Introduction to HIV and AIDS

HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immunodeficiency Syndrome) remain two
of the most significant global health challenges. Since the identification of the virus in the 1980s,
HIV/AIDS has affected millions worldwide, creating substantial social, economic, and health-related
burdens. However, significant progress has been made in understanding the virus, and treatments
have greatly improved the quality of life for those living with HIV. Despite these advancements, HIV
transmission continues, particularly in sub-Saharan Africa and in marginalized communities.

The human body can’t get rid of HIV and no effective HIV cure exists. So, once you have HIV, you have
it for life.
Luckily, however, effective treatment with HIV medicine (called antiretroviral therapy or ART) is
available. If taken as prescribed, HIV medicine can reduce the amount of HIV in the blood (also called
the viral load) to a very low level. This is called viral suppression. If a person’s viral load is so low that
a standard lab can’t detect it, this is called having an undetectable viral load. People with HIV who
take HIV medicine as prescribed and get and keep an undetectable viral load can live long and
healthy lives and will not transmit HIV to their HIV-negative partners through sex.
Origins of HIV and its Sources in Primates

HIV (Human Immunodeficiency Virus) has its origins in non-human primates in West-central Africa.
The virus likely transferred to humans in the early 20th century, with both HIV-1 and HIV-2 believed
to have evolved from different simian immunodeficiency viruses (SIV) in primates. Here’s an
overview of the possible primate sources for HIV:

1. HIV-1 Origin:
HIV-1 is believed to have originated from SIVcpz, a simian immunodeficiency virus that
infects chimpanzees. This transfer likely happened in southern Cameroon, where humans
may have come into contact with infected chimpanzee blood, either through hunting or
butchering chimpanzees for bushmeat. The closest relative of HIV-1 is SIVcpz, which infects
chimpanzee subspecies Pan troglodytes troglodytes. The virus is thought to have jumped the
species barrier multiple times, leading to the evolution of different groups of HIV-1, namely
group M, N, and O.

2. HIV-2 Origin:
HIV-2, a less prevalent strain than HIV-1, is believed to have evolved from SIVsmm, which
infects the sooty mangabey (a type of Old World monkey found in coastal West Africa).
These monkeys live in areas such as southern Senegal and the Ivory Coast, where they were
likely hunted, and their blood may have come into contact with humans, leading to cross-
species transmission of the virus.

3. Other Potential Sources:

There is also evidence suggesting that other primates, such as the African green monkey,
may have contributed to the evolution of simian immunodeficiency viruses (SIV), which
eventually became HIV strains in humans. While HIV-1 and HIV-2 are the primary causes of
the global HIV epidemic, SIV in primates could have contributed to the initial exchange of
viral material between species.

Transmission from Primates to Humans

The transmission of SIV from primates to humans is thought to have happened primarily through
bushmeat hunting and consumption. Humans who hunt and butcher wild primates, or even engage
in the sale of bushmeat, are at a high risk of coming into contact with infected primate blood. While
SIV is typically a weak virus in humans and is usually suppressed by the immune system quickly,
multiple transmissions through rapid contact with infected animals may have allowed the virus to
mutate and adapt into HIV.
What is HIV?
HIV is a virus that damages the immune system. Untreated HIV affects and kills CD4 cells, which are a
type of immune cell called T cell.

Over time, as HIV kills more CD4 cells, the body is more likely to get various types of conditions and
cancers.

HIV is transmitted through bodily fluids that include:

 blood

 semen

 vaginal and rectal fluids

 breast milk

The virus isn’t transferred in air or water, or through casual contact.

Because HIV inserts itself into the DNA of cells, it’s a lifelong condition and currently there’s no drug
that eliminates HIV from the body, although many scientists are working to find one.

However, with medical care, including treatment called antiretroviral therapy, it’s possible to manage
HIV and live with the virus for many years.

Without treatment, a person with HIV is likely to develop a serious condition called the Acquired
Immunodeficiency Syndrome, known as AIDS.

At that point, the immune system is too weak to successfully respond against other diseases,
infections, and conditions.

Untreated, life expectancy with end stage AIDS is about 3 yearsTrusted Source. With antiretroviral
therapy, HIV can be well-managed, and life expectancy can be nearly the same as someone who has
not contracted HIV.
What is AIDS?
AIDS is a disease that can develop in people with HIV. It’s the most advanced stage of HIV. But just
because a person has HIV doesn’t mean AIDS will develop.

HIV kills CD4 cells. Healthy adults generally have a CD4 count of 500 to 1,600 per cubic millimeter. A
person with HIV whose CD4 count falls below 200 per cubic millimeter will be diagnosed with AIDS.

