Human immunodeficiency virus
Human immunodeficiency virus infection and acquired immune deficiency
syndrome (HIV/AIDS) is a spectrum of conditions caused by infection
with the human immunodeficiency virus (HIV). Following
initial infection, a person may not notice any symptoms or may
experience a brief period of influenza-like illness. Typically,
this is followed by a prolonged period with no symptoms. As the
infection progresses, it interferes more with the immune system,
increasing the risk of common infections like tuberculosis, as well as
other opportunistic infections, and tumors that rarely affect people
who have working immune systems. These late symptoms of infection
are referred to as acquired immunodeficiency syndrome (AIDS). This
stage is often also associated with weight loss.
HIV is spread primarily by unprotected sex (including anal and oral
sex), contaminated blood transfusions, hypodermic needles, and from
mother to child during pregnancy, delivery, or breastfeeding. Some
bodily fluids, such as saliva and tears, do not transmit HIV.
Methods of prevention include safe sex, needle exchange programs,
treating those who are infected, and male circumcision. Disease in
a baby can often be prevented by giving both the mother and child
antiretroviral medication. There is no cure or vaccine; however,
antiretroviral treatment can slow the course of the disease and may
lead to a near-normal life expectancy. Treatment is recommended
as soon as the diagnosis is made. Without treatment, the average
survival time after infection is 11 years.
In 2016 about 36.7 million people were living with
HIV and it resulted
in 1 million deaths. There were 300,000 fewer new
HIV cases in
2016 than in 2015. Most of those infected live in sub-Saharan
Africa. From the time AIDS was identified in the early 1980s and
2017, the disease has caused an estimated 35 million deaths
HIV/AIDS is considered a pandemic—a disease outbreak
which is present over a large area and is actively spreading. HIV
is believed to have originated in west-central Africa during the late
19th or early 20th century. AIDS was first recognized by the
Centers for Disease Control and Prevention
Centers for Disease Control and Prevention (CDC) in 1981
and its cause—
HIV infection—was identified in the early part of
HIV/AIDS has had a great impact on society, both as an illness and as
a source of discrimination. The disease also has large economic
impacts. There are many misconceptions about
HIV/AIDS such as the
belief that it can be transmitted by casual non-sexual contact.
The disease has become subject to many controversies involving
religion including the Catholic Church's position not to support
condom use as prevention. It has attracted international medical
and political attention as well as large-scale funding since it was
identified in the 1980s.
1 Signs and symptoms
1.1 Acute infection
1.2 Clinical latency
1.3 Acquired immunodeficiency syndrome
2.2 Body fluids
6.1 Sexual contact
7.1 Antiviral therapy
7.2 Opportunistic infections
7.4 Alternative medicine
11 Society and culture
11.2 Economic impact
11.3 Religion and AIDS
11.4 Media portrayal
11.5 Criminal transmission
14 External links
Signs and symptoms
Main article: Signs and symptoms of HIV/AIDS
There are three main stages of
HIV infection: acute infection,
clinical latency and AIDS.
Main symptoms of acute
The initial period following the contraction of
HIV is called acute
HIV or acute retroviral syndrome. Many individuals
develop an influenza-like illness or a mononucleosis-like illness
2–4 weeks post exposure while others have no significant
symptoms. Symptoms occur in 40–90% of cases and most
commonly include fever, large tender lymph nodes, throat inflammation,
a rash, headache, and/or sores of the mouth and genitals. The
rash, which occurs in 20–50% of cases, presents itself on the trunk
and is maculopapular, classically. Some people also develop
opportunistic infections at this stage. Gastrointestinal symptoms,
such as vomiting or diarrhea may occur. Neurological symptoms of
peripheral neuropathy or
Guillain–Barré syndrome also occurs.
The duration of the symptoms varies, but is usually one or two
Due to their nonspecific character, these symptoms are not often
recognized as signs of
HIV infection. Even cases that do get seen by a
family doctor or a hospital are often misdiagnosed as one of the many
common infectious diseases with overlapping symptoms. Thus, it is
HIV be considered in people presenting an unexplained
fever who may have risk factors for the infection.
The initial symptoms are followed by a stage called clinical latency,
asymptomatic HIV, or chronic HIV. Without treatment, this second
stage of the natural history of
HIV infection can last from about
three years to over 20 years (on average, about eight
years). While typically there are few or no symptoms at first,
near the end of this stage many people experience fever, weight loss,
gastrointestinal problems and muscle pains. Between 50 and 70% of
people also develop persistent generalized lymphadenopathy,
characterized by unexplained, non-painful enlargement of more than one
group of lymph nodes (other than in the groin) for over three to six
HIV-1 infected individuals have a detectable viral load
and in the absence of treatment will eventually progress to AIDS, a
small proportion (about 5%) retain high levels of CD4+ T cells (T
helper cells) without antiretroviral therapy for more than 5
years. These individuals are classified as
HIV controllers or
long-term nonprogressors (LTNP). Another group consists of those
who maintain a low or undetectable viral load without anti-retroviral
treatment, known as "elite controllers" or "elite suppressors". They
represent approximately 1 in 300 infected persons.
Acquired immunodeficiency syndrome
Main symptoms of AIDS.
Acquired immunodeficiency syndrome (AIDS) is defined in terms of
either a CD4+ T cell count below 200 cells per µL or the occurrence
of specific diseases in association with an
HIV infection. In the
absence of specific treatment, around half of people infected with HIV
develop AIDS within ten years. The most common initial conditions
that alert to the presence of AIDS are pneumocystis pneumonia (40%),
cachexia in the form of
HIV wasting syndrome (20%), and esophageal
candidiasis. Other common signs include recurring respiratory
Opportunistic infections may be caused by bacteria, viruses, fungi,
and parasites that are normally controlled by the immune system.
Which infections occur depends partly on what organisms are common in
the person's environment. These infections may affect nearly every
People with AIDS have an increased risk of developing various
viral-induced cancers, including Kaposi's sarcoma, Burkitt's lymphoma,
primary central nervous system lymphoma, and cervical cancer.
Kaposi's sarcoma is the most common cancer occurring in 10 to 20% of
people with HIV. The second most common cancer is lymphoma, which
is the cause of death of nearly 16% of people with AIDS and is the
initial sign of AIDS in 3 to 4%. Both these cancers are associated
with human herpesvirus 8.
Cervical cancer occurs more frequently
in those with AIDS because of its association with human
papillomavirus (HPV). Conjunctival cancer (of the layer that lines
the inner part of eyelids and the white part of the eye) is also more
common in those with HIV.
Additionally, people with AIDS frequently have systemic symptoms such
as prolonged fevers, sweats (particularly at night), swollen lymph
nodes, chills, weakness, and unintended weight loss.
another common symptom, present in about 90% of people with AIDS.
They can also be affected by diverse psychiatric and neurological
symptoms independent of opportunistic infections and cancers.
