"The First Step Toward Change is Awareness. The Second Step is Acceptance." -Dr. Nathaniel Branden

With each week that goes by, I feel like I am becoming one with the pandemic that they call AIDS even though I myself am not HIV/AIDS positive. With all of the intensive information that we are subjected to each week, AIDS has implanted itself into our lives as well. Even if we didn't have this course, why shouldn't it? AIDS affects everyone: your neighbors, teachers, friends, lovers, children, co workers, peers. It is no longer just about protecting yourself to create one less person in the fight, but also about learning for the sake of progression; for the sake of all of those people. AIDS has existed for over thirty years now without a cure or vaccine. It has existed longer than many other infections that have breezed through. I say "breezed" because these infections often receive the attention and precaution that all contagious/infectious diseases need to squander it. AIDS has yet to receive such diligence. So why shouldn't we be the generation to change things? Even for those us not directly affected by AIDS or not directly participating in the pandemic, knowledge is the fundamental key. Just understanding the virus (like an enemy) leaves it's tactics unsurprising and it's existence vulnerable to defeat.

Did You Know...??

We all know stigma, and religious stigma especially takes a toll on the way HIV positive people are viewed. Earlier this month, Representatives of 40 different religious and faith groups including Christianity, Judaism, Islam, Buddhism, Hinduism met in a two day retreat in the Netherlands. There the members signed a "personal commitment to action" which requires them to be clear in their teachings about discriminating against those living with HIV. This is important according to UNAIDS because religious acceptance will empower "solidarity" among the communities that follow them and "ensure people living with HIV are being treated with respect and dignity." However, the draw back is religion is having a hard time incorporating public health issues when discussing morality and spirituality because HIV prevention such as condoms and men to men sex is considered immoral.

Reference:

-web: Religious Leaders Vow to Fight HIV/AIDS Stigma, Discrimination. March 25, 2010. MedicalNewsToday.com. Retrieved 3/31/10 from http://www.medicalnewstoday.com/articles/183480.php.

Russia for the Gold

While many are excited about the chance to eat M&M's in the simulation, my thoughts are turned away from the enjoyable little candies and the fact that I am terrible at following a scheduled pill regiment. The purpose of the simulation comes into play after all. From everything that I've learned so far about HIV/AIDS, I appreciate the fact that I am a healthy and young individual that does not have to bear this particularly sorrowful responsiblity. I like to think of AIDS in the way that Catherine Wyatt-Morley described it during an excerpt from her diary AIDS Memoir: Diary of a HIV-Positive Mother. AIDS is much like a cross that some people are forced to bear. Those who are healthy and bear no burden should not judge them based off of AIDS because sooner or later, we will all bear a cross of our own.

Did You Know...??

Over the decades since HIV/AIDS was first discovered, it has changed hands as too what groups become the largest group of newly infected or most at risk. In America and most of the Western world we have seen that gay's are the most affected. However while areas like the Western countries and Sub Saharan Africa which are taking steps to prevent and reduce newly infected rates, Eastern Europe and Central Asia are taking the lead. Unlike America where the highest rate is passed MSM (men having sex with men), Russia's transmission acounts almost solely from Injecting drug users and women who have sex with those drug users. According to avert.com, 90% of Eastern Europe's new infections come from Russia and Ukraine alone. In 2007, 65% of newly infected cases were from male drug injectors. 83% of all of the people who know their infection history account for transmission through sharing needles. In 2007, 44% of newly infected women recieved the virus through having sex with men who were HIV positive through drug use with another 35% infected directly through drug use.

Reference List:

-Web: HIV and AIDS in Russia Eastern Europe & Central Asia. Updated 3/11/10. Avert.org. Retrieved 3/24/10 from http://www.avert.org/aids-russia.htm.

AZT, synonomous with Cancer?

Spring break has given us time away from classes, and my HIV results have given me time away from the world of AIDS even just for a little while. Although Teach's intention was to heighten our awareness by making us wait the full two weeks, I didn't have too much of a problem. However, I will admit, the prospect was always lingering over my head. On the way home in the car after getting my results (negative), a variety of thoughts streamed through my mind. For one, I was happy to think of my blood as "clean" in regards to HIV because in other ways it is not. I was happy to no longer have to deal with the idea of "what if"; now I had definite results. And while part of me was also happy that I can continue my life without too much of a fight, I remembered and always will remember those that do because of AIDS.

Did You Know...??