A person can also be diagnosed with AIDS if they have HIV and develop an opportunistic infection or
cancer that’s rare in people who don’t have HIV.

An opportunistic infection such as Pneumocystis jiroveci pneumonia is one that only occurs in a
severely immunocompromised person, such as someone with advanced HIV infection (AIDS).

Untreated, HIV can progress to AIDS within a decade. There’s currently no cure for AIDS, and without
treatment, life expectancy after diagnosis is about 3 yearsTrusted Source.

This may be shorter if the person develops a severe opportunistic illness. However, treatment with
antiretroviral drugs can prevent AIDS from developing.

If AIDS does develop, it means that the immune system is severely compromised, that is, weakened
to the point where it can no longer successfully respond against most diseases and infections.

That makes the person living with AIDS vulnerable to a wide range of illnesses, including:

 pneumonia

 tuberculosis

 oral thrush, a fungal condition in the mouth or throat

 cytomegalovirus (CMV), a type of herpes virus

 cryptococcal meningitis, a fungal condition in the brain

 toxoplasmosis, a brain condition caused by a parasite

 cryptosporidiosis, a condition caused by an intestinal parasite

 cancer, including Kaposi sarcoma (KS) and lymphoma

The shortened life expectancy linked with untreated AIDS isn’t a direct result of the syndrome itself.
Rather, it’s a result of the diseases and complications that arise from having an immune system
weakened by AIDS.
HIV vs. AIDS: What’s the Difference?
HIV is a virus
HIV is a virus that can lead to immune system deterioration. The term “HIV”
stands for human immunodeficiency virus. The name describes the virus: Only
humans can contract it, and it attacks the immune system. As a result, the
immune system is unable to work as effectively as it should.
Our immune systems can completely clear many viruses our bodies, but that’s
not the case with HIV. Medications can control HIV very successfully by
interrupting its viral life cycle, however.
AIDS is a condition
While HIV is a virus that may cause an infection, AIDS (which is short for
acquired immunodeficiency syndrome) is a condition. Contracting HIV can lead
to the development of AIDS.
AIDS, or stage 3 HIV, develops when HIV has caused serious damage to the
immune system. It is a complex condition with symptoms that vary from person
to person.
Symptoms of stage 3 HIV are related to the infections a person may develop as
a result of having a damaged immune system that can’t fight them as well.
Known collectively as opportunistic infections, they
include tuberculosis, pneumonia, and others.
Certain types of cancer become more likely when an immune system works
less effectively as well.
Adherence to antiretroviral therapy can prevent stage 3 HIV from developing.
HIV Transmission: An In-Depth Overview

HIV (Human Immunodeficiency Virus) is primarily transmitted through specific bodily fluids, such as
blood, semen, vaginal fluids, and breast milk. These fluids contain the virus and can enter the
bloodstream of an HIV-negative individual, thereby leading to infection.

1. Blood

Blood is one of the most significant routes of HIV transmission. The virus is present in the blood of an
HIV-positive person, and exposure to infected blood can lead to transmission.

Blood Transfusions

Before blood screening became a routine practice, blood transfusions were a major source of HIV
transmission. However, with advancements in medical technology and mandatory blood testing, the
risk of contracting HIV from blood transfusions has been virtually eliminated in developed countries.
Blood banks rigorously test all donated blood for HIV and other blood-borne infections, ensuring that
blood transfusions are as safe as possible.

Sharing Needles and Syringes

One of the most dangerous methods of HIV transmission is through sharing needles and syringes.
People who inject drugs (PWID) are at heightened risk of contracting HIV if they share drug
equipment. The virus can survive in blood for several days, and when a needle is used by multiple
people, the blood of an HIV-positive individual can be transferred to others.

Injection Drug Use: HIV transmission through injection drug use is a significant issue in many parts of
the world. It occurs when an individual who is HIV-positive shares needles or syringes with others.
This is a particularly high-risk activity because the injection directly introduces blood into the
bloodstream.
2. Semen and Vaginal Fluids

Unprotected sexual activity is the most common mode of HIV transmission worldwide. HIV is present
in both semen (the male sexual fluid) and vaginal fluids (the fluid released by women during sexual
activity). The virus can enter the body of an HIV-negative person through mucous membranes in the
genital tract, urethra, rectum, or other areas.

Unprotected Vaginal and Anal Sex

Vaginal Sex: During vaginal sex, HIV is most commonly transmitted through semen, but vaginal fluids
can also carry the virus. The vagina and cervix have thin mucosal layers that can be easily torn during
sex, creating entry points for the virus.