Average per act risk of getting HIV
by exposure route to an infected source
Chance of infection
Childbirth (to child)
Needle-sharing injection drug use
Percutaneous needle stick
Receptive anal intercourse*
Insertive anal intercourse*
Receptive penile-vaginal intercourse*
Insertive penile-vaginal intercourse*
Receptive oral intercourse*§
Insertive oral intercourse*§
* assuming no condom use
§ source refers to oral intercourse
performed on a man
HIV is transmitted by three main routes: sexual contact, significant
exposure to infected body fluids or tissues, and from mother to child
during pregnancy, delivery, or breastfeeding (known as vertical
transmission). There is no risk of acquiring
HIV if exposed to
feces, nasal secretions, saliva, sputum, sweat, tears, urine, or vomit
unless these are contaminated with blood. It is possible to be
co-infected by more than one strain of HIV—a condition known as HIV
The most frequent mode of transmission of
HIV is through sexual
contact with an infected person. Globally, the most common mode of
HIV transmission is via sexual contacts between people of the opposite
sex; however, the pattern of transmission varies among countries.
As of 2014, most
HIV transmission in the United States occurred among
men who had sex with men (83% of new
HIV diagnoses among males aged 13
and older and 67% of total new diagnoses). In the US, gay and
bisexual men aged 13 to 24 accounted for an estimated 92% of new HIV
diagnoses among all men in their age group and 27% of new diagnoses
among all gay and bisexual men. About 15% of gay and bisexual men
HIV while 28 percent of transgender women test positive in the
With regard to unprotected heterosexual contacts, estimates of the
HIV transmission per sexual act appear to be four to ten times
higher in low-income countries than in high-income countries. In
low-income countries, the risk of female-to-male transmission is
estimated as 0.38% per act, and of male-to-female transmission as
0.30% per act; the equivalent estimates for high-income countries are
0.04% per act for female-to-male transmission, and 0.08% per act for
male-to-female transmission. The risk of transmission from anal
intercourse is especially high, estimated as 1.4–1.7% per act in
both heterosexual and homosexual contacts. While the risk of
transmission from oral sex is relatively low, it is still present.
The risk from receiving oral sex has been described as "nearly
nil"; however, a few cases have been reported. The per-act
risk is estimated at 0–0.04% for receptive oral intercourse. In
settings involving prostitution in low income countries, risk of
female-to-male transmission has been estimated as 2.4% per act and
male-to-female transmission as 0.05% per act.
Risk of transmission increases in the presence of many sexually
transmitted infections and genital ulcers. Genital ulcers
appear to increase the risk approximately fivefold. Other sexually
transmitted infections, such as gonorrhea, chlamydia, trichomoniasis,
and bacterial vaginosis, are associated with somewhat smaller
increases in risk of transmission.
The viral load of an infected person is an important risk factor in
both sexual and mother-to-child transmission. During the first
2.5 months of an
HIV infection a person's infectiousness is
twelve times higher due to this high viral load. If the person is
in the late stages of infection, rates of transmission are
approximately eightfold greater. An HIV-positive person who has an
undetectable viral load as a result of long-term treatment has
effectively no risk of transmitting
Commercial sex workers (including those in pornography) have an
increased rate of HIV. Rough sex can be a factor associated
with an increased risk of transmission.
Sexual assault is also
believed to carry an increased risk of
HIV transmission as condoms are
rarely worn, physical trauma to the vagina or rectum is likely, and
there may be a greater risk of concurrent sexually transmitted
CDC poster from 1989 highlighting the threat of AIDS associated with
The second most frequent mode of
HIV transmission is via blood and
blood products. Blood-borne transmission can be through
needle-sharing during intravenous drug use, needle stick injury,
transfusion of contaminated blood or blood product, or medical
injections with unsterilized equipment. The risk from sharing a needle
during drug injection is between 0.63 and 2.4% per act, with an
average of 0.8%. The risk of acquiring
HIV from a needle stick
from an HIV-infected person is estimated as 0.3% (about 1 in 333) per
act and the risk following mucous membrane exposure to infected blood
as 0.09% (about 1 in 1000) per act. In the United States
intravenous drug users made up 12% of all new cases of
2009, and in some areas more than 80% of people who inject drugs
HIV is transmitted in about 93% of blood transfusions using infected
blood. In developed countries the risk of acquiring
HIV from a
blood transfusion is extremely low (less than one in half a million)
where improved donor selection and
HIV screening is performed; for
example, in the UK the risk is reported at one in five million and
in the United States it was one in 1.5 million in 2008. In low
income countries, only half of transfusions may be appropriately
screened (as of 2008), and it is estimated that up to 15% of HIV
infections in these areas come from transfusion of infected blood and
blood products, representing between 5% and 10% of global
infections. Although rare because of screening, it is possible
HIV from organ and tissue transplantation.
Unsafe medical injections play a significant role in
HIV spread in
sub-Saharan Africa. In 2007, between 12 and 17% of infections in this
region were attributed to medical syringe use. The World Health
Organization estimates the risk of transmission as a result of a
medical injection in Africa at 1.2%. Significant risks are also
associated with invasive procedures, assisted delivery, and dental
care in this area of the world.
People giving or receiving tattoos, piercings, and scarification are
theoretically at risk of infection but no confirmed cases have been
documented. It is not possible for mosquitoes or other insects to
HIV and pregnancy and
HIV and breastfeeding
HIV can be transmitted from mother to child during pregnancy, during
delivery, or through breast milk, resulting in the baby also
contracting HIV. This is the third most common way in which
HIV is transmitted globally. In the absence of treatment, the risk
of transmission before or during birth is around 20% and in those who
also breastfeed 35%. As of 2008, vertical transmission accounted
for about 90% of cases of
HIV in children. With appropriate
treatment the risk of mother-to-child infection can be reduced to
about 1%. Preventive treatment involves the mother taking
antiretrovirals during pregnancy and delivery, an elective caesarean
section, avoiding breastfeeding, and administering antiretroviral
drugs to the newborn. Antiretrovirals when taken by either the
mother or the infant decrease the risk of transmission in those who do
breastfeed. However, many of these measures are not available in
the developing world. If blood contaminates food during
pre-chewing it may pose a risk of transmission.
If a woman is untreated, two years of breastfeeding results in an
HIV/AIDS risk in her baby of about 17%. Treatment decreases this risk
to 1 to 2% per year. Due to the increased risk of death without
breastfeeding in many areas in the developing world, the World Health
Organization recommends either: (1) the mother and baby being treated
with antiretroviral medication while breastfeeding being continued (2)
the provision of safe formula.
HIV during pregnancy
is also associated with miscarriage.
Main article: HIV
Diagram of a
HIV virion structure
Scanning electron micrograph
Scanning electron micrograph of HIV-1, colored green, budding from a
HIV is the cause of the spectrum of disease known as HIV/AIDS.
a retrovirus that primarily infects components of the human immune
system such as CD4+ T cells, macrophages and dendritic cells. It
directly and indirectly destroys CD4+ T cells.
