HIV/AIDS and Public Health
By Sam MacArthur

HIV/AIDS is a major public health issue that impacts communities all over the world. HIV stands for Human Immunodeficiency Virus, and it’s the virus that causes AIDS, or Acquired Immunodeficiency Syndrome. When HIV enters the body, it attacks human cells called T cells. These T cells are in charge of the body’s immune system, so when HIV destroys enough of these cells, the body becomes vulnerable to illnessess that it may have otherwise fought off fairly easily. As a matter of fact, when people die from AIDS, it’s not the AIDS itself that causes death but another infection that HIV negative bodies can fight off more easily than HIV positive bodies. 

HIV spreads in three ways: 

  1. Through unprotected sex 
  2. Through the blood (i.e. sharing needles or contaminated blood products) 
  3. From mother to child (breastfeeding or childbirth) 

Contrary to certain misconceptions, HIV does not spread through saliva, hugging, or day to day interaction. 

why is hiv a public health issue

What Makes AIDS/HIV a Public Health Issue?

Because of the impact of HIV and AIDS on public health, it has become a major focus among public health officials. As a matter of fact, HIV/AIDs is a pandemic. Nearly 38 million people have died from HIV/AIDS related causes. 

When it comes to public health and AIDS, awareness about HIV makes a big difference. By raising awareness about HIV, public health officials can help people understand their risk of contracting the virus, what they can do to prevent its spread, and how they can seek treatment if they test positive. 

HIV is a preventable illness, but to prevent its spread, people must be educated and informed. This is where the public health sector comes in. 

Public health experts are especially important because there’s still a lot of misinformation surrounding HIV/AIDS. Avert, a UK-based HIV charity, points out several myths that still persist about HIV and AIDS. For example, many people are still confused about how the virus is spread. A lot of people don’t realize, for example, that HIV can’t live on toilet seats, or that it can’t be spread through insect bites or sharing food. 

In addition to myths about how HIV is spread, some myths spread false information about HIV prevention. For example, some believe that they can prevent or cure HIV by having sex with a virgin, using contraceptives, or washing after sex. 

HIV prevention is fairly straightforward, but with all of the misinformation in the world today, not everyone understands their risk. As a result, people may contract the virus simply because they didn’t understand the best ways to prevent it. 

Education is vital, and with the right public health measures, people can get the education that they need to slow and even stop the spread of HIV. 

History and Stats 

Now, take a look at some of the history and statistics for HIV in the United States. Again, education is critical, and that education can include background information. 

Many people search for the HIV rate in the United States, but HIV actually traces its roots to parts of sub-saharan Africa. The history of HIV/AIDS started in the early 1950s. Researchers believe that hunters contracted the virus through contact with monkeys that had Simeon Immunodeficiency Virus, or SIV. In humans, that virus mutated into HIV. 

Nobody is completely sure how that virus eventually spread all the way to the US, beginning the statistics for HIV in the United States. Nevertheless, HIV statistics in United States cities would explode about 20 years later. 

Perhaps the most notable era in the history of HIV/AIDS was the early 1980s. This is when HIV statistics in the US skyrocketedDuring this time, many gay men in the United States started noticing the same symptoms. For example, a lot of these men sought treatment for flu-like symptoms and even for rare types of cancer. Doctors didn’t realize it at the time, but these men were so sick because the HIV virus had diminished their ability to fight off infections. The virus had depleted their T cells, leaving them vulnerable to the illnesses that they would have been able to fight off otherwise. 

Major cities were hit the hardest, with New York City and San Fransisco seeing a lot of this mystery illness. 

Some researchers pressed the US government for funding so that they could figure out the cause of these symptoms. However, because of a pervading stigma against homosexuality, researchers couldn’t get the funding that they needed no matter how grim the HIV US statistics became. This stigma prevented effective research and treatment for years. As a matter of fact, an early name for HIV/AIDS was “GRIDS,” or “Gay Related Immunodeficiency Syndrome.”

The early HIV US statistics also included the children of Black female sex workers, a population that also went largely ignored. While some doctors and researchers pointed out the alarming illness rates, most people brushed off their concerns. 