Anal Sex: Anal sex is considered to be a much higher-risk activity than vaginal sex because the lining
of the rectum is thinner and more fragile than the vaginal lining, which makes it more susceptible to
tears and bleeding. These tears provide an easy pathway for the virus to enter the bloodstream. HIV
transmission is more likely to occur during receptive anal sex, where the partner receiving
penetration is at higher risk of exposure.

Oral Sex: While the risk of HIV transmission during oral sex is generally lower than during vaginal or
anal sex, it is still possible, particularly if the person performing oral sex has open sores, cuts, or
bleeding gums, or if there is ejaculate or vaginal fluids involved.

3. Breast Milk

Mother-to-child transmission of HIV (MTCT) can occur during pregnancy, childbirth, or

breastfeeding. HIV can be passed from an HIV-positive mother to her baby through breast milk, as
well as during labor and delivery when the baby is exposed to the mother's blood.

HIV Transmission During Pregnancy and Childbirth

During pregnancy, the virus can cross the placenta and enter the bloodstream of the unborn child.
The likelihood of transmission can be reduced significantly through antiretroviral therapy (ART),
which lowers the mother's viral load to undetectable levels.

Labor and Delivery: The risk of transmission during childbirth is high, especially if the mother is not
on ART. During delivery, the baby may come into contact with the mother's blood or vaginal fluids,
which contain HIV.

Breastfeeding

Breastfeeding is another route for HIV transmission to the infant. HIV is present in breast milk, and
babies who breastfeed from an HIV-positive mother can become infected.
How Do I Know If I Have HIV?

The only way to know for sure if you have HIV is to get tested. Testing is relatively simple. You can
ask your health care provider for an HIV test. Many medical clinics, substance abuse programs,
community health centers, and hospitals offer them too. If you test positive, you can be connected to
HIV care to start treatment as soon as possible. If you test negative, you have the information you
need to take steps to prevent getting HIV in the future.

To find an HIV testing location near you, use the HIV Services Locator.

HIV self-testing is also an option. Self-testing allows people to take an HIV test and find out their
result in their own home or other private location. With an HIV self-test, you can get your test results
within 20 minutes. You can buy an HIV self-test kit at a pharmacy or online. Some health
departments or community-based organizations also provide HIV self-test kits for a reduced cost or
for free. You can call your local health department or use the HIV Testing and Care Services Locator to
find organizations that offer HIV self-test kits near you. (Contact the organization for eligibility
requirements.)
ELISA Test - Simplified Explanation

The Enzyme-Linked Immunosorbent Assay (ELISA) is a test used to detect and measure antibodies in
the blood. Antibodies are proteins that your body makes to fight harmful substances like viruses or
bacteria. The presence of antibodies in your blood indicates that your body has responded to an
infection. ELISA is often used to help diagnose infections or diseases by checking for these antibodies
or the harmful substances (antigens) that trigger them.

How the ELISA Test Works

1. Capture: The test uses a special plate coated with either an antibody or antigen.

2. Binding: If the disease or infection is present, the target antibody or antigen in the blood will
attach to the plate.

3. Detection: An enzyme-linked antibody is added, which binds to the target. Then, a special
substance (substrate) is added that reacts with the enzyme, causing a color change.

4. Result: If the color changes, it shows the presence of antibodies or antigens, confirming an
infection or disease.

Uses of the ELISA Test

The ELISA test is used to diagnose various conditions, including:

 HIV: To check for HIV antibodies in the blood.

 Rotavirus: A virus that causes stomach infections in children.

 Squamous Cell Carcinoma: A type of skin cancer.

 Syphilis: A sexually transmitted infection.

 Toxoplasmosis: A disease caused by a parasite, often affecting the immune system.

 Varicella-Zoster Virus: The virus that causes chickenpox and shingles.

Why is ELISA Used?

 Sensitive and Specific: ELISA can detect very small amounts of the target substance and can
specifically identify the disease.

 Easy and Quick: It’s simple to perform and gives results fast, making it useful in diagnosing
conditions early.

 Multiple Diseases: It can test for several diseases at once using a single blood sample.

 Quantitative: It can measure the amount of antibodies or antigens, helping to understand

the severity of the infection.
What Are the Symptoms of HIV?

There are several symptoms of HIV. Not everyone will have the same symptoms. It depends on the
person and what stage of the disease they are in.

Below are the three stages of HIV and some of the symptoms people may experience.

Stage 1: Acute HIV Infection

Within 2 to 4 weeks after infection with HIV, about two-thirds of people will have a flu-like illness.
This is the body’s natural response to HIV infection.

Flu-like symptoms can include:

 Fever

 Chills

 Rash

 Night sweats

 Muscle aches

 Sore throat

 Fatigue

 Swollen lymph nodes

 Mouth ulcers

These symptoms can last anywhere from a few days to several weeks. But some people do not have
any symptoms at all during this early stage of HIV.