HIV is a member of the genus Lentivirus, part of the family
Retroviridae. Lentiviruses share many morphological and biological
characteristics. Many species of mammals are infected by lentiviruses,
which are characteristically responsible for long-duration illnesses
with a long incubation period. Lentiviruses are transmitted as
single-stranded, positive-sense, enveloped
RNA viruses. Upon entry
into the target cell, the viral
RNA genome is converted (reverse
transcribed) into double-stranded
DNA by a virally encoded reverse
transcriptase that is transported along with the viral genome in the
virus particle. The resulting viral
DNA is then imported into the cell
nucleus and integrated into the cellular
DNA by a virally encoded
integrase and host co-factors. Once integrated, the virus may
become latent, allowing the virus and its host cell to avoid detection
by the immune system. Alternatively, the virus may be transcribed,
RNA genomes and viral proteins that are packaged and
released from the cell as new virus particles that begin the
replication cycle anew.
HIV is now known to spread between CD4+ T cells by two parallel
routes: cell-free spread and cell-to-cell spread, i.e. it employs
hybrid spreading mechanisms. In the cell-free spread, virus
particles bud from an infected T cell, enter the blood/extracellular
fluid and then infect another T cell following a chance encounter.
HIV can also disseminate by direct transmission from one cell to
another by a process of cell-to-cell spread. The hybrid
spreading mechanisms of
HIV contribute to the virus's ongoing
replication against antiretroviral therapies.
Two types of
HIV have been characterized:
HIV-1 and HIV-2.
the virus that was originally discovered (and initially referred to
also as LAV or HTLV-III). It is more virulent, more infective, and
is the cause of the majority of
HIV infections globally. The lower
HIV-2 as compared with
HIV-1 implies that fewer people
HIV-2 will be infected per exposure. Because of its
relatively poor capacity for transmission,
HIV-2 is largely confined
to West Africa.
Main article: Pathophysiology of HIV/AIDS
HIV/AIDS explained in a simple way
HIV replication cycle
After the virus enters the body there is a period of rapid viral
replication, leading to an abundance of virus in the peripheral blood.
During primary infection, the level of
HIV may reach several million
virus particles per milliliter of blood. This response is
accompanied by a marked drop in the number of circulating CD4+ T
cells. The acute viremia is almost invariably associated with
activation of CD8+ T cells, which kill HIV-infected cells, and
subsequently with antibody production, or seroconversion. The CD8+ T
cell response is thought to be important in controlling virus levels,
which peak and then decline, as the CD4+ T cell counts recover. A good
CD8+ T cell response has been linked to slower disease progression and
a better prognosis, though it does not eliminate the virus.
HIV causes AIDS by depleting CD4+ T cells. This weakens
the immune system and allows opportunistic infections. T cells are
essential to the immune response and without them, the body cannot
fight infections or kill cancerous cells. The mechanism of CD4+ T cell
depletion differs in the acute and chronic phases. During the
acute phase, HIV-induced cell lysis and killing of infected cells by
cytotoxic T cells accounts for CD4+ T cell depletion, although
apoptosis may also be a factor. During the chronic phase, the
consequences of generalized immune activation coupled with the gradual
loss of the ability of the immune system to generate new T cells
appear to account for the slow decline in CD4+ T cell numbers.
Although the symptoms of immune deficiency characteristic of AIDS do
not appear for years after a person is infected, the bulk of CD4+ T
cell loss occurs during the first weeks of infection, especially in
the intestinal mucosa, which harbors the majority of the lymphocytes
found in the body. The reason for the preferential loss of mucosal
CD4+ T cells is that the majority of mucosal CD4+ T cells express the
CCR5 protein which
HIV uses as a co-receptor to gain access to the
cells, whereas only a small fraction of CD4+ T cells in the
bloodstream do so. A specific genetic change that alters the CCR5
protein when present in both chromosomes very effectively prevents
HIV seeks out and destroys
CCR5 expressing CD4+ T cells during acute
infection. A vigorous immune response eventually controls the
infection and initiates the clinically latent phase. CD4+ T cells in
mucosal tissues remain particularly affected. Continuous HIV
replication causes a state of generalized immune activation persisting
throughout the chronic phase. Immune activation, which is
reflected by the increased activation state of immune cells and
release of pro-inflammatory cytokines, results from the activity of
HIV gene products and the immune response to ongoing HIV
replication. It is also linked to the breakdown of the immune
surveillance system of the gastrointestinal mucosal barrier caused by
the depletion of mucosal CD4+ T cells during the acute phase of
Main article: Diagnosis of HIV/AIDS
A generalized graph of the relationship between
HIV copies (viral
load) and CD4+ T cell counts over the average course of untreated HIV
Lymphocyte count (cells/mm³)
RNA copies per mL of plasma
HIV/AIDS is diagnosed via laboratory testing and then staged based on
the presence of certain signs or symptoms.
HIV screening is
recommended by the
United States Preventive Services Task Force for
all people 15 years to 65 years of age including all
pregnant women. Additionally, testing is recommended for those at
high risk, which includes anyone diagnosed with a sexually transmitted
illness. In many areas of the world, a third of
HIV carriers only
discover they are infected at an advanced stage of the disease when
AIDS or severe immunodeficiency has become apparent.
Most people infected with
HIV develop specific antibodies (i.e.
seroconvert) within three to twelve weeks of the initial
infection. Diagnosis of primary
HIV before seroconversion is done
by measuring HIV-
RNA or p24 antigen. Positive results obtained by
antibody or PCR testing are confirmed either by a different antibody
or by PCR.
Antibody tests in children younger than 18 months are typically
inaccurate due to the continued presence of maternal antibodies.
HIV infection can only be diagnosed by PCR testing for
DNA, or via testing for the p24 antigen. Much of the world lacks
access to reliable PCR testing and many places simply wait until
either symptoms develop or the child is old enough for accurate
antibody testing. In sub-Saharan Africa as of 2007–2009 between
30 and 70% of the population were aware of their
HIV status. In
2009, between 3.6 and 42% of men and women in Sub-Saharan countries
were tested which represented a significant increase compared to
Two main clinical staging systems are used to classify
HIV-related disease for surveillance purposes: the
WHO disease staging
HIV infection and disease, and the CDC classification
HIV infection. The CDC's classification system is more
frequently adopted in developed countries. Since the WHO's staging
system does not require laboratory tests, it is suited to the
resource-restricted conditions encountered in developing countries,
where it can also be used to help guide clinical management. Despite
their differences, the two systems allow comparison for statistical
World Health Organization
World Health Organization first proposed a definition for AIDS in
1986. Since then, the
WHO classification has been updated and
expanded several times, with the most recent version being published
in 2007. The
WHO system uses the following categories:
HIV infection: May be either asymptomatic or associated with
acute retroviral syndrome.
