1 HIV/AIDS 101… continued Anthropology 393 – Cultural Construction of HIV/AIDS Josephine MacIntosh

2 Questions from Yesterday What is Selenium? A trace mineral that is essential to good health Only required in small amounts Incorporated into proteins to make selenoproteins -- important antioxidant enzymes Help prevent cellular damage from free radicals Free radicals linked to chronic diseases such as cancer and heart disease Other selenoproteins help regulate thyroid function and play a role in the immune system

3 What Foods Provide Selenium? Plant foods, some meats and seafood Some nuts (especially Brazil nuts) BUT… the selenium content in food depends on the selenium content of the soil it was raised in/on Selenium deficiency most often reported in regions with low selenium content in the soil

4 Recall… Blood transfusion is the most efficient route for HIV infection Sexual transmission is the most common route of infection 75% to 85% of all HIV infections are sexually transmitted

5 Evolution of a Pandemic “We typically think of a new epidemic in a ‘virgin’ population as something that arises suddenly, sweeps through the population in a few months, and then wanes and disappears” (Anderson, 1996:71).

6 Epidemic Curves Classical epidemic curve is bell-shaped Steepness of slope is a measure of infectivity or contagion Length of the curve describes duration of epidemic Highly infectious diseases (like measles): Short period of infectiousness (generally 2 weeks) Relatively short duration (typically 6 months to a year)

7 Epidemic Curves Not so with HIV/AIDS Marked by elongated curve Lengthy period of infectivity, enduring over generations Several distinct peaks As it moves through different populations (MSMs, IDUs, etc)

8 Infectious Diseases Can Be… Endemic Relatively low but constant presence of the disease in a specific geographic area or population group Epidemic More cases of a disease occur than are expected in a given area or group

9 Infectious Diseases Can Be… Pandemic When an epidemic affects large proportions of a population and spans a wide area (several countries or continents HIV/AIDS May have been endemic to a specific region Is currently a full-fledged epidemic Global distribution gives it pandemic status

10 Incidence Vs. Prevalence Incidence Refers to the total number of persons who became newly infected in a given year Prevalence Refers to the total number of persons who were living with the infection at the end of a given time period

11 Doing the Math In a 1988 study, a mathematical model was used to predict future HIV infection rates based on known AIDS cases The prediction: A “slow but continuous development of the AIDS epidemic over many decades...where the numbers of cases of HIV infection (and hence AIDS) increase faster as time goes on, in compound interest fashion” (Anderson & May, 1992:58)

12 Doing the Math Using this mathematical model and assuming: Exponential growth A doubling time of 3 years It would take: 30 years for the prevalence of HIV to change from 0.001% to a detectable level of 1% 3 years to change from 10 to 20 percent (Anderson & May, 1992:59)

13 Doing the Math Currently, the epidemic is spreading at twice the initial predicted rate Between 1999 & 2002, infection rates have: DOUBLED in East Asia & the Pacific Increased 2 ½ times in North Africa & Middle East Almost TRIPLED in Eastern Europe & Central Asia Eastern Europe & Central Asia currently have the fastest-growing epidemic in the world

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16 **Incidence **Prevalence

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