
Jump up ^ Over M (1992). “The macroeconomic impact of AIDS in Sub-Saharan Africa, Population and Human Resources Department” (PDF). The World Bank. Archived (PDF) from the original on May 27, 2008. Retrieved May 3, 2008.
“Resistance occurs when the virus replicates in the presence of the drugs,” said Dr. Stephen Boswell, president and CEO of Boston’s Fenway Health, a healthcare organization that works with lesbian, gay, bisexual and transgender people. “Missed dosages lead to lower concentrations in the bloodstream and in the body, so the virus can become resistant and spread. So staying on your medications and not missing dosages is absolutely critical.”
In 1983, two separate research groups led by American Robert Gallo and French investigators Françoise Barré-Sinoussi and Luc Montagnier independently declared that a novel retrovirus may have been infecting AIDS patients, and published their findings in the same issue of the journal Science. Gallo claimed that a virus his group had isolated from a person with AIDS was strikingly similar in shape to other human T-lymphotropic viruses (HTLVs) his group had been the first to isolate. Gallo’s group called their newly isolated virus HTLV-III. At the same time, Montagnier’s group isolated a virus from a patient presenting with swelling of the lymph nodes of the neck and physical weakness, two classic symptoms of AIDS. Contradicting the report from Gallo’s group, Montagnier and his colleagues showed that core proteins of this virus were immunologically different from those of HTLV-I. Montagnier’s group named their isolated virus lymphadenopathy-associated virus (LAV). As these two viruses turned out to be the same, in 1986 LAV and HTLV-III were renamed HIV.
Supported by the National Special Science & Technology Program on Major Infectious Diseases (No. 2012ZX10005010-001, No.2013ZX10005001-001); and Henan Province Basic and Advanced Technology Research Project (No.152300410165), and Henan Province Colleges and Universities Key Youth Teachers Scheme (No. 2013GGJS-095)
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.
Without treatment, human immunodeficiency virus (HIV) infection will usually result in acquired immune deficiency syndrome (AIDS). However, in Australia the HIV therapies introduced in the mid-1990s, which are available to all Australians living with HIV, have resulted in fewer AIDS related illnesses and deaths. Therefore, whilst a cure is yet to be found for HIV and it remains a lifelong infection, HIV in Australia is now considered a chronic manageable condition.
The one way in which we know we can protect against infection with HIV is by avoiding contact with body fluids, such as semen, blood, blood products, or milk from people who are infected. Indeed, it been demonstrated repeatedly that this precaution, simple enough in the developed world, is sufficient to prevent infection, as health-care workers can take care of AIDS patients for long periods without seroconversion or signs of infection.
These results provide a dramatic confirmation of experimental work suggesting that CCR5 is the major macrophage and T-lymphocyte co-receptor used by HIV to establish primary infection in vivo, and offers the possibility that primary infection might be blocked by therapeutic antagonists of the CCR5 receptor. Indeed, there is preliminary evidence that low molecular weight inhibitors of this receptor can block infection of macrophages by HIV in vitro. Such low molecular weight inhibitors might be the precursors of useful drugs that could be taken by mouth. Such drugs are very unlikely to provide complete protection against infection, as a very small number of individuals who are homozygous for the nonfunctional variant of CCR5 are infected with HIV. These individuals seem to have suffered from primary infection by CXCR4-using strains of the virus.
The 2016 guidelines include new alternative ARV options with better tolerability, higher efficacy, and lower rates of treatment discontinuation when compared with medicines being used currently: dolutegravir and low-dose efavirenz for first-line therapy, and raltegravir and darunavir/ritonavir for second-line therapy.
Your doctor can monitor how well your HIV treatment is working by measuring the amount of HIV in your blood (also called the viral load.) The goal of treatment is to get the viral load undetectable on labs tests; ideally less than 20 copies. This does not mean the virus is gone or cured, it means the medication is working and must be continued.
A family history of primary immunodeficiency is the strongest predictor of a disorder. At birth and for only a few months, babies are partially protected from infections by antibodies transmitted to them by their mothers. Typically, the earlier the age at onset of signs of an immunodeficiency in children, the more severe the disorder. Testing can be done within the first few months, but it is also important to recognize the early signs: recurrent infections and failure to thrive. Initial laboratory screening should include a complete blood count with differential and measurement of serum immunoglobulin and complement levels.
acquired immune deficiency syndrome of humans, caused by the lentivirus, human immunodeficiency virus 1 (HIV1), less commonly HIV2. The virus initially infects macrophages and then attacks and destroys T helper CD4 lymphocytes, thereby producing immunodeficiency and resulting in death, usually after a very prolonged incubation period followed by a very prolonged clinical course. A very similar virus SIV1 causes simian AIDS in captive macaque monkeys. A further similar virus SIV2 has been isolated from healthy green monkeys.
