Tuesday, February 5, 2013


Definition and history
AIDS is acquired immunodeficiency syndrome or acquired immune deficiency. This is a disease of the human immune system that is caused by a virus known as human immunodeficiency virus, commonly known as HIV. This disease is known for progressively reducing the effectiveness of the human immune system. This leaves the body vulnerable to opportunistic diseases and tumors. Aids was for the first time reported in June 1981. This was when the US Centers for Disease Control reported a group of Pneumocystis carinii pneumonia in five homosexual males in Los Angeles. There was no official name for the disease at the time. In the efforts to come up with an official name for the disease, CDC initially coined “the 4H disease.” This was because the disease seemed to single out “Haitians, homosexuals, hemophiliacs, and heroin users” (Guss, 1994:13). After the realization that the disease was not isolated to any of the four groups, the term GRID became problematic. The term AIDS in reference to the disease came up at a meeting in 1982. This term became popular from September 1982 and the disease became properly defined. The original known affirmative recognition of the HIV-1 virus emanates from the Congo in the year 1959 and 1960. However, there are genetic studies that reveal that the virus was transmitted into human beings from chimpanzees around five decades earlier. There has been a recent research arguing that a strand of the virus possibly came from Africa to Haiti and then came to America around the year 1969. The virus descends from simian immunodeficiency virus that infected monkeys and apes in Africa (Del Rio and Curran, 2009).   
Etiology and course
Aids is a clinical consequence on HIV infection. It is a retrovirus that basically infects vital organs of the immune system. Some of the organs that are infected are the CD4+ T cells, which are a subset of T cells, macrophages and dendritic cells. The virus directly or indirectly damages the CD4+ T cells. When the number of the CD4+ T cells per microliter of blood goes below 200, the immunity of the cells is lost. This disease is progressive from acute HIV infection to clinical latent infection and later to symptomatic infection and finally to full blown AIDS (Piot, 2007). The identification of these stages is on the basis of the number of CD4+ T cells left in the blood. The virus that is responsible for this disease is transmitted from one individual to another through direct contact of the bloodstream or mucus membrane with any fluid from the body that contains the virus. Some of the bodily fluids that are known for carrying the virus are blood, semen, preseminal fluid, vaginal fluid and breast milk. Transmission of the virus can take place through sex (anal, vaginal or oral), blood transfusion, infested hypodermic needles, and mother-child transmission during pregnancy, delivery and breastfeeding (Guss, 1994) Other ways by which the virus can be transmitted is through injury by a needle carrying the virus and organ transplantation. Other exposures to any of the named fluids can cause transmission. This virus once in the body and has attacked the immune system, common yeast, parasites, bacteria, and viruses that normally do not cause deadly diseases to a body with effective immune system cause serious illness. AIDS is not spread by bodily contacts such as hugging, mosquito bites, or touching an item that has been touched by an infected person. Some of the people who are vulnerable to the disease are: the people who inject drugs into their blood stream through shared needles, babies whose parents are infected and did not receive HIV therapy while pregnant, engaging in unprotected sex, receiving blood or organs that are not screened for the disease (Del Rio and Curran, 2009).   

AIDS is the number six among the leading causes of death in the United States among individuals aged between 25 and 44. It has fallen from number one on the list in 1995. International estimates from the World Health Organization (WHO) have revealed that 25 million individuals have died from the disease since it was reported. In the year 2008, there were about 33.4 million individuals infected, including about 2.1 million children below 15 years. Sub-Saharan Africa is the leading region in HIV infections. In the year 2007, it was estimated to have approximately 68 percent of the total number of infected people and 76 percent of all deaths from the disease (Del Rio and Curran, 2009).  
There is a detrimental impact of AIDS on the infected and affected individuals and the entire community. Physiological implication of the disease is evident. As already noted, once a person is infected by the disease, his or her immune system is damaged. This makes the body vulnerable to various opportunistic diseases and tumors. This affects the sick person enough especially at the stage where the infection has progressed to full blown aids. This is a disease that stays in the body for a long time before a person is dead. Even when one has developed AIDS, he or she can take as long as one, while in and out of hospitals with different diseases. This affects not only the person who is infected, but also others who are affected as well as the society in terms of medical costs. Once a loved one is sick, the family and relatives feel the impact. This is because they have to physically care for the sick person and bear the burden of providing for his needs. They have the responsibility of providing for his or her medical expenses as well as other basic needs such as food. The community bears the burden of providing for medical services for all the people suffering from the disease. This is a disease that spends a lot in terms of health care services. These are services that are provided by the community for the sick people. The more people in the community who are suffering from AIDS, the more is spent in terms of health care. These are people who are eating out of the community without returning. This is because since they are sick, they are no longer productive and cannot contribute to the development of the community. A worse impact comes when a family member has to leave employment to care for the sick person. The community in this case suffers a double effect. Most of the people who are normally affected by the disease are the young people reducing the number in the taxable population which impacts in the community in the long-run (Lengauer, Altmann, Thielen and Kaiser, 2010).
Stigma as a result of the disease has impacted the society since it was evident how the disease is transmitted. The stigma associated with the disease includes rejection, discrimination, ostracism, and avoidance. People infected with the disease suffer psychologically due to the social stigma. People suffering from the disease have suffered a lot in the society; some are made to have compulsory tests as a condition for employment, consent or protection of privacy. There have been cases of violence against those infected or believed to be infected and in some cases quarantine of the people who are infected. This stigma is not only directed to the person who is infected, but at times to his or her relatives. They suffer psychologically and emotionally as a result of the illness of their relatives. It is this stigma that has led most people to shy away from testing therefore going to hospital when they are completely sick. This is like signing a death sentence to the person. The community is affected because of the risk of perpetuated spreading by people who are not aware of their status for fear of stigma (Lengauer, Altmann, Thielen and Kaiser, 2010).