As the stigma and ignorance compounded, the HIV rate in the United States grew. After all, as mentioned above, awareness is the key to prevention when it comes to statistics. In the US, where nobody knew how HIV started or how it spread, people had no idea how to protect themselves from the virus. 

What are the results of these early US HIV statistics? The good news is that with awareness, US HIV statistics have improved. However, had the pandemic been handled with more care and education in the 80s, many lives could have been saved. As a result of how HIV/AIDS was mishandled, HIV statistics in the US include about 700,000 deaths from 1981 to 2018. 

Now, what about HIV statistics in the United States today? Today’s United States HIV statistics say that 1.1 million people here currently have HIV. As you’ll see in a moment, HIV treatment has evolved so that those living with HIV in the US can improve their health, protect themselves from secondary infection, and avoid spreading the virus to others. To be clear, the HIV pandemic is still a serious issue that requires public health attention and education. However, an HIV positive person in the US today has a much better prognosis than they would have had in the early eighties, and today’s statistics reflect that improvement. 

Interestingly, HIV statistics in the United States don’t reflect global HIV statistics. As a matter of fact, US HIV demographics are virtually the opposite of the global demographics. Around the globe, women and girls have a higher risk of contracting the virus than men have. According to HIV statistics in the United States, however, African American gay and bisexual men have the highest risk of contracting it. For new diagnoses of HIV, United States statistics show that 69% are gay or bisexual men, 24% are heterosexuals, and 7% are people who inject drugs. 

The good news, again, is that HIV United States statistics are generally declining. However, the US still needs public health experts to emphasize education and the prevention of HIV. 

HIV/AIDS Prevention 

AIDS prevention starts with the prevention of HIV. When you research how to prevent AIDS, remember that HIV is the virus thsat causes AIDS in the first place. In other words, a person cannot contract AIDS without first having the HIV virus. That’s why AIDS is also known as stage 3 HIV. Think of it this way: Every person who has AIDS also has HIV, but not every person with HIV has AIDS. HIV causes AIDS once it has reached a certain threshold of immune system damage. 

When it comes to AIDS prevention, HIV treatment has come a long way, but the most important thing is the prevention of HIV altogether. The CDC outlines several HIV preventions that, in turn, provide a blueprint for how to prevent AIDS. 

The first of these HIV preventions is total abstinance from sex. It’s not a sustainable solution for everybody, but it is for some, and it’s the only 100% effective method of HIV/AIDS prevention through sex.

Likewise, sexual monogamy is a nearly foolproof method of preventing HIV. If both partners in a monogomous relationship are HIV negative, then they have no risk of contracting the virus through sex. Sexual activity in and of itself is not enough for a person to catch the HIV virus. At least one partner during the sexual activity must have HIV to spread the virus to another person. 

Next on the list of HIV preventions is condom usage. Practicing safe sex is one of the most effective methods of prevention of HIV. However, it only works for HIV/AIDS prevention if done correctly. When providing education about prevention for HIV, make sure to provide clear instructions on correct condom usage. Incorrect condom usage can cause a condom to slip or break, making it inneffective for HIV prevention. 

Note that condom usage is important even when both sex partners know that they are HIV positive. One popular myth about HIV says that if two partners both have the virus, they don’t have to worry about spreading it to each other. Unfortunately, the myth is untrue. Few people realize that there is more than one strain of the HIV virus. An HIV positive person can still contract a second strain of the virus from another person. This is called HIV superinfection, and it can lead to additional health complications. Again, this is another area in which public health initiatives can make a difference. Correct information and widespread education can dispel some potentially deadly myths. 

Prevention for HIV is especially important for those who fall into high risk categories. For example, someone who is HIV negative that has an HIV positive partner will need to take extra care when it comes to HIV preventions. In addition to exploring other methods of prevention of HIV, these individuals should talk to a doctor about taking a pre-exposure prophylaxis medication, or prEP. This medication is a daily pill designed to prevent a person from contracting the virus if they should get exposed to it. 

