AIDS / HIV

Sexually Transmitted Diseases

• Infections which are spread mainly through sexual contact.
• Affect the reproductive tracts in the male, as well as the female, and could also affect the eyes, mouth, rectum and urinary tract.
• Could cause pain, disfigurement, miscarriage in pregnant women, still births, premature births, sterility, cervical cancer.
• Main ones: Syphilis, Gonorrhoea, Lymphogranuloma Venereum.
• Signs and symptoms: Genital ulcers or sores, discharge from vagina or penis, burning sensation while urinating, pain during intercourse. Signs usually not visible in women because their reproductive organs are internal.
• Treatment only by a properly trained and qualified doctor. Treatment course should be completed.

Misconceptions

• Disappearance of the symptoms means the disease is cured. Example of Syphilis.
• Sex with a virgin will cure STDs.

AIDS

AIDS stands for Acquired Immuno-Deficiency Syndrome.

• Acquired - something that you get from others.
• Immune - the system that defends your body from disease.
• Deficiency - the immune system becomes weakened by the virus.
• Syndrome - the body shows a variety of symptoms.
• AIDS isn't a disease in itself.

We need to know about AIDS because:

• AIDS can affect anyone, Male, Female, Adult or Child. No one is immune.
• The virus that causes AIDS can be transmitted without a person's knowledge.
• The condition is fatal and has no cure yet.
• Ignorance causes fear, anxiety and prejudice.

AIDS is caused by a virus called the Human Immuno-Deficiency Virus (HIV). As the name suggests it affects only human beings. HIV belongs to a class of viruses called retroviruses which have genes composed of Ribonucleic acid (RNA) molecules. The genes of humans and most other organisms are made of a related molecule Deoxyribonucleic acid (DNA). It has a diameter of 1/10,000 of a millimeter and is spherical in shape.

Scope of the epidemic

Although HIV was first identified in 1983, studies of previously stored blood samples indicate that the virus entered the US population sometime in the late 1970s. An estimated 36 million people are infected worldwide. Through 1997, cumulative HIV/AIDS associated deaths worldwide numbered about 11.7 million - 9 million adults and 2.7 million children. Every hour 100 people in Mumbai become HIV positive. 3.5 million people in India are HIV positive. 50% of those infected are under 24 years of age. Every day around 16,000 people get infected with HIV. 3 million people died in the year 2000. Totally from the year 1981 to 2000, 22 million people have died of AIDS.

HIV is found in large concentrations in blood, semen, vaginal and cervical secretions of an infected person. Hence, any activity that involves an exchange of these body fluids between the HIV infected person and one who is not, is likely to transmit the virus.

HIV can spread only:

Through sexual contact

Through the use of contaminated needles.

By direct transfusion of HIV infected blood.

From an HIV positive mother to her baby, during pregnancy or birth.

It must be noted that, HIV is not transmitted by sharing belongings (except toothbrushes and razors), toilet seat or through mosquito/insect bites because the virus does not survive outside the human body. Secondly, it cannot be transmitted through mosquito bites because the mosquito draws (not injects) blood from the human body. Also, the Human Immuno-Deficiency Virus cannot make a duplicate of itself inside the body of the mosquito as does the malaria parasite. It is neither transmitted by touching, hugging, kissing, body contact in crowded places, playing and working together, shaking hands or by caring for someone with AIDS. Scientists have found no evidence that HIV is spread through sweat, tears, urine or faeces. Although researchers have detected HIV in the saliva of infected individuals, no evidence exists that the virus is spread by contact with saliva.

On entry into the human body, HIV attaches itself to and gradually destroys certain white blood corpuscles which are an important part of the body's defense against disease germs. The body is then vulnerable to infections that it would otherwise, be able to resist (e.g. Herpes Zoster, Pneumocystis Carinii Pneumonia). These are aptly called 'opportunistic infections' since they take the opportunity of a weakened immune system to attack the body. Ultimately these disease take their toll on the person in the form of death. Therefore, technically speaking, the individual does not die of AIDS but of other opportunistic infections. The term AIDS applies to the most advanced stages of HIV infections.

How long it takes for an infected person to develop AIDS ?

It depends on how the person acquired the infection. The person who is infected through a blood transfusion is likely to develop an opportunistic infection sooner than a person who has acquired the infection through sexual intercourse since the concentration of HIV is higher in blood than in the semen or vaginal fluid. (However, it must be pointed out that more than two-thirds of HIV infection in the world today is caused by sexual transmission). During any form of sexual contact with an HIV infected person, the virus can enter the blood stream, be it through the vagina, penis, anus or mouth. Some forms of sexual contact that tear the skin and draw blood are described as High Risk Practices.

