Monday, March 4, 2013

Reviewing HIV: Preventing Future Epidemics


Although some of the information available about HIV/AIDS is inaccurate and largely blown out of proportion (Bauer, 2007), it may be worthwhile to consider the origins of this disease toward preparation for future epidemics. HIV is a lentivirus, which is a type of retrovirus that, once contracted, continues to damage the immune system of its host (Hutchinson, 2001). There are two distinct types of HIV; HIV-1 and HIV-2. HIV-2 is found primarily in Africa and India (Beer et al., 1999), and for the purposes of this essay, HIV-1 is discussed. HIV was initially transferred from primates to humans, although the exact time and manner of this transmission is unknown (Hooper, 2000; Hutchinson, 2001). What is known about the transmission of this virus is that the exchange of fluids is necessary for transmission, and it is transmitted through sexual contact, by transfusion or inoculation with blood products, or by perinatal transmission between mother and child (Hutchinson, 2001).

When HIV was first discovered primarily in men who have sex with men (MSM), many people, including scientists, believed the disease was caused by the MSM lifestyle (Sonnabend et al., 1983; Mavligit et al., 1984). One scientist, a molecular biologist, popularized the myth that HIV was harmless (Duesberg, 1987; Hutchinson, 2001). This may have been the first significant downfall of preventing the increased transmission of the virus. The general public as well as psychologists and health care professionals depend on current scholarly literature for accurate, empirically derived information. Receiving information that is speculative, anecdotal, or based on a priori reasoning falls short in providing medical science with an accurate understanding of disease and its progression. Several years after the initial discovery of HIV, scientists continued to debate the origins and means of transmission, although scientists began to recommended practicing safe sex as a way to evade disease contamination (Hooper, 2000; Hutchinson, 2001). If medical science had understood the gravity of the virus, perhaps preparations and advisories could have been implemented earlier.

The bottom line however, in preventing the transmission of any virus or contagious pathogen, rests on individuals taking personal responsibility for behavior that reduces transmission. Reducing the transmission of HIV requires safe sex practices, and the use of clean needles for IV drug use. Transmission has continued long after these recommendations echoed throughout MSM communities and to IV drug users. Except for the transmission from mother to child, and unusual blood exposure, the only risk factors for contagion are unprotected sex and IV drug use (Marks, Murray, Evans, & Istacio, 2100). These circumstances are manageable. Determining the psychological issues that prevent individuals, especially MSM, from practicing safe sex will help to explain how populations might respond to preventive protocols in future epidemics. At this time, there is a paucity of research on whether failure to implement safe practices is intrinsic to the MSM population, or if other populations would be as negligent in following advisories to reduce transmission of a (theoretically) deadly virus. It is understandable why IV drug abusers do not typically adhere to medical recommendations (Tsai, Morisky, & Chen, 2010). Young people of both genders between the ages of 13-24 are at a greater risk of contracting the virus as well. Factors that place youth at a greater risk include poverty, substance abuse, lack of understanding the risks of HIV, and age specific risk-taking behavior (Zúñiga, Blanco, Sanchez, Carroll, & Olshefsky, 2009).

Understanding the history of HIV/AIDS may help medical science work toward identifying contagious viruses quicker and more accurately in the future. However, until science understands which populations are at risk and how they will respond and adhere to recommendations and advisories, anticipating transmission rates is unpredictable.

References

Bauer, H. H. (2007). The origin, persistence and failings of HIV/AIDS theory. Jefferson, NC: McFarland.

Beer, B. E., Bailes, E., Sharp, P. M., & Hirsch, V. M. (1999). Diversity and Evolution of Primate Lentiviruses. HIV Databases Review Article. Retrieved February 11, 2013, from

http://genome.cbs.dtu.dk/dtucourse/27611spring2009/exercises/ExMul+Phyl/beer.pdf

Duesberg P. (1987). Retroviruses as carcinogens and pathogens: expectations and reality. Cancer

Research 47,1199–1220.

Hooper, E. E. (2000). How did AIDS get started?. South African Journal Of Science, 96(6), 265.

Hutchinson, J. (2001). The biology and evolution of HIV. Annual Review Of Anthropology, 30(1), 85.

Mavligit, G. M., Talpaz, M., Hsia, F. T., Wong, W., Lichtiger, B., Mansell, P. W., & Mumford, D. M. (1984). Chronic immune stimulation by sperm alloantigens: support for the hypothesis that spermatozoa induce immune dysregulation in homosexual males. Journal of the American Medical Association 251(2), 237-241.

Sonnabend, J., Witkin, S. S., & Purtilo, D. T. (1983). Acquired immunodeficiency syndrome, opportunistic infections, and malignancies in male homosexuals. A hypothesis of etiologic factors in pathogenesis. JAMA249(17):2370–74.

Tsai, T., Morisky, D., & Chen, Y. (2010). Role of service providers of needle syringe program in preventing HIV/AIDS. AIDS Education And Prevention: Official Publication Of The International Society For AIDS Education, 22(6), 546-557. doi:10.1521/aeap.2010.22.6.546

Zúñiga, M., Blanco, E., Sanchez, L. M., Carroll, S. P., & Olshefsky, A. M. (2009). Preventing human immunodeficiency virus (HIV) and other sexually transmitted infections and reducing HIV-stigmatizing attitudes in high-risk youth: Evaluation of a comprehensive community-based and peer-facilitated curriculum. Vulnerable Children & Youth Studies, 4(4), 333-345. doi:10.1080/17450120802613179


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