HIV infection is asymptomatic with a CD4+ T cell count (also
known as CD4 count) greater than 500 per microlitre (µl or cubic mm)
of blood. May include generalized lymph node enlargement.
Stage II: Mild symptoms which may include minor mucocutaneous
manifestations and recurrent upper respiratory tract infections. A CD4
count of less than 500/µl.
Stage III: Advanced symptoms which may include unexplained chronic
diarrhea for longer than a month, severe bacterial infections
including tuberculosis of the lung, and a CD4 count of less than
Stage IV or AIDS: severe symptoms which include toxoplasmosis of the
brain, candidiasis of the esophagus, trachea, bronchi or lungs and
Kaposi's sarcoma. A CD4 count of less than 200/µl.
The United States Center for Disease Control and Prevention also
created a classification system for HIV, and updated it in 2008 and
2014. This system classifies
HIV infections based on CD4
count and clinical symptoms, and describes the infection in five
groups. In those greater than six years of age it is:
Stage 0: the time between a negative or indeterminate
followed less than 180 days by a positive test
Stage 1: CD4 count ≥ 500 cells/µl and no AIDS defining
Stage 2: CD4 count 200 to 500 cells/µl and no AIDS defining
Stage 3: CD4 count ≤ 200 cells/µl or AIDS defining conditions
Unknown: if insufficient information is available to make any of the
For surveillance purposes, the AIDS diagnosis still stands even if,
after treatment, the CD4+ T cell count rises to above 200 per µL of
blood or other AIDS-defining illnesses are cured.
Main article: Prevention of HIV/AIDS
AIDS Clinic, McLeod Ganj, Himachal Pradesh, India, 2010
Consistent condom use reduces the risk of
HIV transmission by
approximately 80% over the long term. When condoms are used
consistently by a couple in which one person is infected, the rate of
HIV infection is less than 1% per year. There is some evidence to
suggest that female condoms may provide an equivalent level of
protection. Application of a vaginal gel containing tenofovir (a
reverse transcriptase inhibitor) immediately before sex seems to
reduce infection rates by approximately 40% among African women.
By contrast, use of the spermicide nonoxynol-9 may increase the risk
of transmission due to its tendency to cause vaginal and rectal
Sub-Saharan Africa "reduces the acquisition of
heterosexual men by between 38% and 66% over 24 months". Due to
these studies, both the
World Health Organization
World Health Organization and UNAIDS
recommended male circumcision as a method of preventing female-to-male
HIV transmission in 2007 in areas with a high rates of HIV.
However, whether it protects against male-to-female transmission is
disputed, and whether it is of benefit in developed
countries and among men who have sex with men is
undetermined. The International Antiviral Society,
however, does recommend for all sexually active heterosexual males and
that it be discussed as an option with men who have sex with men.
Some experts fear that a lower perception of vulnerability among
circumcised men may cause more sexual risk-taking behavior, thus
negating its preventive effects.
Programs encouraging sexual abstinence do not appear to affect
HIV risk. Evidence of any benefit from peer education
is equally poor. Comprehensive sexual education provided at
school may decrease high risk behavior. A substantial
minority of young people continues to engage in high-risk practices
despite knowing about HIV/AIDS, underestimating their own risk of
becoming infected with HIV. Voluntary counseling and testing
HIV does not affect risky behavior in those who test
negative but does increase condom use in those who test positive.
It is not known whether treating other sexually transmitted infections
is effective in preventing HIV.
Antiretroviral treatment among people with
HIV whose CD4 count ≤ 550
cells/µL is a very effective way to prevent
HIV infection of their
partner (a strategy known as treatment as prevention, or TASP).
TASP is associated with a 10 to 20 fold reduction in transmission
Pre-exposure prophylaxis (PrEP) with a daily dose of
the medications tenofovir, with or without emtricitabine, is effective
in a number of groups including men who have sex with men, couples
where one is
HIV positive, and young heterosexuals in Africa. It
may also be effective in intravenous drug users with a study finding a
decrease in risk of 0.7 to 0.4 per 100 person years.
Universal precautions within the health care environment are believed
to be effective in decreasing the risk of HIV. Intravenous drug
use is an important risk factor and harm reduction strategies such as
needle-exchange programs and opioid substitution therapy appear
effective in decreasing this risk.
A course of antiretrovirals administered within 48 to 72 hours
after exposure to HIV-positive blood or genital secretions is referred
to as post-exposure prophylaxis (PEP). The use of the single
agent zidovudine reduces the risk of a
HIV infection five-fold
following a needle-stick injury. As of 2013, the prevention
regimen recommended in the United States consists of three
medications—tenofovir, emtricitabine and raltegravir—as this may
reduce the risk further.
PEP treatment is recommended after a sexual assault when the
perpetrator is known to be
HIV positive, but is controversial when
HIV status is unknown. The duration of treatment is usually
four weeks and is frequently associated with adverse
effects—where zidovudine is used, about 70% of cases result in
adverse effects such as nausea (24%), fatigue (22%), emotional
distress (13%) and headaches (9%).
HIV and pregnancy
Programs to prevent the vertical transmission of
HIV (from mothers to
children) can reduce rates of transmission by 92–99%. This
primarily involves the use of a combination of antiviral medications
during pregnancy and after birth in the infant and potentially
includes bottle feeding rather than breastfeeding. If
replacement feeding is acceptable, feasible, affordable, sustainable,
and safe, mothers should avoid breastfeeding their infants; however
exclusive breastfeeding is recommended during the first months of life
if this is not the case. If exclusive breastfeeding is carried
out, the provision of extended antiretroviral prophylaxis to the
infant decreases the risk of transmission. In 2015,
the first country in the world to eradicate mother-to-child
transmission of HIV.
Currently, there is no licensed vaccine for
HIV or AIDS. The most
effective vaccine trial to date, RV 144, was published in 2009 and
found a partial reduction in the risk of transmission of roughly 30%,
stimulating some hope in the research community of developing a truly
effective vaccine. Further trials of the
RV 144 vaccine are
Main article: Management of HIV/AIDS
There is currently no cure or effective
HIV vaccine. Treatment
consists of highly active antiretroviral therapy (HAART) which slows
progression of the disease. As of 2010 more than 6.6 million
people were taking them in low and middle income countries.
Treatment also includes preventive and active treatment of
Stribild – a common once-daily ART regime consisting of
elvitegravir, emtricitabine, tenofovir and the booster cobicistat
HAART options are combinations (or "cocktails") consisting of
at least three medications belonging to at least two types, or
"classes," of antiretroviral agents. Initially treatment is
typically a non-nucleoside reverse transcriptase inhibitor (NNRTI)
plus two nucleoside analog reverse transcriptase inhibitors
(NRTIs). Typical NRTIs include: zidovudine (AZT) or tenofovir
(TDF) and lamivudine (3TC) or emtricitabine (FTC). Combinations
of agents which include protease inhibitors (PI) are used if the above
regimen loses effectiveness.
