Question 9:Discuss factors that have led to the global HIV pandemic (2nd Post)

QUESTION: 9

By Kaitlyn Watson

Within the global pandemic of HIV infection there are many different epidemics, each with its own dynamics and each influenced by many factors including time of introduction of the virus, population density, and cultural and social issues. Effective management strategies depend on knowledge of all these factors. The following points aim look at how the HIV virus has spread and become a pandemic killing hundreds of millions of people.

1) The contagiousness and means of transmission has lead to the spread of the disease. HIV has been detected in a number of body fluids including peripheral blood, semen, cervical secretions, breast milk, urine, cerebrospinal fluid ,saliva and tears

The three main means of infection occurs via;

· sexual contact
· intravenous drug usage
· mother-to-child transmission

Transmission via sexual contact and intravenous drug use are difficult to control. Sexual transmission of the disease and prevention means such as the use of a condom is often a difficult subject to breach due to its personal nature. Whereas intravenous drug usage is a high risk taking behaviour and therefore the additional risk of HIV infection to a drug is often not a significant factor associated with their drug usage.

2) The most important variable that has accounted for the rapid global spread of HIV-1 is increasing travel, which presented the virus an opportunity to become established in the human population and be transmitted widely by sexual intercourse and mother to infant spread. This increase in globalisation, and the improvement of transport technology, has enabled people to become more mobile. This has implications for HIV in that people who are infected can travel to and from their countries having unprotected sex, or participating in IV drug use and sharing needles, increasing the risk of HIV contraction for a number of people, globally. Global sex tourism also increases the risk of people contracting HIV, as often in these activities safer sex is not practised.



3) The spread of HIV can also be attributed in the past to blood transfusions. Although it has been rare since March 1985 when routine screen of blood products was initiated, in the past it was a great risk factor associated with blood transfusions. As a result Haemophilliacs were identified as a high risk group for contracting the disease, and consequently many of those receiving frequent blood transfusion were subsequently infected with and died of the AIDS.

4) Heterosexual transmission is now the most common means of spreading the disease in the current world. It was once thought to be exclusively a homosexual male disease however as the disease has spread to the underdeveloped world heterosexual is the most common sexual means of contracting the disease. The lack of public health messages in the past has lead to its spread.



5) Where the effects of AIDS are most predominately felt and where the greatest amounts of people are infected lie in the populations of the underdeveloped world i.e. Sub-Saharan Africa. The following issues are:
a. poor education- with a low level of education, individuals are more likely to transmit and become infected by the disease... i.e. without knowledge that condom usage can protect against sexual transmitted HIV
b. poor public health messages regarding safe sex and HIV spread
c. low income areas- in areas of low income women are more likely to engage in the sex industry where safe sex is not often practiced and the rates of IV drug usage are higher
d. poor nutrition- This can be seen in increased transmission rates from mother to child, via vertical transmission. When the mother is depleted of micronutrients in particular vitamin A, there is a significant increase in the transmission of HIV/AIDS

6) Medical transmission of HIV/AIDS is extremely rare and the documented cases do not occur frequently, however before safe practice procedures were established this means of transmission and spread was much more prevalent



7) Mother-to-child-transmission
This form of transmission parentally from mother to child can occur in the 2nd and 3rd trimester of a pregnancy, also via blood exposure during birth and subsequently through breast milk from the infected mother. This is currently preventable by the administration of antiretroviral medication to the mother from the 2nd trimester to till after the baby’s birth. Although this means of transmission is preventable, transmission in the underdeveloped world due to insufficient access to the antiretroviral drugs. Also, in the past this means of transmission has lead to millions of children being born with HIV infection and therefore has facilitated it spread throughout the underdeveloped world


Will the AIDS epidemic ever come to an end ... the biological basis for the abatement of the AIDS epidemic cannot depend on evolutionary changes in either the host or the virus, but it will require effective antiretroviral vaccination or chemotherapy to therefore end this pandemic infection.