Don’t assume you have HIV just because you have any of these symptoms—they can be similar to
those caused by other illnesses. But if you think you may have been exposed to HIV, get an HIV test.

Here’s what to do:

 Find an HIV testing site near you—You can get an HIV test at your primary care provider’s
office, your local health department, a health clinic, or many other places. Use the HIV
Services Locator to find an HIV testing site near you.

 Request an HIV test for recent infection—Most HIV tests detect antibodies (proteins your
body makes as a reaction to HIV), not HIV itself. But it can take a few weeks after you have
 HIV for your body to produce these antibodies. There are other types of tests that can detect
HIV infection sooner. Tell your doctor or clinic if you think you were recently exposed to HIV
and ask if their tests can detect early infection.

 Know your status—After you get tested, be sure to learn your test results. If you’re HIV-
positive, see a health care provider as soon as possible so you can start treatment with HIV
medicine. And be aware: when you are in the early stage of infection, you are at very high
risk of transmitting HIV to others. It is important to take steps to reduce your risk of
transmission. If you are HIV-negative, there are prevention tools like pre-exposure
prophylaxis (PrEP) that can help you stay negative.

Stage 2: Clinical Latency

In this stage, the virus still multiplies, but at very low levels. People in this stage may not feel sick or
have any symptoms. This stage is also called chronic HIV infection.

Without HIV treatment, people can stay in this stage for 10 or 15 years, but some move through this
stage faster.

If you take HIV medicine exactly as prescribed and get and keep an undetectable viral load, you
can live and long and healthy life and will not transmit HIV to your HIV-negative partners through
sex.

But if your viral load is detectable, you can transmit HIV during this stage, even when you have no
symptoms. It’s important to see your health care provider regularly to get your viral load checked.

Stage 3: AIDS

If you have HIV and you are not on HIV treatment, eventually the virus will weaken your body’s
immune system and you will progress to AIDS (acquired immunodeficiency syndrome).

This is the late stage of HIV infection.

Symptoms of AIDS can include:

 Rapid weight loss

 Recurring fever or profuse night sweats

 Extreme and unexplained tiredness

 Prolonged swelling of the lymph glands in the armpits, groin, or neck

 Diarrhea that lasts for more than a week

 Sores of the mouth, anus, or genitals

 Pneumonia

 Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or
eyelids

 Memory loss, depression, and other neurologic disorders

Each of these symptoms can also be related to other illnesses. The only way to know for sure if you
have HIV is to get tested. If you are HIV-positive, a health care provider will diagnose if your HIV has
progressed to stage 3 (AIDS) based on certain medical criteria.
What are the symptoms of AIDS?
AIDS refers to acquired immunodeficiency syndrome. With this condition, the immune system is
weakened due to HIV that’s typically gone untreated for many years.

If HIV is found and treated early with antiretroviral therapy, a person will usually not develop AIDS.

People with HIV may develop AIDS if their HIV is not diagnosed until late or if they know they have
HIV but don’t consistently take their antiretroviral therapy.

They may also develop AIDS if they have a type of HIV that’s resistant to (doesn’t respond to) the
antiretroviral treatment.

Without proper and consistent treatment, people living with HIV can develop AIDS sooner. By that
time, the immune system is quite damaged and has a harder time generating a response to infection
and disease.

With the use of antiretroviral therapy, a person can maintain a chronic HIV diagnosis without
developing AIDS for decades.

Symptoms of AIDS can include:

 recurrent fever

 chronic swollen lymph glands, especially of the armpits, neck, and groin

 chronic fatigue

 night sweats

 dark splotches under the skin or inside the mouth, nose, or eyelids

 sores, spots, or lesions of the mouth and tongue, genitals, or anus

 bumps, lesions, or rashes of the skin

 recurrent or chronic diarrhea

 rapid weight loss

 neurologic problems such as trouble concentrating, memory loss, and confusion

 anxiety and depression

Diagnosis

HIV can be diagnosed through rapid diagnostic tests that provide same-day results. This greatly
facilitates early diagnosis and linkage with treatment and prevention. People can also use HIV self-
tests to test themselves. However, no single test can provide a full HIV positive diagnosis;
confirmatory testing is required, conducted by a qualified and trained health worker or community
worker. HIV infection can be detected with great accuracy using WHO prequalified tests within a
nationally approved testing strategy and algorithm.

