HIV/AIDS is a spectrum of diseases ranging from an initial infection with the Human Immunodeficiency Virus (HIV) that eventually degenerates into full-blown Acquired Immunodeficiency Syndrome (AIDS). By destroying the immune system, HIV gradually interferes with the body’s innate ability to fight against infections and cancers. This accounts for why affected individuals are susceptible to certain infections (e.g Pneumocystis Jiroveci Pneumonia) and tumours (e.g Kaposi sarcoma) that are rarely found in immunocompetent people.
Arguably, HIV/AIDS is a global pandemic that spares no region of the world. According to the World Health Organization, about 35 million people were living with the condition worldwide as at 2013 with about 1.5 million AIDS-related deaths recorded in the same year. Sadly, sub-Saharan Africa accounts for nearly 71% of the global burden of HIV/AIDS.
Furthermore, another important fact about HIV/AIDS is that the viral load is a very important determinant of an individual’s infectiousness such that a person with a very high viral load is several times more likely to transmit the infection to others.
Unprotected sex ( vaginal, oral or anal) is the most important risky behaviour associated with HIV transmission. This is especially so in individuals with multiple unprotected sexual partners such as the commercial sex workers who indulge in sex in exchange for money (‘survival’ sex). In the same vein, even if it’s your partner that has multiple unprotected sexual partners, you are equally at risk.
Furthermore, the risk of HIV transmission is significantly higher in the setting of other Sexually Transmitted Infections due to increased likelihood of exposure to infected blood or body fluids during sex. For instance, studies have revealed a five-fold increase in the risk of transmission of HIV in the presence of genital ulcers. Fortunately, the risk of HIV spread due to unprotected sex can be practically eliminated through the adoption of the popular ABC strategy which includes Abstinence, Being Faithful to your partner as well as Consistent and correct use of condoms.
Unsafe transfusion with infected blood and blood products is another important means of HIV transmission, especially in developing countries where facilities for proper comprehensive screening of blood and blood products are often lacking. Sadly, in these regions, about 15% of all cases of HIV can be accounted for by transfusion with infected blood.
Research has shown that recipients of infected blood eventually come down with HIV/AIDS in about 90% of cases. It’s common practice to share sharp objects like razor blades, hair clippers or shaving blades with other people. However, this also contributes its quota to the avoidable spread of HIV from infected individuals (who are not even aware in most cases) to unaffected populations. In the process of using some of these objects, cuts – minor or major may result and are often overlooked which encourages contact with infected blood and facilitates spread of HIV.
Another unfortunate practice, especially in the traditional setting involves making scarification marks on people mostly with unsterilized sharps under the guise of treating certain ailments or conferring some spiritual protection on them.
People who inject drugs (especially hard drugs) directly into their bloodstream are also at increased risk of contracting HIV. In the United States, this practice accounts for about 10% of annual HIV cases. It’s not uncommon for intravenous drug users to share the same needle and syringe or drug preparation. Understandably, if one person is infected with the virus, it can easily be transmitted to others.
Excessive consumption of alcohol gets people drunk such that their sense of judgement is clouded and they lose their inhibitions. A drunk fellow is more likely to indulge in some of the aforementioned risky behaviours like having casual sex without a condom. In addition, excess alcohol has been shown to compromise the immune system and thereby speed up the natural progression of HIV/AIDS.