The HIV/AIDS Epidemic © 2005 John B. Pryor Illinois State University

AIDS -  Acquired  Immune  Deficiency  Syndrome HIV -  Human  Immunodeficiency  Virus

Ways HIV is Transmitted: 1) through unprotected sexual intercourse 2) through sharing needles 3) through exposure to contaminated blood 4) perinatal exposure 5) mother’s milk

Ways you cannot transmit HIV: 1) mosquito bites 2) casual contact 3) toilet seats 4) sharing food

Can I get HIV from oral sex?  CDC says “yes.”  Not as dangerous as vaginal sex or anal sex  Actual risk level is unknown  Oral sex is more dangerous if the person performing it has bleeding gums or cuts/abrasions in the mouth.  Oral sex is more dangerous if the person who receives it has cuts, abrasions, or sores in the genital area.

Natural History of HIV/AIDS HIVInfection 3-6 Weeks AcuteHIVSyndrome 6 Months Positive HIV Test 9.8 Years 14.8 Years ClinicalAIDS Death May be extended by new drug therapies

Advances in HIV-Testing  OraQuick Rapid HIV Test  A swab of the outer gums, upper and lower - collects oral fluid  Test takes 20 minutes  Accuracy - Correctly identified 99.3% of people who were infected with HIV (sensitivity) and 99.8 % of people who were not infected with HIV (specificity)

HIV/AIDS Trends in the USA

History of the Epidemic 1981 – 121 deaths – A disease was identified among men who have sex with men. It was first called “gay cancer” and later named Gay Related Immuno Deficiency (GRID) 1982 – 447 deaths – Institut Pasteur in France discovered Human Immunodeficiency Virus (HIV) the virus that causes Acquired Immunodeficiency Syndrome (AIDS). CDC in US announced that HIV can be spread through sexual contact or exposure to contaminated blood – 1,476 deaths – CDC documented transmission of HIV from heterosexual contact. American Red Cross warned `high risk donors not to donate blood

Number of AIDS patients, AIDS deaths and patients on antiretroviral therapy among men who have sex with men (MSM), San Francisco, USA, 1980 to 1998 Source: San Francisco Department of Public Health (California), USA, 1999

Why is the prevalence of HIV/AIDS higher in African Americans?  POVERTY – Almost 1 in 4 African Americans live in poverty. Research by CDC shows that poverty is a strong predictor of HIV infection.  IMPRISONMENT OF BLACK MALES – Black men are more than 6 times more likely than White men to have served in prison. 1 out of every 7 Black men is in prison. Prison is a place where there are high risks for HIV infection: male- to-male unprotected sex, IV drug use, & prison tattoos. Black men are no more likely to perform risky behaviors than White men while in prison. They are just more likely to be there. When they get out they spread HIV to their communities.  POVERTY also predicts IMPRISONMENT.

HIV/AIDS Trends in Illinois

HIV/AIDS Global Trends

Adults and children estimated to be living with HIV, 2005 Total: 38.6 (33.4 – 46.0) million Western & Central Europe [ – ] North Africa & Middle East [ – ] Sub-Saharan Africa 24.5 million [21.6 – 27.4 million] Eastern Europe & Central Asia 1.5 million [1.0 – 2.3 million] South & South-East Asia 7.6 million [5.1 – 11.7 million] Oceania [ – ] North America 1.3 million [ – 2.1 million] Caribbean [ – ] Latin America 1.6 million [1.2 – 2.4 million] East Asia [ – 1.1 million]

Estimated number of adults and children newly infected with HIV, 2005 Total: 4.1 (3.4 – 6.2) million Western & Central Europe [ – ] North Africa & Middle East [ – ] Sub-Saharan Africa 2.7 million [2.3 – 3.1 million] Eastern Europe & Central Asia [ – ] South & South-East Asia [ – 2.3 million] Oceania7200 [3500 – ] North America [ – ] Caribbean [ – ] Latin America [ – ] East Asia [ – ]

Estimated adult and child deaths from AIDS, 2005 Total: 2.8 (2.4 – 3.3) million Western & Central Europe [<15 000] North Africa & Middle East [ – ] Sub-Saharan Africa 2.0 million [1.7 – 2.3 million] Eastern Europe & Central Asia [ – ] South & South-East Asia [ – ] Oceania3400 [1900 – 5500] North America [ – ] Caribbean [ – ] Latin America [ – ] East Asia [ – ]

HIV/AIDS Trends in Africa

Estimated number of people living with HIV in sub-Saharan Africa, 1985–2005 Number of people living with HIV Million Year

Estimated number of adult and child (all ages) deaths due to AIDS in sub-Saharan Africa, 1985–2005 Number of adult and child deaths due to AIDS Million Year

HIV prevalence (%) in adults in Africa, Namibia Botswana Zimbabwe Zambia

Life expectancy at birth in selected most affected countries, 1980 − 1985 to 2005 − 2010 Source: UN Population Division, World Population Prospects: the 2002 Revision 2004 Report on the Global AIDS Epidemic (Fig 12) Years Botswana South Africa Swaziland Zambia Zimbabwe

HIV/AIDS Trends in

HIV in Russia  The Russian Federation has the largest AIDS epidemic in the whole of Europe.  In some 940,000 people were living with HIV in the country and national HIV prevalence was an estimated 1.1%.  Unsafe drug injecting practices are the main cause of new infections in Russia and large numbers of young people under 30 inject drugs.  In St Petersburg, HIV infection levels of 30% have been found among injecting drug users and HIV is spreading from injecting drug users to their sexual partners, with more women becoming infected.

HIV in Russia  People on the margins of society are especially at risk of HIV infection in Russia – a study at a temporary detention centre in Moscow found HIV prevalence times higher than in the general population.  HIV prevalence in Russia’s prisons is estimated to be at least four times that found in the wider population.  In 2005, only 5,000 of the estimated 100,000 people in need of antiretroviral treatment in Russia were receiving it.

% HIV prevalence Age-group HIV prevalence among female sex workers, by age-group, St. Petersburg, Russian Federation, 2003 Source: T. Smolskaya, et al., XV International AIDS Conference, July Abstract No. ThOrC1371. AIDS epidemic update, December Fig.1 9.

% HIV prevalence 0-1 partner 2-4 partners 5-9 partners partners 20 or more partners HIV prevalence among sex workers, by number of commercial partners in past seven days, St. Petersburg, Russian Federation, 2003 Source: T. Smolskaya, et al., XV International AIDS Conference, July Abstract No. ThOrC1371. AIDS epidemic update, December Fig 20.