On December 18Th, 2009, Zidovudine or otherwise known as AZT was added to the Office of Environmental Health Hazard Assessment list of environmental toxins known to cause cancer and reproductive toxicity. In the process of stopping the integral process of the HIV virus into the host DNA, the medicine causes irreversible damage to the host DNA and mitochondria responsible for cell division. You must also keep in mind that cancer is defined as uncontrolled cell division. According to the official website: AZT causes Cancer, "more HIV positive women in South Africa (where widespread use of AZT occurs) are giving birth to brain- damaged children. Sometimes it shows up years after birth in the form of developmental disabilities." Although AZT remains the most common drug to treat HIV/AIDS, no maximum dosage of toxicity has been warranted.

Reference List:

-Web: AZT Causes Cancer. Feb 27, 2010. Heal London. Retrieved 3/16/10 from, http://www.heallondon.org/health-and-well-being/93-azt-causes-cancer-official.html.

-Photo: http://www.nlm.nih.gov/exhibition/aidsephemera/images/azt.jpg.

If con is the opposite of pro, then is Congress the opposite of Progress?

When I think about what aspect of HIV that I have taken the most from, I must think about what I believed before this course and those elements that have changed along the way. Prior to, most of my knowledge was limited to the scientific fundamentals. What I did not understand is why in the twenty fist century when we had a cure or vaccine for nearly anything, was there not something to prevent the inevitable fate of AIDS? This is where this class comes into play. With all of the information from the first hand documentaries, diaries, and textbooks I've found that one of the most influential factor behind the AIDS epidemic is government. The future of AIDS and those living with it depends on the funding, law passing, prevention, education, research, and many more as the list goes on and on. It essentially is because of the government and their inability to mobilize that we do have an AIDS epidemic. It is because of their standards and personal morality (i.e Jessie Helms, President Reagan) that stigma exists so publically. It shows me that while the science regard is incredibly important, it is just as important to follow policies in government in respect to AIDS since its role is so key to the allocation and progression of medicine.

Did You Know...??

While in class we have learned about CRF's or circulating recombiant forms of HIV, did you know there may be a possibility of superinfection? Superinfection or otherwise known as reinfection, occurs when an already HIV positive person acquires a second different strand of HIV after establishing the existence of the first strand. Superinfection is less common to interpret and often confused with co-infection. Co-infection is when a person acquires two different strands of HIV from multiple partners simultaneously before a seroconversion is established. More importantly though, the people MOST at risk for superinfection are newly infected or those with a low plasma viral load. Oppositely, those with detectable viral loads are less at risk. This is explained by the fact that those with a detectable load, have less cells to target. Unlike their undetectable counterparts, their antiviral immune response is much more active and does not allow the virus to sneak by so passively. (Center for AIDS Prevention Study)

Reference List:

What Do We Know About AIDS Superinfection? Revised May, 2006. Center for AIDS Prevention Study. Retrieved March 10, 2010 from, http://www.caps.ucsf.edu/pubs/FS/revsuperinfection.php.
Photo: http://www.wellsphere.com/wellpage/hiv-virus-pictures.

Mid Semester

As this week comes to an end, I've had more time to absorb the event and the information from the crazy week before. The movies shed new light on the short duration that HIV has existed in this world. It's truely amazing how little we knew about this thirty years ago and how far we have come with ART's and medications to slow and box in the virus. It is also amazing how little society has grown from its affect. Most of this I feel, can be explained by the inability of schools to educate about AIDS without being about to discuss the high risk behaviors involved with it. While some steps have been taken such as promoting condoms in the anscence of abstinence, other topics such as homosexuality (which is on the rise) and drug use (which some may eventually fall victim to) are not talked about. The movie Age of AIDS shed light on the chronological history of AIDS and how it has seeped into nearly every demographic and region of the world. It was fascinating to watch the evolution of this virus unlike anything else.

Did You Know... About False Positives??


We already know that it is possible for people within the window period to test negative when actually being positive for HIV, it is also possible for the reverse. The common screening test, ELISA works by targeting certain anitbodies and then yeilding a positive if the target is found. However, the body can sometimes has different antibodies that trick the test, yeilding a positive when in fact the person is negative. These can include antibodies in instances of tuberculosis, malaria, and rheumatoid arthritis (cross- reactivity with other retroviruses). Other can include contamination at the lab, pregnancy, or a history of drug use. The chances of this happening are minimal: 1-5 per 100,000 assays. Should a person test positive, a Western Blot test should immediatly be taken to ensure the positive is in fact positive. This test works mainly as a confirmation test that specifically targets the HIV virus.