Prevention for HIV also includes getting tested for the virus regularly. For every seven HIV positive people in the US, one doesn’t know that they’re positive. When HIV positive people know their status, they can take steps to improve their own health as well as prevent the spread of HIV to other people. However, when an HIV positive person doesn’t know their status, they may unknowlingly spread the virus to others. Sexually active people, especially those who are not monogamous, should get tested on a regular basis to stay informed. 

This is another area where public health experts can make a big difference. For one thing, the right public health measures can educate people about why testing is so important. For another thing, certain public health measures have provided free or low cost HIV testing to those who need it the most. Public health initiatives can also reduce the stigma around sexual health, empowering people to get tested when they may have otherwise kept themselves in the dark out of fear or shame. 

The next item on the list of HIV preventions isn’t about sex at all. It’s about avoiding drug injections. While HIV is primarily a sexually transmitted virus, any blood-to-blood contact carries the risk of HIV transmission, even when that contact involves no sex at all. If a needle has been contaminated with HIV-infected blood, the next person to use that needle has a high risk of contracting the HIV virus. 

As a public health professional, you should understand the HIV risks that come from contaminated needles. You might advocate for addiction help resources such as counseling, withdrawal medications, and even clean needle exchange programs. Again, public health initiatives can make a big difference in combating the spread of HIV. 

Finally, HIV positive individuals can take part in prevention for HIV by getting treatment.  First of all, by getting treatment, they can take care of their own health and prevent the HIV virus from depleting their T cells and turning into AIDS. Second, by getting treatment, they can reduce their risk of spreading the virus to another person through sex, childbirth, or breastfeeding. 

Treatment Options for HIV/AIDS

The treatment of AIDS has evolved over the past few decades, thanks largely to research, education, and other public health initiatives. Treatment for AIDS involves fighting the HIV virus itself. HIV treatment is called antiretroviral therapy, or ART.  A doctor can prescribe a combination of medications to help HIV positive people combat the virus and live normal, relatively healthy lives. These medications come in pill form and are taken daily. 

Now, treatment for AIDS cannot cure HIV. As of right now, there is no cure for this virus, though researchers haven’t given up on searching for a cure. However, treatment can lower an HIV postive person’s viral load until the virus is undetectable through regular HIV testing. (The term “viral load” refers to the amount of the HIV virus in a person’s blood.)

That said, even when an HIV positive person reaches the “undetectable” stage, they must keep up with their medication so that the virus can stay undetectable. Again, ART medication is not a cure for HIV. If a person with an undetectable viral load should stop taking their medication, then the HIV virus would begin multiplying again until it was no longer undetectable. 

Once again, HIV treatment can also reduce the risk of an HIV positive person spreading the virus to an HIV negative person. As a matter of fact, a person with an undetectable viral load has virtually no risk of spreading the virus to another person through sex or childbirth. 

Treatment for HIV/AIDS can also prolong the lifespan of a person living with HIV. 

How do treatments for HIV/AIDS work? To understand how HIV/AIDS treatments work, you’ll need to understand how HIV itself works. HIV is a type of retrovirus, which means that it makes copies of itself once it enters a person’s DNA. The more copies there are, the more the virus attacks the person’s T cells, leaving that person open to secondary infections. HIV/AIDS treatments prevent the HIV virus from making those copies, giving the body a chance to leave those T cells intact. 

There are seven types of treatment for HIV/AIDS, and each type fights the virus in a different way. Many HIV postive people take more than one type of medication. It’s important for HIV positive individuals to work closely with a doctor to make sure that they get the right treatment combination. 

Finding an effective treatment plan is another reason why testing is so vital. It’s important to get tested for HIV because it’s best to start treatment as soon as possible. The sooner a person realizes that they are HIV positive, the sooner they can get proactive about the treatment of AIDS. In fact, they can prevent the HIV virus from progressing to AIDS altogether. 

None of these treatments or preventions are possible without the right public health measures. Thanks to public health initiatives, the lives of HIV positive people continue to improve while the risk for HIV negative people gets lower and lower every day. 

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