Most widely used HIV diagnostic tests detect antibodies produced by a person as part of their
immune response to fight HIV. In most cases, people develop antibodies to HIV within 28 days of
infection. During this time, people are in the so-called “window period” when they have low levels of
antibodies which cannot be detected by many rapid tests, but they may still transmit HIV to others.
People who have had a recent high-risk exposure and test negative can have a further test after 28
days.

Following a positive diagnosis, people should be retested before they are enrolled in treatment and
care to rule out any potential testing or reporting error. While testing for adolescents and adults has
been made simple and efficient, this is not the case for babies born to HIV-positive mothers. For
children less than 18 months of age, rapid antibody testing is not sufficient to identify HIV infection –
virological testing must be provided as early as birth or at 6 weeks of age. New technologies are now
available to perform this test at the point of care and enable same-day results, which will accelerate
appropriate linkage with treatment and care.
Prevention of HIV/AIDS

HIV/AIDS is a serious global health concern, but there are several effective strategies to reduce the
spread of the virus. Prevention efforts range from personal behaviors like condom use to advanced
medical treatments such as antiretroviral drugs. Below is an expanded version of prevention
methods:

1. Sexual Contact Prevention

 Condom Use: The most widely recognized method for preventing HIV transmission during
sexual activity is the consistent use of condoms. Condoms reduce the risk of HIV
transmission by about 80%. In situations where one partner is HIV-positive, using condoms
consistently can reduce the likelihood of transmission to less than 1% per year. This method
provides protection not only against HIV but also other sexually transmitted infections (STIs).

 Female Condoms: Female condoms are also a useful method of protection against HIV.
Research indicates that when used correctly, female condoms may offer protection similar to
male condoms, although they are less commonly used and may require more effort to
implement correctly.

 Vaginal Gels: There are vaginal gels, such as tenofovir, that can be applied before sex. These
gels contain antiretroviral drugs that help reduce the risk of HIV infection. Studies show that
these gels can reduce the likelihood of infection by about 40% in women, particularly in
regions with high HIV prevalence.

 Circumcision: In certain parts of the world, particularly in sub-Saharan Africa, male

circumcision has been shown to reduce the risk of acquiring HIV through heterosexual
contact by 38% to 66%. The World Health Organization recommends circumcision as a
preventive measure in areas with high HIV rates, particularly to protect men from female-to-
male transmission. However, its effectiveness in preventing male-to-female transmission or
HIV transmission in developed countries is still being debated.

 Abstinence and Peer Education: Programs that encourage sexual abstinence (not engaging in
sexual activity) have not shown significant success in reducing HIV transmission rates.
Similarly, while peer education about HIV risks is important, studies show that it does not
always lead to lasting behavioral changes that reduce the risk of HIV.

 Sexual Education: Comprehensive sexual education programs in schools help young people
understand the risks of HIV and how to protect themselves. These programs may help
reduce risky sexual behaviors such as unprotected sex, which in turn lowers the chances of
HIV transmission. However, despite this knowledge, many young people still engage in high-
risk behaviors, often underestimating their own risk of infection.
2. Pre-Exposure Prevention

 Antiretroviral Treatment (TASP): "Treatment as prevention" (TASP) refers to the strategy

where HIV-positive individuals who are on antiretroviral therapy (ART) and have a low viral
load can prevent transmitting the virus to their HIV-negative partners. This treatment is
highly effective and can reduce transmission risk by 10 to 20 times. For HIV-positive people
with a CD4 count of 550 cells/μL or less, starting ART can greatly reduce the chance of
infecting others.

 Pre-exposure Prophylaxis (PrEP): PrEP is a preventive treatment for HIV-negative individuals

who are at high risk of contracting HIV. PrEP involves taking a daily pill containing
antiretroviral drugs like tenofovir (sometimes combined with emtricitabine). It has been
shown to be highly effective in preventing HIV infection, especially among high-risk groups
such as men who have sex with men, serodiscordant couples (where one partner is HIV-
positive), and people who inject drugs. PrEP has reduced the risk of HIV infection by over
90% when used correctly.

 Healthcare Precautions: In healthcare settings, universal precautions—such as using gloves,

sterilizing equipment, and safe disposal of needles—help prevent the transmission of HIV.
These measures are essential for healthcare workers and patients to avoid accidental
exposure to HIV-positive blood or other bodily fluids.

3. Post-Exposure Prevention

 Post-Exposure Prophylaxis (PEP): PEP is a preventive treatment that involves taking

antiretroviral drugs within 72 hours after potential exposure to HIV. This could be due to an
unprotected sexual encounter with an HIV-positive individual, sharing needles, or a needle-
stick injury in a healthcare setting. PEP significantly reduces the risk of contracting HIV and
must be started as soon as possible after exposure. The typical treatment lasts for four weeks
and is most effective when started within 48 to 72 hours of exposure.

