HIV prevention
Encyclopedia
HIV prevention refers to practices done to prevent the spread of HIV
. HIV prevention practices may be done by individuals to protect their own health and the health of those in their community, or may be instituted by governments or other organizations as public health
policies.
, all in in gay men living in Los Angeles
.
In May 1983, scientists isolated a retrovirus which was later called HIV from an AIDS patient in France. At this point the disease caused AIDS was proposed to be caused by HIV, and people began to consider prevention of HIV as a strategy for preventing AIDS.
In the 1980s public policy makers and most of the public could not understand that the overlap of sexual and needle-sharing networks with the general community had somehow lead to many thousands of people worldwide becoming infected with HIV. In many countries leaders and most of the general public denied both that AIDS and the risk behaviors which spread HIV existed were present outside of concentrated populations.
In 1987 the United States FDA
approved AZT
as the first pharmaceutical treatment for AIDS. Around the same time ACT UP
was formed, with one of the group's first goals being to find a way to get access to pharmaceutical drugs to treat HIV. When AZT was made publicly available, it was extremely expensive and unaffordable to all but the most wealthy AIDS patients. The availability of medicine but the lack of access to it sparked large protests around FDA offices.
and Botswana
nearly 4 out of 10 people were HIV positive. Festus Mogae
, president of Botswana, admitted huge infrastructure problems to the international community and requested foreign intervention in the form of consulting in health care setup and anti-retroviral drug distribution programs. and from this began to be personally involved in HIV issues worldwide. In Swaziland the government chose not to immediately address the problem in the way that international health agencies advised and many people died. In world media, the governments of African countries began to similarly be described as participating in the effort to prevent HIV actively or less actively.
There came to be international discussion about why HIV rates in Africa were so high, because if the cause were known then prevention strategies could be developed. Previously some researchers had suggested that HIV in Africa was widespread because of unsafe medical practices which somehow transferred blood to patients through procedures such as vaccination, injection, or reuse of equipment. In March 2003 the WHO released a statement that almost all infections were, in fact, the result of unsafe practices in heterosexual intercourse.
In response to the rising HIV rates, Cardinal Alfonso López Trujillo
speaking on behalf of the Vatican
said that not only is the use of condoms immoral, but also that condoms were ineffective in preventing HIV. The cardinal was highly criticized by the world health community, who were trying to promote condom use as a way to prevent the spread of HIV.
In 2001 the United States began a War in Afghanistan related to fighting the Taliban. The Taliban, however, had opposed local opium growers and the heroin trade; when the government of Afghanistan fell during the war, opium production was unchecked. By 2003, the world market saw an increase in the available heroin supply, and in former Soviet states especially, there was an increase in HIV infection due to injection drug use. Efforts were renewed to prevent HIV related to sharing needles.
In 2010 Pope Benedict XVI
issued a statement that the church would begin to support the use of condoms in the fight against AIDS.
Of these, the only universally medically proven method for preventing the spread of HIV during sexual intercourse is the correct use of condoms, and condoms are also the only method promoted by health authorities worldwide. For HIV positive mothers wishing to prevent the spread of HIV to their child during birth, antiretroviral drugs have been medically proven to reduce the likelihood of the spread of the infection. Scientists worldwide are currently researching other prevention systems.
Increased risk of contracting HIV often correlates with infection by other diseases, particularly other sexually transmitted infections. Medical professionals and scientists recommend treatment or prevention of other infections such as herpes, hepatitis A
, hepatitis B, hepatitis C
, human papillomavirus
, syphilis
, gonorrhea
, and tuberculosis
as an indirect way to prevent the spread of HIV infection. Often doctors treat these conditions with pharmaceutical interventions.
These strategies have widely differing levels of efficacy, social acceptance, and acceptance in the medical and scientific communities.
Populations which receive HIV testing are less likely to engage in behaviors with high risk of contracting HIV, so HIV testing is almost always a part of any strategy to encourage people to change their behavior to become less likely to contract HIV.
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
. HIV prevention practices may be done by individuals to protect their own health and the health of those in their community, or may be instituted by governments or other organizations as public health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
policies.
1980s
The Centers for Disease Control was the first organization to recognize the pandemic which came to be called AIDS. Their announcement came on June 5, 1981 when one of their journals published an article reporting five cases of pneumonia cased by Pneumocystis jiroveciiPneumocystis jirovecii
Pneumocystis jirovecii is a yeast-like fungus of the genus Pneumocystis. The causative organism of Pneumocystis pneumonia, it is an important human pathogen, particularly among immunocompromised hosts. Prior to its discovery as a human-specific pathogen, P. jirovecii was known as P...
, all in in gay men living in Los Angeles
Los Ángeles
Los Ángeles is the capital of the province of Biobío, in the commune of the same name, in Region VIII , in the center-south of Chile. It is located between the Laja and Biobío rivers. The population is 123,445 inhabitants...
