Blood or blood products: Prior to 1985 HIV was frequently transmitted by
blood transfusions because there was no way to test blood for the AIDS virus.
Since 1985 the blood supply has been screened for HIV with an effective test.
The main way the virus is transmitted by blood products now is through the
sharing of needles by persons abusing drugs.
Sexual contact: The virus can be passed in body fluids including sperm.
Having unprotected sex (for example sex without condoms) can result in passing
the infection. Oral sex can also result in transmission. The infection can be
passed from men to women, women to men, men to men, and women to women.
Mother to infant: The virus can be transmitted from mother to infant
during pregnancy, at the time of birth, or by breast-feeding. Treating
pregnant mothers with anti-HIV drugs is very effective in limiting transmission
to infants, but some transmission still occurs. The risk of transmission is
further diminished by Cesarean section. back to top
2. How does HIV cause disease?
HIV is an infection of the immune system so it destroys the body's ability to
fight off infections. The illness is called AIDS, which stands for "acquired
immune deficiency syndrome." It is caused by a virus, which is a microscopic
organism that can only reproduce itself by entering human cells and using these
to make the building blocks for new viruses. The cell that is entered
eventually dies. Additionally HIV may enter a cell and then remain quiet for a
prolonged time. This is a problem for drug therapy because drugs destroy the
virus while it is active. back to top
3. How many persons are infected?
Over 30 million persons worldwide are infected. In some African countries over
20% of the population is infected. In the US there are as many as one million
persons infected, and there will be an estimated 44,000 new cases of infection
this year. back to top
4. What are the earliest symptoms of HIV infection?
Most people think of HIV infection as causing a debilitating disease called
AIDS that is not apparent until years after infection. In fact, in untreated
persons the average time to the development of AIDS is 10 years or more.
However, HIV infection is also associated with an acute illness in most
infected persons. This illness, called acute HIV infection begins
within one to three weeks of exposure, and most often consists of some
combination of the following symptoms: fever, sore throat, skin rash, swollen
glands, ulcers in the mouth or on the genitalia. Most persons complain of
severe fatigue, but in some there are very few symptoms. The symptoms usually
resolve within one to three weeks, and the infected person can then remain
apparently well for an average of 10 years. During this time the virus
continues to slowly destroy the immune system. back to top
5. How reliable is the AIDS test?
The test for AIDS is a test that measures the immune response to HIV. This
consists of antibodies that are generated in response to the infection. The
standard AIDS test measures these antibodies. Since these take some time to
develop, in the very early stages of infection there may be a negative antibody
test and yet the person can be infected. The way to check for HIV infection in
this circumstance is to measure the virus in the blood. This can be done with
either a viral load assay or a p24 antigen test. Both of these are available
through health care professionals. back to top
6. How do I find out if I have acute HIV infection?
The standard blood test for HIV is negative in persons with acute HIV
infection, so a special blood test has to be used if this diagnosis is
suspected. There are two tests that can help to diagnose acute HIV infection:
HIV viral load and HIV p24 antigen test. These are available through health
care professionals. The standard blood test becomes positive about four to six
weeks after infection. back to top
7. Who should have an AIDS test?
Anyone who has had a blood transfusion before the blood was tested for AIDS
(before 1985), anyone who has had unprotected sex with a person who could be
infected, and the infants of infected mothers. back to top
9. Is there an effective morning after pill?
Physicians are trying to determine whether anti viral drugs given after
exposure to HIV can prevent infection. In most large cities there are now
trials going on to treat people who have been exposed to see if this can
prevent infection. These trials are referred to as "post-exposure
prophylaxis." In Boston, such a trial is underway at the Fenway Community
Health Center. back to top
10. Who should stop therapy to see if the immune system is strong enough to
control the virus?
