Chapter Seventeen The HIV/AIDS Crisis and Sexual Decisions

The Evolution of HIV and AIDS §First identified in 1981 §Origins uncertain, maybe Africa §Has spread rapidly, infecting millions throughout the world Global Increase in HIV/AIDS Cases

Epidemiology §While spread first among gay males and IV drug abuses, HIV infection is now present in women, children and heterosexuals §HIV may be spread via sexual contact, blood transfusion, shared needles, and perinatally

HIV Globally Incidence varies in different parts of the world, with rates high in parts of Africa and Southeast Asia

HIV: The Infection and the Virus §HIV is a retrovirus l Several strains l Attacks CD4 cells crucial to immune system §Number of infected cells remain stable for some time, where person is symptom-free §Transmitted via direct transfer of bodily fluids §Casual contacts with infected persons are not dangerous §Small proportion with HIV are AIDS-free l Raises question of potential immunity

HIV Testing, Treatment, & Vaccines §Antibodies detected around 6 months post- exposure through ELISA blood test l If positive, Western blot test administered §Controversy over testing and confidentiality §Since there is no cure, treatment focuses on prevention and control of infections l Many drugs and therapies l HIV can develop resistance §Vaccine and drug research is ongoing

HIV and Society Individual Freedom vs. Public Health Confidentiality Cost of patient care and research Legal Ramifications

HIV and Personal Decisions About Sex §HIV/AIDS education in schools §Some still engage in risky sexual behaviors §New approaches to sexual decision-making needed §Minimize sexual risk by l Knowing partner’s history l Make agreements for safe sex l Use condoms and spermicides l Avoid contact with bodily fluids or secretions