If you’ve heard of only one STD, it's probably AIDS (acquired immunodeficiency syndrome), which is linked to infections by HIV (human immunodeficiency virus). Why is so much more attention given to HIV/AIDS than to any other sexually transmitted disease? Because AIDS is deadly, and it has no cure and no vaccine.

HIV is most commonly passed on through sexual activity or by shared needles. In Africa, 60 percent of HIV transmissions occur in women through vaginal intercourse. HIV can also be passed through transfusions of contaminated blood products (though since 1985 all blood is screened for HIV in the United States), from a woman to her fetus during pregnancy, and through breastfeeding.

Although HIV has been detected in small quantities in body fluids such as saliva, feces, urine, and tears, to date no evidence exists that HIV can spread through these body fluids, despite extensive testing. You can’t contract AIDS by touching someone who has the disease, by being coughed or sneezed on by that person, by sharing a glass with that person, or through any other routine contact that may take place.

AIDS poses a risk to everyone:

  • HIV infections weaken the body’s ability to fight disease, causing acquired immunodeficiency syndrome (AIDS) and other health problems.

  • A person can be infected by HIV and not show any symptoms for up to ten years.

  • If AIDS develops, a variety of different ailments may attack the body, leading to death.

Two known human immunodeficiency viruses exist, HIV-1 and HIV-2. They both cause disease by infecting and destroying blood cells called lymphocytes that protect the body against infection. HIV-1 is most common in Western countries; HIV-2 occurs most frequently in Africa, where the disease is thought to have originated.

HIV/AIDS: Diagnosis, symptoms, and treatment

Doctors diagnose HIV infection with tests to detect HIV antibodies in the blood. These antibodies usually appear in the bloodstream three to eight weeks after infection, though it may take as long as six months for these antibodies to show up. Because of this window of time, a person can have a negative HIV test and still be able to pass the disease to others. In addition, the first 60 days after being infected with the virus is a period of high contagion. For that reason, you should always use a condom; it’s impossible to really know whether or not a partner can infect you.

Initial symptoms of HIV infection may resemble those of a common nonsexual disease, mononucleosis: high fevers, swollen glands, and night sweats. After that you may go through a period, which commonly lasts for years, during which you have no symptoms. Eventually, as the body’s immune system weakens from fighting HIV, some opportunistic microbe — an organism that the body’s immune system would normally dispose of — causes an infection, such as pneumonia, that just won’t go away. At this point, a doctor usually discovers that the person is infected with HIV and diagnoses a case of AIDS.

In the United States, 50 percent of people infected with HIV will have AIDS after ten years; the median life expectancy from the time of infection is about 12 years. Life expectancy is shorter for those people infected by transfusions of blood or blood products and for people who don’t get good medical care.

Medical science has, as yet, produced no vaccine against AIDS, nor has it found a cure. The medical field has developed many different drugs that can now help prolong the life of a person with HIV and manage the various symptoms.

Three basic categories of drugs exist:

  • Antiretroviral drugs that inhibit the growth and multiplication of HIV at various steps in its life cycle. Doctors prescribe these drugs in groups known as cocktails.

  • Other drugs fight the opportunistic infections that may occur because HIV lowers the immune system’s ability to fight them.

  • A third group, which is more experimental and has not proven very successful, helps to boost the immune system. And although no vaccine is imminent, microbicides, which women could apply to their vaginas, seem to offer some protection for women, though their approval and availability are still years away.

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