Add On

Freddie Mercury


Lead vocalist of the rock band Queen. Died on November 24, 1991 by AIDS related bronchopneumonia just 24 hrs. after the public disclosure of his status.








Arthur Ashe

First and only African American to win the Wimbledon's men singles to date, and one of two African American men to win the Grand Slams Title. Ashe contracted HIV through blood transfusions recieved during heart surgery and later died on February 6, 1993 from AIDS related toxoplasmosis.





Reference List:

1. Jones, Liz. Causes of a False Positive. eHow. retrieved March 3, 2010 from, http://www.ehow.com/about_5045612_causes-false-positive-hiv-test.html.

2. Arthur Ashe. Arthurashe.org. Retrieved March 3, 2010

3. Photo: Biographicon. Retrieved March 3, 2010 from, http://www.biographicon.com/view/ah91h.

4. Freddie Mercury Biography. Retrieved March 3, 2010 from http://www.freddie.ru/e/bio/.

5. Photo: Style Inspiraion: Mr. Mercury. Retrieved March 3, 2010 from :http://www.ultrapdx.com/zero/2007/12/18/style-inspiration-mr-mercury/.

Irony

This week has definitely been interesting one in regards to the aspect I have found this class to be playing in my personal life. This past Friday was when I went to Miracle of Love for my HIV test. With much searching and driving in circles, my friend and I were finally able to find the quaint little household turned business called Miracle of Love. We felt like we were at some sort of private resort rehab from the looks of the outside. Once inside, the lady at the desk gave us free handouts, free condoms, magazines, and even a free DVD on AIDS and black women. We were the only ones there and waited less than ten minutes before Iris took me back and went through the drill with me. The entire process was pretty much effortless as there was no wait and even no fee! I don't know how many people go seeing as there was no inside, but I would hope and recommend this place to anyone because it is free and the environment and people are comforting and genuine.

On another note, I finally got around to watching Common Threads yesterday in the library. I had already previously rented Silverlake Life and ended up crying at the end as I'm sure most people do. What I enjoyed so much about Common Threads is that it tries to break the notion that HIV/AIDS is restricted to homosexuals. Instead, it evokes stories of all those affected, both gay, hemophiliacs, and drug users alike. Overall, the emotions that I felt from watching this movie wasn't just sadness, but anger. Much of the footage is from the 80's, the time when AIDS was just being discovered. During this time, people were unbelievably discriminated against; houses were being burned down, people were being mugged and killed, and the Reagan administration didn't even address AIDS until after thousands had died. On top of that, the administration was against sex education despite the need to inform children about AIDS based on the fact he may advocating sex. He should have been worried about saving lives.

But to now get to the point of the title of my blog for this week: Irony. I say this, because this week I found out that someone in my immediate family has been seeing someone who is HIV positive. While AIDS/HIV does exist and we have often times run into people who are positive without even knowing it, it was incredibly unexpected to think that someone I love dearly has put themselves knowingly at risk for this disease. I call it ironic because of the circumstance in addition to my enrollment in this class. Needless to say, we discussed it thoroughly and considered the risk at hand. Since my return date for my HIV results are coming up, we have decided to go together so that she may get tested as well. While none of this pleases me, I am happy about one thing: the timing. Had I not been enrolled in this class, I would not have been able to comfort or educate her in any manner besides my support really. I would not have been able to tell her about the window period, about ALL of the types of transmission, or the finite details of how the virus works.


Did You Know...HIV Risk of Different Sex Practice?


Perhaps one thing that spurred on this topic is the referral to AIDS as a "gay disease." I was interested to find why homosexuals were at such a greater risk for contracting HIV more so than heterosexuals. From anatomy and biology, we learn that the skin all over your body has different structures and makeup (stratified, simple, transitional, pseudo stratified, etc.) depending on its location. From this we can ask, why is anal sex much more risky than vaginal sex? This is because the skin and mucosa lining in the rectum has fewer cells than the vagina and can be damaged more easily (especially since things aren't meant to go in). I found statistics from the Center for Disease and Control Website that matched this inference.