4. Mother-to-Child Transmission Prevention

 Antiretroviral Medications: HIV can be transmitted from mother to child during pregnancy,
childbirth, or breastfeeding. However, the use of antiretroviral medications during pregnancy
and after birth has been shown to reduce this risk by 92–99%. Pregnant women with HIV are
typically given a combination of antiretroviral drugs to prevent transmission to their child.

 Feeding Practices: If possible, HIV-positive mothers should avoid breastfeeding because HIV
can be transmitted through breast milk. However, if breastfeeding is necessary due to a lack
of safe alternatives, the infant may be given antiretroviral drugs to reduce the likelihood of
infection. In areas where safe and affordable formula feeding is an option, this is
recommended instead of breastfeeding.

 Cuba’s Success: In 2015, Cuba became the first country in the world to successfully eliminate
mother-to-child transmission of HIV. This was achieved through an aggressive national
strategy involving regular testing, early treatment, and education about preventing HIV
transmission.

5. HIV Vaccine
 Vaccine Development: While no licensed HIV vaccine currently exists, researchers are
working towards developing one. The most successful trial to date, known as RV 144,
showed a partial reduction in HIV transmission risk by about 30%. This provides hope that a
fully effective vaccine may be developed in the future. However, the complexity of the virus
Treatment

This section discusses the management and treatment of HIV/AIDS, emphasizing the key components
of treatment strategies, including antiretroviral therapy (ART), the role of antivirals, opportunistic
infection prevention, diet, and alternative medicine.

Antiretroviral Therapy (ART)

The cornerstone of HIV/AIDS treatment is highly active antiretroviral therapy (ART). ART involves the
use of a combination of medications to suppress HIV replication, slow disease progression, and
reduce the risk of complications. As of 2022, around 39 million people globally are living with HIV,
and 29.8 million are receiving ART.

 ART typically includes a combination of three or more drugs from at least two classes of
antiretroviral medications. There are eight classes of antiretroviral drugs, including:

o NRTIs (nucleoside/nucleotide reverse transcriptase inhibitors)

o NNRTIs (non-nucleoside reverse transcriptase inhibitors)

o PIs (protease inhibitors)

o INSTIs (integrase strand transfer inhibitors)

o Other specialized inhibitors, such as fusion inhibitors and CCR5 antagonists.

 A common ART regimen includes drugs like elvitegravir, emtricitabine, tenofovir, and
cobicistat, as seen in Stribild, a once-daily regimen.

 ART initiation is recommended immediately upon diagnosis, regardless of the CD4 count, as
early treatment has been shown to improve long-term outcomes.

 The goal of ART is to achieve a plasma HIV-RNA count below 50 copies/mL, which is an
indication that the virus is under control.

 Adherence to treatment is crucial. Poor adherence can lead to treatment failure and drug
resistance. Factors that may affect adherence include access to medical care, mental health
issues, substance use, and medication side effects.

Opportunistic Infections

People with HIV are more vulnerable to opportunistic infections (OIs) due to their weakened immune
system. ART reduces the risk of these infections, but preventive measures are also necessary.

 Tuberculosis (TB) is a major concern for those living with HIV, especially in regions with a high
TB burden. Isoniazid preventive therapy (IPT) is recommended for people living with HIV in
these settings.

 Vaccination against diseases like hepatitis A and hepatitis B is advised before HIV infection,
though it may also be given after infection.

 Trimethoprim/sulfamethoxazole (TMP-SMX) is recommended to prevent Pneumocystis

jirovecii pneumonia (PCP) for people with low CD4 counts and those who have had previous
PCP infections.
Diet and Nutrition

Nutrition plays a crucial role in supporting the immune system of people with HIV/AIDS.

 The World Health Organization (WHO) recommends a generally healthy diet and adequate
intake of micronutrients. Supplementation may be necessary for those with deficiencies.

 Pregnant or lactating women with HIV benefit from multivitamin supplementation, which
helps improve maternal and child outcomes.

 Individuals with HIV are at a higher risk of developing type 2 diabetes, and certain dietary
adjustments may be necessary to manage this risk.

Alternative Medicine

Many people with HIV use complementary or alternative medicine alongside conventional
treatments. However, there is insufficient evidence to support the use of herbal remedies or medical
cannabis for appetite or weight gain in HIV patients.

Recent Advances in HIV Treatment

New treatment options include long-acting injectable antiretroviral therapies like cabotegravir and
rilpivirine (sold as Cabenuva), which provide an alternative to daily oral pills. These injections are
administered monthly or every two months, offering a convenient option for those who are
virologically suppressed.
Recent developments on HIV

Genetic changes identified that make HIV elusive to drugs

Scientists have identified two locations where slight differences in genetic code can change the way
human immunodeficiency virus infects cells - a change associated with worsening symptoms and
resistance to antiretroviral drugs.