In 1981, cases of a rare lung infection called Pneumocystis carinii pneumonia (PCP) were found in five young, previously healthy gay men in Los Angeles.2 At the same time, there were reports of a group of men in New York and California with an unusually aggressive cancer named Kaposi’s Sarcoma.3
Malaria occurs in over 100 countries and territories. More than 40% of the people in the world are at risk. Large areas of Central and South America, Hispaniola (Haiti and the Dominican Republic), Africa, the Indian subcontinent, Southeast Asia, the Middle East, and Oceania are considered malaria-risk areas. The World Health Organization estimates that yearly 300-500 million cases of malaria occur and more than 1 million people die of malaria. About 1,200 cases of malaria are diagnosed in the United States each year. Most cases in the United States are in immigrants and travelers returning from malaria-risk areas, mostly from sub-Saharan Africa and the Indian subcontinent.
^ Jump up to: a b World Health Organization (May 2003). Nutrient requirements for people living with HIV/AIDS: Report of a technical consultation (PDF). Geneva. Archived (PDF) from the original on March 25, 2009. Retrieved March 31, 2009.
(See also Human Immunodeficiency Virus (HIV) Infection in Infants and Children, the National Institute’s of Health AIDSInfo web site, and the recommendations of the HIV Medicine Association of the Infectious Diseases Society of America: Primary Care Guidelines for the Management of Persons Infected with HIV.)
The specific details of the disease process that leads to AIDS are not fully understood despite considerable progress in the virology of HIV and the immunology of the human host, much of which has been driven by the urge to better understand AIDS. [23, 24, 25]
Criminal transmission of HIV is the intentional or reckless infection of a person with the human immunodeficiency virus (HIV). Some countries or jurisdictions, including some areas of the United States, have laws that criminalize HIV transmission or exposure. Others may charge the accused under laws enacted before the HIV pandemic.
ART can usually achieve its goals if patients take their drugs > 95% of the time. However, maintaining this degree of adherence is difficult. Partial suppression (failure to lower plasma levels to undetectable levels) may select for single or multiple accumulated mutations in HIV that make viruses partially or completely resistant to a single drug or entire classes of drugs. Unless subsequent treatment uses drugs of other classes to which HIV remains sensitive, treatment is more likely to fail.
HIV continues to be a major public health crisis both in the United States and around the world. While major scientific advances have made it easier than ever to prevent and treat HIV, there remains no vaccine or cure, and tens of thousands of people continue to contract HIV every year. Insufficient funding for public health programs, ideological opposition to common sense prevention policies, and societal barriers like stigma and discrimination, have made it especially difficult for us to turn the tide against the epidemic. Together, HRC and the HRC Foundation are committed to working with our friends, partners, members, and supporters to end the dual epidemics of HIV and HIV-related stigma.
Preexposure prophylaxis with antiretrovirals (PrEP): In PrEP, people who are not infected with HIV but are at high risk (eg, by having an HIV-infected sexual partner) take an antiretroviral drug daily to reduce their risk of infection. The combination of tenofovir disoproxil fumarate plus emtricitabine (TDF/FTC) can be used. Use of PrEP does not eliminate the need to use other methods of reducing risk of HIV infection, including using condoms and avoiding high-risk behaviors (eg, needle sharing). Data concerning infants of HIV-negative mothers taking TDF/FTC PrEP during pregnancy are incomplete, but currently, no adverse effects have been reported in children born to HIV-infected women treated with TDF/FTC. Use of PrEP to reduce the risk of HIV infection in injection drug users is being studied. For the current CDC recommendations, see Pre-Exposure Prophylaxis (PrEP).
Risk of transmission from infected health care practitioners who take appropriate precautions is unclear but appears minimal. In the 1980s, one dentist transmitted HIV to ≥ 6 of his patients by unknown means. However, extensive investigations of patients cared for by other HIV-infected physicians, including surgeons, have uncovered few other cases.
Two points in this update deserve emphasis. First, the eventual case-mortality rate of AIDS, a few years after diagnosis, may be far greater than the 41% overall case-mortality rate noted above. Second, the reported incidence of AIDS has continued to increase rapidly. Only a small percentage of cases have none of the identified risk factors (male homosexuality, intravenous drug abuse, Haitian origin, and perhaps hemophilia A). To avoid a reporting bias, physicians should report cases regardless of the absence of these factors.
HIV-2’s closest relative is SIVsm, a strain of SIV found in sooty mangabees. Since HIV-1 is derived from SIVcpz, and HIV-2 from SIVsm, the genetic sequence of HIV-2 is only partially homologous to HIV-1 and more closely resembles that of SIVsm.
Sexual contact. People at greatest risk are those who do not practice safer sex by always using a condom, those who have multiple sexual partners, those who participate in anal intercourse, and those who have sex with a partner who has HIV infection and/or other sexually transmitted diseases (STDs). In the United States and Europe, most cases of sexually transmitted HIV infection result from homosexual contact, whereas in Africa, the disease is spread primarily through sexual intercourse among heterosexuals. Most people with AIDS in the United States are between 25 and 44 years of age. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]