This information is AIDS cases by transmission up to 2007



Type
Male to Male Contact: 487,695
Drug Injection: Male:175,704 Female: 80,155 (255,859 total)
Male to Male Contact + Drug Injection: 71,242
Male to Female Contact: Male: 63,927 Female: 112,230 (176,157 total)
Other: Male: 12,108 Female: 6,158 (18,266 Total)

From this I calculated the percentage that people contract HIV from male to male (anal) and male to female (vaginal). Accordingly, 48% of all estimated cases are homosexuals, 6% of heterosexual men, and 11% of heterosexual women. While the percentage for heterosexuals seem small, the percentage of those infected by drug use (24% total men and women) is not accounted for transmission via intercourse. Obviously, these numbers are in accordance with the fact that anal intercourse is the number one high risk behavior. Oral sex is least risky with only 4% (Avert.org). In addition, an article from About.com: AIDS/HIV claims that female heterosexuals are more at risk than male heterosexuals. This, much like the recipient of anal sex, is caused from the tearing of the mucosa lining in the woman allowing direct entrance into the bloodstream. These statistics support this inference as well as 11% of heterosexual woman are infected compared to the 6% in men.

Overall, AIDS is not a "gay disease", but rather the behavior that puts you most at risk. From a biological standpoint, having anal sex is the highest at risk behavior simply because of the skin tissue found there.

Reference List:
Cichocki, M. About.com:AIDS/HIV (2009). Retrieved Feb 24, 2010
CDC: Center for Disease and Control. (2007). Retrieved Feb 24, 2010 from http://www.cdc.gov/hiv/topics/surveillance/basic.htm#exposure.
Picture: bp.blogspot.com/.../s320/homosexual-gay.gif

Week Four... Approaching HIV Testing

Looking at the calendar, we are coming up to the last three weeks that we need to allot for HIV test results before they are due. Although in one sense, the drive to get free testing is a little bit of a nuisance,but the prospect of having concrete results makes it worth it. I have considered today, would I even go get HIV tested if this class didn't require me to? And the answer is yes. Ultimately by not doing so, I am putting myself and others at risk and not being a responsible being of society.

On another note, I'm also coming to close to AIDS Memoir, a diary of a HIV positive black mother. It really plays of the theme of how detrimental lack of education plays on the spread of AIDS. For example, one group Catherine targets are those with geriatric AIDS. Many old people choose to be uneducated because they feel HIV doesn't happen to them but rather their children and grandchildren. They don't seem the harm in a little fling in their old age until they show up with AIDS. Many don't even get tested for it was a possibility to their poor health in old age. I found this information to be interesting as most people point the finger at the homosexual congregation.

Did You Know...You Can Get More Than One Strand of HIV??

For many of us, we assume that HIV is one single evil entity killing thousands of people at a time. But much like the common cold or flu that has multiple strands that mutate throughout the year, HIV can be divided into types, groups, and even further to subtypes!

As the diagram shows, HIV can be first categorized as either HIV-1 or HIV-2. HIV-2 is regionalized to on West Africa and is less virulent than HIV-1. This means that people living with HIV-2 have a longer time period between infection and serious illness or AIDS. While both types are spread through blood contact, intercourse, and childbirth, HIV-2 cannot be spread via sharing needles. HIV-1 is divided into groups M (major), O (Outlier), and N (New). HIV-1 group M accounts for 90% of all cases and is generally what people refer to when they say "HIV". Group M has 9 subtypes plus CRFS (circulating recombinant forms). (Avert.org).

Subtype B is found in the Americas, Europe, Japan, and Australia
Subtype C is found in southern/eastern Africa, and India. It accounts for half of all HIV cases and has caused the worst epidemics

Subtype A / CRFs are found in West/Central Africa and is less virulent than C or B
Now if you didn't know that HIV had that many subdivisions, let me blow your mind a little more as to how quickly HIV likes to join and compound the problem. As I briefly mentioned CRFs before, they stand for circulating recombinant forms. This means that two virus strands have replicated together or rather had "viral sex" and created a totally new subtype distinct for that person. For example, if a person has CRF A/B, they have both subtype A and subtype B. (Introduction to HIV Types, Groups, and Subtypes).

Reference List:
HIV Types, Groups, Subtypes and Strains. Avert.org. Retrieved February 16, 2010 from Avert.org

Text and Graph 1:

Introduction to HIV Types, Groups, and Subtypes. Retrieved February 16, 2010 from
http://www.bodyandmind.co.za/healthweb/Introduction_to_HIV_types.html

Map: The Age of AIDS; Frontline. PBS.org. Retrieved February 16, 2010 from http://www.pbs.org/wgbh/pages/frontline/aids/atlas/clade.html