World Health Organization
World Health Organization and United States recommends
antiretrovirals in people of all ages including pregnant women as soon
as the diagnosis is made regardless of CD4 count. Once
treatment is begun it is recommended that it is continued without
breaks or "holidays". Many people are diagnosed only after
treatment ideally should have begun. The desired outcome of
treatment is a long term plasma HIV-
RNA count below
50 copies/mL. Levels to determine if treatment is effective
are initially recommended after four weeks and once levels fall below
50 copies/mL checks every three to six months are typically
adequate. Inadequate control is deemed to be greater than
400 copies/mL. Based on these criteria treatment is effective
in more than 95% of people during the first year.
Benefits of treatment include a decreased risk of progression to AIDS
and a decreased risk of death. In the developing world treatment
also improves physical and mental health. With treatment there is
a 70% reduced risk of acquiring tuberculosis. Additional benefits
include a decreased risk of transmission of the disease to sexual
partners and a decrease in mother-to-child transmission. The
effectiveness of treatment depends to a large part on compliance.
Reasons for non-adherence include poor access to medical care,
inadequate social supports, mental illness and drug abuse. The
complexity of treatment regimens (due to pill numbers and dosing
frequency) and adverse effects may reduce adherence. Even though
cost is an important issue with some medications, 47% of those
who needed them were taking them in low and middle income countries as
of 2010 and the rate of adherence is similar in low-income and
Specific adverse events are related to the antiretroviral agent
taken. Some relatively common adverse events include:
lipodystrophy syndrome, dyslipidemia, and diabetes mellitus,
especially with protease inhibitors. Other common symptoms include
diarrhea, and an increased risk of cardiovascular
disease. Newer recommended treatments are associated with fewer
adverse effects. Certain medications may be associated with birth
defects and therefore may be unsuitable for women hoping to have
Treatment recommendations for children are somewhat different from
those for adults. The
World Health Organization
World Health Organization recommends treating
all children less than 5 years of age; children above 5 are treated
like adults. The United States guidelines recommend treating all
children less than 12 months of age and all those with
greater than 100,000 copies/mL between one year and five years of
Measures to prevent opportunistic infections are effective in many
people with HIV/AIDS. In addition to improving current disease,
treatment with antiretrovirals reduces the risk of developing
additional opportunistic infections. Adults and adolescents who
are living with
HIV (even on anti-retroviral therapy) with no evidence
of active tuberculosis in settings with high tuberculosis burden
should receive isoniazid preventive therapy (IPT), the tuberculin skin
test can be used to help decide if IPT is needed. Vaccination
against hepatitis A and B is advised for all people at risk of HIV
before they become infected; however it may also be given after
Trimethoprim/sulfamethoxazole prophylaxis between four
and six weeks of age and ceasing breastfeeding in infants born to HIV
positive mothers is recommended in resource limited settings. It
is also recommended to prevent PCP when a person's CD4 count is below
200 cells/uL and in those who have or have previously had
PCP. People with substantial immunosuppression are also advised
to receive prophylactic therapy for toxoplasmosis and MAC.
Appropriate preventive measures have reduced the rate of these
infections by 50% between 1992 and 1997.
and pneumococcal polysaccharide vaccine are often recommended in
HIV/AIDS with some evidence of benefit.
Main article: Nutrition and HIV/AIDS
World Health Organization
World Health Organization (WHO) has issued recommendations
regarding nutrient requirements in HIV/AIDS. A generally healthy
diet is promoted. Dietary intake of micronutrients at RDA levels by
HIV-infected adults is recommended by the WHO; higher intake of
vitamin A, zinc, and iron can produce adverse effects in
adults, and is not recommended unless there is documented
deficiency. Dietary supplementation for people who
are infected with
HIV and who have inadequate nutrition or dietary
deficiencies may strengthen their immune systems or help them recover
from infections, however evidence indicating an overall benefit in
morbidity or reduction in mortality is not consistent.
Evidence for supplementation with selenium is mixed with some
tentative evidence of benefit. For pregnant and lactating women
with HIV, multivitamin supplement improves outcomes for both mothers
and children. If the pregnant or lactating mother has been
advised to take anti-retroviral medication to prevent mother-to-child
HIV transmission, multivitamin supplements should not replace these
treatments. There is some evidence that vitamin A supplementation
in children with an
HIV infection reduces mortality and improves
In the US, approximately 60% of people with
HIV use various forms of
complementary or alternative medicine, even though the
effectiveness of most of these therapies has not been
established. There is not enough evidence to support the use of
herbal medicines. There is insufficient evidence to recommend or
support the use of medical cannabis to try to increase appetite or
Deaths due to
HIV/AIDS per million persons in 2012
HIV/AIDS has become a chronic rather than an acutely fatal disease in
many areas of the world. Prognosis varies between people, and
both the CD4 count and viral load are useful for predicted
outcomes. Without treatment, average survival time after infection
HIV is estimated to be 9 to 11 years, depending on the HIV
subtype. After the diagnosis of AIDS, if treatment is not
available, survival ranges between 6 and 19 months.
HAART and appropriate prevention of opportunistic infections reduces
the death rate by 80%, and raises the life expectancy for a newly
diagnosed young adult to 20–50 years. This is between
two thirds and nearly that of the general population. If
treatment is started late in the infection, prognosis is not as
good: for example, if treatment is begun following the diagnosis
of AIDS, life expectancy is ~10–40 years. Half of
infants born with
HIV die before two years of age without
Disability-adjusted life year
Disability-adjusted life year for
HIV and AIDS per
100,000 inhabitants as of 2004.
The primary causes of death from
HIV/AIDS are opportunistic infections
and cancer, both of which are frequently the result of the progressive
failure of the immune system. Risk of cancer appears to
increase once the CD4 count is below 500/μL. The rate of clinical
disease progression varies widely between individuals and has been
shown to be affected by a number of factors such as a person's
susceptibility and immune function; their access to health care,
the presence of co-infections; and the particular strain (or
strains) of the virus involved.
Tuberculosis co-infection is one of the leading causes of sickness and
death in those with
HIV/AIDS being present in a third of all
HIV-infected people and causing 25% of HIV-related deaths.
also one of the most important risk factors for tuberculosis.
Hepatitis C is another very common co-infection where each disease
increases the progression of the other. The two most common
cancers associated with
Kaposi's sarcoma and AIDS-related
non-Hodgkin's lymphoma. Other cancers that are more frequent
include anal cancer, Burkitt's lymphoma, primary central nervous
system lymphoma, and cervical cancer.
Even with anti-retroviral treatment, over the long term HIV-infected
people may experience neurocognitive disorders,
osteoporosis, neuropathy, cancers,
nephropathy, and cardiovascular disease. Some conditions
like lipodystrophy may be caused both by
HIV and its treatment.
