HIV/AIDS—its pathology, transmission, incidence and prevalence, and treatment (Avert, 2019a). 1990s The U.S. enacted the Americans with Disabilities Act (ADA), which prohibits discrimination against people with disabilities, including those with HIV infection. ● The Red Ribbon Project was created to increase AIDS awareness. ● The U.S. Congress implemented a ban on entry into the country for people living with HIV. ● The CDC added pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer to the list of AIDS indicators. ● The FDA approved an oral HIV test (the first nonblood HIV test). ● The FDA approved the first protease inhibitor, marking an era of significant antiretroviral treatment (highly active antiretroviral therapy [HAART]). ● HIV infection continued to spread. By the end of the decade, the WHO reported that AIDS was the fourth leading cause of death worldwide and the number one cause of death in Africa. There were approximately 33 million people living with HIV, and 14 million people died from AIDS since the first documented case (Avert, 2019a). 2000s ● Funding for antiretroviral drugs increased, as did efforts to decrease their price. ● Experts found that male circumcision reduced the risk of female-to-male HIV transmission by 60%. ● In 2010, the travel ban that prevented HIV positive people from entering the U.S. was lifted. ● Research showed that early initiation of antiretroviral treatment reduced the risk of HIV transmission by 96% among serodiscordant (one partner is HIV positive and the other is not) couples. ● Treatment options for people living with HIV were expanded. ● In 2012, The FDA approved PrEP for HIV-negative people to prevent sexual transmission of HIV and, for the first time, the majority of people eligible for treatment received it (54%). ● In 2015, the WHO published new treatment guidelines stating that all people living with HIV should receive antiretroviral treatment as soon as possible after diagnosis, regardless of their CD4 count. ● In 2016, there were 18.2 million people on antiretroviral therapy (ART), including 910,000 children, which is double the number 5 years previously. However, increased ART medication access also translates to greater risk of drug resistance (Avert, 2019a). Evidence-Based Practice Research shows that young people (ages 13–24) are the group most likely to be unaware of their HIV infection (CDC, 2020f). Healthcare professionals must increase their efforts to reach this group with information about HIV transmission and the importance of being tested.
population and a growing sex trade that facilitated the transmission of the virus among humans. The virus spread quickly beyond Kinshasa and, ultimately, worldwide (Avert, 2019c). Although sporadic cases of acquired immunodeficiency syndrome (AIDS) were documented before 1970, scientific data indicate that the current epidemic started in the mid- to late 1970s. By the time researchers and other healthcare professionals began to realize the seriousness of the infection, HIV had already spread to North and South America, Europe, Africa, Asia, and Australia. In fact, it is estimated that between 100,000 and 300,000 people may have been initially infected (Avert, 2019a). The following is a timeline of key points that have occurred since HIV was first acknowledged as a potentially lethal disease (Avert, 2019a): 1980s ● People with HIV/AIDS were subjected to severe discrimination and ostracization and were objects of fear and hatred. In 1981, five young previously healthy gay men in Los Angeles were found to have a rare lung infection: Pneumocystis jirovecii pneumonia (PCP). Pneumocystis jirovecii used to be called pneumocystis carinii . When scientists renamed it P. jirovecii , some people considered using the abbreviation PJP, but to avoid confusion, pneumocystis jirovecii pneumonia is still abbreviated PCP. Simultaneously, an unusually aggressive cancer, Kaposi sarcoma, was diagnosed in groups of men in New York and California. That same year, PCP was diagnosed in some people who had injected drugs. By the end of 1981, there were 270 documented cases of severe immune deficiency among gay men, and 121 men had died (Avert, n.d.). ● In 1982, researchers suggested that the cause of the infection was sexual, primarily among the gay population, and the disease was initially referred to as gay-related immune deficiency (GRID). Cases of HIV infection were identified throughout the world, and several AIDS-specific organizations were established, including the San Francisco AIDS Foundation in the U.S. (Avert, n.d.). ● In 1983, female partners of men with AIDS were diagnosed with the disease, thus indicating that infection could be transmitted via heterosexual sex. Scientists at the Centers for Disease Control and Prevention (CDC) identified all major transmission mechanisms and ruled out casual contact (Avert, n.d.). ● In 1985, doctors developed a blood test to screen for the virus, and every region of the world had reported at least one case of AIDS. That same year, the famous actor Rock Hudson was the first high-profile celebrity to die from AIDS (Avert, 2019a). ● The remainder of the decade saw the spread of HIV infection and AIDS-related deaths; the Food and Drug Administration (FDA) approved the first antiretroviral drug, Zidovudine (AZT), also known as azidothymidine (AZT) , to treat HIV. In addition, national and international organizations, including the World Health Organization (WHO), devoted extensive time and money to studying
INCIDENCE AND PREVALENCE OF HIV
At the end of 2019, an estimated 1,189,700 people aged 13 and older had HIV, including about 13% who were undiagnosed (CDC, 2022). Of the 34,800 new HIV infections in 2019, 53% were in the South.
Healthcare Consideration: Healthcare professionals should incorporate an assessment of geographic distribution among high-risk demographic groups into their strategic planning for education, prevention, and treatment initiatives.
EliteLearning.com/Massage-Therapy
Book Code: MMD0724
Page 26
Powered by FlippingBook