Living with AIDS
Acquired immune deficiency syndrome (AIDS), a virus leading to fatalities, was first reported in the United States in the early ’80s – no one has recovered from AIDS, but many are living with it.
Stan Penfold, executive director of the Utah AIDS Foundation, said the disease first surfaced in the country in groups of gay men in Los Angeles and New York City. The men began having symptoms that ranged from rare opportunistic diseases like Kaposi’s sarcoma to pnuemocrystis carinii pneumonia.
“By ’84, people pretty much knew what it [AIDS] was and how it was transmitted,” he said.
The disease first attacked gay men and Haitians, which Penfold said was just a coincidence that it entered the country within these communities.
However, he said, internationally AIDS has moved into other communities.
Approximately 90 to 95 percent of all new infections are within the heterosexual communities. Currently 48 to 49 percent of infections are in women.
What is HIV and AIDS?
According to the Center for Disease Control (CDC) Web site, www.cdc.gov/
hiv/dhap.htm, AIDS actually is caused by an infection called human immunodeficiency virus (HIV).
HIV destroys the blood cells known as CD4+T cells. These cells are often called the helper cells and are needed for the normal function of the human immune system. AIDS is the advanced stages of the HIV infection.
“AIDS is just a description of certain stages in the disease – usually the later stages,” Penfold said.
Transmission
According to the Web site, HIV is transmitted by sexual contact with an infected person, by sharing needles and/or syringes (mostly for drug injection) and from other medical related sources. The site points out the number of cases within the workplace or among the medical profession are very low, and it is uncommon for such infections to occur.
Kissing has often been thought to be a “safe” practice, but the CDC indicates that closed-mouth or social kissing is not a risk factor for transmission. However, open-mouthed or French kissing carries a risk of blood exposure and is therefore considered a risk factor which should be avoided with individuals who are known to be HIV-positive.
“Saliva is very, very safe unless someone has bleeding gums or some type of open sore in their mouth,” Penfold said.
It has often been thought the transmission can come from insect bites as well, but the CDC site states there has been no evidence to support such thoughts. Insects inject their own saliva into the skin to act as a lubricant, and do not inject blood of any kind, making the transmission unlikely.
Penfold said HIV is transmitted in four major bodily fluids: Blood, semen, vaginal fluids and breast milk.
“Any kind of risk behaviors that exposes someone to these four body fluids is how you get HIV,” he said.
The most common method of transmitting the disease is through the exchange of blood. For the gay community the risk increases, said Lapriel Clark, a nurse practitioner and preventative service director for the Bear River Health Department.
“The sexual practices of the gay community puts them at risk,” Clark said. “Rectal sex is a very risky thing to do – you have both blood and semen and the rectum was made to absorb things.”
She also indicated that multiple partners increases the risk for individuals.
Penfold said the disease affects the gay community on a greater scale than other social groups. However, in Utah, of the men who are having sex with men, the trend is moving to men who do not identify themselves as being gay, and many are married men.
Injectable drug users are also one of the main risk groups.
“We are seeing more women in Utah [with HIV] – those who are partners of injectable drug users,” he said.
There is also an increase among the younger generation in the state.
Robert A. Jones, the manager of the HIV prevention program with the Utah AIDS Foundation, said, “I think in Utah media there is a tendency to think this does not affect our Mormon kids, but it is. Mormon kids are sexually active as well.”
Following Possible Exposure
Once an individual has reason to believe they have been exposed to the virus, several things should happen.
Clark said the first step is to make an appointment with a health provider to be tested. There are two types of tests available. The first is the standard blood test, and the other is a new oral test called OraSure which collects white blood cells from the cheek and gums. Both tests are sent out from the testing site and processed. Results are typically returned in one week.
Once the results are returned, she said the patient is counseled on what to do with the results.
“If [the test is] positive, we re-test them right then. On something this important, we want to be accurate,” she said.
If the results are returned negative, Clark said she counsels with the patient on ways to remain disease-free. If the results are positive, an appointment is made with an AIDS specialist as well as a mental health provider.
“Once a person is positive, our focus is to keep them healthy so they don’t get AIDS,” Clark said.
She also said once a person’s results are positive, the center works with the person to identify and talk to all partners they have had in the past year in order to get them tested as well.
One test is normally enough to determine if an individual is infected.
“As long as there are no additional risk activities – there is no need to re-test,” Penfold said.
Tests range in price from $10 to $25, but many of the departments can waive these fees he said.
The tests are 97 to 98 percent accurate after three months and after six months, it is almost 100 percent accurate, Penfold said.
Testing is available from the Student Wellness Center as well as from the Bear River Health Department.
Jim Davis, the director of the Student Wellness Center, said, “We will do AIDS testing under an anonymous name if they want. We work with them to maintain anonymity and confidentiality.”
Clark said the health department sends their tests under a number so the patient name is never seen.
Living with HIV/AIDS
Jones said there are many programs to help individuals deal with the disease.
‘We have a program called the Village. It was started about a year and a half ago,” he said.
Jones said the message for the past 20 years has always been to use condoms, but today that is not as effective.
“Safe sex is not always No. 1 on the list. You need to address the issues in people’s lives before you can address safe sex,” he said.
Some of the issues that are dealt with include body image, dating and depression.
“Studies have shown that when you address some of these other things, people want to take care of themselves,” he said.
The virus can live in the body for up to five years before it manifests itself.
Penfold said the gay community is the only one to see a drop in the number of new cases in the state while all others are increasing.
Clark said, “I am seeing a lot more awareness. People seem a lot more educated. However, the level of knowledge of AIDS does not match the lifestyle. The ones who have the most knowledge are the ones taking the most risks.”
For more information call the Utah AIDS foundation at 1-800-865-5004.