Main article: Epidemiology of HIV/AIDS
Estimated percentage of
HIV among young adults (15–49) per country
as of 2011.
HIV/AIDS is a global pandemic. As of 2016, approximately
36.7 million people have
HIV worldwide with the number of new
infections that year being about 1.8 million. This is down from
3.1 million new infections in 2001. Slightly over half the
infected population are women and 2.1 million are children. It
resulted in about 1 million deaths in 2016, down from a peak of
1.9 million in 2005.
Sub-Saharan Africa is the region most affected. In 2010, an estimated
68% (22.9 million) of all
HIV cases and 66% of all deaths
(1.2 million) occurred in this region. This means that about
5% of the adult population is infected and it is believed to be
the cause of 10% of all deaths in children. Here in contrast to
other regions women compose nearly 60% of cases.
South Africa has
the largest population of people with
HIV of any country in the world
at 5.9 million.
Life expectancy has fallen in the
worst-affected countries due to HIV/AIDS; for example, in 2006 it was
estimated that it had dropped from 65 to 35 years in Botswana.
Mother-to-child transmission, as of 2013, in
Botswana and South Africa
has decreased to less than 5% with improvement in many other African
nations due to improved access to antiretroviral therapy.
South & South
East Asia is the second most affected; in 2010 this
region contained an estimated 4 million cases or 12% of all
people living with
HIV resulting in approximately 250,000 deaths.
Approximately 2.4 million of these cases are in India.
In 2008 in the United States approximately 1.2 million people
were living with HIV, resulting in about 17,500 deaths. The US Centers
for Disease Control and Prevention estimated that in 2008 20% of
infected Americans were unaware of their infection. As of 2016
about 675,000 people have died of
HIV/AIDS in the USA since the
beginning of the
HIV epidemic. In the United Kingdom as of 2015
there were approximately 101,200 cases which resulted in 594
deaths. In Canada as of 2008 there were about 65,000 cases
causing 53 deaths. Between the first recognition of AIDS in 1981
and 2009 it has led to nearly 30 million deaths. Prevalence
is lowest in Middle East and North Africa at 0.1% or less, East Asia
at 0.1% and Western and Central Europe at 0.2%. The worst
affected European countries, in 2009 and 2012 estimates, are Russia,
Ukraine, Latvia, Moldova,
Portugal and Belarus, in decreasing order of
Main article: History of HIV/AIDS
Morbidity and Mortality Weekly Report
Morbidity and Mortality Weekly Report reported in 1981 on what was
later to be called "AIDS".
AIDS was first clinically observed in 1981 in the United States.
The initial cases were a cluster of injecting drug users and
homosexual men with no known cause of impaired immunity who showed
Pneumocystis carinii pneumonia (PCP), a rare opportunistic
infection that was known to occur in people with very compromised
immune systems. Soon thereafter, an unexpected number of
homosexual men developed a previously rare skin cancer called Kaposi's
sarcoma (KS). Many more cases of PCP and KS emerged,
Centers for Disease Control and Prevention
Centers for Disease Control and Prevention (CDC) and a
CDC task force was formed to monitor the outbreak.
In the early days, the CDC did not have an official name for the
disease, often referring to it by way of the diseases that were
associated with it, for example, lymphadenopathy, the disease after
which the discoverers of
HIV originally named the virus.
They also used
Kaposi's sarcoma and opportunistic infections, the name
by which a task force had been set up in 1981. At one point, the
CDC coined the phrase "the 4H disease", since the syndrome seemed to
affect heroin users, homosexuals, hemophiliacs, and
Haitians. In the general press, the term "GRID", which stood
for gay-related immune deficiency, had been coined. However,
after determining that AIDS was not isolated to the gay
community, it was realized that the term GRID was misleading and
the term AIDS was introduced at a meeting in July 1982. By
September 1982 the CDC started referring to the disease as AIDS.
In 1983, two separate research groups led by
Robert Gallo and Luc
Montagnier declared that a novel retrovirus may have been infecting
people with AIDS, and published their findings in the same issue of
the journal Science. Gallo claimed that a virus his group
had isolated from a person with AIDS was strikingly similar in shape
to other human T-lymphotropic viruses (HTLVs) his group had been the
first to isolate. Gallo's group called their newly isolated virus
HTLV-III. At the same time, Montagnier's group isolated a virus from a
person presenting with swelling of the lymph nodes of the neck and
physical weakness, two characteristic symptoms of AIDS. Contradicting
the report from Gallo's group, Montagnier and his colleagues showed
that core proteins of this virus were immunologically different from
those of HTLV-I. Montagnier's group named their isolated virus
lymphadenopathy-associated virus (LAV). As these two viruses
turned out to be the same, in 1986, LAV and HTLV-III were renamed
Left to right: the
African green monkey
African green monkey source of SIV, the sooty
mangabey source of
HIV-2 and the chimpanzee source of HIV-1
HIV-2 are believed to have originated in non-human
primates in West-central Africa and were transferred to humans in the
early 20th century.
HIV-1 appears to have originated in southern
Cameroon through the evolution of SIV(cpz), a simian immunodeficiency
virus (SIV) that infects wild chimpanzees (
HIV-1 descends from the
SIVcpz endemic in the chimpanzee subspecies Pan troglodytes
troglodytes). The closest relative of
HIV-2 is SIV(smm), a
virus of the sooty mangabey (Cercocebus atys atys), an Old World
monkey living in coastal
West Africa (from southern
Senegal to western
Côte d'Ivoire). New World monkeys such as the owl monkey are
HIV-1 infection, possibly because of a genomic fusion of
two viral resistance genes.
HIV-1 is thought to have jumped the
species barrier on at least three separate occasions, giving rise to
the three groups of the virus, M, N, and O.
There is evidence that humans who participate in bushmeat activities,
either as hunters or as bushmeat vendors, commonly acquire SIV.
However, SIV is a weak virus which is typically suppressed by the
human immune system within weeks of infection. It is thought that
several transmissions of the virus from individual to individual in
quick succession are necessary to allow it enough time to mutate into
HIV. Furthermore, due to its relatively low person-to-person
transmission rate, SIV can only spread throughout the population in
the presence of one or more high-risk transmission channels, which are
thought to have been absent in Africa before the 20th century.
Specific proposed high-risk transmission channels, allowing the virus
to adapt to humans and spread throughout the society, depend on the
proposed timing of the animal-to-human crossing. Genetic studies of
the virus suggest that the most recent common ancestor of the
group dates back to circa 1910. Proponents of this dating link
HIV epidemic with the emergence of colonialism and growth of large
colonial African cities, leading to social changes, including a higher
degree of sexual promiscuity, the spread of prostitution, and the
accompanying high frequency of genital ulcer diseases (such as
syphilis) in nascent colonial cities. While transmission rates of
HIV during vaginal intercourse are low under regular circumstances,
they are increased many fold if one of the partners suffers from a
sexually transmitted infection causing genital ulcers. Early 1900s
colonial cities were notable due to their high prevalence of
prostitution and genital ulcers, to the degree that, as of 1928, as
many as 45% of female residents of eastern
Kinshasa were thought to
have been prostitutes, and, as of 1933, around 15% of all residents of
the same city had syphilis.