Scripps team lays 'spectacular' foundations for HIV vaccine

"A leap forward" has been made to develop a vaccine against HIV, claim the authors of two new
studies that are published concurrently in the journals Cell and Science.

Latent HIV cells only 'wake up' once a week after antiretroviral therapy, study finds

A new study published in PLOS Pathogens provides new insight into how often HIV cells "wake up"
among individuals undergoing antiretroviral therapy for the virus, bringing researchers one step
closer to getting patients off the treatment for good and into remission.

Vaginal ring reduces risk of HIV by up to 61%

A vaginal ring can safely provide some protection against HIV infection by continuously releasing an
experimental antiretroviral drug, say findings published in the New England Journal of Medicine.
Epidemiology of HIV/AIDS in India
India has one of the largest populations affected by HIV/AIDS in the world. However, the country has
made significant progress in controlling the spread of the virus through prevention programs,
awareness campaigns, and access to treatment. Here’s an overview of the situation:

1. Prevalence of HIV in India

 Overall Prevalence: According to the National AIDS Control Organization (NACO), the
estimated adult HIV prevalence in India is around 0.22% (as of 2020). This means that
roughly 2.1 million people are living with HIV in India.

 Regional Differences: The prevalence of HIV varies significantly across different regions in
India. Some states, such as Manipur, Nagaland, Andhra Pradesh, and Karnataka, have higher
rates, while other states have lower rates. The northeastern states of India have a
particularly high prevalence.

2. Modes of Transmission

HIV in India spreads through several common modes:

 Unprotected Sexual Contact: The majority of HIV infections (around 85-90%) are transmitted
through unprotected sex between heterosexual couples and, to a smaller extent, among
men who have sex with men (MSM).

 Mother-to-Child Transmission: This is a significant route of transmission, though efforts have

been made to prevent mother-to-child transmission through ART.

 Blood Transfusion and Needle Sharing: Transmission through infected blood products and
sharing needles among drug users is also a concern, though it is less common due to better
regulation and needle exchange programs.

3. Affected Population Groups

 High-Risk Groups: Certain groups are more at risk for HIV in India:

o Men who have sex with men (MSM)

o Female sex workers

o Injecting drug users

o Transgender individuals

o Migrants and mobile populations (like truck drivers and laborers)

These groups are often at a higher risk due to factors like lack of awareness, high-risk behaviors, and
limited access to healthcare.

 General Population: Although HIV affects all populations, the general adult population in
India has a relatively lower rate of infection due to awareness campaigns and prevention
programs.
4. Efforts to Control HIV in India

 Prevention Programs: India has implemented several programs to reduce the spread of HIV,
including promoting safe sex, condom distribution, and harm reduction programs for
injecting drug users.

 Awareness Campaigns: The government and non-government organizations (NGOs) have run
nationwide campaigns to educate people about HIV prevention and reduce stigma.

 ART Access: The government has made ART (antiretroviral therapy) available to a large
number of people living with HIV through the National AIDS Control Program (NACP). ART
helps to control the virus, prevent progression to AIDS, and improve the quality of life for
people living with HIV.

5. Challenges

 Stigma and Discrimination: HIV-related stigma remains high in many parts of India,
discouraging people from getting tested, seeking treatment, or disclosing their status.

 Limited Awareness in Rural Areas: While urban areas have better access to healthcare, rural
areas often lack education and healthcare services related to HIV prevention and treatment.

 High-Risk Behavior: Some high-risk populations, such as sex workers and drug users, often
don’t have consistent access to prevention tools like condoms or clean needles, increasing
the spread of HIV.

6. Trends and Future Outlook

 Declining New Infections: The number of new HIV infections in India has been declining due
to awareness campaigns, ART access, and prevention strategies.

 Challenges Ahead: Despite improvements, India faces ongoing challenges with high-risk
groups, rural areas, and stigma. However, continued efforts in prevention, testing, and
treatment are expected to improve the situation further.
 INITIATIVES
India has taken several significant initiatives to combat HIV/AIDS through awareness
programs, prevention, treatment, and support services. The government, along with non-
governmental organizations (NGOs), has made substantial progress in addressing the
HIV/AIDS epidemic. Here are some of the key initiatives taken by India to tackle the HIV/AIDS
crisis:

1. National AIDS Control Program (NACP)

The National AIDS Control Program (NACP) is the cornerstone of India's efforts to combat
HIV/AIDS. Launched by the Ministry of Health and Family Welfare, NACP has gone through
multiple phases:

 NACP I (1992-1999): The first phase focused on raising awareness about HIV/AIDS, providing
education about safe practices, and promoting the use of condoms. It also began creating a
network of counseling and testing centers.