.
In May 1983, scientists isolated a retrovirus which was later called HIV from an AIDS patient in France. At this point the disease caused AIDS was proposed to be caused by HIV, and people began to consider prevention of HIV as a strategy for preventing AIDS.
In the 1980s public policy makers and most of the public could not understand that the overlap of sexual and needle-sharing networks with the general community had somehow lead to many thousands of people worldwide becoming infected with HIV. In many countries leaders and most of the general public denied both that AIDS and the risk behaviors which spread HIV existed were present outside of concentrated populations.
In 1987 the United States FDA
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
approved AZT
Zidovudine
Zidovudine or azidothymidine is a nucleoside analog reverse-transcriptase inhibitor , a type of antiretroviral drug used for the treatment of HIV/AIDS. It is an analog of thymidine....
as the first pharmaceutical treatment for AIDS. Around the same time ACT UP
AIDS Coalition to Unleash Power
AIDS Coalition to Unleash Power is an international direct action advocacy group working to impact the lives of people with AIDS and the AIDS pandemic to bring about legislation, medical research and treatment and policies to ultimately bring an end to the disease by mitigating loss of health and...
was formed, with one of the group's first goals being to find a way to get access to pharmaceutical drugs to treat HIV. When AZT was made publicly available, it was extremely expensive and unaffordable to all but the most wealthy AIDS patients. The availability of medicine but the lack of access to it sparked large protests around FDA offices.
From 2003
In 2003 there were reports that in SwazilandSwaziland
Swaziland, officially the Kingdom of Swaziland , and sometimes called Ngwane or Swatini, is a landlocked country in Southern Africa, bordered to the north, south and west by South Africa, and to the east by Mozambique...
and Botswana
Botswana
Botswana, officially the Republic of Botswana , is a landlocked country located in Southern Africa. The citizens are referred to as "Batswana" . Formerly the British protectorate of Bechuanaland, Botswana adopted its new name after becoming independent within the Commonwealth on 30 September 1966...
nearly 4 out of 10 people were HIV positive. Festus Mogae
Festus Mogae
Festus Gontebanye Mogae is a Botswana politician who was President of Botswana from 1998 to 2008. He succeeded Quett Masire as President in 1998 and was reelected in October 2004; after ten years in office, he stepped down in 2008 and was succeeded by Lieutenant General Ian Khama...
, president of Botswana, admitted huge infrastructure problems to the international community and requested foreign intervention in the form of consulting in health care setup and anti-retroviral drug distribution programs. and from this began to be personally involved in HIV issues worldwide. In Swaziland the government chose not to immediately address the problem in the way that international health agencies advised and many people died. In world media, the governments of African countries began to similarly be described as participating in the effort to prevent HIV actively or less actively.
There came to be international discussion about why HIV rates in Africa were so high, because if the cause were known then prevention strategies could be developed. Previously some researchers had suggested that HIV in Africa was widespread because of unsafe medical practices which somehow transferred blood to patients through procedures such as vaccination, injection, or reuse of equipment. In March 2003 the WHO released a statement that almost all infections were, in fact, the result of unsafe practices in heterosexual intercourse.
In response to the rising HIV rates, Cardinal Alfonso López Trujillo
Alfonso López Trujillo
Alfonso López Trujillo was a Colombian Cardinal Bishop of the Roman Catholic Church and president of the Pontifical Council for the Family.-Youth:...
speaking on behalf of the Vatican
Holy See
The Holy See is the episcopal jurisdiction of the Catholic Church in Rome, in which its Bishop is commonly known as the Pope. It is the preeminent episcopal see of the Catholic Church, forming the central government of the Church. As such, diplomatically, and in other spheres the Holy See acts and...
said that not only is the use of condoms immoral, but also that condoms were ineffective in preventing HIV. The cardinal was highly criticized by the world health community, who were trying to promote condom use as a way to prevent the spread of HIV.
In 2001 the United States began a War in Afghanistan related to fighting the Taliban. The Taliban, however, had opposed local opium growers and the heroin trade; when the government of Afghanistan fell during the war, opium production was unchecked. By 2003, the world market saw an increase in the available heroin supply, and in former Soviet states especially, there was an increase in HIV infection due to injection drug use. Efforts were renewed to prevent HIV related to sharing needles.
In 2010 Pope Benedict XVI
Pope Benedict XVI
Benedict XVI is the 265th and current Pope, by virtue of his office of Bishop of Rome, the Sovereign of the Vatican City State and the leader of the Catholic Church as well as the other 22 sui iuris Eastern Catholic Churches in full communion with the Holy See...
issued a statement that the church would begin to support the use of condoms in the fight against AIDS.
Pharmaceutical strategies
Some commonly considered pharmaceutical interventions for the prevention of HIV include the use of the following:- microbicides for sexually transmitted diseasesMicrobicides for sexually transmitted diseasesMicrobicides for sexually transmitted diseases, are pharmacologic agents and chemical substances that are capable of killing or destroying certain microorganisms that commonly cause human infection, for example the human immunodeficiency virus....