An alternative view holds that unsafe medical practices in Africa
after World War II, such as unsterile reuse of single use syringes
during mass vaccination, antibiotic and anti-malaria treatment
campaigns, were the initial vector that allowed the virus to adapt to
humans and spread.
The earliest well-documented case of
HIV in a human dates back to 1959
in the Congo. The earliest retrospectively described case of AIDS
is believed to have been in Norway beginning in 1966. In July
1960, in the wake its independence, the
United Nations recruited
Francophone experts and technicians from all over the world to assist
in filling administrative gaps left by Belgium, who did not leave
behind an African elite to run the country. By 1962, Haitians made up
the second largest group of well-educated experts (out of the 48
national groups recruited), that totaled around 4500 in the
country. Dr. Jacques Pépin, a Quebecer author of The
Origins of AIDS, stipulates that
Haiti was one of HIV's entry points
to the United States and that one of them may have carried
across the Atlantic in the 1960s. Although the virus may have
been present in the United States as early as 1966, the vast
majority of infections occurring outside sub-Saharan Africa (including
the U.S.) can be traced back to a single unknown individual who became
Haiti and then brought the infection to the
United States some time around 1969. The epidemic then rapidly
spread among high-risk groups (initially, sexually promiscuous men who
have sex with men). By 1978, the prevalence of
HIV-1 among homosexual
male residents of
New York City
New York City and
San Francisco was estimated at 5%,
suggesting that several thousand individuals in the country had been
Society and culture
Main article: Discrimination against people with HIV/AIDS
Ryan White became a poster child for
HIV after being expelled from
school because he was infected.
AIDS stigma exists around the world in a variety of ways, including
ostracism, rejection, discrimination and avoidance of
HIV testing without prior consent or protection of
confidentiality; violence against
HIV infected individuals or people
who are perceived to be infected with HIV; and the quarantine of HIV
infected individuals. Stigma-related violence or the fear of
violence prevents many people from seeking
HIV testing, returning for
their results, or securing treatment, possibly turning what could be a
manageable chronic illness into a death sentence and perpetuating the
spread of HIV.
AIDS stigma has been further divided into the following three
Instrumental AIDS stigma—a reflection of the fear and apprehension
that are likely to be associated with any deadly and transmissible
Symbolic AIDS stigma—the use of
HIV/AIDS to express attitudes toward
the social groups or lifestyles perceived to be associated with the
Courtesy AIDS stigma—stigmatization of people connected to the issue
HIV/AIDS or HIV-positive people.
Often, AIDS stigma is expressed in conjunction with one or more other
stigmas, particularly those associated with homosexuality,
bisexuality, promiscuity, prostitution, and intravenous drug use.
In many developed countries, there is an association between AIDS and
homosexuality or bisexuality, and this association is correlated with
higher levels of sexual prejudice, such as anti-homosexual/bisexual
attitudes. There is also a perceived association between AIDS and
all male-male sexual behavior, including sex between uninfected
men. However, the dominant mode of spread worldwide for HIV
remains heterosexual transmission.
In 2003, as part of an overall reform of marriage and population
legislation, it became legal for people with AIDS to marry in
In 2013 the U.S.
National Library of Medicine
National Library of Medicine developed a traveling
exhibition titled, "Surviving and Thriving: AIDS, Politics, and
Culture", covering medical research, U.S. government's response,
and personal stories from people with AIDS, caregivers, and
Economic impact of HIV/AIDS
Economic impact of HIV/AIDS and Cost of
Changes in life expectancy in some African countries, 1960–2012
HIV/AIDS affects the economics of both individuals and countries.
The gross domestic product of the most affected countries has
decreased due to the lack of human capital. Without proper
nutrition, health care and medicine, large numbers of people die from
AIDS-related complications. They will not only be unable to work, but
will also require significant medical care. It is estimated that as of
2007 there were 12 million AIDS orphans. Many are cared for
by elderly grandparents.
Returning to work after beginning treatment for
HIV/AIDS is difficult,
and affected people often work less than the average worker.
Unemployment in people with
HIV/AIDS also is associated with suicidal
ideation, memory problems, and social isolation; employment increases
self-esteem, sense of dignity, confidence, and quality of life. A 2015
Cochrane review found low-quality evidence that antiretroviral
treatment helps people with
HIV/AIDS work more, and increases the
chance that a person with
HIV/AIDS will be employed.
By affecting mainly young adults, AIDS reduces the taxable population,
in turn reducing the resources available for public expenditures such
as education and health services not related to AIDS resulting in
increasing pressure for the state's finances and slower growth of the
economy. This causes a slower growth of the tax base, an effect that
is reinforced if there are growing expenditures on treating the sick,
training (to replace sick workers), sick pay and caring for AIDS
orphans. This is especially true if the sharp increase in adult
mortality shifts the responsibility and blame from the family to the
government in caring for these orphans.
At the household level, AIDS causes both loss of income and increased
spending on healthcare. A study in
Côte d'Ivoire showed that
households having a person with
HIV/AIDS spent twice as much on
medical expenses as other households. This additional expenditure also
leaves less income to spend on education and other personal or family
Religion and AIDS
Main article: Religion and HIV/AIDS
The topic of religion and AIDS has become highly controversial in the
past twenty years, primarily because some religious authorities have
publicly declared their opposition to the use of condoms.
The religious approach to prevent the spread of AIDS according to a
report by American health expert Matthew Hanley titled The Catholic
Church and the Global AIDS Crisis argues that cultural changes are
needed including a re-emphasis on fidelity within marriage and sexual
abstinence outside of it.
Some religious organizations have claimed that prayer can cure
HIV/AIDS. In 2011, the BBC reported that some churches in London were
claiming that prayer would cure AIDS, and the Hackney-based Centre for
the Study of Sexual Health and
HIV reported that several people
stopped taking their medication, sometimes on the direct advice of
their pastor, leading to a number of deaths. The Synagogue Church
Of All Nations advertised an "anointing water" to promote God's
healing, although the group denies advising people to stop taking
Main article: Media portrayal of HIV/AIDS
One of the first high-profile cases of AIDS was the American Rock
Hudson, a gay actor who had been married and divorced earlier in life,
who died on October 2, 1985 having announced that he was suffering
from the virus on July 25 that year. He had been diagnosed during
1984. A notable British casualty of AIDS that year was Nicholas
Eden, a gay politician and son of the late prime minister Anthony
Eden. On November 24, 1991, the virus claimed the life of British
rock star Freddie Mercury, lead singer of the band Queen, who died
from an AIDS-related illness having only revealed the diagnosis on the
previous day. However, he had been diagnosed as
HIV positive in
1987. One of the first high-profile heterosexual cases of the
virus was Arthur Ashe, the American tennis player. He was diagnosed as
HIV positive on August 31, 1988, having contracted the virus from
blood transfusions during heart surgery earlier in the 1980s. Further
tests within 24 hours of the initial diagnosis revealed that Ashe had
AIDS, but he did not tell the public about his diagnosis until April
1992. He died as a result on February 6, 1993 at age 49.
Therese Frare's photograph of gay activist David Kirby, as he lay
dying from AIDS while surrounded by family, was taken in April 1990.
