HIV/AIDS

The following article was contributed by Jerri Guo.

HIV/AIDS Information: http://www.cdc.gov/hiv/default.html

Introduction

World-wide, 33.4 million people are infected with HIV/AIDS. One half of those infected are women. Each year one million women die of HIV/AIDS. More than 80% of those infected contacted the disease from heterosexual activity as described below. While prevention is the desired outcome, there are now effective treatments for controlling the disease, while there is no firm evidence that HIV/AIDS can be cured, although medical science is moving in that direction.

HIV is the human immunodeficiency virus. It is the virus that can lead to acquired immune deficiency syndrome, or AIDS. Within a few weeks of being infected with HIV, some people develop flu-like symptoms that last for a week or two, but others have no symptoms at all. People living with HIV may appear and feel healthy for several years. However, even if they feel healthy, HIV is still affecting their bodies. All people with HIV should be seen on a regular basis by a health care provider experienced with treating HIV infection.

Many people with HIV, including those who feel healthy, can benefit greatly from current medications used to treat HIV infection. These medications can limit or slow down the destruction of the immune system, improve the health of people living with HIV, and may reduce their ability to transmit HIV. Untreated early HIV infection is also associated with many diseases including cardiovascular disease, kidney disease, liver disease, and cancer.

Transmission

HIV is spread primarily by:

  • Not using a condom when having sex with a person who has HIV. All unprotected sex with someone who has HIV contains some risk. However:
    • Unprotected anal sex is riskier than unprotected vaginal sex.
    • Among men who have sex with other men, unprotected receptive anal sex is riskier than unprotected insertive anal sex.
  • Having multiple sex partners or the presence of other sexually transmitted diseases (STDs) can increase the risk of infection during sex. Unprotected oral sex can also be a risk for HIV transmission, but it is a much lower risk than anal or vaginal sex.
  • Sharing needles, syringes, rinse water, or other equipment used to prepare illicit drugs for injection.
  • Being born to an infected mother—HIV can be passed from mother to child during pregnancy, birth, or breast-feeding.

Less common modes of transmission include:

  • Being “stuck” with an HIV-contaminated needle or other sharp object. This risk pertains mainly to healthcare workers.
  • Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This risk is extremely remote due to the rigorous testing of the U.S. blood supply and donated organs/tissue.
  • HIV may also be transmitted through unsafe or unsanitary injections or other medical or dental practices. However, the risk is also remote with current safety standards in the U.S.
  • Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when infected blood from a caregiver’s mouth mixes with food while chewing. This appears to be a rare occurrence and has only been documented among infants whose caregiver gave them pre-chewed food.
  • Being bitten by a person with HIV. Each of the very small number of cases has included severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken.
  • Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids. These reports have also been extremely rare.
  • There is an extremely remote chance that HIV could be transmitted during “French” or deep, open-mouth kissing with an HIV-infected person if the HIV-infected person’s mouth or gums are bleeding.
  • Tattooing or body piercing present a potential risk of HIV transmission, but no cases of HIV transmission from these activities have been documented. Only sterile equipment should be used for tattooing or body piercing.
  • There have been a few documented cases in Europe and North Africa where infants have been infected by unsafe injections and then transmitted HIV to their mothers through breastfeeding. There have been no documented cases of this mode of transmission in the U.S.

HIV cannot reproduce outside the human body. It is not spread by:

  • Air or water.
  • Insects, including mosquitoes. Studies conducted by CDC researchers and others have shown no evidence of HIV transmission from insects.
  • Saliva, tears, or sweat. There is no documented case of HIV being transmitted by spitting.
  • Casual contact like shaking hands or sharing dishes.
  • Closed-mouth or “social” kissing.

Treatment

There is no cure for HIV/AIDS, but a variety of drugs can be used in combination to control the virus. Each of the classes of anti-HIV drugs blocks the virus in different ways. It’s best to combine at least three drugs from two different classes to avoid creating strains of HIV that are immune to single drugs. The classes of anti-HIV drugs include:

  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs disable a protein needed by HIV to make copies of itself. Examples include efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune).
  • Nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are faulty versions of building blocks that HIV needs to make copies of itself. Examples include Abacavir (Ziagen), and the combination drugs emtricitabine and tenofovir (Truvada), and lamivudine and zidovudine (Combivir).
  • Protease inhibitors (PIs). PIs disable protease, another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and ritonavir (Norvir).
  • Entry or fusion inhibitors. These drugs block HIV’s entry into CD4 cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry).
  • Integrase inhibitors. Raltegravir (Isentress) works by disabling integrase, a protein that HIV uses to insert its genetic material into CD4 cells.

Current guidelines indicate that treatment should begin if:

  • You have severe symptoms
  • Your CD4 count is under 500
  • You are pregnant
  • You have HIV-related kidney disease
  • You’re being treated for hepatitis B

Assistance from Board of World Mission – North America

Likewise Ministries is the Moravian Church’s response to “Go and do likewise” (Luke 10:36-37) in living out the Gospel as we care for and love those affected by HIV/AIDS.

If your congregation would like assistance with an HIV/AIDS education program or care program, contact the Moravian Board of World Mission – North America at http://moravianmission.org/aids-ministry/likewise-ministries/. The Board of World Mission staff and members of the HIV/AIDS Advisory Board are available to coordinate education and resources in congregations.

If your congregation is already engaged in any type of AIDS ministry, please send information about your programs and activities to the Board of World Mission. We would like to share and inspire other congregations.