 NACP II (1999-2006): This phase aimed at expanding prevention efforts, particularly among
high-risk groups such as sex workers, intravenous drug users, and men who have sex with
men (MSM). The focus was on creating awareness campaigns and strengthening blood safety
measures.

 NACP III (2007-2012): NACP III focused on scaling up the treatment and care programs, with
an emphasis on Antiretroviral Therapy (ART). It expanded ART centers, providing treatment
to people living with HIV/AIDS across India.

 NACP IV (2012-2017): This phase emphasized comprehensive care and support services for
people living with HIV, reducing stigma and discrimination, and strengthening surveillance
systems to monitor the epidemic's progress.

 NACP V (2017-Present): The current phase aims at achieving "End AIDS by 2030" by focusing
on universal access to treatment, the elimination of mother-to-child transmission of HIV, and
strengthening efforts for the prevention of new infections.

2. National AIDS Control Organization (NACO)

The National AIDS Control Organization (NACO), under the Ministry of Health and Family
Welfare, plays a pivotal role in overseeing the implementation of the National AIDS Control
Program. NACO coordinates efforts across the country, conducts awareness campaigns,
provides treatment and counseling, and works to reduce the stigma associated with
HIV/AIDS. NACO’s efforts are complemented by a network of Integrated Counseling and
Testing Centers (ICTCs) and ART Centers, which offer testing and treatment services.

3. Free ART Program

India introduced a Free ART Program to ensure that people living with HIV can access
Antiretroviral Therapy (ART) free of charge. ART is a life-saving treatment that suppresses the
HIV virus, enabling people to live longer and healthier lives. The government has established
ART centers across the country, where people can access this treatment, and it also provides
second-line ART when first-line treatments are not effective.

4. Prevention of Parent-to-Child Transmission (PPTCT) Program

 India launched the Prevention of Parent-to-Child Transmission (PPTCT) program to prevent
HIV transmission from mother to child during pregnancy, childbirth, or breastfeeding. The
program provides:

 Antiretroviral drugs to HIV-positive pregnant women to reduce the chances of transmission.

 Counseling and testing services to expectant mothers to identify and treat HIV early in
pregnancy.

This program has significantly reduced the number of children born with HIV in India.

5. HIV Awareness and Education Campaigns

India has run numerous HIV awareness campaigns through television, radio, print media,
and social media platforms. These campaigns focus on:

 Educating people about how HIV is transmitted and how to prevent it.

 Promoting condom use and safe sex practices.

 Raising awareness about testing and counseling services.

One of the most notable campaigns was the "Red Ribbon Campaign", which became an
international symbol of HIV awareness and solidarity.
Conclusion
In conclusion, HIV/AIDS remains a serious global health issue, impacting
millions of people worldwide. However, significant progress has been made in
understanding the virus, improving treatments, and developing prevention
methods. Today, with the help of antiretroviral therapy (ART), HIV is no longer a
death sentence, and people living with HIV can lead longer, healthier lives.
Despite these advances, challenges still exist, such as finding a complete cure,
ensuring everyone has access to treatment, and overcoming the stigma
associated with HIV. Ongoing research is focused on new treatments, potential
vaccines, and better ways to manage HIV, giving hope for a future where
HIV/AIDS is better controlled or even eradicated.
It’s essential for society to continue raising awareness, promoting education,
and providing support to affected communities. With collective global efforts,
we can move towards a future where HIV/AIDS no longer causes widespread
fear and suffering, and is instead a manageable condition for those affected.
HYPOTHESIS

AIDS is non curable due to its nature of pathogen. It also damage immune
system of the body. Therefore any medicine (Antiviral) drugs are not effective
against HIV virus. Ignorance and lack of knowledge about this disease is the
root cause of wide spread of this disease Malaria is one of the major diseases
which is caused by Protozoan. Protozoan causes many diseases in human
beings. Malaria has been for thousands of years a very serious disease of the
tropical and temperate regions. Prevalence of malaria continues to be one of
the major health problems of developing countries. It was almost eliminated a
few years back with the efforts of WHO and our National Malaria Eradication
Programme (NMEP), but unfortunately it has appeared again. Plasmodium is a
genus of Protozoa belonging to subphylum Sporozoa, class Telosporidea,
includes causative agent of malaria in man and lower animals. Members of the
genus plasmodium are collectively known as Malaria parasite, because they
cause a horrible disease called malaria
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