LIFE magazine said the photo became the one image "most powerfully
identified with the
HIV/AIDS epidemic." The photo was displayed in
LIFE magazine, was the winner of the World Press Photo, and acquired
worldwide notoriety after being used in a United Colors of Benetton
advertising campaign in 1992. In 1996, Johnson Aziga, a
Ugandan-born Canadian was diagnosed with HIV, but subsequently had
unprotected sex with 11 women without disclosing his diagnosis. By
2003 seven had contracted HIV, and two died from complications related
to AIDS. Aziga was convicted of first-degree murder and was
sentenced for life.
Main article: Criminal transmission of HIV
Criminal transmission of
HIV is the intentional or reckless infection
of a person with the human immunodeficiency virus (HIV). Some
countries or jurisdictions, including some areas of the United States,
have laws that criminalize
HIV transmission or exposure. Others
may charge the accused under laws enacted before the
Misconceptions about HIV/AIDS
Misconceptions about HIV/AIDS and Discredited HIV/AIDS
There are many misconceptions about
HIV and AIDS. Three of the most
common are that AIDS can spread through casual contact, that sexual
intercourse with a virgin will cure AIDS, and that HIV
can infect only gay men and drug users. In 2014, some among the
British public wrongly thought one could get
HIV from kissing (16%),
sharing a glass (5%), spitting (16%), a public toilet seat (4%), and
coughing or sneezing (5%). Other misconceptions are that any act
of anal intercourse between two uninfected gay men can lead to HIV
infection, and that open discussion of
HIV and homosexuality in
schools will lead to increased rates of AIDS.
A small group of individuals continue to dispute the connection
HIV and AIDS, the existence of
HIV itself, or the
HIV testing and treatment methods. These claims,
known as AIDS denialism, have been examined and rejected by the
scientific community. However, they have had a significant
political impact, particularly in South Africa, where the government's
official embrace of
AIDS denialism (1999–2005) was responsible for
its ineffective response to that country's AIDS epidemic, and has been
blamed for hundreds of thousands of avoidable deaths and HIV
Several discredited conspiracy theories have held that
HIV was created
by scientists, either inadvertently or deliberately. Operation
INFEKTION was a worldwide Soviet active measures operation to spread
the claim that the United States had created HIV/AIDS. Surveys show
that a significant number of people believed – and continue to
believe – in such claims.
HIV/AIDS research includes all medical research which attempts to
prevent, treat, or cure
HIV/AIDS along with fundamental research about
the nature of
HIV as an infectious agent and AIDS as the disease
caused by HIV.
Many governments and research institutions participate in HIV/AIDS
research. This research includes behavioral health interventions such
as sex education, and drug development, such as research into
microbicides for sexually transmitted diseases,
HIV vaccines, and
antiretroviral drugs. Other medical research areas include the topics
of pre-exposure prophylaxis, post-exposure prophylaxis, and
circumcision and HIV.
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V · T · D
ICD-10: B20 – B24
Patient UK: HIV/AIDS
Wikipedia's health care articles can be viewed offline with the
Wikimedia Commons has media related to AIDS.
HIV/AIDS at Curlie (based on DMOZ)
UNAIDS – Joint
United Nations Program on HIV/AIDS.
AIDSinfo – Information on
HIV/AIDS treatment, prevention, and
research, U.S. Department of Health and Human Services.
Diseases of poverty
Diseases of poverty
African sleeping sickness
Priority review voucher
structure and genome
disease progression rates
WHO disease staging system for
HIV infection and disease
Teens / Adults
Countries by AIDS prevalence rate
Signs and symptoms
AIDS-defining clinical condition
Diffuse infiltrative lymphocytosis syndrome
HIV Drug Resistance Database
Innate resistance to HIV
Multiple sex partners
Timothy Ray Brown
Catholic Church and HIV/AIDS
Circumcision and HIV
Discrimination against people
List of HIV-positive people
People With AIDS Self-Empowerment Movement
International AIDS Conference
International AIDS Society
United Nations Programme on
President's Emergency Plan for AIDS Relief
President's Emergency Plan for AIDS Relief (PEPFAR)
Treatment Action Campaign
World AIDS Day
Media portrayal of HIV/AIDS
Misconceptions about HIV/AIDS
HIV/AIDS origins theories
AIDS pandemic by region / country
Democratic Republic of the Congo
Côte d'Ivoire (Ivory Coast)
New York City
China (PRC) (Yunnan)
United Arab Emirates
Papua New Guinea
List of countries by
HIV/AIDS adult prevalence rate
HIV/AIDS cases and deaths registered by region
Infectious diseases – viral systemic diseases (A80–B34, 042–079)
Follicular dendritic cell sarcoma
Extranodal NK/T-cell lymphoma, nasal type
Splenic marginal zone lymphoma
Adult T-cell leukemia/lymphoma
Progressive multifocal leukoencephalopathy
Subacute sclerosing panencephalitis
Ramsay Hunt syndrome type 2
Tropical spastic paraparesis
Herpes of the eye
acute viral nasopharyngitis/
EBV infection/Infectious mononucleosis
IV: SARS coronavirus
Severe acute respiratory syndrome
V: Orthomyxoviridae: Influenzavirus A/B/C
V, Paramyxoviridae: Human parainfluenza viruses
Human digestive system
Sexually transmitted infection
Sexually transmitted infection (STI) (primarily A50–A64, 090–099)
Chancroid (Haemophilus ducreyi)
Lymphogranuloma venereum (Chlamydia trachomatis)
Donovanosis or Granuloma Inguinale (Klebsiella granulomatis)
Gonorrhea (Neisseria gonorrhoeae)
Mycoplasma hominis infection
Mycoplasma hominis infection (Mycoplasma hominis)
Syphilis (Treponema pallidum)
Ureaplasma infection (Ureaplasma urealyticum)
Trichomoniasis (Trichomonas vaginalis)
Cervical cancer, vulvar cancer & Genital warts (condyloma), Penile
Anal cancer (
Human papillomavirus (HPV))
Hepatitis B (
Hepatitis B virus)
Herpes simplex (HSV1/HSV2)
Molluscum contagiosum (MCV)
Pelvic inflammatory disease
Pelvic inflammatory disease (PID)
Non-gonococcal urethritis (NGU)
BNF: cb11975352k (data)