HIV/AIDS

What is HIV?

'HIV' stands for Human Immunodeficiency Virus.

HIV attacks the body's immune system, reducing its ability to fight off infections.

It does this by infecting white blood cells (CD4 cells), which are responsible for engaging the immune system when infections enter the body.

What is AIDS?

One of the effects that HIV causes is Acquired Immune Deficiency Syndrome (AIDS). Although people with HIV can live for many years without major negative health effects, their weakened immune system leaves them very vulnerable to infections. When someone with HIV succumbs to another infection, the onset of AIDS is said to have occurred.

However, the term 'AIDS' is no longer widely used, according to the Terrence Higgins Trust. It is perhaps more commonly referred to, in medical circles at least, as 'late stage' or 'advanced HIV infection'.

Background

HIV became an issue of serious concern in the UK when it was first identified in the early 1980s.

The infection was particularly stigmatised when it was first discovered because the public didn't know how the disease was caught and what its consequences were. HIV/AIDS was initially thought to only infect homosexual men and drug users, complicating impartial debate, and a small minority claimed, and still claim, that the condition was a form of 'divine retribution'.

Since the disease was discovered, successive governments have funded public awareness and education campaigns to raise the profile and improve understanding of the illness. The HIV/AIDS campaigns of the 1980s led to a growth in public awareness of the importance of avoiding unsafe sex and to a lesser extent the use of 'dirty needles' - two of the principal means of transmission.

Safe sex and the development of antiretroviral therapies, which delay the onset of AIDs, have resulted in substantial reductions in AIDS incidence and deaths in the UK.

Controversies

In the developed world, HIV/AIDS is increasingly understood, avoidable and treatable - although it cannot yet be cured. The stigma once associated with the condition has also considerably reduced.

However, some parts of the developing world are experiencing an HIV/AIDS epidemic of horrifying proportions. Sub-Saharan Africa and, to a lesser but growing extent, parts of southern Asia have large proportions of their populations that are HIV positive.

These communities are some of the poorest in the world and many of those infected don't have access to effective HIV treatments. Some people argue that access to effective treatments is being hindered by some pharmaceutical companies demanding high prices for their treatments and preventing the reproduction of their drugs, under threat of legal action.

However, pharmaceutical companies say they are making their treatments available cheaply to the developing world. For example, five manufacturers of antiretroviral therapies and five manufacturers of HIV/AIDS diagnostic tests announced in April 2004 that they had agreed to make their products available to developing countries at the lowest prices, in many cases for more than fifty per cent less.

The HIV/AIDs problem in the developing world is exacerbated by low public awareness and standards of public health, religious injunctions against contraception in many areas and considerable levels of prejudice and stigma.

The United Nations Millennium Declaration adopted by world leaders in September 2000 and endorsed by 189 countries set out eight Millennium Development Goals (MDGs) to be met by 2015. MDG 6 aims to achieve by 2010 universal access to treatment for HIV/AIDS for all those who need it and to have halted, and begun to reverse, the spread of HIV/AIDS by 2015.

Statistics

The number of people living with HIV in the UK continues to rise, with an estimated 83,000 infected at the end of 2008, of whom over a quarter (27%) were unaware of their infection.
During 2008, there were 7,298 new diagnoses of HIV in the UK. This represents a slight decline on previous years, predominantly due to fewer diagnoses among black African women who acquired their infection abroad.
New HIV diagnoses among those who acquired their infection heterosexually within the UK have risen, from an estimated 740 in 2004 to 1,130 in 2008.

Source: Health Protection Agency - November 2009

According to a UNAIDS estimate, there are more than 33 million people worldwide living with HIV and 15 million children have been orphaned by the disease.
The number of people living with HIV continues to increase. For every two people starting treatment, five others become newly infected - more than 7,000 people each day.

Source: DIFID - AUGUST 2010

At the end of 2009, 5 250 000 people were receiving antiretroviral therapy in low- and middle-income countries - an increase of over 1.2 million people from December 2008. This represents a 30% rise from a year earlier and a 13-fold increase in six years.

Sub-Saharan Africa had the greatest increase in the absolute number of people receiving treatment in 2009, from 2 950 000 in December 2008 to about 3 910 000 a year later.

As of December 2009, eight low- and middle-income countries had already achieved universal access to antiretroviral therapy, defined as providing antiretroviral therapy to at least 80% of patients in need, and 21 additional countries had coverage rates higher than 50%.

The number of children under 15 years of age receiving antiretroviral therapy increased by 29% between 2008 and 2009. About 356 400 children less than 15 years of age were receiving antiretroviral therapy at the end of 2009, up from 275 300 at the end of 2008. Children represented 6.8% of people receiving antiretroviral therapy and 8.7% of people in need.

Source: WHO 'Towards Universal Access' progress report - 2010

Quotes

"HIV affects the lives of many people caught up in conflict.....People may be subjected to mass displacement, human rights abuses - including sexual violence, and be left in conditions of poverty and powerlessness that might force some individuals to sell sex to survive. In addition, infrastructure may be damaged, and prevention and health services disrupted. Such conditions put populations at increased risk of HIV infection, and women and children are especially vulnerable."

Forced Migration Review - UNAIDS - October 2010

"HIV continues to be one of the most important communicable diseases in the UK.. Each year, many thousands of individuals are diagnosed with HIV for the first time.
"The infection is still frequently regarded as stigmatising and has a prolonged 'silent' period during which it often remains undiagnosed. Highly active antiretroviral therapies have resulted in substantial reductions in AIDS incidence and deaths in the UK."

Health Protection Agency - 2010