The person's life style. An infected person who is particular about consuming good food and building good habits (like adequate rest and exercise among other things) will be more likely to delay developing opportunistic illnesses than one who is not.

Among patients enrolled in large epidemiologic studies in western countries, the median time from infection with HIV to the development of AIDS related symptoms has been about 10 to 12 years. About 10 percent of HIV infected people in these studies have progressed to AIDS within the first 2 to 3 years following infection, while upto 5 percent of individuals in the studies have no symptoms even after 12 or more years.

It is not possible to recognise persons who are infected by just looking at them. The "signs and symptoms" such as flu-like fever, diarrhea and weight loss are so common that they can be caused by any other condition. The only way to know for sure is to undergo an HIV test such as ELISA or WESTERN BLOT. These, check the blood for antibodies to HIV, the presence of which indicate that the person is infected. The test must always be accompanied by counselling.

Here, one must always remember that the person who tests positive is infected with the virus and can infect others, but is not yet ill. Rather such a person can, and should be encouraged to, be a productive member of society. Such individuals need our compassion rather than censure. Blaming groups like commercial sex workers ("Prostitutes") or gays ("Homosexuals") is not only counterproductive, as they will only go underground and refuse to be tested, but also contributes to a false sense of security by blinding us to the fact that we could be infected in other ways.

Treatment

Drugs like AZT, 3TC, d4T, and ddC may slow down the spread of HIV in the body and delay the onset of opportunistic infections. Importantly, they do not prevent transmission of HIV to other individuals. More recently, drugs called protease inhibitors, which interrupt virus duplication at a later step in its life cycle, are used. A number of drugs are available to help treat opportunistic infections to which people with HIV are especially prone. Just two doses of an inexpensive HIV drug called Nevirapine can prevent mothers from infecting their babies with the virus at birth, state researchers.

Prevention

The risk of HIV transmission from a pregnant woman to her fetus is significantly reduced if she takes AZT during pregnancy, labor and delivery and if her baby takes it for the first six weeks of life. As there is no cure, we can only concentrate on prevention. While condoms are often touted as the only means of protection, it is not widely known that they are not completely fool-proof. Condoms can break, tear or leak. Rather more important in terms of health, as well as, values are behavioral measures or chastity. This involves saving sex for marriage, avoiding intimate sexual contact before marriage and being faithful to one's spouse after marriage. This makes for both, a healthy, as well as a happy life.

SEXUAL PERVERSIONS

Sexual perversions are acts aimed to obtain sexual gratification without normal sexual intercourse. These acts are self centered, immoral and have consequences. The following are some of the sexual perversions.

1. HOMOSEXUALITY OR SODOMY
When there is sexual connection between the members of the same sex it is termed as homosexuality. Where there is sexual connection between two male members then it is homosexual sodomy and unnatural connections between a man and woman is hetero-sexual sodomy. When the sexual desires of a woman are gratified by another woman then it is called lesbianism or female homosexuality.

2. MASTURBATION
Masturbation in males or females is the achievement of sexual response by self stimulation. It causes an unbalanced concept of sexuality that can influence against future sexual health within the concept of marriage.

3. BESTIALITY
Bestiality means sexual intercourse by a human being with a lower animal, either through the anus or the vagina.

4. EXHIBITIONISM
The acts of men whose sexual desire consists principally of the exhibition of the genitals with or without performance of the masturbatory acts, in the presence of women and young girls. Occasionally, women too may expose themselves in public.

5. SADISM
This perversion may be practiced by either sex, but is more common in males. In order to satisfy the sexual desires, the sadist bites, flogs, injures the partner. Multiple injuries are inflicted on many body areas, but breasts and external genitalia are commonly selected.

6. MASOCHISM
This is the reverse of sadism. Victims of this perversion obtain sexual enjoyment and satisfaction only when they receive a painful stimulus from their partner.

7. FROTTEURISM
This is a compulsion to rub the genitalia against the other person, usually in lifts or crowds.

8. FETISHISM
This is a type of sexual perversion in which sexual gratification is associated with contact and sight of certain parts of the female body, or even clothing or other articles known as fetish objects.

9. VOYEURISM
In voyeurism, the desire to observe the genitals of others or to watch sexual intercourse becomes the condition of erotic excitement and gratification.

10. PORNOGRAPHY
Watching films of sexual acts (blue films), photos and reading such literature and deriving sexual pleasures.

11. INCEST
This is the act of sexual intercourse between men and women within a certain degree of blood relationship. For example, father and daughter, mother and son, brother and sister.

12. NECROPHILIA
An erotic/sexual attraction to corpses.

13. RAPE
Forcible or fraudulent sexual intercourse especially imposed on women.