1. PRESENTED BY: SURABHI MAHAJAN HIV/AIDS

2. History of HIV/AIDS The first major outbreak in the United States was in the early 1980’s when gay men in Los Angeles and New York started developing infections and cancers that were non-responsive to treatment. Scientists discovered that AIDS (Acquired Immunodeficiency Syndrome) is caused by the Human Immunodeficiency Virus. The journey of HIV/AIDS is also one of how the LGBTQA rights movement has been shaped.

3. Zoonosis of HIV/AIDS HIV actually originates from non-human primates in Central and West Africa called the Simian Immunodeficiency Virus originating 32,000 years ago. The strain of SIV that is identical to HIV is a hybrid strain passed down from red-capped mangabeys to chimpanzees. There are many theories as to how this zoonosis took place but most common is the “hunter” theory where contamination took place when people would hunt primates and come into close contact.

4. The Stigma of HIV/AIDS When doctors and scientists noticed that the symptoms of HIV/AIDS were a trend among gay men, the stigma for homosexuality came out into the open and started a long discussion for acceptance. Because the stigma against homosexuality was so rampant, many people believed that HIV/AIDS was a punishment for homosexuality. This prevented many people from gaining the help they needed. The story of HIV/AIDS tells a story of how our society has progressed. As we learned more about this disease with the help of scientists and doctors, the more society accepted the LGBTQA community.

5. The Fight for Gay Marriage The Supreme Court of the United States legalized gay marriage after a long fight by many organizations just in 2015. However, this struggle for homosexual couples to get married started in the HIV/AIDS epidemic in the 1980’s. Because hospital visitation rights are associated with heterosexual married couples, partners couldn’t visit each other if one of them was hospitalized due to AIDS related illnesses. Thus, HIV/AIDS and consequentially homosexuality was stigmatized as a lonely, very devastating disease. The struggle for equality in marriage has its roots in the start of HIV/AIDS in the United States over 30 years ago and is now being accepted into law nationally.

6. The first cases of HIV The first case of HIV/AIDS documented in the United States was on June 5 th, 1981 by the Center for Disease Control. This case was documenting a rare lung infection, Pneumocystis carinii pneumonia (PCP). Among this lung infection, many opportunistic infections and rare cancers such as Kaposi’s Sarcoma were also showing up in the population of gay men. Many gay men started dying of these infections in New York and California.

7. The Virus HIV is a lentivirus and attacks the immune system. Lentiviruses are part of a larger group of viruses called retroviruses that are known for long- duration illnesses and long incubation times.

8. The Virus (cont.) Lentiviruses are transmitted as single-stranded, positive-sense, enveloped RNA viruses. They convert their viral RNA into double-stranded DNA which is imported into the host cell’s nucleus. The virus can become latent after integration which lets it avoid detection by the host immune system. Two types:  HIV-1: responsible for most of the global outbreaks of AIDS, more virulent, more infective  HIV-2: contained to parts in West Africa, not as virulent, originates from a different strain of SIV

9. How do you get HIV/AIDS? Transmitted in 3 ways:  Sexual contact  Exposure to infected bodily fluids  Vertical transmission from mother to child HIV is not transmitted through the air, saliva, from touching a person who is infected, from sweat, from coughing or sneezing.

10. Transmission Transmission from sexual contact is one of the leading causes of HIV because people don’t practice safe sex and unknowingly pass the infection on. The specific vectors for bodily fluids are contaminated needles, blood transfusions using infected blood, or unsafe medical injections. For mother to child transmission, the vectors are from the amniotic fluid during pregnancy, during childbirth, and then through the breast milk after birth.

11. Symptoms-Acute HIV After HIV has been contracted, the initial stage is called acute HIV, primary HIV, or acute retroviral syndrome.  Influenza-like symptoms appear after 2-4 weeks from exposure.  Symptoms include a fever, tender lymph nodes, throat soreness, and a rash.  Prime stage for opportunistic infections because this stage is the most misdiagnosed so the focus is on diseases that are more closely linked with these symptoms.

12. Symptoms-Clinical latency Clinical latency is when the virus can go dormant.  This stage can last about 3-20 years for an individual.  At the end of this stage, people experience fevers, unintended weight loss, muscle pains, and enlargement of the lymph nodes.  For most people this stage lasts about 10 years.

13. Symptoms-AIDS When AIDS develops from HIV, a whole group of infections and diseases can occur because the CD4+ T cell count becomes less than 200 cells/μL. The conditions that alert to AIDS are pneumonia, cachexia in the form of HIV/wasting syndrome, and esophagal conditions. Systemic symptoms are prolonged fevers, sweats, swollen lymph nodes, chills, weakness, and unintended weight loss. Because people don’t get treatment in the early stages, most people develop AIDS within 10 years after exposure.

14. How to Diagnose HIV/AIDS: HIV testing:  Recommended for all people 15-65 years of age including pregnant women  Most people start developing antibodies within 3-12 weeks of the initial HIV infection. The diagnosis of HIV is based on measuring the presence of the HIV RNA and confirming through PCR.  The World Health Organization created a system for diagnosing HIV/AIDS without the use of a laboratory based on a range of symptoms from low T-cell count to respiratory problems, all associated with different kinds of cancers and infections.

15. Prevention Because unsafe sexual practices is a leading cause of HIV/AIDS, consistent use of condoms reduces the risk of HIV transmission by approximately 80%. Female condoms such as a vaginal gel has reduced infection rates in African women by approximately 40%. Preventing vertical transmission from mother to child reduces rates of transmission by 92% by using antiviral medication during pregnancy and after birth in the infant. Also replacing breastfeeding with bottle-feeding helps reduce transmission to infants since they are still developing their immune systems.

16. Can HIV/AIDS be treated? Currently there is no known cure for HIV/AIDS.  This is why prevention is almost as good as a cure. An antiretroviral treatment (HAART) can suppress HIV which can delay the symptoms for AIDS for many years.  This treatment does not clear the virus completely.  The World Health Organization recommends therapy for anybody with a CD4+ T cell count below 500 cells/μL because this is what will lessen the likelihood of death.

17. U.S. Statistics About 1.2 million people are living in the United States that are positive for HIV. There are 50,000 new cases every year. The incidence for HIV is consistent at this rate. Approximately 12,000 people died from an AIDS diagnosis in 2012. Overall, over 600,000 people have died with an AIDS diagnosis.

18. Why should we spend more time on HIV/AIDS? Many people are still suffering from HIV/AIDS, especially in developing countries where access to medical care is not consistent or enough to cover treatment. Not enough education about the transmission of HIV/AIDS so people are still unknowingly spreading the virus. Discrimination of people with the infection is still happening because people are not educated about HIV/AIDS.

19. References U.S. Department of Health and Human Services. 30 Years of AIDS: A Timeline of AIDS, from the government website on AIDS. https://www.aids.gov/hiv-aids-basics/hiv-aids-101/aids-timeline/https://www.aids.gov/hiv-aids-basics/hiv-aids-101/aids-timeline/ Averting HIV and AIDS. Origins of HIV and AIDS. http://www.avert.org/origin-hiv-aids.htmhttp://www.avert.org/origin-hiv-aids.htm The AIDS Institute. Where did HIV Come from? http://www.theaidsinstitute.org/education/aids-101/where- did-hiv-come-0 WebMD. AIDS Retrospective Slideshow: A Pictorial of the HIV/AIDS Pandemic. http://www.webmd.com/hiv-aids/ss/slideshow-aids-retrospective