- pre-exposure prophylaxisPre-exposure prophylaxisPre-exposure prophylaxis is any medical or public health procedure used before exposure to the disease causing agent, its purpose is to prevent, rather than treat or cure a disease. An example would be if a doctor gave a medication used to treat a disease to a healthy person who is not thought to...
- post-exposure prophylaxisPost-exposure prophylaxisPost-exposure prophylaxis is any prophylactic treatment started immediately after exposure to a pathogen , in order to prevent infection by the pathogen and the development of disease.-Rabies:...
- HIV vaccines
- circumcisionCircumcisionMale circumcision is the surgical removal of some or all of the foreskin from the penis. The word "circumcision" comes from Latin and ....
(see also Circumcision and HIVCircumcision and HIVOver forty epidemiological studies have been conducted to investigate the relationship between male circumcision and HIV infection. Reviews of these studies have reached differing conclusions about whether circumcision could be used as a prevention method against HIV.Experimental evidence was...
) - antiretroviral drugs to reduce viral loadViral loadViral load is a measure of the severity of a viral infection, and can be calculated by estimating the amount of virus in an involved body fluid. For example, it can be given in RNA copies per milliliter of blood plasma...
in the infected, and - condoms
Of these, the only universally medically proven method for preventing the spread of HIV during sexual intercourse is the correct use of condoms, and condoms are also the only method promoted by health authorities worldwide. For HIV positive mothers wishing to prevent the spread of HIV to their child during birth, antiretroviral drugs have been medically proven to reduce the likelihood of the spread of the infection. Scientists worldwide are currently researching other prevention systems.
Increased risk of contracting HIV often correlates with infection by other diseases, particularly other sexually transmitted infections. Medical professionals and scientists recommend treatment or prevention of other infections such as herpes, hepatitis A
Hepatitis A
Hepatitis A is an acute infectious disease of the liver caused by the hepatitis A virus , an RNA virus, usually spread the fecal-oral route; transmitted person-to-person by ingestion of contaminated food or water or through direct contact with an infectious person...
, hepatitis B, hepatitis C
Hepatitis C
Hepatitis C is an infectious disease primarily affecting the liver, caused by the hepatitis C virus . The infection is often asymptomatic, but chronic infection can lead to scarring of the liver and ultimately to cirrhosis, which is generally apparent after many years...
, human papillomavirus
Human papillomavirus
Human papillomavirus is a member of the papillomavirus family of viruses that is capable of infecting humans. Like all papillomaviruses, HPVs establish productive infections only in keratinocytes of the skin or mucous membranes...
, syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
, gonorrhea
Gonorrhea
Gonorrhea is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The usual symptoms in men are burning with urination and penile discharge. Women, on the other hand, are asymptomatic half the time or have vaginal discharge and pelvic pain...
, and tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
as an indirect way to prevent the spread of HIV infection. Often doctors treat these conditions with pharmaceutical interventions.
Social strategies
Social strategies do not require any drug or object to be effective, but rather require persons to change their behavior in order to gain protection from HIV. Some social strategies which people consider include the following- sex educationSex educationSex education refers to formal programs of instruction on a wide range of issues relating to human sexuality, including human sexual anatomy, sexual reproduction, sexual intercourse, reproductive health, emotional relations, reproductive rights and responsibilities, abstinence, contraception, and...
- LGBT sex educationLGBT sex educationLGBT sex education is a type of sex education that explores the sexual practices of LGBT people.-Status of LGBT youth:In many countries, homosexual, bisexual, transgender youth, and those with other sexual orientations or practices, are often ignored in sex education classes, including a frequent...
- needle-exchange programmes
- safe injection sites
- safe sexSafe sexSafe sex is sexual activity engaged in by people who have taken precautions to protect themselves against sexually transmitted diseases such as AIDS. It is also referred to as safer sex or protected sex, while unsafe or unprotected sex is sexual activity engaged in without precautions...
- serosortingSerosortingSerosorting is the practice of using HIV status as a decision-making point in choosing sexual behavior. Frequently the term is used to describe the behavior of a person who chooses a sexual partner assumed to be of the same HIV serostatus for the purpose of engaging in unprotected sex with the...
- sexual abstinenceSexual abstinenceSexual abstinence is the practice of refraining from some or all aspects of sexual activity for medical, psychological, legal, social, philosophical or religious reasons.Common reasons for practicing sexual abstinence include:*poor health - medical celibacy...
These strategies have widely differing levels of efficacy, social acceptance, and acceptance in the medical and scientific communities.
Populations which receive HIV testing are less likely to engage in behaviors with high risk of contracting HIV, so HIV testing is almost always a part of any strategy to encourage people to change their behavior to become less likely to contract HIV.