This should only be done in carefully controlled experiments under the
supervision of AIDS specialists. The NOVA program "Surviving AIDS" describes a
new kind of experiment in which doctors are trying to determine if the body's
natural defense mechanism, the immune system, can keep the virus under control
after drug therapy is stopped. They have found that persons who are treated
with potent anti viral drugs (often referred to as HAART for highly active
antiretroviral therapy) as soon as they become infected develop strong immune
responses to the virus, and now they are trying to see if this is enough to
successfully control the virus. These experiments are being performed in a
very select group of persons. back to top
11. How many persons are long-term non-progressors and what does this mean?
About 1 in 100 HIV infected persons is a so-called long-term non-progressor,
meaning that they have been infected for up to 20 years and still have a normal
CD4 count and low viral load. Clearly the virus has caused little damage in
these persons thus far, but whether these persons will be affected by the virus
in the future remains uncertain. back to top
12. Can the new drug cocktails cure HIV infection?
The new drug cocktail for HIV, which consists of a combination of three or more
drugs, can be very effective in lowering the amount of virus in the blood, but
it no longer appears that this cocktail will result in complete eradication of
the virus. In fact, persons who have stopped the drug cocktail even after two
years of treatment have generally had a rapid return of the virus. back to top
13. Is there an effective AIDS vaccine?
Attempts to make an effective AIDS vaccine have not been successful thus far.
Numerous different methods are being tried, and progress is being made. Since
anti viral drugs are extremely expensive, the only hope for worldwide control
of HIV is to develop an effective vaccine. back to top
14. What are clinical trials?
Clinical trials of AIDS treatments are studies designed to answer whether new
experimental treatments are more effective. Usually these trials involve
comparing the effects of one treatment compared to another. Information about
AIDS clinical trials in Boston can be obtained from the AIDS Clinical Trial
Unit at MGB, 617-716-3819.
back to top
Phone NumbersProject Inform National HIV/AIDS Treatment Hotline
800-822-7422 (toll-free in the United States)
415-558-9051 (in the San Francisco Bay Area or internationally).
Hours: Monday - Friday, 9am - 5pm and Saturday, 10am - 4pm (PT).
This confidential hotline offers treatment information.
The AIDS Action Hotline provides AIDS information, such as testing and risk
CDC National AIDS Hotline
(800) 342 - AIDS (2437) (English) (24 hours, 7 days a week)
(800) 344 - SIDA (7432) (Spanish) (8 AM - 2 AM ET)
(800) 243 - 7889 (TTY for hearing impaired) (Monday-Friday 10 AM - 10 PM ET)
CDC National AIDS Hotline offers information on transmission and prevention of
As the main advocate for global action on HIV/AIDS, UNAIDS leads, strengthens,
and supports an expanded response aimed at preventing the transmission of HIV,
providing care and support, reducing the vulnerability of individuals and
communities to HIV/AIDS, and alleviating the impact of the epidemic.
Presented by NIAID, this thorough, well-organized site offers information on
the latest efforts to find an AIDS vaccine. The site includes news, general
information, science, resources, and a bulletin board.
Since 1985, Project Inform has been an active advocate for the HIV/AIDS
community, working to provide information on the diagnosis and treatment of HIV
to HIV-infected individuals, their caregivers, and healthcare providers. Their
Web site offers educational information, a hotline number, resources and
literature on the foundation.
The site of the Names Project Foundation provides information on AIDS and the
mission of the Foundation. Other features include the Quilt display schedule
and a searchable image database of over 78,000 names and over 41,000 viewable
images of panels in the AIDS Memorial Quilt.
A strong advocate and pioneer in research for AIDS in children, the Pediatric
AIDS Foundation is one of the most well-known organizations for the research of
HIV/AIDS. Their Web site offers information on what the PAF is currently doing
and what it hopes to do.
CDC's HIV mission is to prevent HIV infection and reduce the incidence of
HIV-related illness and death, in collaboration with community, state,
national, and international partners. The site offers a variety of
information, including FAQs, publications, brochures, and fact sheets.
BooksBig Shot: Passion, Politics, and the Struggle for an AIDS Vaccine, by Patricia Thomas.
New York: Public Affairs, 2001
In this important chronicle of the race to develop an antidote, veteran medical journalist Patricia Thomas tackles the question: Why is there yet no AIDS vaccine a full two decades after the pandemic began? Thomas tells her story with passion, humanity, and uncommon intelligence.
And the Band Played on: Politics, People, and the AIDS Epidemic, by
Randy Shilts. Penguin, 1995 (Reissue edition).
In the first major book on AIDS, San Francisco Chronicle reporter Randy Shilts
examines the first days of the AIDS epidemic and is critical of the initial
response of the medical and political communities.
Dr. José Assouline
Dr. Bruce Walker
Lauren Aguirre, Senior Producer
Christine Chan, Intern
Kim Ducharme, Senior Designer
Rick Groleau, Hot Science Developer
Tyler Howe, Assistant Designer
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Rob Meyer, Production Assistant
Peter Tyson, Producer