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AIDS

Collection of opportunistic diseases associated with immunodeficiency Caused by human immunodeficiency virus HIV = retrovirus (contains RNA) that commandeers the infected cells proteinmanufacturing machinery Targets helper T cells (T lymphocytes)

HIV
Essentially a ball of protein & lipid surrounding core of RNA, containing reverse transcriptase & integrase Can only reproduce INSIDE a host cell

HIV
HIV often infects Tlymphocytes, especially those with CD4 receptors in plasma membranes

T cells are vital play key role in protecting against infectious diseases, especially viral diseases If T cells are destroyed, opportunistic infections occur e.g. respiratory tract infections like pneumonia, diarrhoea, tuberculosis, Kaposis sarcoma TO DATE NO CURE although do have drug therapies that extend and improve quality of life. EXPENSIVE and may not be freely available!

AIDS symptoms
Persistent tiredness & weight loss Night sweats Persistent diarrhoea Blurred vision White spots on the tongue or mouth Dry cough & shortness of breath Persistent fever or swollen glands

AIDS

TRANSMISSION
Transmitted when body fluids come into DIRECT CONTACT
During sexual intercourse Sharing hypodermic needles Blood transfusions Mother to unborn child

Once infected, may develop AIDS, after an incubation period ranging from 2 weeks to 20+ years

During the incubation period, the virus replicates Flu-like symptoms may appear As virus replicates, infected cells are destroyed as the viruses bud out or the cell bursts CDC: AIDS is defined as being HIV+ and having a CD4 cell count of <200 per L of blood, or %<14.

AIDS: A CLOSER LOOK


The global AIDS epidemic (widespread outbreak of an infectious disease) continues to grow Also a PANDEMIC (disease that has spread worldwide) 39.5 million people are living with HIV 65% of new infections in 2005 occurred in subSaharan Africa Some prevention programmes have not been sustained! In many, they are not reaching people most at risk: the young, the sex workers, the women, drug-users etc.

In 2009 approximately 7000 people were newly infected with HIV each day 97% were in low- & mid-income countries About 1000 of these were in children < 15 Of remaining 6000, ~51% women and 41% in age range 15 24 y.o.

AIDS figures

Prevalence of HIV/AIDS in adults >15 y.o. in Caribbean (2007)

HIV/AIDS in the Caribbean


Caribbean has some of the highest rates of infection (2nd highest level of adult HIV prevalence. 1st = Sub-Saharan Africa)

2009 STATISTICS

AIDS in the Caribbean


Women account for ~50% of all infections in Caribbean (prevalence especially high in young women) Treatment coverage increased to about 67%. BUT AIDS remains one of leading causes of death among adults aged 15 44 years in the region KEY REGIONAL DYNAMICS:
o Heterosexual transmission (often tied to sex work) o Substantial transmission among men who have sex with men (HIV prevalence of 38% in Jamaica) o Injecting drug use plays small role but important in Puerto Rico

Adult HIV prevalence in 2011 ~ 1% Sharp decline in new infections & AIDSrelated deaths since 2001 Nearly 75% of HIV+ live in Dominican Republic & Haiti

EXPLAINING OUR RATES


Unprotected sexual intercourse Multiple partners Unwillingness to admit to being HIVpositive

How has each of the following contributed to the global HIV pandemic?
Length of incubation period (often symptomless) Ease of global travel Common practice of multiple sex partners High cost of effective drug therapies Poor education about transmission of HIV

The Caribbean Story