Impact of community prevention programs
As a way of reacting to the AIDS pandemic, a number of programs have been developed that are community based to fight the spread of the disease. One of the programs that has had a great impact in fighting the spreading of the disease as well as providing support for the infected individuals are the support groups. This is where people who are infected come together to share their experiences and provide each other with the moral support. This has helped people who are infected to realize that they are not alone in the fight and that they can still live a positive life despite of the infection. Realization of the fact that AIDS is not a death sentence has helped infected people live a long and productive life. This denies the disease the chance to deprive the community of young and productive people who contribute a lot to the economy (Hel, McGhee and Mestecky, 2006).
Education is another factor related to community prevention programs that has had a lot of impact. The rate of AIDS infection is on the decrease as more people are becoming enlightened on the ways of preventing it. Education plays a key role in dispersing the knowledge on how the disease is transmitted and how it can be prevented. Education under these programs is not only targeted to the disease, but also to the issue of drugs in the society which is a major factor behind high rate of infections. Such programs have had a great impact in influencing behavior and situations that put individuals at a higher risk of infection. They have achieved this through enhancing access to AIDS prevention and sexual health information and messages. They also address the most common social and economic factors that are detrimental to individuals and the community in as far as the disease is concerned. Development and vibrant working of the community prevention programs have enabled the reduction of the number of deaths from the disease by more than 20 percent since it was first reported. The number of new infections has reduced. In the United States only, AIDS has gone from number one cause of death in 1995, to number six. This is a revelation of the great work that is being done by these programs. Various programs have been developed, at a state and national level, and are all are working towards the goal of reducing the number of new infections, a goal that can be said to be achieved to a great extent (Hel, McGhee and Mestecky, 2006).
Aids or acquired immunodeficiency syndrome or acquired immune deficiency is a disease that is transmitted by a virus known as human immunodeficiency virus or HIV. This virus is known to damage the immune system of the body making it vulnerable to opportunistic diseases and tumors. Aids was for the first time reported in June 1981 when the US Centers for Disease Control reported a group of Pneumocystis carinii pneumonia in five homosexual males in Los Angeles. The term AIDS to refer to the diseases was for the first time used in the year 1982 in a meeting. It is believed to have originated in Africa. HIV is transmitted from one individual to another through direct contact of the bloodstream or mucus membrane with any fluid from the body that contains the virus, including blood, semen, preseminal fluid, vaginal fluid and breast milk. It can be transmitted through sex, blood transfusion, injury by an infected needle or from mother to child during pregnancy. The disease is prevalent in all parts of the world, but the highest rate of infection is in Sub-Saharan countries. AIDS has both physiological and psychological impact on the infected individual and also affects the people related or close, as the community in general. There are various community prevention programs that have been developed in response to the disease whose impact has been felt in the community.

Del Rio C. & Curran J.W. (2009). Epidemiology and prevention of acquired immunodeficiency
syndrome and human immunodeficiency virus infection. In: Mandell G.L., Bennett J.E., & Dolin R., eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone.
Guss D.A. (1994). The acquired immune deficiency syndrome: an overview for the emergency
physician, Part 1. J Emerg Med 12 (3):
Hel, Z., McGhee, J.R. & Mestecky, J. (2006). HIV infection: first battle decides the war. Trends
Immunol. 27 (6): 274–81.
Lengauer, T., Altmann, A., Thielen, A. & Kaiser, R. (2010). Chasing the AIDS virus.
Communications of the ACM 53 (3): 66.
Piot P. (2007). Human immunodeficiency virus infection and acquired immunodeficiency
syndrome: A global overview. In: Goldman L. & Ausiello D. eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier.